401k Plan data: VRFA HRA PLAN REIMBURSES MEDICAL EXPENSES NOT COVERED BY MEMBER'S HEALTH INSURANCE. CONTRIBUTIONS TO THE PLAN ARE MADE BY THE EMPLOYER ONLY. plan

VRFA HRA PLAN REIMBURSES MEDICAL EXPENSES NOT COVERED BY MEMBER'S HEALTH INSURANCE. CONTRIBUTIONS TO THE PLAN ARE MADE BY THE EMPLOYER ONLY. 401k Plan overview

Plan Name	VRFA HRA PLAN REIMBURSES MEDICAL EXPENSES NOT COVERED BY MEMBER'S HEALTH INSURANCE. CONTRIBUTIONS TO THE PLAN ARE MADE BY THE EMPLOYER ONLY.
Plan identification number	501

VRFA HRA PLAN REIMBURSES MEDICAL EXPENSES NOT COVERED BY MEMBER'S HEALTH INSURANCE. CONTRIBUTIONS TO THE PLAN ARE MADE BY THE EMPLOYER ONLY. Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Dental Vision Collectively bargained welfare benefit arrangement under Code section 419A(f)(5).

401k Sponsoring company profile

VALLEY REGIONAL FIRE AUTHORITY has sponsored the creation of one or more 401k plans.

Company Name: VALLEY REGIONAL FIRE AUTHORITY

Employer identification number (EIN): 743195524

NAIC Classification: 921000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VRFA HRA PLAN REIMBURSES MEDICAL EXPENSES NOT COVERED BY MEMBER'S HEALTH INSURANCE. CONTRIBUTIONS TO THE PLAN ARE MADE BY THE EMPLOYER ONLY.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2015-01-01 MARK HORASKI MARK HORASKI 2016-07-21
501 2014-01-01 MARK HORASKI 2015-07-22
501 2013-01-01 MARK HORASKI
501 2012-01-01 MARK HORASKI MARK HORASKI 2013-07-24

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2015-01-01	MARK HORASKI	MARK HORASKI	2016-07-21
501	2014-01-01		MARK HORASKI	2015-07-22
501	2013-01-01	MARK HORASKI
501	2012-01-01	MARK HORASKI	MARK HORASKI	2013-07-24

Plan Statistics for VRFA HRA PLAN REIMBURSES MEDICAL EXPENSES NOT COVERED BY MEMBER'S HEALTH INSURANCE. CONTRIBUTIONS TO THE PLAN ARE MADE BY THE EMPLOYER ONLY.

401k plan membership statisitcs for VRFA HRA PLAN REIMBURSES MEDICAL EXPENSES NOT COVERED BY MEMBER'S HEALTH INSURANCE. CONTRIBUTIONS TO THE PLAN ARE MADE BY THE EMPLOYER ONLY.

Measure Date Value
2015: VRFA HRA PLAN REIMBURSES MEDICAL EXPENSES NOT COVERED BY MEMBER'S HEALTH INSURANCE. CONTRIBUTIONS TO THE PLAN ARE MADE BY THE EMPLOYER ONLY. 2015 401k membership
Total participants, beginning-of-year 2015-01-01 110
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 113
Total of all active and inactive participants 2015-01-01 113
Total participants 2015-01-01 113
Number of participants with account balances 2015-01-01 109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: VRFA HRA PLAN REIMBURSES MEDICAL EXPENSES NOT COVERED BY MEMBER'S HEALTH INSURANCE. CONTRIBUTIONS TO THE PLAN ARE MADE BY THE EMPLOYER ONLY. 2014 401k membership
Total participants, beginning-of-year 2014-01-01 110
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 110
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: VRFA HRA PLAN REIMBURSES MEDICAL EXPENSES NOT COVERED BY MEMBER'S HEALTH INSURANCE. CONTRIBUTIONS TO THE PLAN ARE MADE BY THE EMPLOYER ONLY. 2013 401k membership
Total participants, beginning-of-year 2013-01-01 107
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 108
Total of all active and inactive participants 2013-01-01 108
Total participants 2013-01-01 108
2012: VRFA HRA PLAN REIMBURSES MEDICAL EXPENSES NOT COVERED BY MEMBER'S HEALTH INSURANCE. CONTRIBUTIONS TO THE PLAN ARE MADE BY THE EMPLOYER ONLY. 2012 401k membership
Total participants, beginning-of-year 2012-01-01 111
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 111
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 111
Total participants 2012-01-01 111

Measure	Date	Value
2015: VRFA HRA PLAN REIMBURSES MEDICAL EXPENSES NOT COVERED BY MEMBER'S HEALTH INSURANCE. CONTRIBUTIONS TO THE PLAN ARE MADE BY THE EMPLOYER ONLY. 2015 401k membership
Total participants, beginning-of-year	2015-01-01	110
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	113
Total of all active and inactive participants	2015-01-01	113
Total participants	2015-01-01	113
Number of participants with account balances	2015-01-01	109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: VRFA HRA PLAN REIMBURSES MEDICAL EXPENSES NOT COVERED BY MEMBER'S HEALTH INSURANCE. CONTRIBUTIONS TO THE PLAN ARE MADE BY THE EMPLOYER ONLY. 2014 401k membership
Total participants, beginning-of-year	2014-01-01	110
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	110
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: VRFA HRA PLAN REIMBURSES MEDICAL EXPENSES NOT COVERED BY MEMBER'S HEALTH INSURANCE. CONTRIBUTIONS TO THE PLAN ARE MADE BY THE EMPLOYER ONLY. 2013 401k membership
Total participants, beginning-of-year	2013-01-01	107
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	108
Total of all active and inactive participants	2013-01-01	108
Total participants	2013-01-01	108
2012: VRFA HRA PLAN REIMBURSES MEDICAL EXPENSES NOT COVERED BY MEMBER'S HEALTH INSURANCE. CONTRIBUTIONS TO THE PLAN ARE MADE BY THE EMPLOYER ONLY. 2012 401k membership
Total participants, beginning-of-year	2012-01-01	111
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	111
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	111
Total participants	2012-01-01	111

Form 5500 Responses for VRFA HRA PLAN REIMBURSES MEDICAL EXPENSES NOT COVERED BY MEMBER'S HEALTH INSURANCE. CONTRIBUTIONS TO THE PLAN ARE MADE BY THE EMPLOYER ONLY.

2015: VRFA HRA PLAN REIMBURSES MEDICAL EXPENSES NOT COVERED BY MEMBER'S HEALTH INSURANCE. CONTRIBUTIONS TO THE PLAN ARE MADE BY THE EMPLOYER ONLY. 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	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	Yes
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: VRFA HRA PLAN REIMBURSES MEDICAL EXPENSES NOT COVERED BY MEMBER'S HEALTH INSURANCE. CONTRIBUTIONS TO THE PLAN ARE MADE BY THE EMPLOYER ONLY. 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	Yes
2014-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: VRFA HRA PLAN REIMBURSES MEDICAL EXPENSES NOT COVERED BY MEMBER'S HEALTH INSURANCE. CONTRIBUTIONS TO THE PLAN ARE MADE BY THE EMPLOYER ONLY. 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	Yes
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: VRFA HRA PLAN REIMBURSES MEDICAL EXPENSES NOT COVERED BY MEMBER'S HEALTH INSURANCE. CONTRIBUTIONS TO THE PLAN ARE MADE BY THE EMPLOYER ONLY. 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	First time form 5500 has been submitted	Yes
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	Yes
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

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Company Name:	VALLEY REGIONAL FIRE AUTHORITY
Employer identification number (EIN):	743195524
NAIC Classification:	921000