401k Plan data: WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN plan

WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN 401k Plan overview

Plan Name	WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN
Plan identification number	501

WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN Benefits

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

401k Sponsoring company profile

WESTERN NATIONAL MUTUAL INSURANCE COMPANY has sponsored the creation of one or more 401k plans.

Company Name: WESTERN NATIONAL MUTUAL INSURANCE COMPANY

Employer identification number (EIN): 410430825

NAIC Classification: 524150

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2017-01-01 SHARON STERRIKER SHARON STERRIKER 2018-07-24
501 2016-01-01 SHARON STERRIKER
501 2015-01-01 SHARON STERRIKER
501 2014-01-01 SHARON STERRIKER SHARON STERRIKER 2015-07-30
501 2013-01-01 VIRGINIA LATOCKI VIRGINIA LATOCKI 2014-07-24
501 2012-01-01 VIRGINIA LATOCKI VIRGINIA LATOCKI 2013-07-24
501 2011-01-01 VIRGINIA LATOCKI
501 2010-01-01 VIRGINIA LATOCKI
501 2009-01-01 VIRGINIA LATOCKI

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2017-01-01	SHARON STERRIKER	SHARON STERRIKER	2018-07-24
501	2016-01-01	SHARON STERRIKER
501	2015-01-01	SHARON STERRIKER
501	2014-01-01	SHARON STERRIKER	SHARON STERRIKER	2015-07-30
501	2013-01-01	VIRGINIA LATOCKI	VIRGINIA LATOCKI	2014-07-24
501	2012-01-01	VIRGINIA LATOCKI	VIRGINIA LATOCKI	2013-07-24
501	2011-01-01	VIRGINIA LATOCKI
501	2010-01-01	VIRGINIA LATOCKI
501	2009-01-01	VIRGINIA LATOCKI

Plan Statistics for WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN

401k plan membership statisitcs for WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN

Measure Date Value
2017: WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 604
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 585
Number of retired or separated participants receiving benefits 2017-01-01 1
Total of all active and inactive participants 2017-01-01 586
Total participants 2017-01-01 586
2016: WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 527
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 617
Number of retired or separated participants receiving benefits 2016-01-01 5
Total of all active and inactive participants 2016-01-01 622
Total participants 2016-01-01 622
2015: WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 480
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 512
Number of retired or separated participants receiving benefits 2015-01-01 10
Total of all active and inactive participants 2015-01-01 522
Total participants 2015-01-01 522
2014: WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 387
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 394
Number of retired or separated participants receiving benefits 2014-01-01 9
Total of all active and inactive participants 2014-01-01 403
Total participants 2014-01-01 403
2013: WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 364
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 360
Number of retired or separated participants receiving benefits 2013-01-01 10
Total of all active and inactive participants 2013-01-01 370
Total participants 2013-01-01 370
2012: WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 360
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 352
Number of retired or separated participants receiving benefits 2012-01-01 12
Total of all active and inactive participants 2012-01-01 364
Total participants 2012-01-01 364
2011: WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 356
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 350
Number of retired or separated participants receiving benefits 2011-01-01 10
Total of all active and inactive participants 2011-01-01 360
Total participants 2011-01-01 360
2010: WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 324
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 350
Number of retired or separated participants receiving benefits 2010-01-01 6
Total of all active and inactive participants 2010-01-01 356
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 356
2009: WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 336
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 303
Number of retired or separated participants receiving benefits 2009-01-01 20
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 323
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 1
Total participants 2009-01-01 324

Measure	Date	Value
2017: WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	604
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	585
Number of retired or separated participants receiving benefits	2017-01-01	1
Total of all active and inactive participants	2017-01-01	586
Total participants	2017-01-01	586
2016: WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	527
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	617
Number of retired or separated participants receiving benefits	2016-01-01	5
Total of all active and inactive participants	2016-01-01	622
Total participants	2016-01-01	622
2015: WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	480
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	512
Number of retired or separated participants receiving benefits	2015-01-01	10
Total of all active and inactive participants	2015-01-01	522
Total participants	2015-01-01	522
2014: WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	387
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	394
Number of retired or separated participants receiving benefits	2014-01-01	9
Total of all active and inactive participants	2014-01-01	403
Total participants	2014-01-01	403
2013: WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	364
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	360
Number of retired or separated participants receiving benefits	2013-01-01	10
Total of all active and inactive participants	2013-01-01	370
Total participants	2013-01-01	370
2012: WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	360
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	352
Number of retired or separated participants receiving benefits	2012-01-01	12
Total of all active and inactive participants	2012-01-01	364
Total participants	2012-01-01	364
2011: WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	356
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	350
Number of retired or separated participants receiving benefits	2011-01-01	10
Total of all active and inactive participants	2011-01-01	360
Total participants	2011-01-01	360
2010: WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	324
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	350
Number of retired or separated participants receiving benefits	2010-01-01	6
Total of all active and inactive participants	2010-01-01	356
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	356
2009: WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	336
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	303
Number of retired or separated participants receiving benefits	2009-01-01	20
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	323
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	1
Total participants	2009-01-01	324

Form 5500 Responses for WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN

2017: WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single 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 benefit arrangement – Insurance	Yes
2016: WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN 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	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 benefit arrangement – Insurance	Yes
2015: WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN 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 – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN 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 – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN 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 – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN 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 – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN 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 – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN 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: WESTERN NATIONAL MUTUAL MEDICAL AND DISABILITY PLAN 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 – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	99275751001
Policy instance	3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	G000B3QC
Policy instance	2
HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	18949
Policy instance	1
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	011178
Policy instance	2
HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	18949
Policy instance	1
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	011178
Policy instance	2
HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	18949
Policy instance	1
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	011178
Policy instance	2
HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	18949
Policy instance	1
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	011178
Policy instance	2
HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	18949
Policy instance	1
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	011178
Policy instance	2
HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	18949
Policy instance	1
HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	18949
Policy instance	2
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	011178
Policy instance	1

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Company Name:	WESTERN NATIONAL MUTUAL INSURANCE COMPANY
Employer identification number (EIN):	410430825
NAIC Classification:	524150