CENTRAL STATES INDEMNITY CO. OF OMAHA EMPLOYEES WELFARE BENEFIT PLAN 401k Plan overview

CENTRAL STATES INDEMNITY CO. OF OMAHA EMPLOYEES WELFARE BENEFIT PLAN Benefits

401k Sponsoring company profile

Company Name:	CENTRAL STATES INDEMNITY CO. OF OMAHA
Employer identification number (EIN):	470591908
NAIC Classification:	524290

Form 5500 Filing Information

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2013-01-01	KEVIN MORAN		KEVIN MORAN	2014-07-23
501	2012-01-01	JEFF HARRINGTON
501	2011-01-01	JEFF HARRINGTON
501	2009-01-01	JEFF HARRINGTON

Plan Statistics for CENTRAL STATES INDEMNITY CO. OF OMAHA EMPLOYEES WELFARE BENEFIT PLAN

Measure	Date	Value
2013: CENTRAL STATES INDEMNITY CO. OF OMAHA EMPLOYEES WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	240
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	99
Number of retired or separated participants receiving benefits	2013-01-01	8
Number of other retired or separated participants entitled to future benefits	2013-01-01	12
Total of all active and inactive participants	2013-01-01	119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	119
2012: CENTRAL STATES INDEMNITY CO. OF OMAHA EMPLOYEES WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	282
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	196
Number of retired or separated participants receiving benefits	2012-01-01	19
Number of other retired or separated participants entitled to future benefits	2012-01-01	24
Total of all active and inactive participants	2012-01-01	239
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	1
Total participants	2012-01-01	240
2011: CENTRAL STATES INDEMNITY CO. OF OMAHA EMPLOYEES WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	286
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	267
Number of retired or separated participants receiving benefits	2011-01-01	4
Number of other retired or separated participants entitled to future benefits	2011-01-01	10
Total of all active and inactive participants	2011-01-01	281
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	1
Total participants	2011-01-01	282
2009: CENTRAL STATES INDEMNITY CO. OF OMAHA EMPLOYEES WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	428
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	316
Number of retired or separated participants receiving benefits	2009-01-01	5
Number of other retired or separated participants entitled to future benefits	2009-01-01	12
Total of all active and inactive participants	2009-01-01	333
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	1
Total participants	2009-01-01	334

Form 5500 Responses for CENTRAL STATES INDEMNITY CO. OF OMAHA EMPLOYEES WELFARE BENEFIT PLAN

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