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| Plan Name | FOOD N FUN INC. |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | FOOD-N-FUN, INC. |
| Employer identification number (EIN): | 720929345 |
| NAIC Classification: | 445120 |
| NAIC Description: | Convenience Stores |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2016-01-01 | TODD STREET | |||
| 501 | 2015-01-01 | TODD STREET |
| Measure | Date | Value |
|---|---|---|
| 2016: FOOD N FUN INC. 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-01-01 | 103 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 87 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
| Total of all active and inactive participants | 2016-01-01 | 87 |
| 2015: FOOD N FUN INC. 2015 401k membership | ||
| Total participants, beginning-of-year | 2015-01-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 103 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
| Total of all active and inactive participants | 2015-01-01 | 103 |
| 2016: FOOD N FUN INC. 2016 form 5500 responses | ||
|---|---|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: FOOD N FUN INC. 2015 form 5500 responses | ||
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | First time form 5500 has been submitted | Yes |
| 2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 ) | |||||||||||||||||||||||||
| Policy contract number | 75972FF2 | ||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||
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| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) | |||||||||||||||||||||||||
| Policy contract number | E3984556 | ||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||
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| SOUTHERN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60009 ) | |||||||||||||||||||||||||
| Policy contract number | 75972FF2 | ||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||
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