401k Plan data: ASHLAND FOOD COOPERATIVE HEALTH PLAN plan

ASHLAND FOOD COOPERATIVE HEALTH PLAN 401k Plan overview

Plan Name	ASHLAND FOOD COOPERATIVE HEALTH PLAN
Plan identification number	501

ASHLAND FOOD COOPERATIVE HEALTH 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 Other welfare benefit cover

401k Sponsoring company profile

ASHLAND FOOD COOPERATIVE has sponsored the creation of one or more 401k plans.

Company Name: ASHLAND FOOD COOPERATIVE

Employer identification number (EIN): 930634581

NAIC Classification: 445110
NAIC Description: Supermarkets and Other Grocery (except Convenience) Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ASHLAND FOOD COOPERATIVE HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2017-01-01 SHARON VAN DUKER SHARON VAN DUKER 2018-07-30
501 2016-01-01 SHARON VAN DUKER SHARON VAN DUKER 2017-06-19
501 2015-01-01 SHARON VAN DUKER SHARON VAN DUKER 2016-09-19
501 2014-01-01 SHARON VAN DUKER SHARON VAN DUKER 2015-07-28
501 2013-01-01 SHARON VAN DUKER SHARON VAN DUKER 2014-07-28
501 2012-01-01 SHARON VAN DUKER SHARON VAN DUKER 2013-06-25
501 2011-01-01 SHARON VAN DUKER
501 2010-01-01 SHARON VAN DUKER
501 2009-01-01 SHARON VAN DUKER 2010-10-13
501 2009-01-01 SHARON VAN DUKER

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2017-01-01	SHARON VAN DUKER	SHARON VAN DUKER	2018-07-30
501	2016-01-01	SHARON VAN DUKER	SHARON VAN DUKER	2017-06-19
501	2015-01-01	SHARON VAN DUKER	SHARON VAN DUKER	2016-09-19
501	2014-01-01	SHARON VAN DUKER	SHARON VAN DUKER	2015-07-28
501	2013-01-01	SHARON VAN DUKER	SHARON VAN DUKER	2014-07-28
501	2012-01-01	SHARON VAN DUKER	SHARON VAN DUKER	2013-06-25
501	2011-01-01	SHARON VAN DUKER
501	2010-01-01	SHARON VAN DUKER
501	2009-01-01		SHARON VAN DUKER	2010-10-13
501	2009-01-01	SHARON VAN DUKER

Plan Statistics for ASHLAND FOOD COOPERATIVE HEALTH PLAN

401k plan membership statisitcs for ASHLAND FOOD COOPERATIVE HEALTH PLAN

Measure Date Value
2017: ASHLAND FOOD COOPERATIVE HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 156
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 151
Total of all active and inactive participants 2017-01-01 151
Total participants 2017-01-01 151
2016: ASHLAND FOOD COOPERATIVE HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 155
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 156
Total of all active and inactive participants 2016-01-01 156
Total participants 2016-01-01 156
2015: ASHLAND FOOD COOPERATIVE HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 152
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 153
Total of all active and inactive participants 2015-01-01 153
Total participants 2015-01-01 153
2014: ASHLAND FOOD COOPERATIVE HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 148
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 154
Total of all active and inactive participants 2014-01-01 154
Total participants 2014-01-01 154
2013: ASHLAND FOOD COOPERATIVE HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 145
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 154
Total of all active and inactive participants 2013-01-01 154
Total participants 2013-01-01 154
2012: ASHLAND FOOD COOPERATIVE HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 129
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 145
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 145
2011: ASHLAND FOOD COOPERATIVE HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 129
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 139
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 139
Total participants 2011-01-01 139
2010: ASHLAND FOOD COOPERATIVE HEALTH PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 123
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 129
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 129
Total participants 2010-01-01 129
2009: ASHLAND FOOD COOPERATIVE HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 124
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 133
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 133

Measure	Date	Value
2017: ASHLAND FOOD COOPERATIVE HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	156
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	151
Total of all active and inactive participants	2017-01-01	151
Total participants	2017-01-01	151
2016: ASHLAND FOOD COOPERATIVE HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	155
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	156
Total of all active and inactive participants	2016-01-01	156
Total participants	2016-01-01	156
2015: ASHLAND FOOD COOPERATIVE HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	152
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	153
Total of all active and inactive participants	2015-01-01	153
Total participants	2015-01-01	153
2014: ASHLAND FOOD COOPERATIVE HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	148
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	154
Total of all active and inactive participants	2014-01-01	154
Total participants	2014-01-01	154
2013: ASHLAND FOOD COOPERATIVE HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	145
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	154
Total of all active and inactive participants	2013-01-01	154
Total participants	2013-01-01	154
2012: ASHLAND FOOD COOPERATIVE HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	129
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	145
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	145
2011: ASHLAND FOOD COOPERATIVE HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	129
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	139
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	139
Total participants	2011-01-01	139
2010: ASHLAND FOOD COOPERATIVE HEALTH PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	123
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	129
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	129
Total participants	2010-01-01	129
2009: ASHLAND FOOD COOPERATIVE HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	124
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	133
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	133

Form 5500 Responses for ASHLAND FOOD COOPERATIVE HEALTH PLAN

2017: ASHLAND FOOD COOPERATIVE HEALTH PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: ASHLAND FOOD COOPERATIVE HEALTH PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: ASHLAND FOOD COOPERATIVE HEALTH 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 funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: ASHLAND FOOD COOPERATIVE HEALTH PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
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 funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: ASHLAND FOOD COOPERATIVE HEALTH PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: ASHLAND FOOD COOPERATIVE HEALTH PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: ASHLAND FOOD COOPERATIVE HEALTH PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: ASHLAND FOOD COOPERATIVE HEALTH PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: ASHLAND FOOD COOPERATIVE HEALTH PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number	947-4597
Policy instance	2
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract number	WVT000169
Policy instance	1
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number	527009520064
Policy instance	2
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract number	WBT000169
Policy instance	1
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number	527009520064
Policy instance	1
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract number	WBT000169
Policy instance	2
RELIANT BEHAVIORAL HEALTH (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	15021688
Policy instance	3
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract number	WBT000169
Policy instance	2
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number	527009520064
Policy instance	1
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract number	WBT000169
Policy instance	2
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number	527009520064
Policy instance	1
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number	527009520064
Policy instance	1
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract number	WBT000169
Policy instance	2
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract number	WBT000169
Policy instance	2
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	527008520064
Policy instance	1

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Company Name:	ASHLAND FOOD COOPERATIVE
Employer identification number (EIN):	930634581
NAIC Classification:	445110
NAIC Description:	Supermarkets and Other Grocery (except Convenience) Stores