401k Plan data: HAYNES MANAGEMENT SERVICES, INC. RESTATED CAFETERIA PLAN plan

HAYNES MANAGEMENT SERVICES, INC. RESTATED CAFETERIA PLAN 401k Plan overview

Plan Name	HAYNES MANAGEMENT SERVICES, INC. RESTATED CAFETERIA PLAN
Plan identification number	501

HAYNES MANAGEMENT SERVICES, INC. RESTATED CAFETERIA PLAN Benefits

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

401k Sponsoring company profile

HAYNES MANAGEMENT SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name: HAYNES MANAGEMENT SERVICES, INC.

Employer identification number (EIN): 853927261

NAIC Classification: 621900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HAYNES MANAGEMENT SERVICES, INC. RESTATED CAFETERIA PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-01-01 TONY A HAYNES 2024-07-23
501 2022-01-01 TONY A. HAYNES 2023-06-07
501 2021-01-01 TONY A. HAYNES 2022-05-31 TONY A. HAYNES 2022-05-31

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2023-01-01	TONY A HAYNES	2024-07-23
501	2022-01-01	TONY A. HAYNES	2023-06-07
501	2021-01-01	TONY A. HAYNES	2022-05-31	TONY A. HAYNES	2022-05-31

Plan Statistics for HAYNES MANAGEMENT SERVICES, INC. RESTATED CAFETERIA PLAN

401k plan membership statisitcs for HAYNES MANAGEMENT SERVICES, INC. RESTATED CAFETERIA PLAN

Measure Date Value
2023: HAYNES MANAGEMENT SERVICES, INC. RESTATED CAFETERIA PLAN 2023 401k membership
Total participants, beginning-of-year 2023-01-01 250
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 211
Number of retired or separated participants receiving benefits 2023-01-01 61
Number of other retired or separated participants entitled to future benefits 2023-01-01 0
Total of all active and inactive participants 2023-01-01 272
Number of employers contributing to the scheme 2023-01-01 0
2022: HAYNES MANAGEMENT SERVICES, INC. RESTATED CAFETERIA PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 334
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 231
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 231
2021: HAYNES MANAGEMENT SERVICES, INC. RESTATED CAFETERIA PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 270
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 235
Number of other retired or separated participants entitled to future benefits 2021-01-01 99
Total of all active and inactive participants 2021-01-01 334

Measure	Date	Value
2023: HAYNES MANAGEMENT SERVICES, INC. RESTATED CAFETERIA PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	250
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	211
Number of retired or separated participants receiving benefits	2023-01-01	61
Number of other retired or separated participants entitled to future benefits	2023-01-01	0
Total of all active and inactive participants	2023-01-01	272
Number of employers contributing to the scheme	2023-01-01	0
2022: HAYNES MANAGEMENT SERVICES, INC. RESTATED CAFETERIA PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	334
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	231
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	231
2021: HAYNES MANAGEMENT SERVICES, INC. RESTATED CAFETERIA PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	270
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	235
Number of other retired or separated participants entitled to future benefits	2021-01-01	99
Total of all active and inactive participants	2021-01-01	334

Form 5500 Responses for HAYNES MANAGEMENT SERVICES, INC. RESTATED CAFETERIA PLAN

2023: HAYNES MANAGEMENT SERVICES, INC. RESTATED CAFETERIA PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2022: HAYNES MANAGEMENT SERVICES, INC. RESTATED CAFETERIA PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: HAYNES MANAGEMENT SERVICES, INC. RESTATED CAFETERIA PLAN 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

Insurance Providers Used on plan

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

Policy contract number

5954768

Policy instance

Insurance contract or identification number	5954768
Number of Individuals Covered	596
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $58,296
Total amount of fees paid to insurance company	USD $3,931
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $316,686
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

A8V93

Policy instance

Insurance contract or identification number	A8V93
Number of Individuals Covered	110
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $18,115
Total amount of fees paid to insurance company	USD $756
Other welfare benefits provided	ACCIDENT, HOSPITAL, CANCER
Welfare Benefit Premiums Paid to Carrier	USD $97,821
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

TMO5954768

Policy instance

Insurance contract or identification number	TMO5954768
Number of Individuals Covered	595
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $55,677
Total amount of fees paid to insurance company	USD $4,930
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	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ADD
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 $249,247
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

82-2723296

Policy instance

Insurance contract or identification number	82-2723296
Number of Individuals Covered	109
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $19,288
Total amount of fees paid to insurance company	USD $1,003
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	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	SUPPLEMENTAL HOSPITAL, ACCIDENT, CANCER
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 $95,845
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

5954768

Policy instance

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

82-2723296

Policy instance

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Company Name:	HAYNES MANAGEMENT SERVICES, INC.
Employer identification number (EIN):	853927261
NAIC Classification:	621900