401k Plan data: SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO plan

SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO 401k Plan overview

Plan Name	SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO
Plan identification number	505

SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Temporary disability (accident and sickness)

401k Sponsoring company profile

BENJAMIN MOORE & CO. has sponsored the creation of one or more 401k plans.

Company Name: BENJAMIN MOORE & CO.

Employer identification number (EIN): 135256230

NAIC Classification: 325500

Additional information about BENJAMIN MOORE & CO.

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 1957-08-12

Company Identification Number: 0001833506

Legal Registered Office Address: 101 PARAGON DR

MONTVALE
United States of America (USA)
07645

More information about BENJAMIN MOORE & CO.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
505 2016-01-01 MICHAEL FARRELL
505 2015-01-01 MICHAEL FARRELL
505 2014-01-01 MICHAEL FARRELL
505 2013-01-01 MICHAEL FARRELL
505 2012-01-01 MICHAEL FARRELL
505 2011-01-01 MICHAEL FARRELL
505 2010-01-01 MICHAEL FARRELL
505 2009-01-01 MICHAEL FARRELL

Plan id#	Filing Submission Date	Name of Administrator
505	2016-01-01	MICHAEL FARRELL
505	2015-01-01	MICHAEL FARRELL
505	2014-01-01	MICHAEL FARRELL
505	2013-01-01	MICHAEL FARRELL
505	2012-01-01	MICHAEL FARRELL
505	2011-01-01	MICHAEL FARRELL
505	2010-01-01	MICHAEL FARRELL
505	2009-01-01	MICHAEL FARRELL

Plan Statistics for SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO

401k plan membership statisitcs for SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO

Measure Date Value
2016: SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO 2016 401k membership
Total participants, beginning-of-year 2016-01-01 1,517
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 0
2015: SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO 2015 401k membership
Total participants, beginning-of-year 2015-01-01 1,411
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 1,517
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 1,517
2014: SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO 2014 401k membership
Total participants, beginning-of-year 2014-01-01 1,438
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 1,411
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 1,411
2013: SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1,532
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 1,438
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 1,438
2012: SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1,391
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 1,532
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 1,532
2011: SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,420
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 1,391
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 1,391
2010: SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO 2010 401k membership
Total participants, beginning-of-year 2010-01-01 1,206
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 1,420
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 1,420
2009: SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO 2009 401k membership
Total participants, beginning-of-year 2009-01-01 1,416
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 1,206
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 1,206

Measure	Date	Value
2016: SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO 2016 401k membership
Total participants, beginning-of-year	2016-01-01	1,517
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	0
2015: SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO 2015 401k membership
Total participants, beginning-of-year	2015-01-01	1,411
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	1,517
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	1,517
2014: SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO 2014 401k membership
Total participants, beginning-of-year	2014-01-01	1,438
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	1,411
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	1,411
2013: SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,532
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	1,438
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	1,438
2012: SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,391
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	1,532
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	1,532
2011: SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,420
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1,391
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	1,391
2010: SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO 2010 401k membership
Total participants, beginning-of-year	2010-01-01	1,206
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	1,420
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	1,420
2009: SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,416
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1,206
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	1,206

Form 5500 Responses for SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO

2016: SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO 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	Yes
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 – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO 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 – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO 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 – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO 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 – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO 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 – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO 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 – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO 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 – General assets of the sponsor	Yes
2010-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: SICKNESS & ACCIDENT PLAN OF BENJAMIN MOORE & CO 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 – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

PO3-810-261309-

Policy instance

Insurance contract or identification number	PO3-810-261309-
Number of Individuals Covered	1517
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $88
Are there contracts with allocated funds for individual policies?	No
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	Yes
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 $38,445
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	88
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3
Insurance broker name	TOWERS WATSON PENNSYLVANIA INC

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

PO3-810-261309-

Policy instance

Insurance contract or identification number	PO3-810-261309-
Number of Individuals Covered	1499
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $877
Total amount of fees paid to insurance company	USD $877
Are there contracts with allocated funds for individual policies?	No
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	Yes
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 $37,050
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $877
Amount paid for insurance broker fees	877
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3
Insurance broker name	TOWERS WATSON PENNSYLVANIA INC

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Company Name:	BENJAMIN MOORE & CO.
Employer identification number (EIN):	135256230
NAIC Classification:	325500

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	1957-08-12
Company Identification Number:	0001833506
Legal Registered Office Address:	101 PARAGON DR MONTVALE United States of America (USA) 07645