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| Plan Name | SHOE STATION,INC. LIFE INSURANCE PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | SHOE STATION, INC. |
| Employer identification number (EIN): | 630879160 |
| NAIC Classification: | 448210 |
| NAIC Description: | Shoe Stores |
Additional information about SHOE STATION, INC.
| Jurisdiction of Incorporation: | Alabama Secretary of State |
| Incorporation Date: | 1984-07-03 |
| Company Identification Number: | 098-921 |
| Legal Registered Office Address: |
720 EXECUTIVE PARK DR MOBILE, United States of America (USA) 36606 |
More information about SHOE STATION, INC.
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2021-04-01 | ||||
| 501 | 2020-04-01 | MATT LURSEN | 2021-10-11 | ||
| 501 | 2019-04-01 | G. BRENT BARKIN | 2020-08-25 | ||
| 501 | 2018-04-01 | G. BRENT BARKIN | 2019-07-26 |
| Measure | Date | Value |
|---|---|---|
| 2021: SHOE STATION,INC. LIFE INSURANCE PLAN 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-04-01 | 195 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-04-01 | 0 |
| Total of all active and inactive participants | 2021-04-01 | 0 |
| Total participants | 2021-04-01 | 0 |
| 2020: SHOE STATION,INC. LIFE INSURANCE PLAN 2020 401k membership | ||
| Total participants, beginning-of-year | 2020-04-01 | 255 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-04-01 | 195 |
| Total of all active and inactive participants | 2020-04-01 | 195 |
| 2019: SHOE STATION,INC. LIFE INSURANCE PLAN 2019 401k membership | ||
| Total participants, beginning-of-year | 2019-04-01 | 334 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-04-01 | 255 |
| Total of all active and inactive participants | 2019-04-01 | 255 |
| 2018: SHOE STATION,INC. LIFE INSURANCE PLAN 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-04-01 | 334 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-04-01 | 334 |
| Total of all active and inactive participants | 2018-04-01 | 334 |
| 2021: SHOE STATION,INC. LIFE INSURANCE PLAN 2021 form 5500 responses | ||
|---|---|---|
| 2021-04-01 | Type of plan entity | Single employer plan |
| 2021-04-01 | Submission has been amended | No |
| 2021-04-01 | This submission is the final filing | Yes |
| 2021-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-04-01 | Plan is a collectively bargained plan | No |
| 2021-04-01 | Plan funding arrangement – Insurance | Yes |
| 2021-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: SHOE STATION,INC. LIFE INSURANCE PLAN 2020 form 5500 responses | ||
| 2020-04-01 | Type of plan entity | Single employer plan |
| 2020-04-01 | Plan funding arrangement – Insurance | Yes |
| 2020-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: SHOE STATION,INC. LIFE INSURANCE PLAN 2019 form 5500 responses | ||
| 2019-04-01 | Type of plan entity | Single employer plan |
| 2019-04-01 | Plan funding arrangement – Insurance | Yes |
| 2019-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: SHOE STATION,INC. LIFE INSURANCE PLAN 2018 form 5500 responses | ||
| 2018-04-01 | Type of plan entity | Single employer plan |
| 2018-04-01 | First time form 5500 has been submitted | Yes |
| 2018-04-01 | Plan funding arrangement – Insurance | Yes |
| 2018-04-01 | Plan benefit arrangement – Insurance | Yes |
| GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 00550080 | ||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||
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| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 00550080 | ||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||
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| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 00550080 | ||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||
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| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 00550080 | ||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||
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