401k Plan data: PYXUS INTERNATIONAL HEALTH CARE & BENEFIT PLAN FOR HOURLY EMPLOYEES plan

PYXUS INTERNATIONAL HEALTH CARE & BENEFIT PLAN FOR HOURLY EMPLOYEES 401k Plan overview

Plan Name	PYXUS INTERNATIONAL HEALTH CARE & BENEFIT PLAN FOR HOURLY EMPLOYEES
Plan identification number	502

PYXUS INTERNATIONAL HEALTH CARE & BENEFIT PLAN FOR HOURLY EMPLOYEES Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

PYXUS INTERNATIONAL, INC. has sponsored the creation of one or more 401k plans.

Company Name: PYXUS INTERNATIONAL, INC.

Employer identification number (EIN): 852386250

NAIC Classification: 312200
NAIC Description: Tobacco Manufacturing

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PYXUS INTERNATIONAL HEALTH CARE & BENEFIT PLAN FOR HOURLY EMPLOYEES

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2021-01-01
502 2021-01-01
502 2020-01-01

Plan Statistics for PYXUS INTERNATIONAL HEALTH CARE & BENEFIT PLAN FOR HOURLY EMPLOYEES

401k plan membership statisitcs for PYXUS INTERNATIONAL HEALTH CARE & BENEFIT PLAN FOR HOURLY EMPLOYEES

Measure Date Value
2021: PYXUS INTERNATIONAL HEALTH CARE & BENEFIT PLAN FOR HOURLY EMPLOYEES 2021 401k membership
Total participants, beginning-of-year 2021-01-01 471
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 457
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 457
2020: PYXUS INTERNATIONAL HEALTH CARE & BENEFIT PLAN FOR HOURLY EMPLOYEES 2020 401k membership
Total participants, beginning-of-year 2020-01-01 459
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 471
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 471

Measure	Date	Value
2021: PYXUS INTERNATIONAL HEALTH CARE & BENEFIT PLAN FOR HOURLY EMPLOYEES 2021 401k membership
Total participants, beginning-of-year	2021-01-01	471
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	457
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	457
2020: PYXUS INTERNATIONAL HEALTH CARE & BENEFIT PLAN FOR HOURLY EMPLOYEES 2020 401k membership
Total participants, beginning-of-year	2020-01-01	459
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	471
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	471

Form 5500 Responses for PYXUS INTERNATIONAL HEALTH CARE & BENEFIT PLAN FOR HOURLY EMPLOYEES

2021: PYXUS INTERNATIONAL HEALTH CARE & BENEFIT PLAN FOR HOURLY EMPLOYEES 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: PYXUS INTERNATIONAL HEALTH CARE & BENEFIT PLAN FOR HOURLY EMPLOYEES 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80012 )

Policy contract number

802135

Policy instance

Insurance contract or identification number	802135
Number of Individuals Covered	113
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $259,719
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

0225296

Policy instance

Insurance contract or identification number	0225296
Number of Individuals Covered	1575
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $59,628
Total amount of fees paid to insurance company	USD $18,020
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $641,673
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $59,628
Amount paid for insurance broker fees	18020
Additional information about fees paid to insurance broker	NON-MONETARY / SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

0225296

Policy instance

Insurance contract or identification number	0225296
Number of Individuals Covered	1759
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $2,751
Total amount of fees paid to insurance company	USD $344
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $30,024
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,751
Insurance broker organization code?	3
Amount paid for insurance broker fees	344

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80012 )

Policy contract number

802135

Policy instance

Insurance contract or identification number	802135
Number of Individuals Covered	125
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $247,933
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	PYXUS INTERNATIONAL, INC.
Employer identification number (EIN):	852386250
NAIC Classification:	312200
NAIC Description:	Tobacco Manufacturing