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SIX ROBBLEES INC. WELFARE BENEFIT PLAN 401k Plan overview

Plan NameSIX ROBBLEES INC. WELFARE BENEFIT PLAN
Plan identification number 501

SIX ROBBLEES INC. WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

SIX ROBBLEES INC. has sponsored the creation of one or more 401k plans.

Company Name:SIX ROBBLEES INC.
Employer identification number (EIN):910412250
NAIC Classification:423100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SIX ROBBLEES INC. WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-10-01MATTHEW MOONEY2024-03-13
5012021-10-01MATTHEW MOONEY2023-01-30
5012020-10-01MATTHEW MOONEY2022-01-25
5012019-10-01MATTHEW MOONEY2021-02-15
5012017-10-01
5012016-10-01
5012015-10-01MATTHEW MOONEY
5012014-10-01MATTHEW MOONEY
5012013-10-01MATTHEW MOONEY
5012012-10-01RICHARD W. METCALF
5012011-10-01RICHARD W METCALF
5012009-10-01
5012009-10-01RICHARD METCALF RIHCARD METCALF2011-04-26

Plan Statistics for SIX ROBBLEES INC. WELFARE BENEFIT PLAN

401k plan membership statisitcs for SIX ROBBLEES INC. WELFARE BENEFIT PLAN

Measure Date Value
2022: SIX ROBBLEES INC. WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-10-01137
Total number of active participants reported on line 7a of the Form 55002022-10-01151
Number of retired or separated participants receiving benefits2022-10-010
Number of other retired or separated participants entitled to future benefits2022-10-010
Total of all active and inactive participants2022-10-01151
Number of employers contributing to the scheme2022-10-010
2021: SIX ROBBLEES INC. WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-10-01151
Total number of active participants reported on line 7a of the Form 55002021-10-01137
Number of retired or separated participants receiving benefits2021-10-010
Number of other retired or separated participants entitled to future benefits2021-10-010
Total of all active and inactive participants2021-10-01137
Number of employers contributing to the scheme2021-10-010
2020: SIX ROBBLEES INC. WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-10-01148
Total number of active participants reported on line 7a of the Form 55002020-10-01151
Number of retired or separated participants receiving benefits2020-10-010
Number of other retired or separated participants entitled to future benefits2020-10-010
Total of all active and inactive participants2020-10-01151
Number of employers contributing to the scheme2020-10-010
2019: SIX ROBBLEES INC. WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-10-01171
Total number of active participants reported on line 7a of the Form 55002019-10-01146
Number of retired or separated participants receiving benefits2019-10-010
Number of other retired or separated participants entitled to future benefits2019-10-010
Total of all active and inactive participants2019-10-01146
Number of employers contributing to the scheme2019-10-010
2017: SIX ROBBLEES INC. WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-10-01161
Total number of active participants reported on line 7a of the Form 55002017-10-01170
Number of retired or separated participants receiving benefits2017-10-010
Number of other retired or separated participants entitled to future benefits2017-10-010
Total of all active and inactive participants2017-10-01170
Number of employers contributing to the scheme2017-10-010
2016: SIX ROBBLEES INC. WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-01167
Total number of active participants reported on line 7a of the Form 55002016-10-01161
Number of retired or separated participants receiving benefits2016-10-010
Number of other retired or separated participants entitled to future benefits2016-10-010
Total of all active and inactive participants2016-10-01161
2015: SIX ROBBLEES INC. WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-01174
Total number of active participants reported on line 7a of the Form 55002015-10-01167
Number of retired or separated participants receiving benefits2015-10-010
Number of other retired or separated participants entitled to future benefits2015-10-010
Total of all active and inactive participants2015-10-01167
2014: SIX ROBBLEES INC. WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-10-01180
Total number of active participants reported on line 7a of the Form 55002014-10-01178
Number of retired or separated participants receiving benefits2014-10-010
Number of other retired or separated participants entitled to future benefits2014-10-010
Total of all active and inactive participants2014-10-01178
2013: SIX ROBBLEES INC. WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-10-01154
Total number of active participants reported on line 7a of the Form 55002013-10-01173
Number of retired or separated participants receiving benefits2013-10-010
Number of other retired or separated participants entitled to future benefits2013-10-010
Total of all active and inactive participants2013-10-01173
2012: SIX ROBBLEES INC. WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-10-01154
Total number of active participants reported on line 7a of the Form 55002012-10-01159
Number of retired or separated participants receiving benefits2012-10-012
Number of other retired or separated participants entitled to future benefits2012-10-010
Total of all active and inactive participants2012-10-01161
2011: SIX ROBBLEES INC. WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-10-01153
Total number of active participants reported on line 7a of the Form 55002011-10-01152
Number of retired or separated participants receiving benefits2011-10-012
Number of other retired or separated participants entitled to future benefits2011-10-010
Total of all active and inactive participants2011-10-01154
2009: SIX ROBBLEES INC. WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-10-01161
Total number of active participants reported on line 7a of the Form 55002009-10-01148
Number of retired or separated participants receiving benefits2009-10-013
Number of other retired or separated participants entitled to future benefits2009-10-010
Total of all active and inactive participants2009-10-01151

Form 5500 Responses for SIX ROBBLEES INC. WELFARE BENEFIT PLAN

2022: SIX ROBBLEES INC. WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-10-01Type of plan entitySingle employer plan
2022-10-01Plan funding arrangement – InsuranceYes
2022-10-01Plan funding arrangement – General assets of the sponsorYes
2022-10-01Plan benefit arrangement – InsuranceYes
2022-10-01Plan benefit arrangement – General assets of the sponsorYes
2021: SIX ROBBLEES INC. WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-10-01Type of plan entitySingle employer plan
2021-10-01Plan funding arrangement – InsuranceYes
2021-10-01Plan funding arrangement – General assets of the sponsorYes
2021-10-01Plan benefit arrangement – InsuranceYes
2021-10-01Plan benefit arrangement – General assets of the sponsorYes
2020: SIX ROBBLEES INC. WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-10-01Type of plan entitySingle employer plan
2020-10-01Plan funding arrangement – InsuranceYes
2020-10-01Plan funding arrangement – General assets of the sponsorYes
2020-10-01Plan benefit arrangement – InsuranceYes
2020-10-01Plan benefit arrangement – General assets of the sponsorYes
2019: SIX ROBBLEES INC. WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01Plan funding arrangement – InsuranceYes
2019-10-01Plan funding arrangement – General assets of the sponsorYes
2019-10-01Plan benefit arrangement – InsuranceYes
2019-10-01Plan benefit arrangement – General assets of the sponsorYes
2017: SIX ROBBLEES INC. WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan funding arrangement – General assets of the sponsorYes
2017-10-01Plan benefit arrangement – InsuranceYes
2017-10-01Plan benefit arrangement – General assets of the sponsorYes
2016: SIX ROBBLEES INC. WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Submission has been amendedNo
2016-10-01This submission is the final filingNo
2016-10-01This return/report is a short plan year return/report (less than 12 months)No
2016-10-01Plan is a collectively bargained planNo
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan funding arrangement – General assets of the sponsorYes
2016-10-01Plan benefit arrangement – InsuranceYes
2016-10-01Plan benefit arrangement – General assets of the sponsorYes
2015: SIX ROBBLEES INC. WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Submission has been amendedNo
2015-10-01This submission is the final filingNo
2015-10-01This return/report is a short plan year return/report (less than 12 months)No
2015-10-01Plan is a collectively bargained planNo
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan funding arrangement – General assets of the sponsorYes
2015-10-01Plan benefit arrangement – InsuranceYes
2015-10-01Plan benefit arrangement – General assets of the sponsorYes
2014: SIX ROBBLEES INC. WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Submission has been amendedNo
2014-10-01This submission is the final filingNo
2014-10-01This return/report is a short plan year return/report (less than 12 months)No
2014-10-01Plan is a collectively bargained planNo
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan funding arrangement – General assets of the sponsorYes
2014-10-01Plan benefit arrangement – InsuranceYes
2014-10-01Plan benefit arrangement – General assets of the sponsorYes
2013: SIX ROBBLEES INC. WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Submission has been amendedNo
2013-10-01This submission is the final filingNo
2013-10-01This return/report is a short plan year return/report (less than 12 months)No
2013-10-01Plan is a collectively bargained planNo
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan funding arrangement – General assets of the sponsorYes
2013-10-01Plan benefit arrangement – InsuranceYes
2013-10-01Plan benefit arrangement – General assets of the sponsorYes
2012: SIX ROBBLEES INC. WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Submission has been amendedNo
2012-10-01This submission is the final filingNo
2012-10-01This return/report is a short plan year return/report (less than 12 months)No
2012-10-01Plan is a collectively bargained planNo
2012-10-01Plan funding arrangement – InsuranceYes
2012-10-01Plan funding arrangement – General assets of the sponsorYes
2012-10-01Plan benefit arrangement – InsuranceYes
2012-10-01Plan benefit arrangement – General assets of the sponsorYes
2011: SIX ROBBLEES INC. WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-10-01Type of plan entitySingle employer plan
2011-10-01Submission has been amendedNo
2011-10-01This submission is the final filingNo
2011-10-01This return/report is a short plan year return/report (less than 12 months)No
2011-10-01Plan is a collectively bargained planNo
2011-10-01Plan funding arrangement – InsuranceYes
2011-10-01Plan funding arrangement – General assets of the sponsorYes
2011-10-01Plan benefit arrangement – InsuranceYes
2011-10-01Plan benefit arrangement – General assets of the sponsorYes
2009: SIX ROBBLEES INC. WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-10-01Type of plan entitySingle employer plan
2009-10-01Submission has been amendedNo
2009-10-01This submission is the final filingNo
2009-10-01This return/report is a short plan year return/report (less than 12 months)No
2009-10-01Plan is a collectively bargained planNo
2009-10-01Plan funding arrangement – InsuranceYes
2009-10-01Plan funding arrangement – General assets of the sponsorYes
2009-10-01Plan benefit arrangement – InsuranceYes
2009-10-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberGRP00002322
Policy instance 1
Insurance contract or identification numberGRP00002322
Number of Individuals Covered151
Insurance policy start date2022-10-01
Insurance policy end date2023-09-30
Total amount of commissions paid to insurance brokerUSD $816
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $16,320
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $816
Amount paid for insurance broker fees0
Insurance broker organization code?3
COMMENCEMENT BAY RISK MANAGEMENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 78879 )
Policy contract numberGRP00002322
Policy instance 1
Insurance contract or identification numberGRP00002322
Number of Individuals Covered199
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $439,151
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberGRP00002322
Policy instance 1
Insurance contract or identification numberGRP00002322
Number of Individuals Covered148
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $752
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $15,030
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $752
Amount paid for insurance broker fees0
Insurance broker organization code?3
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberGRP00002322
Policy instance 1
Insurance contract or identification numberGRP00002322
Number of Individuals Covered146
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $820
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $16,403
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $820
Amount paid for insurance broker fees0
Insurance broker organization code?3

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