SHIVELY, BROS., INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan HEALTH BENEFIT PLAN FOR SHIVELY BROTHERS, INC.
| 2018: HEALTH BENEFIT PLAN FOR SHIVELY BROTHERS, INC. 2018 form 5500 responses |
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| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | This submission is the final filing | Yes |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: HEALTH BENEFIT PLAN FOR SHIVELY BROTHERS, INC. 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 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: HEALTH BENEFIT PLAN FOR SHIVELY BROTHERS, INC. 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 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: HEALTH BENEFIT PLAN FOR SHIVELY BROTHERS, INC. 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 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: HEALTH BENEFIT PLAN FOR SHIVELY BROTHERS, INC. 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | First time form 5500 has been submitted | 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 |
| SIRIUS AMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35408 ) |
| Policy contract number | IMG-01370-17-M |
| Policy instance | 1 |
| Insurance contract or identification number | IMG-01370-17-M | | Number of Individuals Covered | 166 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $47,969 | | Welfare Benefit Premiums Paid to Carrier | USD $368,992 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SIRIUS AMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35408 ) |
| Policy contract number | IMG-01370-17-M |
| Policy instance | 1 |
| Insurance contract or identification number | IMG-01370-17-M | | Number of Individuals Covered | 168 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $43,011 | | Welfare Benefit Premiums Paid to Carrier | USD $330,852 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SIRIUS AMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35408 ) |
| Policy contract number | IMG-01370-15-M |
| Policy instance | 1 |
| Insurance contract or identification number | IMG-01370-15-M | | Number of Individuals Covered | 163 | | Insurance policy start date | 2016-01-01 | | Insurance policy end date | 2016-12-31 | | Total amount of commissions paid to insurance broker | USD $42,382 | | Welfare Benefit Premiums Paid to Carrier | USD $326,017 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SIRIUS AMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35408 ) |
| Policy contract number | IMG-01370-15-M |
| Policy instance | 1 |
| Insurance contract or identification number | IMG-01370-15-M | | Number of Individuals Covered | 141 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $53,001 | | Welfare Benefit Premiums Paid to Carrier | USD $294,451 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PAN AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67539 ) |
| Policy contract number | 07858 |
| Policy instance | 1 |
| Insurance contract or identification number | 07858 | | Number of Individuals Covered | 126 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $22,666 | | Welfare Benefit Premiums Paid to Carrier | USD $453,312 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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