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GO-MART, INC. MEDICAL PLAN 401k Plan overview

Plan NameGO-MART, INC. MEDICAL PLAN
Plan identification number 501

GO-MART, INC. MEDICAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

GO-MART, INC. has sponsored the creation of one or more 401k plans.

Company Name:GO-MART, INC.
Employer identification number (EIN):550484692
NAIC Classification:445120
NAIC Description:Convenience Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GO-MART, INC. MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01BOBBI MORGAN2024-04-18
5012022-01-01BOBBI MORGAN2023-08-02
5012021-01-01BOBBI MORGAN2022-05-27
5012020-01-01BOBBI MORGAN2021-10-08
5012019-01-01BOBBI MORGAN2021-10-08
5012018-01-01BOBBI MORGAN2021-10-08
5012017-01-01BOBBI MORGAN2021-10-08
5012016-01-01BOBBI MORGAN2021-10-08
5012015-01-01BOBBI MORGAN2021-10-08
5012014-01-01BOBBI MORGAN2021-10-08
5012013-01-01BOBBI MORGAN2021-10-08
5012012-01-01BOBBI MORGAN2021-10-08
5012011-01-01BOBBI MORGAN2021-10-08
5012010-01-01BOBBI MORGAN2021-10-08
5012009-01-01BOBBI MORGAN2021-10-08
5012008-01-01BOBBI MORGAN2021-10-08
5012007-01-01BOBBI MORGAN2021-10-08
5012006-01-01BOBBI MORGAN2021-10-08
5012005-01-01BOBBI MORGAN2021-10-08
5012004-01-01BOBBI MORGAN2021-10-08

Plan Statistics for GO-MART, INC. MEDICAL PLAN

401k plan membership statisitcs for GO-MART, INC. MEDICAL PLAN

Measure Date Value
2023: GO-MART, INC. MEDICAL PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01165
Total number of active participants reported on line 7a of the Form 55002023-01-01152
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-01152
Number of employers contributing to the scheme2023-01-010
2022: GO-MART, INC. MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01307
Total number of active participants reported on line 7a of the Form 55002022-01-01165
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01165
Number of employers contributing to the scheme2022-01-010
2021: GO-MART, INC. MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01415
Total number of active participants reported on line 7a of the Form 55002021-01-01307
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01307
Number of employers contributing to the scheme2021-01-010
2020: GO-MART, INC. MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01200
Total number of active participants reported on line 7a of the Form 55002020-01-01191
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01191
Number of employers contributing to the scheme2020-01-010
2019: GO-MART, INC. MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01228
Total number of active participants reported on line 7a of the Form 55002019-01-01200
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01200
Number of employers contributing to the scheme2019-01-010
2018: GO-MART, INC. MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01223
Total number of active participants reported on line 7a of the Form 55002018-01-01228
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01228
Number of employers contributing to the scheme2018-01-010
2017: GO-MART, INC. MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01207
Total number of active participants reported on line 7a of the Form 55002017-01-01223
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01223
Number of employers contributing to the scheme2017-01-010
2016: GO-MART, INC. MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01293
Total number of active participants reported on line 7a of the Form 55002016-01-01207
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01207
Number of employers contributing to the scheme2016-01-010
2015: GO-MART, INC. MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01293
Total number of active participants reported on line 7a of the Form 55002015-01-01293
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01293
Number of employers contributing to the scheme2015-01-010
2014: GO-MART, INC. MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01203
Total number of active participants reported on line 7a of the Form 55002014-01-01293
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01293
Number of employers contributing to the scheme2014-01-010
2013: GO-MART, INC. MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01196
Total number of active participants reported on line 7a of the Form 55002013-01-01203
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01203
Number of employers contributing to the scheme2013-01-010
2012: GO-MART, INC. MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01192
Total number of active participants reported on line 7a of the Form 55002012-01-01196
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01196
Number of employers contributing to the scheme2012-01-010
2011: GO-MART, INC. MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01373
Total number of active participants reported on line 7a of the Form 55002011-01-01192
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01192
Number of employers contributing to the scheme2011-01-010
2010: GO-MART, INC. MEDICAL PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01373
Total number of active participants reported on line 7a of the Form 55002010-01-01373
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-01373
Number of employers contributing to the scheme2010-01-010
2009: GO-MART, INC. MEDICAL PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01373
Total number of active participants reported on line 7a of the Form 55002009-01-01373
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01373
Number of employers contributing to the scheme2009-01-010
2008: GO-MART, INC. MEDICAL PLAN 2008 401k membership
Total participants, beginning-of-year2008-01-01373
Total number of active participants reported on line 7a of the Form 55002008-01-01373
Number of retired or separated participants receiving benefits2008-01-010
Number of other retired or separated participants entitled to future benefits2008-01-010
Total of all active and inactive participants2008-01-01373
Number of employers contributing to the scheme2008-01-010
2007: GO-MART, INC. MEDICAL PLAN 2007 401k membership
Total participants, beginning-of-year2007-01-01373
Total number of active participants reported on line 7a of the Form 55002007-01-01373
Number of retired or separated participants receiving benefits2007-01-010
Number of other retired or separated participants entitled to future benefits2007-01-010
Total of all active and inactive participants2007-01-01373
Number of employers contributing to the scheme2007-01-010
2006: GO-MART, INC. MEDICAL PLAN 2006 401k membership
Total participants, beginning-of-year2006-01-01373
Total number of active participants reported on line 7a of the Form 55002006-01-01373
Number of retired or separated participants receiving benefits2006-01-010
Number of other retired or separated participants entitled to future benefits2006-01-010
Total of all active and inactive participants2006-01-01373
Number of employers contributing to the scheme2006-01-010
2005: GO-MART, INC. MEDICAL PLAN 2005 401k membership
Total participants, beginning-of-year2005-01-01373
Total number of active participants reported on line 7a of the Form 55002005-01-01373
Number of retired or separated participants receiving benefits2005-01-010
Number of other retired or separated participants entitled to future benefits2005-01-010
Total of all active and inactive participants2005-01-01373
Number of employers contributing to the scheme2005-01-010
2004: GO-MART, INC. MEDICAL PLAN 2004 401k membership
Total participants, beginning-of-year2004-01-01373
Total number of active participants reported on line 7a of the Form 55002004-01-01373
Number of retired or separated participants receiving benefits2004-01-010
Number of other retired or separated participants entitled to future benefits2004-01-010
Total of all active and inactive participants2004-01-01373
Number of employers contributing to the scheme2004-01-010

Form 5500 Responses for GO-MART, INC. MEDICAL PLAN

2023: GO-MART, INC. MEDICAL PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – InsuranceYes
2022: GO-MART, INC. MEDICAL PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: GO-MART, INC. MEDICAL PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: GO-MART, INC. MEDICAL PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: GO-MART, INC. MEDICAL PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: GO-MART, INC. MEDICAL PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: GO-MART, INC. MEDICAL PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: GO-MART, INC. MEDICAL PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: GO-MART, INC. MEDICAL PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: GO-MART, INC. MEDICAL PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: GO-MART, INC. MEDICAL PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: GO-MART, INC. MEDICAL PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: GO-MART, INC. MEDICAL PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: GO-MART, INC. MEDICAL PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: GO-MART, INC. MEDICAL PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes
2008: GO-MART, INC. MEDICAL PLAN 2008 form 5500 responses
2008-01-01Type of plan entitySingle employer plan
2008-01-01Plan funding arrangement – InsuranceYes
2008-01-01Plan benefit arrangement – InsuranceYes
2007: GO-MART, INC. MEDICAL PLAN 2007 form 5500 responses
2007-01-01Type of plan entitySingle employer plan
2007-01-01Plan funding arrangement – InsuranceYes
2007-01-01Plan benefit arrangement – InsuranceYes
2006: GO-MART, INC. MEDICAL PLAN 2006 form 5500 responses
2006-01-01Type of plan entitySingle employer plan
2006-01-01Plan funding arrangement – InsuranceYes
2006-01-01Plan benefit arrangement – InsuranceYes
2005: GO-MART, INC. MEDICAL PLAN 2005 form 5500 responses
2005-01-01Type of plan entitySingle employer plan
2005-01-01Plan funding arrangement – InsuranceYes
2005-01-01Plan benefit arrangement – InsuranceYes
2004: GO-MART, INC. MEDICAL PLAN 2004 form 5500 responses
2004-01-01Type of plan entitySingle employer plan
2004-01-01Plan funding arrangement – InsuranceYes
2004-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HEALTH PLAN UPPER OHIO VALLEY (National Association of Insurance Commissioners NAIC id number: 95677 )
Policy contract number12725 ET AL
Policy instance 1
Insurance contract or identification number12725 ET AL
Number of Individuals Covered358
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $147,738
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,428,520
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH PLAN UPPER OHIO VALLEY (National Association of Insurance Commissioners NAIC id number: 95677 )
Policy contract number12725 ET AL
Policy instance 1
Insurance contract or identification number12725 ET AL
Number of Individuals Covered388
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $135,746
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,895,774
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH PLAN UPPER OHIO VALLEY (National Association of Insurance Commissioners NAIC id number: 95677 )
Policy contract number12725 ET AL
Policy instance 1
HEALTH PLAN UPPER OHIO VALLEY (National Association of Insurance Commissioners NAIC id number: 95677 )
Policy contract number12725 ET AL
Policy instance 1
HEALTH PLAN UPPER OHIO VALLEY (National Association of Insurance Commissioners NAIC id number: 95677 )
Policy contract number12725 ET AL
Policy instance 1
HEALTH PLAN UPPER OHIO VALLEY (National Association of Insurance Commissioners NAIC id number: 95677 )
Policy contract number12725 ET AL
Policy instance 1
HEALTH PLAN UPPER OHIO VALLEY (National Association of Insurance Commissioners NAIC id number: 95677 )
Policy contract number12725 ET AL
Policy instance 1
HEALTH PLAN UPPER OHIO VALLEY (National Association of Insurance Commissioners NAIC id number: 95677 )
Policy contract number12725 ET AL
Policy instance 1
HIGHMARK WEST VIRGINIA (National Association of Insurance Commissioners NAIC id number: 54828 )
Policy contract number93765
Policy instance 1
HIGHMARK WEST VIRGINIA (National Association of Insurance Commissioners NAIC id number: 54828 )
Policy contract number93765
Policy instance 1
HIGHMARK WEST VIRGINIA (National Association of Insurance Commissioners NAIC id number: 54828 )
Policy contract number93765
Policy instance 1
HIGHMARK WEST VIRGINIA (National Association of Insurance Commissioners NAIC id number: 54828 )
Policy contract number93765
Policy instance 1
HIGHMARK WEST VIRGINIA (National Association of Insurance Commissioners NAIC id number: 54828 )
Policy contract number93765
Policy instance 1
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number5102000
Policy instance 1
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number5102000
Policy instance 1
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number5102000
Policy instance 1
MT STATE BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number5102000
Policy instance 1
MT STATE BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number5102000
Policy instance 1
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number5102000
Policy instance 1
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number5102000
Policy instance 1

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