401k Plan data: MRS. GRISSOM'S 401(K) PLAN plan

MRS. GRISSOM'S 401(K) PLAN 401k Plan overview

Plan Name	MRS. GRISSOM'S 401(K) PLAN
Plan identification number	003

MRS. GRISSOM'S 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

MRS. GRISSSOMS SALADS, INC. has sponsored the creation of one or more 401k plans.

Company Name: MRS. GRISSSOMS SALADS, INC.

Employer identification number (EIN): 620604308

NAIC Classification: 311900
NAIC Description: Other Food Manufacturing

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MRS. GRISSOM'S 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2023-01-01 KENNETH FUNGER 2023-08-04
003 2022-01-01 KENNETH FUNGER 2023-03-24
003 2021-01-01 KEITH MCINTOSH 2022-10-11
003 2020-01-01
003 2019-01-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
003	2023-01-01	KENNETH FUNGER	2023-08-04
003	2022-01-01	KENNETH FUNGER	2023-03-24
003	2021-01-01	KEITH MCINTOSH	2022-10-11
003	2020-01-01
003	2019-01-01

Plan Statistics for MRS. GRISSOM'S 401(K) PLAN

401k plan membership statisitcs for MRS. GRISSOM'S 401(K) PLAN

Measure Date Value
2020: MRS. GRISSOM'S 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 102
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 37
Number of retired or separated participants receiving benefits 2020-01-01 1
Number of other retired or separated participants entitled to future benefits 2020-01-01 16
Total of all active and inactive participants 2020-01-01 54
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 54
Number of participants with account balances 2020-01-01 37
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: MRS. GRISSOM'S 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 114
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 97
Number of retired or separated participants receiving benefits 2019-01-01 2
Number of other retired or separated participants entitled to future benefits 2019-01-01 3
Total of all active and inactive participants 2019-01-01 102
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 102
Number of participants with account balances 2019-01-01 47
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0

Measure	Date	Value
2020: MRS. GRISSOM'S 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	102
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	37
Number of retired or separated participants receiving benefits	2020-01-01	1
Number of other retired or separated participants entitled to future benefits	2020-01-01	16
Total of all active and inactive participants	2020-01-01	54
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	54
Number of participants with account balances	2020-01-01	37
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: MRS. GRISSOM'S 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	114
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	97
Number of retired or separated participants receiving benefits	2019-01-01	2
Number of other retired or separated participants entitled to future benefits	2019-01-01	3
Total of all active and inactive participants	2019-01-01	102
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	102
Number of participants with account balances	2019-01-01	47
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0

Financial Data on MRS. GRISSOM'S 401(K) PLAN

Measure	Date	Value
2020 : MRS. GRISSOM'S 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$761,609
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$387,920
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$386,620
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$296,905
Value of total assets at end of year	2020-12-31	$2,861,006
Value of total assets at beginning of year	2020-12-31	$2,487,317
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$1,300
Total interest from all sources	2020-12-31	$859
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Administrative expenses professional fees incurred	2020-12-31	$1,300
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$198,645
Participant contributions at end of year	2020-12-31	$9,621
Participant contributions at beginning of year	2020-12-31	$15,786
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$373,689
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$2,861,006
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$2,487,317
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$2,851,109
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$2,471,435
Interest on participant loans	2020-12-31	$859
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-12-31	$276
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-12-31	$96
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-12-31	$96
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$463,845
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$98,260
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$386,620
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Unqualified
Accountancy firm name	2020-12-31	LBMC
Accountancy firm EIN	2020-12-31	621199757
2019 : MRS. GRISSOM'S 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total transfer of assets to this plan	2019-12-31	$2,018,612
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$609,185
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$140,480
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$100,388
Expenses. Certain deemed distributions of participant loans	2019-12-31	$38,342
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$278,527
Value of total assets at end of year	2019-12-31	$2,487,317
Value of total assets at beginning of year	2019-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$1,750
Total interest from all sources	2019-12-31	$1,969
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Administrative expenses professional fees incurred	2019-12-31	$1,750
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$180,921
Participant contributions at end of year	2019-12-31	$15,786
Participant contributions at beginning of year	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$420
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$468,705
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$2,487,317
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$2,471,435
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$0
Interest on participant loans	2019-12-31	$1,969
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$96
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$328,689
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$97,186
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$100,388
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2019-12-31	Yes
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	LBMC
Accountancy firm EIN	2019-12-31	621199757

Form 5500 Responses for MRS. GRISSOM'S 401(K) PLAN

2020: MRS. GRISSOM'S 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: MRS. GRISSOM'S 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	First time form 5500 has been submitted	Yes
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

81B796

Policy instance

Insurance contract or identification number	81B796
Number of Individuals Covered	41
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $12,593
Total amount of fees paid to insurance company	USD $1,519
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $12,593
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	0
Insurance broker organization code?	4

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

81B796

Policy instance

Insurance contract or identification number	81B796
Number of Individuals Covered	50
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $10,080
Total amount of fees paid to insurance company	USD $8,441
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,080
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	0
Insurance broker organization code?	4

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Company Name:	MRS. GRISSSOMS SALADS, INC.
Employer identification number (EIN):	620604308
NAIC Classification:	311900
NAIC Description:	Other Food Manufacturing