401k Plan data: MEDICAL AND DENTAL plan

MEDICAL AND DENTAL 401k Plan overview

Plan Name	MEDICAL AND DENTAL
Plan identification number	505

MEDICAL AND DENTAL Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

HOME BUILDERS INSTITUTE has sponsored the creation of one or more 401k plans.

Company Name: HOME BUILDERS INSTITUTE

Employer identification number (EIN): 521266885

NAIC Classification: 813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MEDICAL AND DENTAL

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
505 2016-01-01 FAYE M NOCK
505 2015-01-01 FAYE NOCK EDWARD HARRISON 2016-11-02
505 2014-08-01 FAYE NOCK EDWARD HARRISON 2015-06-22
505 2013-08-01 EDWARD HARRISON 2015-02-02 EDWARD HARRISON 2015-01-28
505 2013-01-01 FAYE NOCK EDWARD HARRISON 2014-04-28
505 2012-08-01 FAYE NOCK EDWARD HARRISON 2014-02-10
505 2012-01-01 FAYE NOCK EDWARD HARRISON 2013-04-25
505 2011-08-01 FAYE NOCK EDWARD HARRISON 2013-01-08
505 2011-01-01 FAYE NOCK EDWARD HARRISON 2012-07-12
505 2010-01-01 FAYE NOCK EDWARD HARRISON 2011-05-31
505 2009-01-01 FAYE NOCK EDWARD HARRISON 2010-09-08
505 2008-08-01 FAYE NOCK EDWARD HARRISON 2010-03-02

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
505	2016-01-01	FAYE M NOCK
505	2015-01-01	FAYE NOCK		EDWARD HARRISON	2016-11-02
505	2014-08-01	FAYE NOCK		EDWARD HARRISON	2015-06-22
505	2013-08-01	EDWARD HARRISON	2015-02-02	EDWARD HARRISON	2015-01-28
505	2013-01-01	FAYE NOCK		EDWARD HARRISON	2014-04-28
505	2012-08-01	FAYE NOCK		EDWARD HARRISON	2014-02-10
505	2012-01-01	FAYE NOCK		EDWARD HARRISON	2013-04-25
505	2011-08-01	FAYE NOCK		EDWARD HARRISON	2013-01-08
505	2011-01-01	FAYE NOCK		EDWARD HARRISON	2012-07-12
505	2010-01-01	FAYE NOCK		EDWARD HARRISON	2011-05-31
505	2009-01-01	FAYE NOCK		EDWARD HARRISON	2010-09-08
505	2008-08-01	FAYE NOCK		EDWARD HARRISON	2010-03-02

Plan Statistics for MEDICAL AND DENTAL

401k plan membership statisitcs for MEDICAL AND DENTAL

Measure Date Value
2016: MEDICAL AND DENTAL 2016 401k membership
Total participants, beginning-of-year 2016-01-01 357
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
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 0
2015: MEDICAL AND DENTAL 2015 401k membership
Total participants, beginning-of-year 2015-01-01 365
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 357
Total of all active and inactive participants 2015-01-01 357
Total participants 2015-01-01 357
2014: MEDICAL AND DENTAL 2014 401k membership
Total participants, beginning-of-year 2014-08-01 373
Total number of active participants reported on line 7a of the Form 5500 2014-08-01 365
Total of all active and inactive participants 2014-08-01 365
Total participants 2014-08-01 365
2013: MEDICAL AND DENTAL 2013 401k membership
Total participants, beginning-of-year 2013-08-01 382
Total number of active participants reported on line 7a of the Form 5500 2013-08-01 373
Total of all active and inactive participants 2013-08-01 373
Total participants 2013-08-01 373
Total participants, beginning-of-year 2013-01-01 262
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 257
Total of all active and inactive participants 2013-01-01 257
Total participants 2013-01-01 257
2012: MEDICAL AND DENTAL 2012 401k membership
Total participants, beginning-of-year 2012-08-01 392
Total number of active participants reported on line 7a of the Form 5500 2012-08-01 382
Total of all active and inactive participants 2012-08-01 382
Total participants 2012-08-01 382
Total participants, beginning-of-year 2012-01-01 259
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 262
Total of all active and inactive participants 2012-01-01 262
Total participants 2012-01-01 262
2011: MEDICAL AND DENTAL 2011 401k membership
Total participants, beginning-of-year 2011-08-01 374
Total number of active participants reported on line 7a of the Form 5500 2011-08-01 392
Total of all active and inactive participants 2011-08-01 392
Total participants 2011-08-01 392
Total participants, beginning-of-year 2011-01-01 264
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 259
Total of all active and inactive participants 2011-01-01 259
Total participants 2011-01-01 259
2010: MEDICAL AND DENTAL 2010 401k membership
Total participants, beginning-of-year 2010-01-01 253
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 264
Total of all active and inactive participants 2010-01-01 264
Total participants 2010-01-01 264
2009: MEDICAL AND DENTAL 2009 401k membership
Total participants, beginning-of-year 2009-01-01 251
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 253
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 253
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 253
2008: MEDICAL AND DENTAL 2008 401k membership
Total participants, beginning-of-year 2008-08-01 191
Total number of active participants reported on line 7a of the Form 5500 2008-08-01 188
Number of retired or separated participants receiving benefits 2008-08-01 0
Number of other retired or separated participants entitled to future benefits 2008-08-01 0
Total of all active and inactive participants 2008-08-01 188
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2008-08-01 0
Total participants 2008-08-01 188
Number of participants with account balances 2008-08-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2008-08-01 0
Number of employers contributing to the scheme 2008-08-01 0

Measure	Date	Value
2016: MEDICAL AND DENTAL 2016 401k membership
Total participants, beginning-of-year	2016-01-01	357
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
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	0
2015: MEDICAL AND DENTAL 2015 401k membership
Total participants, beginning-of-year	2015-01-01	365
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	357
Total of all active and inactive participants	2015-01-01	357
Total participants	2015-01-01	357
2014: MEDICAL AND DENTAL 2014 401k membership
Total participants, beginning-of-year	2014-08-01	373
Total number of active participants reported on line 7a of the Form 5500	2014-08-01	365
Total of all active and inactive participants	2014-08-01	365
Total participants	2014-08-01	365
2013: MEDICAL AND DENTAL 2013 401k membership
Total participants, beginning-of-year	2013-08-01	382
Total number of active participants reported on line 7a of the Form 5500	2013-08-01	373
Total of all active and inactive participants	2013-08-01	373
Total participants	2013-08-01	373
Total participants, beginning-of-year	2013-01-01	262
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	257
Total of all active and inactive participants	2013-01-01	257
Total participants	2013-01-01	257
2012: MEDICAL AND DENTAL 2012 401k membership
Total participants, beginning-of-year	2012-08-01	392
Total number of active participants reported on line 7a of the Form 5500	2012-08-01	382
Total of all active and inactive participants	2012-08-01	382
Total participants	2012-08-01	382
Total participants, beginning-of-year	2012-01-01	259
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	262
Total of all active and inactive participants	2012-01-01	262
Total participants	2012-01-01	262
2011: MEDICAL AND DENTAL 2011 401k membership
Total participants, beginning-of-year	2011-08-01	374
Total number of active participants reported on line 7a of the Form 5500	2011-08-01	392
Total of all active and inactive participants	2011-08-01	392
Total participants	2011-08-01	392
Total participants, beginning-of-year	2011-01-01	264
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	259
Total of all active and inactive participants	2011-01-01	259
Total participants	2011-01-01	259
2010: MEDICAL AND DENTAL 2010 401k membership
Total participants, beginning-of-year	2010-01-01	253
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	264
Total of all active and inactive participants	2010-01-01	264
Total participants	2010-01-01	264
2009: MEDICAL AND DENTAL 2009 401k membership
Total participants, beginning-of-year	2009-01-01	251
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	253
Number of retired or separated participants receiving benefits	2009-01-01	0
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	253
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	253
2008: MEDICAL AND DENTAL 2008 401k membership
Total participants, beginning-of-year	2008-08-01	191
Total number of active participants reported on line 7a of the Form 5500	2008-08-01	188
Number of retired or separated participants receiving benefits	2008-08-01	0
Number of other retired or separated participants entitled to future benefits	2008-08-01	0
Total of all active and inactive participants	2008-08-01	188
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2008-08-01	0
Total participants	2008-08-01	188
Number of participants with account balances	2008-08-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2008-08-01	0
Number of employers contributing to the scheme	2008-08-01	0

Form 5500 Responses for MEDICAL AND DENTAL

2016: MEDICAL AND DENTAL 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	Yes
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: MEDICAL AND DENTAL 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: MEDICAL AND DENTAL 2014 form 5500 responses
2014-08-01	Type of plan entity	Single employer plan
2014-08-01	Submission has been amended	No
2014-08-01	This submission is the final filing	No
2014-08-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2014-08-01	Plan is a collectively bargained plan	No
2014-08-01	Plan funding arrangement – Insurance	Yes
2014-08-01	Plan benefit arrangement – Insurance	Yes
2013: MEDICAL AND DENTAL 2013 form 5500 responses
2013-08-01	Type of plan entity	Single employer plan
2013-08-01	Submission has been amended	No
2013-08-01	This submission is the final filing	No
2013-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-08-01	Plan is a collectively bargained plan	No
2013-08-01	Plan funding arrangement – Insurance	Yes
2013-08-01	Plan benefit arrangement – Insurance	Yes
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: MEDICAL AND DENTAL 2012 form 5500 responses
2012-08-01	Type of plan entity	Single employer plan
2012-08-01	Submission has been amended	No
2012-08-01	This submission is the final filing	No
2012-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-08-01	Plan is a collectively bargained plan	No
2012-08-01	Plan funding arrangement – Insurance	Yes
2012-08-01	Plan benefit arrangement – Insurance	Yes
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: MEDICAL AND DENTAL 2011 form 5500 responses
2011-08-01	Type of plan entity	Single employer plan
2011-08-01	Submission has been amended	No
2011-08-01	This submission is the final filing	No
2011-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-08-01	Plan is a collectively bargained plan	No
2011-08-01	Plan funding arrangement – Insurance	Yes
2011-08-01	Plan benefit arrangement – Insurance	Yes
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: MEDICAL AND DENTAL 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
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: MEDICAL AND DENTAL 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
2008: MEDICAL AND DENTAL 2008 form 5500 responses
2008-08-01	Type of plan entity	Single employer plan
2008-08-01	Submission has been amended	No
2008-08-01	This submission is the final filing	No
2008-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-08-01	Plan is a collectively bargained plan	No
2008-08-01	Plan funding arrangement – Insurance	Yes
2008-08-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number	3208796
Policy instance	1
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number	3208796
Policy instance	1
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number	3208796
Policy instance	1
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	025967
Policy instance	1
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number	3208796
Policy instance	1
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	025967
Policy instance	1
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number	3208796
Policy instance	1
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	025967
Policy instance	1
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	025967
Policy instance	1

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Company Name:	HOME BUILDERS INSTITUTE
Employer identification number (EIN):	521266885
NAIC Classification:	813000
NAIC Description:	Religious, Grantmaking, Civic, Professional, and Similar Organizations