401k Plan data: FOURTH AVENUE HOLDING LLC CAFETERIA PLAN plan

FOURTH AVENUE HOLDING LLC CAFETERIA PLAN 401k Plan overview

Plan Name	FOURTH AVENUE HOLDING LLC CAFETERIA PLAN
Plan identification number	501

FOURTH AVENUE HOLDING LLC 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) Other welfare benefit cover

401k Sponsoring company profile

FOURTH AVENUE HOLDING, LLC has sponsored the creation of one or more 401k plans.

Company Name: FOURTH AVENUE HOLDING, LLC

Employer identification number (EIN): 901023644

NAIC Classification: 561440
NAIC Description: Collection Agencies

Additional information about FOURTH AVENUE HOLDING, LLC

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 2016-08-08

Company Identification Number: 0802516529

Legal Registered Office Address: 327 W 4TH AVE

HUTCHINSON
United States of America (USA)
67501

More information about FOURTH AVENUE HOLDING, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FOURTH AVENUE HOLDING LLC CAFETERIA PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-01-01 MARK PERFETTI 2023-07-24
501 2021-01-01 MARK PERFETTI 2022-06-21
501 2020-01-01 MARK PERFETTI 2021-10-11
501 2019-01-01 MARK PERFETTI 2020-09-09
501 2018-01-01
501 2017-01-01
501 2016-01-01
501 2015-01-01 MARK PERFETTI MARK PERFETTI 2016-09-20
501 2014-01-01 FLORENTINO ZAMORA JR.

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2022-01-01	MARK PERFETTI	2023-07-24
501	2021-01-01	MARK PERFETTI	2022-06-21
501	2020-01-01	MARK PERFETTI	2021-10-11
501	2019-01-01	MARK PERFETTI	2020-09-09
501	2018-01-01
501	2017-01-01
501	2016-01-01
501	2015-01-01	MARK PERFETTI		MARK PERFETTI	2016-09-20
501	2014-01-01	FLORENTINO ZAMORA JR.

Plan Statistics for FOURTH AVENUE HOLDING LLC CAFETERIA PLAN

401k plan membership statisitcs for FOURTH AVENUE HOLDING LLC CAFETERIA PLAN

Measure Date Value
2022: FOURTH AVENUE HOLDING LLC CAFETERIA PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 232
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 187
Total of all active and inactive participants 2022-01-01 187
2021: FOURTH AVENUE HOLDING LLC CAFETERIA PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 285
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 232
Total of all active and inactive participants 2021-01-01 232
2020: FOURTH AVENUE HOLDING LLC CAFETERIA PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 272
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 285
Total of all active and inactive participants 2020-01-01 285
2019: FOURTH AVENUE HOLDING LLC CAFETERIA PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 250
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 272
Total of all active and inactive participants 2019-01-01 272
2018: FOURTH AVENUE HOLDING LLC CAFETERIA PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 270
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 250
Total of all active and inactive participants 2018-01-01 250
2017: FOURTH AVENUE HOLDING LLC CAFETERIA PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 325
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 272
Total of all active and inactive participants 2017-01-01 272
2016: FOURTH AVENUE HOLDING LLC CAFETERIA PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 392
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 326
Total of all active and inactive participants 2016-01-01 326
2015: FOURTH AVENUE HOLDING LLC CAFETERIA PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 279
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 392
Total of all active and inactive participants 2015-01-01 392
2014: FOURTH AVENUE HOLDING LLC CAFETERIA PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 201
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 279
Total of all active and inactive participants 2014-01-01 279

Measure	Date	Value
2022: FOURTH AVENUE HOLDING LLC CAFETERIA PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	232
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	187
Total of all active and inactive participants	2022-01-01	187
2021: FOURTH AVENUE HOLDING LLC CAFETERIA PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	285
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	232
Total of all active and inactive participants	2021-01-01	232
2020: FOURTH AVENUE HOLDING LLC CAFETERIA PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	272
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	285
Total of all active and inactive participants	2020-01-01	285
2019: FOURTH AVENUE HOLDING LLC CAFETERIA PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	250
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	272
Total of all active and inactive participants	2019-01-01	272
2018: FOURTH AVENUE HOLDING LLC CAFETERIA PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	270
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	250
Total of all active and inactive participants	2018-01-01	250
2017: FOURTH AVENUE HOLDING LLC CAFETERIA PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	325
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	272
Total of all active and inactive participants	2017-01-01	272
2016: FOURTH AVENUE HOLDING LLC CAFETERIA PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	392
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	326
Total of all active and inactive participants	2016-01-01	326
2015: FOURTH AVENUE HOLDING LLC CAFETERIA PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	279
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	392
Total of all active and inactive participants	2015-01-01	392
2014: FOURTH AVENUE HOLDING LLC CAFETERIA PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	201
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	279
Total of all active and inactive participants	2014-01-01	279

Form 5500 Responses for FOURTH AVENUE HOLDING LLC CAFETERIA PLAN

2022: FOURTH AVENUE HOLDING LLC CAFETERIA PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2021: FOURTH AVENUE HOLDING LLC CAFETERIA PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2020: FOURTH AVENUE HOLDING LLC CAFETERIA PLAN 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 benefit arrangement – Insurance	Yes
2019: FOURTH AVENUE HOLDING LLC CAFETERIA PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: FOURTH AVENUE HOLDING LLC CAFETERIA 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: FOURTH AVENUE HOLDING LLC CAFETERIA 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: FOURTH AVENUE HOLDING LLC CAFETERIA 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: FOURTH AVENUE HOLDING LLC CAFETERIA PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
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	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: FOURTH AVENUE HOLDING LLC CAFETERIA PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	First time form 5500 has been submitted	Yes
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	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

ADVANCE INSURANCE COMPANY OF KANSAS (National Association of Insurance Commissioners NAIC id number: 12143 )

Policy contract number

00009392

Policy instance

Insurance contract or identification number	00009392
Number of Individuals Covered	209
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $5,013
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Temporary Disability 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 $93,365
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

ADVANCE INSURANCE COMPANY OF KANSAS (National Association of Insurance Commissioners NAIC id number: 12143 )

Policy contract number

00009392

Policy instance

Insurance contract or identification number	00009392
Number of Individuals Covered	187
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $4,689
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Temporary Disability 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 $85,103
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF KANSAS (National Association of Insurance Commissioners NAIC id number: 70729 )

Policy contract number

09392

Policy instance

ADVANCE INSURANCE COMPANY OF KANSAS (National Association of Insurance Commissioners NAIC id number: 12143 )

Policy contract number

00009392

Policy instance

ADVANCE INSURANCE COMPANY OF KANSAS (National Association of Insurance Commissioners NAIC id number: 12143 )

Policy contract number

00009392

Policy instance

BLUE CROSS BLUE SHIELD OF KANSAS (National Association of Insurance Commissioners NAIC id number: 70729 )

Policy contract number

09392

Policy instance

BLUE CROSS BLUE SHIELD OF KANSAS (National Association of Insurance Commissioners NAIC id number: 70729 )

Policy contract number

09392

Policy instance

ADVANCE INSURANCE COMPANY OF KANSAS (National Association of Insurance Commissioners NAIC id number: 12143 )

Policy contract number

00009392

Policy instance

BLUE CROSS BLUE SHIELD OF KANSAS (National Association of Insurance Commissioners NAIC id number: 70729 )

Policy contract number

09392

Policy instance

ADVANCE INSURANCE COMPANY OF KANSAS (National Association of Insurance Commissioners NAIC id number: 12143 )

Policy contract number

00009392

Policy instance

BLUE CROSS BLUE SHIELD OF KANSAS (National Association of Insurance Commissioners NAIC id number: 70729 )

Policy contract number

09392

Policy instance

ADVANCE INSURANCE COMPANY OF KANSAS (National Association of Insurance Commissioners NAIC id number: 12143 )

Policy contract number

00009392

Policy instance

ADVANCE INSURANCE COMPANY OF KANSAS (National Association of Insurance Commissioners NAIC id number: 12143 )

Policy contract number

00009392

Policy instance

BLUE CROSS BLUE SHIELD OF KANSAS (National Association of Insurance Commissioners NAIC id number: 70729 )

Policy contract number

09392

Policy instance

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G00031201-0006

Policy instance

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G 00031201-0005

Policy instance

SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )

Policy contract number

042-1589-00

Policy instance

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G 00031201-0005

Policy instance

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G00031201-0006

Policy instance

BLUE CROSS BLUE SHIELD OF KANSAS (National Association of Insurance Commissioners NAIC id number: 70729 )

Policy contract number

09392

Policy instance

SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )

Policy contract number

042-1589-00

Policy instance

ADVANCE INSURANCE COMPANY OF KANSAS (National Association of Insurance Commissioners NAIC id number: 12143 )

Policy contract number

00009392

Policy instance

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Company Name:	FOURTH AVENUE HOLDING, LLC
Employer identification number (EIN):	901023644
NAIC Classification:	561440
NAIC Description:	Collection Agencies

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	2016-08-08
Company Identification Number:	0802516529
Legal Registered Office Address:	327 W 4TH AVE HUTCHINSON United States of America (USA) 67501