401k Plan data: SAFEWAY INSURANCE COMPANY HEALTH & WELFARE PLAN plan

SAFEWAY INSURANCE COMPANY HEALTH & WELFARE PLAN 401k Plan overview

Plan Name	SAFEWAY INSURANCE COMPANY HEALTH & WELFARE PLAN
Plan identification number	501

SAFEWAY INSURANCE COMPANY HEALTH & WELFARE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover

401k Sponsoring company profile

SAFEWAY INSURANCE COMPANY has sponsored the creation of one or more 401k plans.

Company Name: SAFEWAY INSURANCE COMPANY

Employer identification number (EIN): 392497730

NAIC Classification: 524290

Additional information about SAFEWAY INSURANCE COMPANY

Jurisdiction of Incorporation: Georgia Department of States Corporations Division

Incorporation Date:

Company Identification Number: 675107

More information about SAFEWAY INSURANCE COMPANY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SAFEWAY INSURANCE COMPANY HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2014-01-01
501 2013-01-01
501 2012-01-01 DAWN MOSTACCI
501 2010-01-01 DAWN MOSTACCI ROBERT M. BORDEMAN 2011-08-31
501 2009-01-01 DAWN MOSTACCI ROBERT M. BORDEMAN 2010-07-27

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2014-01-01
501	2013-01-01
501	2012-01-01	DAWN MOSTACCI
501	2010-01-01	DAWN MOSTACCI	ROBERT M. BORDEMAN	2011-08-31
501	2009-01-01	DAWN MOSTACCI	ROBERT M. BORDEMAN	2010-07-27

Plan Statistics for SAFEWAY INSURANCE COMPANY HEALTH & WELFARE PLAN

401k plan membership statisitcs for SAFEWAY INSURANCE COMPANY HEALTH & WELFARE PLAN

Measure Date Value
2014: SAFEWAY INSURANCE COMPANY HEALTH & WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 402
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 402
Total of all active and inactive participants 2014-01-01 402
2013: SAFEWAY INSURANCE COMPANY HEALTH & WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 408
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 414
Total of all active and inactive participants 2013-01-01 414
2012: SAFEWAY INSURANCE COMPANY HEALTH & WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 401
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 408
Total of all active and inactive participants 2012-01-01 408
2010: SAFEWAY INSURANCE COMPANY HEALTH & WELFARE PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 404
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 409
Total of all active and inactive participants 2010-01-01 409
2009: SAFEWAY INSURANCE COMPANY HEALTH & WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 418
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 404
Total of all active and inactive participants 2009-01-01 404

Measure	Date	Value
2014: SAFEWAY INSURANCE COMPANY HEALTH & WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	402
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	402
Total of all active and inactive participants	2014-01-01	402
2013: SAFEWAY INSURANCE COMPANY HEALTH & WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	408
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	414
Total of all active and inactive participants	2013-01-01	414
2012: SAFEWAY INSURANCE COMPANY HEALTH & WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	401
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	408
Total of all active and inactive participants	2012-01-01	408
2010: SAFEWAY INSURANCE COMPANY HEALTH & WELFARE PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	404
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	409
Total of all active and inactive participants	2010-01-01	409
2009: SAFEWAY INSURANCE COMPANY HEALTH & WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	418
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	404
Total of all active and inactive participants	2009-01-01	404

Form 5500 Responses for SAFEWAY INSURANCE COMPANY HEALTH & WELFARE PLAN

2014: SAFEWAY INSURANCE COMPANY HEALTH & WELFARE PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: SAFEWAY INSURANCE COMPANY HEALTH & WELFARE PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: SAFEWAY INSURANCE COMPANY HEALTH & WELFARE PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: SAFEWAY INSURANCE COMPANY HEALTH & WELFARE PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: SAFEWAY INSURANCE COMPANY HEALTH & WELFARE PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	This submission is the final filing	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

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Company Name:	SAFEWAY INSURANCE COMPANY
Employer identification number (EIN):	392497730
NAIC Classification:	524290

Jurisdiction of Incorporation:	Georgia Department of States Corporations Division
Incorporation Date:
Company Identification Number:	675107