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| Plan Name | SMITTY'S SUPPLY EMPLOYEE ANCILLARY BENEFITS PLAN |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | SMITTY'S SUPPLY INC. |
| Employer identification number (EIN): | 721000182 |
| NAIC Classification: | 324190 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2021-01-01 | JAYE COLLURA | 2022-04-29 | ||
| 502 | 2021-01-01 | JAYE COLLURA | 2022-08-16 | ||
| 502 | 2020-01-01 | TIFFANY CRESSIONNIE | 2021-08-09 | ||
| 502 | 2020-01-01 | JAYE COLLURA | 2022-08-16 | ||
| 502 | 2019-01-01 | TIFFANY CRESSIONNIE | 2020-12-17 | ||
| 502 | 2019-01-01 | JAYE COLLURA | 2022-08-16 | ||
| 502 | 2018-01-01 | TIFFANY CRESSIONNIE | 2020-12-17 | ||
| 502 | 2017-01-01 | TIFFANY CRESSIONNIE | 2020-12-17 | ||
| 502 | 2016-01-01 | TIFFANY CRESSIONNIE | 2020-12-17 | ||
| 502 | 2015-01-01 | TIFFANY CRESSIONNIE | 2020-12-17 |
| 2021: SMITTY'S SUPPLY EMPLOYEE ANCILLARY BENEFITS PLAN 2021 form 5500 responses | ||
|---|---|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Submission has been amended | Yes |
| 2021-01-01 | This submission is the final filing | Yes |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: SMITTY'S SUPPLY EMPLOYEE ANCILLARY BENEFITS PLAN 2020 form 5500 responses | ||
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Submission has been amended | Yes |
| 2020-01-01 | This submission is the final filing | Yes |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: SMITTY'S SUPPLY EMPLOYEE ANCILLARY BENEFITS PLAN 2019 form 5500 responses | ||
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Submission has been amended | Yes |
| 2019-01-01 | This submission is the final filing | Yes |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: SMITTY'S SUPPLY EMPLOYEE ANCILLARY BENEFITS PLAN 2018 form 5500 responses | ||
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: SMITTY'S SUPPLY EMPLOYEE ANCILLARY BENEFITS PLAN 2017 form 5500 responses | ||
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: SMITTY'S SUPPLY EMPLOYEE ANCILLARY BENEFITS PLAN 2016 form 5500 responses | ||
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: SMITTY'S SUPPLY EMPLOYEE ANCILLARY BENEFITS PLAN 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 – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | AI961243 |
| Policy instance | 3 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | GLUG0BLSY |
| Policy instance | 2 |
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) | |
| Policy contract number | 010-350949 |
| Policy instance | 1 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | AI961243 |
| Policy instance | 3 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | GLUG0BLSY |
| Policy instance | 2 |
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) | |
| Policy contract number | 010-350949 |
| Policy instance | 1 |
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) | |
| Policy contract number | 010-350949 |
| Policy instance | 1 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | FLX968338 |
| Policy instance | 2 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | VAI826289 |
| Policy instance | 3 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | VAI826289 |
| Policy instance | 3 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | FLX968338 |
| Policy instance | 2 |
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) | |
| Policy contract number | 010-350949 |
| Policy instance | 1 |
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) | |
| Policy contract number | 5474355 |
| Policy instance | 1 |
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) | |
| Policy contract number | 5474355 |
| Policy instance | 1 |
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