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| Plan Name | SPARETIME SUPPLY HEALTH & WELFARE BENEFIT PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | SPARETIME SUPPLY, INC. |
| Employer identification number (EIN): | 562393945 |
| NAIC Classification: | 423990 |
| NAIC Description: | Other Miscellaneous Durable Goods Merchant Wholesalers |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2021-08-01 | LENE VINDING | 2023-03-15 | ||
| 501 | 2021-08-01 | LENE VINDING | 2023-12-18 |
| Measure | Date | Value |
|---|---|---|
| 2021: SPARETIME SUPPLY HEALTH & WELFARE BENEFIT PLAN 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-08-01 | 127 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-08-01 | 99 |
| Number of retired or separated participants receiving benefits | 2021-08-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-08-01 | 0 |
| Total of all active and inactive participants | 2021-08-01 | 99 |
| Number of employers contributing to the scheme | 2021-08-01 | 0 |
| 2021: SPARETIME SUPPLY HEALTH & WELFARE BENEFIT PLAN 2021 form 5500 responses | ||
|---|---|---|
| 2021-08-01 | Type of plan entity | Single employer plan |
| 2021-08-01 | First time form 5500 has been submitted | Yes |
| 2021-08-01 | Submission has been amended | Yes |
| 2021-08-01 | Plan funding arrangement – Insurance | Yes |
| 2021-08-01 | Plan benefit arrangement – Insurance | Yes |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | L03295 |
| Policy instance | 1 |
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) | |
| Policy contract number | 1143108 |
| Policy instance | 2 |
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