401k Plan data: THE HEALTH CARE PLAN OF NCASI plan

THE HEALTH CARE PLAN OF NCASI 401k Plan overview

Plan Name	THE HEALTH CARE PLAN OF NCASI
Plan identification number	501

THE HEALTH CARE PLAN OF NCASI Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Dental Vision Other welfare benefit cover Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

NATIONAL COUNCIL FOR AIR AND STREAM IMPROVEMENT, INC. has sponsored the creation of one or more 401k plans.

Company Name: NATIONAL COUNCIL FOR AIR AND STREAM IMPROVEMENT, INC.

Employer identification number (EIN): 131085344

NAIC Classification: 541990
NAIC Description: All Other Professional, Scientific, and Technical Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE HEALTH CARE PLAN OF NCASI

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2017-07-01 TAMMERAH D. GARREN 2019-04-05
501 2016-07-01
501 2015-07-01
501 2014-07-01
501 2013-07-01 DIRK J. KROUSKOP
501 2012-07-01 RONALD YESKE
501 2011-07-01 RONALD A. YESKE
501 2010-07-01 RONALD A. YESKE
501 2009-07-01 DONNA SMITH

Plan Statistics for THE HEALTH CARE PLAN OF NCASI

401k plan membership statisitcs for THE HEALTH CARE PLAN OF NCASI

Measure Date Value
2017: THE HEALTH CARE PLAN OF NCASI 2017 401k membership
Total participants, beginning-of-year 2017-07-01 47
Total number of active participants reported on line 7a of the Form 5500 2017-07-01 45
Number of retired or separated participants receiving benefits 2017-07-01 1
Number of other retired or separated participants entitled to future benefits 2017-07-01 3
Total of all active and inactive participants 2017-07-01 49
2016: THE HEALTH CARE PLAN OF NCASI 2016 401k membership
Total participants, beginning-of-year 2016-07-01 52
Total number of active participants reported on line 7a of the Form 5500 2016-07-01 49
Number of retired or separated participants receiving benefits 2016-07-01 0
Number of other retired or separated participants entitled to future benefits 2016-07-01 0
Total of all active and inactive participants 2016-07-01 49
2015: THE HEALTH CARE PLAN OF NCASI 2015 401k membership
Total participants, beginning-of-year 2015-07-01 67
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 57
Number of retired or separated participants receiving benefits 2015-07-01 1
Total of all active and inactive participants 2015-07-01 58
2014: THE HEALTH CARE PLAN OF NCASI 2014 401k membership
Total participants, beginning-of-year 2014-07-01 62
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 60
Number of retired or separated participants receiving benefits 2014-07-01 9
Total of all active and inactive participants 2014-07-01 69
2013: THE HEALTH CARE PLAN OF NCASI 2013 401k membership
Total participants, beginning-of-year 2013-07-01 68
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 62
Number of retired or separated participants receiving benefits 2013-07-01 7
Total of all active and inactive participants 2013-07-01 69
2012: THE HEALTH CARE PLAN OF NCASI 2012 401k membership
Total participants, beginning-of-year 2012-07-01 70
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 64
Number of retired or separated participants receiving benefits 2012-07-01 2
Number of other retired or separated participants entitled to future benefits 2012-07-01 2
Total of all active and inactive participants 2012-07-01 68
2011: THE HEALTH CARE PLAN OF NCASI 2011 401k membership
Total participants, beginning-of-year 2011-07-01 75
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 68
Number of retired or separated participants receiving benefits 2011-07-01 1
Number of other retired or separated participants entitled to future benefits 2011-07-01 1
Total of all active and inactive participants 2011-07-01 70
2010: THE HEALTH CARE PLAN OF NCASI 2010 401k membership
Total participants, beginning-of-year 2010-07-01 90
Total number of active participants reported on line 7a of the Form 5500 2010-07-01 64
Number of retired or separated participants receiving benefits 2010-07-01 7
Number of other retired or separated participants entitled to future benefits 2010-07-01 4
Total of all active and inactive participants 2010-07-01 75
2009: THE HEALTH CARE PLAN OF NCASI 2009 401k membership
Total participants, beginning-of-year 2009-07-01 94
Total number of active participants reported on line 7a of the Form 5500 2009-07-01 78
Number of retired or separated participants receiving benefits 2009-07-01 7
Number of other retired or separated participants entitled to future benefits 2009-07-01 5
Total of all active and inactive participants 2009-07-01 90

Measure	Date	Value
2017: THE HEALTH CARE PLAN OF NCASI 2017 401k membership
Total participants, beginning-of-year	2017-07-01	47
Total number of active participants reported on line 7a of the Form 5500	2017-07-01	45
Number of retired or separated participants receiving benefits	2017-07-01	1
Number of other retired or separated participants entitled to future benefits	2017-07-01	3
Total of all active and inactive participants	2017-07-01	49
2016: THE HEALTH CARE PLAN OF NCASI 2016 401k membership
Total participants, beginning-of-year	2016-07-01	52
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	49
Number of retired or separated participants receiving benefits	2016-07-01	0
Number of other retired or separated participants entitled to future benefits	2016-07-01	0
Total of all active and inactive participants	2016-07-01	49
2015: THE HEALTH CARE PLAN OF NCASI 2015 401k membership
Total participants, beginning-of-year	2015-07-01	67
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	57
Number of retired or separated participants receiving benefits	2015-07-01	1
Total of all active and inactive participants	2015-07-01	58
2014: THE HEALTH CARE PLAN OF NCASI 2014 401k membership
Total participants, beginning-of-year	2014-07-01	62
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	60
Number of retired or separated participants receiving benefits	2014-07-01	9
Total of all active and inactive participants	2014-07-01	69
2013: THE HEALTH CARE PLAN OF NCASI 2013 401k membership
Total participants, beginning-of-year	2013-07-01	68
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	62
Number of retired or separated participants receiving benefits	2013-07-01	7
Total of all active and inactive participants	2013-07-01	69
2012: THE HEALTH CARE PLAN OF NCASI 2012 401k membership
Total participants, beginning-of-year	2012-07-01	70
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	64
Number of retired or separated participants receiving benefits	2012-07-01	2
Number of other retired or separated participants entitled to future benefits	2012-07-01	2
Total of all active and inactive participants	2012-07-01	68
2011: THE HEALTH CARE PLAN OF NCASI 2011 401k membership
Total participants, beginning-of-year	2011-07-01	75
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	68
Number of retired or separated participants receiving benefits	2011-07-01	1
Number of other retired or separated participants entitled to future benefits	2011-07-01	1
Total of all active and inactive participants	2011-07-01	70
2010: THE HEALTH CARE PLAN OF NCASI 2010 401k membership
Total participants, beginning-of-year	2010-07-01	90
Total number of active participants reported on line 7a of the Form 5500	2010-07-01	64
Number of retired or separated participants receiving benefits	2010-07-01	7
Number of other retired or separated participants entitled to future benefits	2010-07-01	4
Total of all active and inactive participants	2010-07-01	75
2009: THE HEALTH CARE PLAN OF NCASI 2009 401k membership
Total participants, beginning-of-year	2009-07-01	94
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	78
Number of retired or separated participants receiving benefits	2009-07-01	7
Number of other retired or separated participants entitled to future benefits	2009-07-01	5
Total of all active and inactive participants	2009-07-01	90

Financial Data on THE HEALTH CARE PLAN OF NCASI

Measure	Date	Value
2017 : THE HEALTH CARE PLAN OF NCASI 2017 401k financial data
Total income from all sources	2017-06-30	$891,900
Expenses. Total of all expenses incurred	2017-06-30	$731,361
Benefits paid (including direct rollovers)	2017-06-30	$730,534
Total plan assets at end of year	2017-06-30	$164,125
Total plan assets at beginning of year	2017-06-30	$3,586
Value of fidelity bond covering the plan	2017-06-30	$500,000
Total contributions received or receivable from participants	2017-06-30	$129,548
Expenses. Other expenses not covered elsewhere	2017-06-30	$827
Other income received	2017-06-30	$726,503
Net income (gross income less expenses)	2017-06-30	$160,539
Net plan assets at end of year (total assets less liabilities)	2017-06-30	$164,125
Net plan assets at beginning of year (total assets less liabilities)	2017-06-30	$3,586
Total contributions received or receivable from employer(s)	2017-06-30	$35,849
2016 : THE HEALTH CARE PLAN OF NCASI 2016 401k financial data
Total income from all sources	2016-06-30	$2,106,588
Expenses. Total of all expenses incurred	2016-06-30	$2,107,617
Benefits paid (including direct rollovers)	2016-06-30	$2,106,981
Total plan assets at end of year	2016-06-30	$3,586
Total plan assets at beginning of year	2016-06-30	$4,615
Value of fidelity bond covering the plan	2016-06-30	$500,000
Total contributions received or receivable from participants	2016-06-30	$224,707
Expenses. Other expenses not covered elsewhere	2016-06-30	$636
Net income (gross income less expenses)	2016-06-30	$-1,029
Net plan assets at end of year (total assets less liabilities)	2016-06-30	$3,586
Net plan assets at beginning of year (total assets less liabilities)	2016-06-30	$4,615
Total contributions received or receivable from employer(s)	2016-06-30	$1,881,881
2015 : THE HEALTH CARE PLAN OF NCASI 2015 401k financial data
Total income from all sources	2015-06-30	$1,284,533
Expenses. Total of all expenses incurred	2015-06-30	$1,335,506
Benefits paid (including direct rollovers)	2015-06-30	$1,334,937
Total plan assets at end of year	2015-06-30	$4,615
Total plan assets at beginning of year	2015-06-30	$55,588
Value of fidelity bond covering the plan	2015-06-30	$500,000
Total contributions received or receivable from participants	2015-06-30	$181,401
Expenses. Other expenses not covered elsewhere	2015-06-30	$569
Contributions received from other sources (not participants or employers)	2015-06-30	$0
Other income received	2015-06-30	$0
Net income (gross income less expenses)	2015-06-30	$-50,973
Net plan assets at end of year (total assets less liabilities)	2015-06-30	$4,615
Net plan assets at beginning of year (total assets less liabilities)	2015-06-30	$55,588
Total contributions received or receivable from employer(s)	2015-06-30	$1,103,132
2014 : THE HEALTH CARE PLAN OF NCASI 2014 401k financial data
Total plan liabilities at end of year	2014-06-30	$0
Total plan liabilities at beginning of year	2014-06-30	$40,827
Total income from all sources	2014-06-30	$869,844
Expenses. Total of all expenses incurred	2014-06-30	$1,021,786
Benefits paid (including direct rollovers)	2014-06-30	$1,021,203
Total plan assets at end of year	2014-06-30	$55,588
Total plan assets at beginning of year	2014-06-30	$248,357
Value of fidelity bond covering the plan	2014-06-30	$500,000
Total contributions received or receivable from participants	2014-06-30	$161,283
Expenses. Other expenses not covered elsewhere	2014-06-30	$583
Other income received	2014-06-30	$33,445
Net income (gross income less expenses)	2014-06-30	$-151,942
Net plan assets at end of year (total assets less liabilities)	2014-06-30	$55,588
Net plan assets at beginning of year (total assets less liabilities)	2014-06-30	$207,530
Total contributions received or receivable from employer(s)	2014-06-30	$675,116
2013 : THE HEALTH CARE PLAN OF NCASI 2013 401k financial data
Total plan liabilities at end of year	2013-06-30	$40,827
Total income from all sources	2013-06-30	$1,343,803
Expenses. Total of all expenses incurred	2013-06-30	$1,264,559
Benefits paid (including direct rollovers)	2013-06-30	$1,264,027
Total plan assets at end of year	2013-06-30	$248,357
Total plan assets at beginning of year	2013-06-30	$128,286
Value of fidelity bond covering the plan	2013-06-30	$500,000
Total contributions received or receivable from participants	2013-06-30	$171,699
Expenses. Other expenses not covered elsewhere	2013-06-30	$532
Other income received	2013-06-30	$30,647
Net income (gross income less expenses)	2013-06-30	$79,244
Net plan assets at end of year (total assets less liabilities)	2013-06-30	$207,530
Net plan assets at beginning of year (total assets less liabilities)	2013-06-30	$128,286
Total contributions received or receivable from employer(s)	2013-06-30	$1,141,457
2012 : THE HEALTH CARE PLAN OF NCASI 2012 401k financial data
Total income from all sources	2012-06-30	$1,188,248
Expenses. Total of all expenses incurred	2012-06-30	$1,217,171
Benefits paid (including direct rollovers)	2012-06-30	$1,216,596
Total plan assets at end of year	2012-06-30	$128,286
Total plan assets at beginning of year	2012-06-30	$157,209
Value of fidelity bond covering the plan	2012-06-30	$500,000
Total contributions received or receivable from participants	2012-06-30	$107,368
Expenses. Other expenses not covered elsewhere	2012-06-30	$575
Other income received	2012-06-30	$6,696
Net income (gross income less expenses)	2012-06-30	$-28,923
Net plan assets at end of year (total assets less liabilities)	2012-06-30	$128,286
Net plan assets at beginning of year (total assets less liabilities)	2012-06-30	$157,209
Total contributions received or receivable from employer(s)	2012-06-30	$1,074,184
2011 : THE HEALTH CARE PLAN OF NCASI 2011 401k financial data
Total income from all sources	2011-06-30	$970,295
Expenses. Total of all expenses incurred	2011-06-30	$997,251
Benefits paid (including direct rollovers)	2011-06-30	$996,230
Total plan assets at end of year	2011-06-30	$157,209
Total plan assets at beginning of year	2011-06-30	$184,165
Value of fidelity bond covering the plan	2011-06-30	$500,000
Total contributions received or receivable from participants	2011-06-30	$119,978
Expenses. Other expenses not covered elsewhere	2011-06-30	$1,021
Other income received	2011-06-30	$-13,948
Net income (gross income less expenses)	2011-06-30	$-26,956
Net plan assets at end of year (total assets less liabilities)	2011-06-30	$157,209
Net plan assets at beginning of year (total assets less liabilities)	2011-06-30	$184,165
Total contributions received or receivable from employer(s)	2011-06-30	$864,265

Form 5500 Responses for THE HEALTH CARE PLAN OF NCASI

2017: THE HEALTH CARE PLAN OF NCASI 2017 form 5500 responses
2017-07-01	Type of plan entity	Single employer plan
2017-07-01	Submission has been amended	No
2017-07-01	This submission is the final filing	No
2017-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-07-01	Plan is a collectively bargained plan	No
2017-07-01	Plan funding arrangement – Insurance	Yes
2017-07-01	Plan funding arrangement – Trust	Yes
2017-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-07-01	Plan benefit arrangement – Insurance	Yes
2017-07-01	Plan benefit arrangement - Trust	Yes
2017-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: THE HEALTH CARE PLAN OF NCASI 2016 form 5500 responses
2016-07-01	Type of plan entity	Single employer plan
2016-07-01	Submission has been amended	No
2016-07-01	This submission is the final filing	No
2016-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-07-01	Plan is a collectively bargained plan	No
2016-07-01	Plan funding arrangement – Insurance	Yes
2016-07-01	Plan funding arrangement – Trust	Yes
2016-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-07-01	Plan benefit arrangement – Insurance	Yes
2016-07-01	Plan benefit arrangement - Trust	Yes
2016-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: THE HEALTH CARE PLAN OF NCASI 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	Submission has been amended	No
2015-07-01	This submission is the final filing	No
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-07-01	Plan is a collectively bargained plan	No
2015-07-01	Plan funding arrangement – Trust	Yes
2015-07-01	Plan benefit arrangement - Trust	Yes
2014: THE HEALTH CARE PLAN OF NCASI 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	Submission has been amended	No
2014-07-01	This submission is the final filing	No
2014-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-07-01	Plan is a collectively bargained plan	No
2014-07-01	Plan funding arrangement – Trust	Yes
2014-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-07-01	Plan benefit arrangement - Trust	Yes
2014-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: THE HEALTH CARE PLAN OF NCASI 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
2013-07-01	Submission has been amended	No
2013-07-01	This submission is the final filing	No
2013-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-07-01	Plan is a collectively bargained plan	No
2013-07-01	Plan funding arrangement – Trust	Yes
2013-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-07-01	Plan benefit arrangement - Trust	Yes
2013-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: THE HEALTH CARE PLAN OF NCASI 2012 form 5500 responses
2012-07-01	Type of plan entity	Single employer plan
2012-07-01	Submission has been amended	No
2012-07-01	This submission is the final filing	No
2012-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-07-01	Plan is a collectively bargained plan	No
2012-07-01	Plan funding arrangement – Trust	Yes
2012-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-07-01	Plan benefit arrangement - Trust	Yes
2012-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: THE HEALTH CARE PLAN OF NCASI 2011 form 5500 responses
2011-07-01	Type of plan entity	Single employer plan
2011-07-01	Submission has been amended	No
2011-07-01	This submission is the final filing	No
2011-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-07-01	Plan is a collectively bargained plan	No
2011-07-01	Plan funding arrangement – Trust	Yes
2011-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-07-01	Plan benefit arrangement - Trust	Yes
2011-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: THE HEALTH CARE PLAN OF NCASI 2010 form 5500 responses
2010-07-01	Type of plan entity	Single employer plan
2010-07-01	Submission has been amended	No
2010-07-01	This submission is the final filing	No
2010-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-07-01	Plan is a collectively bargained plan	No
2010-07-01	Plan funding arrangement – Trust	Yes
2010-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-07-01	Plan benefit arrangement - Trust	Yes
2010-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: THE HEALTH CARE PLAN OF NCASI 2009 form 5500 responses
2009-07-01	Type of plan entity	Single employer plan
2009-07-01	Submission has been amended	No
2009-07-01	This submission is the final filing	No
2009-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-07-01	Plan is a collectively bargained plan	No
2009-07-01	Plan funding arrangement – Trust	Yes
2009-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-07-01	Plan benefit arrangement - Trust	Yes
2009-07-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )

Policy contract number

081824

Policy instance

Insurance contract or identification number	081824
Number of Individuals Covered	99
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $18,208
Total amount of fees paid to insurance company	USD $0
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 $815,462
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	NATIONAL COUNCIL FOR AIR AND STREAM IMPROVEMENT, INC.
Employer identification number (EIN):	131085344
NAIC Classification:	541990
NAIC Description:	All Other Professional, Scientific, and Technical Services

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2017-07-01	TAMMERAH D. GARREN	2019-04-05
501	2016-07-01
501	2015-07-01
501	2014-07-01
501	2013-07-01	DIRK J. KROUSKOP
501	2012-07-01	RONALD YESKE
501	2011-07-01	RONALD A. YESKE
501	2010-07-01	RONALD A. YESKE
501	2009-07-01	DONNA SMITH