401k Plan data: BLUE SHIELD MEDICAL plan

BLUE SHIELD MEDICAL 401k Plan overview

Plan Name	BLUE SHIELD MEDICAL
Plan identification number	501

BLUE SHIELD MEDICAL Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Dental

401k Sponsoring company profile

HYDE & HYDE, INC. has sponsored the creation of one or more 401k plans.

Company Name: HYDE & HYDE, INC.

Employer identification number (EIN): 330061330

NAIC Classification: 311900
NAIC Description: Other Food Manufacturing

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BLUE SHIELD MEDICAL

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2017-02-01 TIMOTHY LALONDE TIMOTHY LALONDE 2018-08-29
501 2016-02-01 TIMOTHY LALONDE TIMOTHY LALONDE 2017-08-31
501 2015-02-01 TIMOTHY LALONDE TIMOTHY LALONDE 2016-07-29
501 2014-01-01 RAUN SINGLETON
501 2013-01-01 TIMOTHY HYDE TIMOTHY HYDE 2014-10-23
501 2012-02-01 TIM HYDE
501 2011-02-01 TIM HYDE
501 2010-02-01 TIM HYDE
501 2009-02-01 TIM HYDE
501 2008-02-01 TIM HYDE
501 2007-02-01 TIM HYDE

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2017-02-01	TIMOTHY LALONDE	TIMOTHY LALONDE	2018-08-29
501	2016-02-01	TIMOTHY LALONDE	TIMOTHY LALONDE	2017-08-31
501	2015-02-01	TIMOTHY LALONDE	TIMOTHY LALONDE	2016-07-29
501	2014-01-01	RAUN SINGLETON
501	2013-01-01	TIMOTHY HYDE	TIMOTHY HYDE	2014-10-23
501	2012-02-01	TIM HYDE
501	2011-02-01	TIM HYDE
501	2010-02-01	TIM HYDE
501	2009-02-01	TIM HYDE
501	2008-02-01	TIM HYDE
501	2007-02-01	TIM HYDE

Plan Statistics for BLUE SHIELD MEDICAL

401k plan membership statisitcs for BLUE SHIELD MEDICAL

Measure Date Value
2017: BLUE SHIELD MEDICAL 2017 401k membership
Total participants, beginning-of-year 2017-02-01 143
Total number of active participants reported on line 7a of the Form 5500 2017-02-01 137
Total of all active and inactive participants 2017-02-01 137
Total participants 2017-02-01 137
2016: BLUE SHIELD MEDICAL 2016 401k membership
Total participants, beginning-of-year 2016-02-01 256
Total number of active participants reported on line 7a of the Form 5500 2016-02-01 143
Total of all active and inactive participants 2016-02-01 143
Total participants 2016-02-01 143
2015: BLUE SHIELD MEDICAL 2015 401k membership
Total participants, beginning-of-year 2015-02-01 243
Total number of active participants reported on line 7a of the Form 5500 2015-02-01 256
Total of all active and inactive participants 2015-02-01 256
Total participants 2015-02-01 256
2014: BLUE SHIELD MEDICAL 2014 401k membership
Total participants, beginning-of-year 2014-01-01 222
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 243
Total of all active and inactive participants 2014-01-01 243
Total participants 2014-01-01 243
2013: BLUE SHIELD MEDICAL 2013 401k membership
Total participants, beginning-of-year 2013-01-01 149
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 222
Total of all active and inactive participants 2013-01-01 222
Total participants 2013-01-01 222
2012: BLUE SHIELD MEDICAL 2012 401k membership
Total participants, beginning-of-year 2012-02-01 129
Total number of active participants reported on line 7a of the Form 5500 2012-02-01 149
Total of all active and inactive participants 2012-02-01 149
Total participants 2012-02-01 149
2011: BLUE SHIELD MEDICAL 2011 401k membership
Total participants, beginning-of-year 2011-02-01 99
Total number of active participants reported on line 7a of the Form 5500 2011-02-01 129
Total of all active and inactive participants 2011-02-01 129
Total participants 2011-02-01 129
2010: BLUE SHIELD MEDICAL 2010 401k membership
Total participants, beginning-of-year 2010-02-01 109
Total number of active participants reported on line 7a of the Form 5500 2010-02-01 99
Total of all active and inactive participants 2010-02-01 99
Total participants 2010-02-01 99
2009: BLUE SHIELD MEDICAL 2009 401k membership
Total participants, beginning-of-year 2009-02-01 132
Total number of active participants reported on line 7a of the Form 5500 2009-02-01 109
Total of all active and inactive participants 2009-02-01 109
Total participants 2009-02-01 109
2008: BLUE SHIELD MEDICAL 2008 401k membership
Total participants, beginning-of-year 2008-02-01 122
Total number of active participants reported on line 7a of the Form 5500 2008-02-01 132
Total of all active and inactive participants 2008-02-01 132
Total participants 2008-02-01 132
2007: BLUE SHIELD MEDICAL 2007 401k membership
Total participants, beginning-of-year 2007-02-01 63
Total number of active participants reported on line 7a of the Form 5500 2007-02-01 122
Total of all active and inactive participants 2007-02-01 122
Total participants 2007-02-01 122

Measure	Date	Value
2017: BLUE SHIELD MEDICAL 2017 401k membership
Total participants, beginning-of-year	2017-02-01	143
Total number of active participants reported on line 7a of the Form 5500	2017-02-01	137
Total of all active and inactive participants	2017-02-01	137
Total participants	2017-02-01	137
2016: BLUE SHIELD MEDICAL 2016 401k membership
Total participants, beginning-of-year	2016-02-01	256
Total number of active participants reported on line 7a of the Form 5500	2016-02-01	143
Total of all active and inactive participants	2016-02-01	143
Total participants	2016-02-01	143
2015: BLUE SHIELD MEDICAL 2015 401k membership
Total participants, beginning-of-year	2015-02-01	243
Total number of active participants reported on line 7a of the Form 5500	2015-02-01	256
Total of all active and inactive participants	2015-02-01	256
Total participants	2015-02-01	256
2014: BLUE SHIELD MEDICAL 2014 401k membership
Total participants, beginning-of-year	2014-01-01	222
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	243
Total of all active and inactive participants	2014-01-01	243
Total participants	2014-01-01	243
2013: BLUE SHIELD MEDICAL 2013 401k membership
Total participants, beginning-of-year	2013-01-01	149
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	222
Total of all active and inactive participants	2013-01-01	222
Total participants	2013-01-01	222
2012: BLUE SHIELD MEDICAL 2012 401k membership
Total participants, beginning-of-year	2012-02-01	129
Total number of active participants reported on line 7a of the Form 5500	2012-02-01	149
Total of all active and inactive participants	2012-02-01	149
Total participants	2012-02-01	149
2011: BLUE SHIELD MEDICAL 2011 401k membership
Total participants, beginning-of-year	2011-02-01	99
Total number of active participants reported on line 7a of the Form 5500	2011-02-01	129
Total of all active and inactive participants	2011-02-01	129
Total participants	2011-02-01	129
2010: BLUE SHIELD MEDICAL 2010 401k membership
Total participants, beginning-of-year	2010-02-01	109
Total number of active participants reported on line 7a of the Form 5500	2010-02-01	99
Total of all active and inactive participants	2010-02-01	99
Total participants	2010-02-01	99
2009: BLUE SHIELD MEDICAL 2009 401k membership
Total participants, beginning-of-year	2009-02-01	132
Total number of active participants reported on line 7a of the Form 5500	2009-02-01	109
Total of all active and inactive participants	2009-02-01	109
Total participants	2009-02-01	109
2008: BLUE SHIELD MEDICAL 2008 401k membership
Total participants, beginning-of-year	2008-02-01	122
Total number of active participants reported on line 7a of the Form 5500	2008-02-01	132
Total of all active and inactive participants	2008-02-01	132
Total participants	2008-02-01	132
2007: BLUE SHIELD MEDICAL 2007 401k membership
Total participants, beginning-of-year	2007-02-01	63
Total number of active participants reported on line 7a of the Form 5500	2007-02-01	122
Total of all active and inactive participants	2007-02-01	122
Total participants	2007-02-01	122

Form 5500 Responses for BLUE SHIELD MEDICAL

2017: BLUE SHIELD MEDICAL 2017 form 5500 responses
2017-02-01	Type of plan entity	Single employer plan
2017-02-01	Submission has been amended	No
2017-02-01	This submission is the final filing	No
2017-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-02-01	Plan is a collectively bargained plan	No
2017-02-01	Plan funding arrangement – Insurance	Yes
2017-02-01	Plan benefit arrangement – Insurance	Yes
2016: BLUE SHIELD MEDICAL 2016 form 5500 responses
2016-02-01	Type of plan entity	Single employer plan
2016-02-01	Submission has been amended	No
2016-02-01	This submission is the final filing	No
2016-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-02-01	Plan is a collectively bargained plan	No
2016-02-01	Plan funding arrangement – Insurance	Yes
2016-02-01	Plan benefit arrangement – Insurance	Yes
2015: BLUE SHIELD MEDICAL 2015 form 5500 responses
2015-02-01	Type of plan entity	Single employer plan
2015-02-01	Submission has been amended	No
2015-02-01	This submission is the final filing	No
2015-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-02-01	Plan is a collectively bargained plan	No
2015-02-01	Plan funding arrangement – Insurance	Yes
2015-02-01	Plan benefit arrangement – Insurance	Yes
2014: BLUE SHIELD MEDICAL 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: BLUE SHIELD MEDICAL 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: BLUE SHIELD MEDICAL 2012 form 5500 responses
2012-02-01	Type of plan entity	Single employer plan
2012-02-01	Submission has been amended	No
2012-02-01	This submission is the final filing	No
2012-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-02-01	Plan is a collectively bargained plan	No
2012-02-01	Plan funding arrangement – Insurance	Yes
2012-02-01	Plan benefit arrangement – Insurance	Yes
2011: BLUE SHIELD MEDICAL 2011 form 5500 responses
2011-02-01	Type of plan entity	Single employer plan
2011-02-01	Submission has been amended	No
2011-02-01	This submission is the final filing	No
2011-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-02-01	Plan is a collectively bargained plan	No
2011-02-01	Plan funding arrangement – Insurance	Yes
2011-02-01	Plan benefit arrangement – Insurance	Yes
2010: BLUE SHIELD MEDICAL 2010 form 5500 responses
2010-02-01	Type of plan entity	Single employer plan
2010-02-01	Submission has been amended	Yes
2010-02-01	This submission is the final filing	No
2010-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-02-01	Plan is a collectively bargained plan	No
2010-02-01	Plan funding arrangement – Insurance	Yes
2010-02-01	Plan benefit arrangement – Insurance	Yes
2009: BLUE SHIELD MEDICAL 2009 form 5500 responses
2009-02-01	Type of plan entity	Single employer plan
2009-02-01	Submission has been amended	No
2009-02-01	This submission is the final filing	No
2009-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-02-01	Plan is a collectively bargained plan	No
2009-02-01	Plan funding arrangement – Insurance	Yes
2009-02-01	Plan benefit arrangement – Insurance	Yes
2008: BLUE SHIELD MEDICAL 2008 form 5500 responses
2008-02-01	Type of plan entity	Single employer plan
2008-02-01	Submission has been amended	No
2008-02-01	This submission is the final filing	No
2008-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-02-01	Plan is a collectively bargained plan	No
2008-02-01	Plan funding arrangement – Insurance	Yes
2008-02-01	Plan benefit arrangement – Insurance	Yes
2007: BLUE SHIELD MEDICAL 2007 form 5500 responses
2007-02-01	Type of plan entity	Single employer plan
2007-02-01	First time form 5500 has been submitted	Yes
2007-02-01	Submission has been amended	No
2007-02-01	This submission is the final filing	No
2007-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2007-02-01	Plan is a collectively bargained plan	No
2007-02-01	Plan funding arrangement – Insurance	Yes
2007-02-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract number	W0001848
Policy instance	1
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract number	W0001848
Policy instance	1
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract number	VH1035 V00191
Policy instance	1
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract number	VH1035 V00191
Policy instance	1
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract number	VH1035 V00191
Policy instance	1
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract number	VH1035 V00191
Policy instance	1
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract number	VH1035, VH00191
Policy instance	1

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Company Name:	HYDE & HYDE, INC.
Employer identification number (EIN):	330061330
NAIC Classification:	311900
NAIC Description:	Other Food Manufacturing