401k Plan data: AMERICAN COMMUNITY MUTUAL INS. CO. LIFE, HOSPITAL, MAJOR MEDICAL, ETC. plan

AMERICAN COMMUNITY MUTUAL INS. CO. LIFE, HOSPITAL, MAJOR MEDICAL, ETC. 401k Plan overview

Plan Name	AMERICAN COMMUNITY MUTUAL INS. CO. LIFE, HOSPITAL, MAJOR MEDICAL, ETC.
Plan identification number	501

AMERICAN COMMUNITY MUTUAL INS. CO. LIFE, HOSPITAL, MAJOR MEDICAL, ETC. Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Long-term disability cover

401k Sponsoring company profile

AMERICAN COMMUNITY MUTUAL INS. CO. has sponsored the creation of one or more 401k plans.

Company Name: AMERICAN COMMUNITY MUTUAL INS. CO.

Employer identification number (EIN): 381290976

NAIC Classification: 524140

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AMERICAN COMMUNITY MUTUAL INS. CO. LIFE, HOSPITAL, MAJOR MEDICAL, ETC.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2011-01-01 JAMES GERBER
501 2010-01-01 JAMES GERBER
501 2009-01-01 JAMES GERBER
501 2009-01-01 JAMES GERBER 2011-10-25
501 2008-01-01 JAMES GERBER
501 2007-01-01 JAMES GERBER

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2011-01-01	JAMES GERBER
501	2010-01-01	JAMES GERBER
501	2009-01-01	JAMES GERBER
501	2009-01-01		JAMES GERBER	2011-10-25
501	2008-01-01	JAMES GERBER
501	2007-01-01	JAMES GERBER

Plan Statistics for AMERICAN COMMUNITY MUTUAL INS. CO. LIFE, HOSPITAL, MAJOR MEDICAL, ETC.

401k plan membership statisitcs for AMERICAN COMMUNITY MUTUAL INS. CO. LIFE, HOSPITAL, MAJOR MEDICAL, ETC.

Measure Date Value
2011: AMERICAN COMMUNITY MUTUAL INS. CO. LIFE, HOSPITAL, MAJOR MEDICAL, ETC. 2011 401k membership
Total participants, beginning-of-year 2011-01-01 128
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 29
Number of retired or separated participants receiving benefits 2011-01-01 51
Total of all active and inactive participants 2011-01-01 80
Total participants 2011-01-01 80
2010: AMERICAN COMMUNITY MUTUAL INS. CO. LIFE, HOSPITAL, MAJOR MEDICAL, ETC. 2010 401k membership
Total participants, beginning-of-year 2010-01-01 131
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 75
Number of retired or separated participants receiving benefits 2010-01-01 53
Total of all active and inactive participants 2010-01-01 128
Total participants 2010-01-01 128
2009: AMERICAN COMMUNITY MUTUAL INS. CO. LIFE, HOSPITAL, MAJOR MEDICAL, ETC. 2009 401k membership
Total participants, beginning-of-year 2009-01-01 412
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 100
Number of retired or separated participants receiving benefits 2009-01-01 53
Total of all active and inactive participants 2009-01-01 153
Total participants 2009-01-01 153
2008: AMERICAN COMMUNITY MUTUAL INS. CO. LIFE, HOSPITAL, MAJOR MEDICAL, ETC. 2008 401k membership
Total participants, beginning-of-year 2008-01-01 332
Total number of active participants reported on line 7a of the Form 5500 2008-01-01 273
Number of retired or separated participants receiving benefits 2008-01-01 59
Total of all active and inactive participants 2008-01-01 332
Total participants 2008-01-01 332
2007: AMERICAN COMMUNITY MUTUAL INS. CO. LIFE, HOSPITAL, MAJOR MEDICAL, ETC. 2007 401k membership
Total participants, beginning-of-year 2007-01-01 332
Total number of active participants reported on line 7a of the Form 5500 2007-01-01 354
Number of retired or separated participants receiving benefits 2007-01-01 58
Total of all active and inactive participants 2007-01-01 412
Total participants 2007-01-01 412

Measure	Date	Value
2011: AMERICAN COMMUNITY MUTUAL INS. CO. LIFE, HOSPITAL, MAJOR MEDICAL, ETC. 2011 401k membership
Total participants, beginning-of-year	2011-01-01	128
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	29
Number of retired or separated participants receiving benefits	2011-01-01	51
Total of all active and inactive participants	2011-01-01	80
Total participants	2011-01-01	80
2010: AMERICAN COMMUNITY MUTUAL INS. CO. LIFE, HOSPITAL, MAJOR MEDICAL, ETC. 2010 401k membership
Total participants, beginning-of-year	2010-01-01	131
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	75
Number of retired or separated participants receiving benefits	2010-01-01	53
Total of all active and inactive participants	2010-01-01	128
Total participants	2010-01-01	128
2009: AMERICAN COMMUNITY MUTUAL INS. CO. LIFE, HOSPITAL, MAJOR MEDICAL, ETC. 2009 401k membership
Total participants, beginning-of-year	2009-01-01	412
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	100
Number of retired or separated participants receiving benefits	2009-01-01	53
Total of all active and inactive participants	2009-01-01	153
Total participants	2009-01-01	153
2008: AMERICAN COMMUNITY MUTUAL INS. CO. LIFE, HOSPITAL, MAJOR MEDICAL, ETC. 2008 401k membership
Total participants, beginning-of-year	2008-01-01	332
Total number of active participants reported on line 7a of the Form 5500	2008-01-01	273
Number of retired or separated participants receiving benefits	2008-01-01	59
Total of all active and inactive participants	2008-01-01	332
Total participants	2008-01-01	332
2007: AMERICAN COMMUNITY MUTUAL INS. CO. LIFE, HOSPITAL, MAJOR MEDICAL, ETC. 2007 401k membership
Total participants, beginning-of-year	2007-01-01	332
Total number of active participants reported on line 7a of the Form 5500	2007-01-01	354
Number of retired or separated participants receiving benefits	2007-01-01	58
Total of all active and inactive participants	2007-01-01	412
Total participants	2007-01-01	412

Form 5500 Responses for AMERICAN COMMUNITY MUTUAL INS. CO. LIFE, HOSPITAL, MAJOR MEDICAL, ETC.

2011: AMERICAN COMMUNITY MUTUAL INS. CO. LIFE, HOSPITAL, MAJOR MEDICAL, ETC. 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	First time form 5500 has been submitted	Yes
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 benefit arrangement – Insurance	Yes
2010: AMERICAN COMMUNITY MUTUAL INS. CO. LIFE, HOSPITAL, MAJOR MEDICAL, ETC. 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	Yes
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 benefit arrangement – Insurance	Yes
2009: AMERICAN COMMUNITY MUTUAL INS. CO. LIFE, HOSPITAL, MAJOR MEDICAL, ETC. 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
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 benefit arrangement – Insurance	Yes
2008: AMERICAN COMMUNITY MUTUAL INS. CO. LIFE, HOSPITAL, MAJOR MEDICAL, ETC. 2008 form 5500 responses
2008-01-01	Type of plan entity	Single employer plan
2008-01-01	Submission has been amended	Yes
2008-01-01	This submission is the final filing	No
2008-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-01-01	Plan is a collectively bargained plan	No
2008-01-01	Plan funding arrangement – Insurance	Yes
2008-01-01	Plan benefit arrangement – Insurance	Yes
2007: AMERICAN COMMUNITY MUTUAL INS. CO. LIFE, HOSPITAL, MAJOR MEDICAL, ETC. 2007 form 5500 responses
2007-01-01	Type of plan entity	Single employer plan
2007-01-01	First time form 5500 has been submitted	Yes
2007-01-01	Submission has been amended	Yes
2007-01-01	This submission is the final filing	No
2007-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2007-01-01	Plan is a collectively bargained plan	No
2007-01-01	Plan funding arrangement – Insurance	Yes

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Company Name:	AMERICAN COMMUNITY MUTUAL INS. CO.
Employer identification number (EIN):	381290976
NAIC Classification:	524140