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TOP POT DOUGHNUTS LIFE/AD&D PLAN 401k Plan overview

Plan NameTOP POT DOUGHNUTS LIFE/AD&D PLAN
Plan identification number 502

TOP POT DOUGHNUTS LIFE/AD&D PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

DOUGHNUT CORPORATION OF AMERICA has sponsored the creation of one or more 401k plans.

Company Name:DOUGHNUT CORPORATION OF AMERICA
Employer identification number (EIN):770637919
NAIC Classification:445291
NAIC Description:Baked Goods Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TOP POT DOUGHNUTS LIFE/AD&D PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-05-01LING VAN2023-11-20
5022021-05-01RUSS BLAIN2022-09-08
5022020-05-01GINGER BLENDHEIM2021-12-13
5022019-05-01GINGER BLENDHEIM2020-10-23
5022018-05-01GINGER BLENDHEIM2020-01-13

Plan Statistics for TOP POT DOUGHNUTS LIFE/AD&D PLAN

401k plan membership statisitcs for TOP POT DOUGHNUTS LIFE/AD&D PLAN

Measure Date Value
2022: TOP POT DOUGHNUTS LIFE/AD&D PLAN 2022 401k membership
Total participants, beginning-of-year2022-05-01109
Total number of active participants reported on line 7a of the Form 55002022-05-01126
Number of retired or separated participants receiving benefits2022-05-010
Number of other retired or separated participants entitled to future benefits2022-05-010
Total of all active and inactive participants2022-05-01126
Number of employers contributing to the scheme2022-05-010
2021: TOP POT DOUGHNUTS LIFE/AD&D PLAN 2021 401k membership
Total participants, beginning-of-year2021-05-01101
Total number of active participants reported on line 7a of the Form 55002021-05-01109
Number of retired or separated participants receiving benefits2021-05-010
Number of other retired or separated participants entitled to future benefits2021-05-010
Total of all active and inactive participants2021-05-01109
Number of employers contributing to the scheme2021-05-010
2020: TOP POT DOUGHNUTS LIFE/AD&D PLAN 2020 401k membership
Total participants, beginning-of-year2020-05-01125
Total number of active participants reported on line 7a of the Form 55002020-05-01101
Number of retired or separated participants receiving benefits2020-05-010
Number of other retired or separated participants entitled to future benefits2020-05-010
Total of all active and inactive participants2020-05-01101
Number of employers contributing to the scheme2020-05-010
2019: TOP POT DOUGHNUTS LIFE/AD&D PLAN 2019 401k membership
Total participants, beginning-of-year2019-05-01154
Total number of active participants reported on line 7a of the Form 55002019-05-01126
Number of retired or separated participants receiving benefits2019-05-010
Number of other retired or separated participants entitled to future benefits2019-05-010
Total of all active and inactive participants2019-05-01126
Number of employers contributing to the scheme2019-05-010
2018: TOP POT DOUGHNUTS LIFE/AD&D PLAN 2018 401k membership
Total participants, beginning-of-year2018-05-01100
Total number of active participants reported on line 7a of the Form 55002018-05-01165
Number of retired or separated participants receiving benefits2018-05-010
Number of other retired or separated participants entitled to future benefits2018-05-010
Total of all active and inactive participants2018-05-01165
Number of employers contributing to the scheme2018-05-010

Form 5500 Responses for TOP POT DOUGHNUTS LIFE/AD&D PLAN

2022: TOP POT DOUGHNUTS LIFE/AD&D PLAN 2022 form 5500 responses
2022-05-01Type of plan entitySingle employer plan
2022-05-01Plan funding arrangement – InsuranceYes
2022-05-01Plan benefit arrangement – InsuranceYes
2021: TOP POT DOUGHNUTS LIFE/AD&D PLAN 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan benefit arrangement – InsuranceYes
2020: TOP POT DOUGHNUTS LIFE/AD&D PLAN 2020 form 5500 responses
2020-05-01Type of plan entitySingle employer plan
2020-05-01Plan funding arrangement – InsuranceYes
2020-05-01Plan benefit arrangement – InsuranceYes
2019: TOP POT DOUGHNUTS LIFE/AD&D PLAN 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan benefit arrangement – InsuranceYes
2018: TOP POT DOUGHNUTS LIFE/AD&D PLAN 2018 form 5500 responses
2018-05-01Type of plan entitySingle employer plan
2018-05-01First time form 5500 has been submittedYes
2018-05-01Plan funding arrangement – InsuranceYes
2018-05-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BC6J
Policy instance 1
Insurance contract or identification numberGLUG0BC6J
Number of Individuals Covered126
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $890
Total amount of fees paid to insurance companyUSD $261
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $8,900
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $890
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerOTHER COMPENSATION
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BC6J
Policy instance 1
Insurance contract or identification numberGLUG0BC6J
Number of Individuals Covered114
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $736
Total amount of fees paid to insurance companyUSD $368
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $7,361
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $736
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerOTHER COMPENSATION
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BC6J
Policy instance 1
Insurance contract or identification numberGLUG0BC6J
Number of Individuals Covered103
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $519
Total amount of fees paid to insurance companyUSD $336
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $5,191
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $519
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerOTHER COMPENSATION
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BC6J
Policy instance 1
Insurance contract or identification numberGLUG0BC6J
Number of Individuals Covered147
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $687
Total amount of fees paid to insurance companyUSD $453
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $6,867
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $687
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerOTHER COMPENSATION
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BC6J
Policy instance 1
Insurance contract or identification numberGLUG0BC6J
Number of Individuals Covered165
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $679
Total amount of fees paid to insurance companyUSD $348
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $6,789
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $679
Amount paid for insurance broker fees290
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3

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