401k Plan data: ASSOCIATED BUILDERS AND CONTRACTORS, INDIANA/KENTUCKY CHAPTER, INC. 401K PROFIT SHARING PLAN plan

ASSOCIATED BUILDERS AND CONTRACTORS, INDIANA/KENTUCKY CHAPTER, INC. 401K PROFIT SHARING PLAN 401k Plan overview

Plan Name	ASSOCIATED BUILDERS AND CONTRACTORS, INDIANA/KENTUCKY CHAPTER, INC. 401K PROFIT SHARING PLAN
Plan identification number	001

ASSOCIATED BUILDERS AND CONTRACTORS, INDIANA/KENTUCKY CHAPTER, INC. 401K PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

ASSOCIATED BUILDERS AND CONTRACTORS INDIANA/KENTUCKY CHAPTER, INC. has sponsored the creation of one or more 401k plans.

Company Name: ASSOCIATED BUILDERS AND CONTRACTORS INDIANA/KENTUCKY CHAPTER, INC.

Employer identification number (EIN): 237298705

NAIC Classification: 238900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ASSOCIATED BUILDERS AND CONTRACTORS, INDIANA/KENTUCKY CHAPTER, INC. 401K PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01 ANTHONY WARREN 2022-08-12
001 2020-01-01 ADAM WARREN 2021-05-24
001 2019-01-01 ADAM WARREN 2020-09-11
001 2018-01-01 JOHN R GAYLOR 2019-09-29
001 2017-01-01
001 2016-01-01
001 2015-01-01 JOHN R GAYLOR
001 2015-01-01 JOHN R GAYLOR
001 2014-01-01 JOHN R GAYLOR

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01
001	2021-01-01	ANTHONY WARREN	2022-08-12
001	2020-01-01	ADAM WARREN	2021-05-24
001	2019-01-01	ADAM WARREN	2020-09-11
001	2018-01-01	JOHN R GAYLOR	2019-09-29
001	2017-01-01
001	2016-01-01
001	2015-01-01	JOHN R GAYLOR
001	2015-01-01	JOHN R GAYLOR
001	2014-01-01	JOHN R GAYLOR

Plan Statistics for ASSOCIATED BUILDERS AND CONTRACTORS, INDIANA/KENTUCKY CHAPTER, INC. 401K PROFIT SHARING PLAN

401k plan membership statisitcs for ASSOCIATED BUILDERS AND CONTRACTORS, INDIANA/KENTUCKY CHAPTER, INC. 401K PROFIT SHARING PLAN

Measure Date Value
2018: ASSOCIATED BUILDERS AND CONTRACTORS, INDIANA/KENTUCKY CHAPTER, INC. 401K PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 66
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 22
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 1
Total of all active and inactive participants 2018-01-01 23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 23
Number of participants with account balances 2018-01-01 23
2017: ASSOCIATED BUILDERS AND CONTRACTORS, INDIANA/KENTUCKY CHAPTER, INC. 401K PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 43
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 46
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 2
Total of all active and inactive participants 2017-01-01 48
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 48
Number of participants with account balances 2017-01-01 37
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: ASSOCIATED BUILDERS AND CONTRACTORS, INDIANA/KENTUCKY CHAPTER, INC. 401K PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 16
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 43
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 43
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 43
Number of participants with account balances 2016-01-01 43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: ASSOCIATED BUILDERS AND CONTRACTORS, INDIANA/KENTUCKY CHAPTER, INC. 401K PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 16
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 16
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 16
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 16
Number of participants with account balances 2015-01-01 16
2014: ASSOCIATED BUILDERS AND CONTRACTORS, INDIANA/KENTUCKY CHAPTER, INC. 401K PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 0
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 16
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 16
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 16
Number of participants with account balances 2014-01-01 16
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0

Measure	Date	Value
2018: ASSOCIATED BUILDERS AND CONTRACTORS, INDIANA/KENTUCKY CHAPTER, INC. 401K PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	66
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	22
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	1
Total of all active and inactive participants	2018-01-01	23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	23
Number of participants with account balances	2018-01-01	23
2017: ASSOCIATED BUILDERS AND CONTRACTORS, INDIANA/KENTUCKY CHAPTER, INC. 401K PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	43
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	46
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	2
Total of all active and inactive participants	2017-01-01	48
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	48
Number of participants with account balances	2017-01-01	37
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: ASSOCIATED BUILDERS AND CONTRACTORS, INDIANA/KENTUCKY CHAPTER, INC. 401K PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	16
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	43
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	43
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	43
Number of participants with account balances	2016-01-01	43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: ASSOCIATED BUILDERS AND CONTRACTORS, INDIANA/KENTUCKY CHAPTER, INC. 401K PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	16
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	16
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	16
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	16
Number of participants with account balances	2015-01-01	16
2014: ASSOCIATED BUILDERS AND CONTRACTORS, INDIANA/KENTUCKY CHAPTER, INC. 401K PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	0
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	16
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	16
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	16
Number of participants with account balances	2014-01-01	16
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0

Financial Data on ASSOCIATED BUILDERS AND CONTRACTORS, INDIANA/KENTUCKY CHAPTER, INC. 401K PROFIT SHARING PLAN

Measure	Date	Value
2018 : ASSOCIATED BUILDERS AND CONTRACTORS, INDIANA/KENTUCKY CHAPTER, INC. 401K PROFIT SHARING PLAN 2018 401k financial data
Total income from all sources	2018-12-31	$112,697
Expenses. Total of all expenses incurred	2018-12-31	$192,733
Benefits paid (including direct rollovers)	2018-12-31	$187,693
Total plan assets at end of year	2018-12-31	$601,463
Total plan assets at beginning of year	2018-12-31	$681,499
Value of fidelity bond covering the plan	2018-12-31	$100,000
Total contributions received or receivable from participants	2018-12-31	$92,210
Contributions received from other sources (not participants or employers)	2018-12-31	$7,048
Other income received	2018-12-31	$-20,389
Net income (gross income less expenses)	2018-12-31	$-80,036
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$601,463
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$681,499
Total contributions received or receivable from employer(s)	2018-12-31	$33,828
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$5,040
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
2017 : ASSOCIATED BUILDERS AND CONTRACTORS, INDIANA/KENTUCKY CHAPTER, INC. 401K PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources	2017-12-31	$236,076
Expenses. Total of all expenses incurred	2017-12-31	$86,185
Benefits paid (including direct rollovers)	2017-12-31	$81,907
Total plan assets at end of year	2017-12-31	$681,499
Total plan assets at beginning of year	2017-12-31	$531,608
Value of fidelity bond covering the plan	2017-12-31	$100,000
Total contributions received or receivable from participants	2017-12-31	$123,209
Contributions received from other sources (not participants or employers)	2017-12-31	$24,913
Other income received	2017-12-31	$44,222
Net income (gross income less expenses)	2017-12-31	$149,891
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$681,499
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$531,608
Total contributions received or receivable from employer(s)	2017-12-31	$43,732
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$4,278
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : ASSOCIATED BUILDERS AND CONTRACTORS, INDIANA/KENTUCKY CHAPTER, INC. 401K PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$233,121
Expenses. Total of all expenses incurred	2016-12-31	$6,865
Benefits paid (including direct rollovers)	2016-12-31	$3,703
Total plan assets at end of year	2016-12-31	$531,608
Total plan assets at beginning of year	2016-12-31	$305,352
Value of fidelity bond covering the plan	2016-12-31	$100,000
Total contributions received or receivable from participants	2016-12-31	$108,580
Contributions received from other sources (not participants or employers)	2016-12-31	$38,678
Other income received	2016-12-31	$29,284
Net income (gross income less expenses)	2016-12-31	$226,256
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$531,608
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$305,352
Total contributions received or receivable from employer(s)	2016-12-31	$56,579
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$3,162
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : ASSOCIATED BUILDERS AND CONTRACTORS, INDIANA/KENTUCKY CHAPTER, INC. 401K PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$73,294
Expenses. Total of all expenses incurred	2015-12-31	$1,495
Benefits paid (including direct rollovers)	2015-12-31	$276
Total plan assets at end of year	2015-12-31	$305,352
Total plan assets at beginning of year	2015-12-31	$233,553
Value of fidelity bond covering the plan	2015-12-31	$100,000
Total contributions received or receivable from participants	2015-12-31	$48,114
Other income received	2015-12-31	$-13,153
Noncash contributions received	2015-12-31	$4,786
Net income (gross income less expenses)	2015-12-31	$71,799
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$305,352
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$233,553
Total contributions received or receivable from employer(s)	2015-12-31	$33,547
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$1,219
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : ASSOCIATED BUILDERS AND CONTRACTORS, INDIANA/KENTUCKY CHAPTER, INC. 401K PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$234,468
Expenses. Total of all expenses incurred	2014-12-31	$915
Benefits paid (including direct rollovers)	2014-12-31	$705
Total plan assets at end of year	2014-12-31	$233,553
Total plan assets at beginning of year	2014-12-31	$0
Value of fidelity bond covering the plan	2014-12-31	$100,000
Total contributions received or receivable from participants	2014-12-31	$23,425
Contributions received from other sources (not participants or employers)	2014-12-31	$192,371
Other income received	2014-12-31	$-423
Net income (gross income less expenses)	2014-12-31	$233,553
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$233,553
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$0
Total contributions received or receivable from employer(s)	2014-12-31	$19,095
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$210
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0

Form 5500 Responses for ASSOCIATED BUILDERS AND CONTRACTORS, INDIANA/KENTUCKY CHAPTER, INC. 401K PROFIT SHARING PLAN

2018: ASSOCIATED BUILDERS AND CONTRACTORS, INDIANA/KENTUCKY CHAPTER, INC. 401K PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Mulitple employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: ASSOCIATED BUILDERS AND CONTRACTORS, INDIANA/KENTUCKY CHAPTER, INC. 401K PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Mulitple 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 – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: ASSOCIATED BUILDERS AND CONTRACTORS, INDIANA/KENTUCKY CHAPTER, INC. 401K PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Mulitple 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 – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: ASSOCIATED BUILDERS AND CONTRACTORS, INDIANA/KENTUCKY CHAPTER, INC. 401K PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Mulitple 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 – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: ASSOCIATED BUILDERS AND CONTRACTORS, INDIANA/KENTUCKY CHAPTER, INC. 401K PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Mulitple 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 – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )

Policy contract number

631826

Policy instance

Insurance contract or identification number	631826
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $915
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	No
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
Amount paid for insurance broker fees	565
Additional information about fees paid to insurance broker	BROKER FEES
Insurance broker organization code?	3

ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )

Policy contract number

631826

Policy instance

Insurance contract or identification number	631826
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $2,596
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	No
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
Amount paid for insurance broker fees	1201
Additional information about fees paid to insurance broker	BROKER FEES
Insurance broker organization code?	3
Insurance broker name	SWBC INVESTEMENT ADVISORY SERV.LLC

ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )

Policy contract number

631826

Policy instance

Insurance contract or identification number	631826
Number of Individuals Covered	14
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $355
Total amount of fees paid to insurance company	USD $0
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	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
Commission paid to Insurance Broker	USD $322
Insurance broker organization code?	3
Insurance broker name	RMFS BENEFIT SOLUTIONS

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Company Name:	ASSOCIATED BUILDERS AND CONTRACTORS INDIANA/KENTUCKY CHAPTER, INC.
Employer identification number (EIN):	237298705
NAIC Classification:	238900