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401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 401k Plan overview

Plan Name401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN
Plan identification number 002

401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.

401k Sponsoring company profile

ROSSMEYER DAYTONA MOTORCYCLES, INC. has sponsored the creation of one or more 401k plans.

Company Name:ROSSMEYER DAYTONA MOTORCYCLES, INC.
Employer identification number (EIN):593205613
NAIC Classification:441228
NAIC Description:Motorcycle, ATV, and All Other Motor Vehicle Dealers

Additional information about ROSSMEYER DAYTONA MOTORCYCLES, INC.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations
Incorporation Date: 1993-10-11
Company Identification Number: P93000070419
Legal Registered Office Address: 1637 N. US Hwy 1

ORMOND BEACH

32174

More information about ROSSMEYER DAYTONA MOTORCYCLES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022016-01-01LEE LICHTENSTEIN
0022016-01-01LEE LICHTENSTEIN
0022015-01-01LEE LICHTENSTEIN
0022014-01-01LEE LICHTENSTEIN
0022013-01-01LEE LICHTENSTEIN

Plan Statistics for 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN

401k plan membership statisitcs for 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN

Measure Date Value
2016: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01138
Total number of active participants reported on line 7a of the Form 55002016-01-010
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-010
Number of participants with account balances2016-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01169
Total number of active participants reported on line 7a of the Form 55002015-01-01130
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0115
Total of all active and inactive participants2015-01-01145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01145
Number of participants with account balances2015-01-0171
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-0115
2014: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01219
Total number of active participants reported on line 7a of the Form 55002014-01-01164
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0114
Total of all active and inactive participants2014-01-01178
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01178
Number of participants with account balances2014-01-0175
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-0114
2013: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01239
Total number of active participants reported on line 7a of the Form 55002013-01-01203
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0123
Total of all active and inactive participants2013-01-01226
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01226
Number of participants with account balances2013-01-01107
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010

Financial Data on 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN

Measure Date Value
2016 : 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-02-03$0
Total transfer of assets from this plan2016-02-03$1,671,872
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-02-03$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-02-03$0
Total income from all sources (including contributions)2016-02-03$-51,145
Total loss/gain on sale of assets2016-02-03$0
Total of all expenses incurred2016-02-03$453,407
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-02-03$450,000
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-02-03$0
Value of total assets at end of year2016-02-03$0
Value of total assets at beginning of year2016-02-03$2,176,424
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-02-03$3,407
Total interest from all sources2016-02-03$0
Total dividends received (eg from common stock, registered investment company shares)2016-02-03$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-02-03No
Was this plan covered by a fidelity bond2016-02-03Yes
Value of fidelity bond cover2016-02-03$500,000
If this is an individual account plan, was there a blackout period2016-02-03No
Were there any nonexempt tranactions with any party-in-interest2016-02-03No
Participant contributions at end of year2016-02-03$0
Participant contributions at beginning of year2016-02-03$61,395
Participant contributions at end of year2016-02-03$0
Participant contributions at beginning of year2016-02-03$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-02-03$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-02-03$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-02-03$0
Administrative expenses (other) incurred2016-02-03$1,823
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-02-03No
Value of net income/loss2016-02-03$-504,552
Value of net assets at end of year (total assets less liabilities)2016-02-03$0
Value of net assets at beginning of year (total assets less liabilities)2016-02-03$2,176,424
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-02-03No
Were any loans by the plan or fixed income obligations due to the plan in default2016-02-03No
Were any leases to which the plan was party in default or uncollectible2016-02-03No
Value of interest in pooled separate accounts at end of year2016-02-03$0
Value of interest in pooled separate accounts at beginning of year2016-02-03$1,808,258
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-02-03$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-02-03$306,771
Net investment gain/loss from pooled separate accounts2016-02-03$-51,145
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-02-03No
Was there a failure to transmit to the plan any participant contributions2016-02-03No
Has the plan failed to provide any benefit when due under the plan2016-02-03No
Employer contributions (assets) at end of year2016-02-03$0
Employer contributions (assets) at beginning of year2016-02-03$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-02-03$450,000
Contract administrator fees2016-02-03$1,584
Did the plan have assets held for investment2016-02-03No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-02-03No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-02-03Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-02-03Yes
Opinion of an independent qualified public accountant for this plan2016-02-03Disclaimer
Accountancy firm name2016-02-03LBMC, PC
Accountancy firm EIN2016-02-03631199757
2015 : 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$1,139
Total income from all sources (including contributions)2015-12-31$216,355
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$463,294
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$434,615
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$281,170
Value of total assets at end of year2015-12-31$2,176,424
Value of total assets at beginning of year2015-12-31$2,424,502
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$28,679
Total interest from all sources2015-12-31$3,267
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Administrative expenses professional fees incurred2015-12-31$4,082
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$194,965
Participant contributions at end of year2015-12-31$61,395
Participant contributions at beginning of year2015-12-31$87,335
Participant contributions at end of year2015-12-31$0
Participant contributions at beginning of year2015-12-31$4,682
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2015-12-31$6,049
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$3,345
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$1,139
Other income not declared elsewhere2015-12-31$1,997
Administrative expenses (other) incurred2015-12-31$7,543
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-246,939
Value of net assets at end of year (total assets less liabilities)2015-12-31$2,176,424
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$2,423,363
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in pooled separate accounts at end of year2015-12-31$1,808,258
Value of interest in pooled separate accounts at beginning of year2015-12-31$2,004,780
Income. Interest from loans (other than to participants)2015-12-31$3,267
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$306,771
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$322,121
Net investment gain/loss from pooled separate accounts2015-12-31$-70,079
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$86,205
Employer contributions (assets) at end of year2015-12-31$0
Employer contributions (assets) at beginning of year2015-12-31$2,239
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$428,566
Contract administrator fees2015-12-31$17,054
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31LBMC, PC
Accountancy firm EIN2015-12-31631199757
2014 : 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$1,139
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$327,241
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$144,099
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$117,973
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$272,673
Value of total assets at end of year2014-12-31$2,424,502
Value of total assets at beginning of year2014-12-31$2,240,221
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$26,126
Total interest from all sources2014-12-31$4,187
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Administrative expenses professional fees incurred2014-12-31$102
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$178,028
Participant contributions at end of year2014-12-31$87,335
Participant contributions at beginning of year2014-12-31$110,896
Participant contributions at end of year2014-12-31$4,682
Participant contributions at beginning of year2014-12-31$19
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$12,496
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2014-12-31$6,000
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$3,345
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$1,799
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$1,139
Other income not declared elsewhere2014-12-31$1,753
Administrative expenses (other) incurred2014-12-31$8,771
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$183,142
Value of net assets at end of year (total assets less liabilities)2014-12-31$2,423,363
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$2,240,221
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in pooled separate accounts at end of year2014-12-31$2,004,780
Value of interest in pooled separate accounts at beginning of year2014-12-31$1,844,890
Interest on participant loans2014-12-31$4,187
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$322,121
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$282,523
Net investment gain/loss from pooled separate accounts2014-12-31$48,628
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$82,149
Employer contributions (assets) at end of year2014-12-31$2,239
Employer contributions (assets) at beginning of year2014-12-31$94
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$111,973
Contract administrator fees2014-12-31$17,253
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31LATTIMORE, BLACK, MORGAN & CAIN, PC
Accountancy firm EIN2014-12-31621199757
2013 : 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total transfer of assets to this plan2013-12-31$2,800,079
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total income from all sources (including contributions)2013-12-31$669,935
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$1,229,793
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$1,194,020
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$318,108
Value of total assets at end of year2013-12-31$2,240,221
Value of total assets at beginning of year2013-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$35,773
Total interest from all sources2013-12-31$5,974
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$224,100
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$217,023
Participant contributions at end of year2013-12-31$110,896
Participant contributions at end of year2013-12-31$19
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-12-31$11,572
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$1,799
Other income not declared elsewhere2013-12-31$4,938
Administrative expenses (other) incurred2013-12-31$8,961
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$-559,858
Value of net assets at end of year (total assets less liabilities)2013-12-31$2,240,221
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in pooled separate accounts at end of year2013-12-31$1,844,890
Interest on participant loans2013-12-31$5,974
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$282,523
Net investment gain/loss from pooled separate accounts2013-12-31$340,915
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31Yes
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$101,085
Employer contributions (assets) at end of year2013-12-31$94
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$1,182,448
Contract administrator fees2013-12-31$26,812
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31WARREN AVERETT, LLC
Accountancy firm EIN2013-12-31454084437

Form 5500 Responses for 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN

2016: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingYes
2016-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: 401K SAFE, LLC MULTIPLE EMPLOYER 401(K) PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01First time form 5500 has been submittedYes
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberGP16694
Policy instance 1
Insurance contract or identification numberGP16694
Number of Individuals Covered107
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $5,180
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees3819
Additional information about fees paid to insurance brokerTPA SUBSIDY
Insurance broker organization code?5
Insurance broker namePINNACLE FINANCIAL SERVICES INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberGP16694
Policy instance 1
Insurance contract or identification numberGP16694
Number of Individuals Covered122
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,529
Total amount of fees paid to insurance companyUSD $5,053
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,529
Insurance broker organization code?4
Amount paid for insurance broker fees3729
Additional information about fees paid to insurance brokerTPA SUBSIDY
Insurance broker namePINNACLE FINANCIAL SERVICES, INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberGP16694
Policy instance 1
Insurance contract or identification numberGP16694
Number of Individuals Covered107
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $6,478
Total amount of fees paid to insurance companyUSD $5,081
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,478
Insurance broker organization code?4
Amount paid for insurance broker fees3814
Additional information about fees paid to insurance brokerTPA SUBSIDY
Insurance broker namePINNACLE FINANCIAL SERVICES, INC.

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