401k Plan data: GROUP TRAVEL ACCIDENT INSURANCE plan

GROUP TRAVEL ACCIDENT INSURANCE 401k Plan overview

Plan Name	GROUP TRAVEL ACCIDENT INSURANCE
Plan identification number	503

GROUP TRAVEL ACCIDENT INSURANCE Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

NATIONAL TOBACCO COMPANY, L.P. has sponsored the creation of one or more 401k plans.

Company Name: NATIONAL TOBACCO COMPANY, L.P.

Employer identification number (EIN): 611133037

NAIC Classification: 312200
NAIC Description: Tobacco Manufacturing

Additional information about NATIONAL TOBACCO COMPANY, L.P.

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 1989-03-20

Company Identification Number: 0005495111

Legal Registered Office Address: 5201 INTERCHANGE WAY

LOUISVILLE
United States of America (USA)
40229

More information about NATIONAL TOBACCO COMPANY, L.P.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP TRAVEL ACCIDENT INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2014-09-27 CONNIE JANOWSKI
503 2013-09-27 DAVID L JOHNSON
503 2012-09-27 DAVID JOHNSON
503 2011-09-27 DAVID L. JOHNSON
503 2009-09-27 DAVID JOHNSON

Plan id#	Filing Submission Date	Name of Administrator
503	2014-09-27	CONNIE JANOWSKI
503	2013-09-27	DAVID L JOHNSON
503	2012-09-27	DAVID JOHNSON
503	2011-09-27	DAVID L. JOHNSON
503	2009-09-27	DAVID JOHNSON

Plan Statistics for GROUP TRAVEL ACCIDENT INSURANCE

401k plan membership statisitcs for GROUP TRAVEL ACCIDENT INSURANCE

Measure Date Value
2014: GROUP TRAVEL ACCIDENT INSURANCE 2014 401k membership
Total participants, beginning-of-year 2014-09-27 211
Total number of active participants reported on line 7a of the Form 5500 2014-09-27 0
Number of retired or separated participants receiving benefits 2014-09-27 0
Number of other retired or separated participants entitled to future benefits 2014-09-27 0
Total of all active and inactive participants 2014-09-27 0
2013: GROUP TRAVEL ACCIDENT INSURANCE 2013 401k membership
Total participants, beginning-of-year 2013-09-27 212
Total number of active participants reported on line 7a of the Form 5500 2013-09-27 211
Number of retired or separated participants receiving benefits 2013-09-27 0
Number of other retired or separated participants entitled to future benefits 2013-09-27 0
Total of all active and inactive participants 2013-09-27 211
2012: GROUP TRAVEL ACCIDENT INSURANCE 2012 401k membership
Total participants, beginning-of-year 2012-09-27 210
Total number of active participants reported on line 7a of the Form 5500 2012-09-27 209
Number of retired or separated participants receiving benefits 2012-09-27 0
Number of other retired or separated participants entitled to future benefits 2012-09-27 0
Total of all active and inactive participants 2012-09-27 209
2011: GROUP TRAVEL ACCIDENT INSURANCE 2011 401k membership
Total participants, beginning-of-year 2011-09-27 202
Total number of active participants reported on line 7a of the Form 5500 2011-09-27 213
Number of retired or separated participants receiving benefits 2011-09-27 0
Number of other retired or separated participants entitled to future benefits 2011-09-27 0
Total of all active and inactive participants 2011-09-27 213
2009: GROUP TRAVEL ACCIDENT INSURANCE 2009 401k membership
Total participants, beginning-of-year 2009-09-27 199
Total number of active participants reported on line 7a of the Form 5500 2009-09-27 198
Number of retired or separated participants receiving benefits 2009-09-27 0
Number of other retired or separated participants entitled to future benefits 2009-09-27 0
Total of all active and inactive participants 2009-09-27 198
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-09-27 0
Total participants 2009-09-27 198

Measure	Date	Value
2014: GROUP TRAVEL ACCIDENT INSURANCE 2014 401k membership
Total participants, beginning-of-year	2014-09-27	211
Total number of active participants reported on line 7a of the Form 5500	2014-09-27	0
Number of retired or separated participants receiving benefits	2014-09-27	0
Number of other retired or separated participants entitled to future benefits	2014-09-27	0
Total of all active and inactive participants	2014-09-27	0
2013: GROUP TRAVEL ACCIDENT INSURANCE 2013 401k membership
Total participants, beginning-of-year	2013-09-27	212
Total number of active participants reported on line 7a of the Form 5500	2013-09-27	211
Number of retired or separated participants receiving benefits	2013-09-27	0
Number of other retired or separated participants entitled to future benefits	2013-09-27	0
Total of all active and inactive participants	2013-09-27	211
2012: GROUP TRAVEL ACCIDENT INSURANCE 2012 401k membership
Total participants, beginning-of-year	2012-09-27	210
Total number of active participants reported on line 7a of the Form 5500	2012-09-27	209
Number of retired or separated participants receiving benefits	2012-09-27	0
Number of other retired or separated participants entitled to future benefits	2012-09-27	0
Total of all active and inactive participants	2012-09-27	209
2011: GROUP TRAVEL ACCIDENT INSURANCE 2011 401k membership
Total participants, beginning-of-year	2011-09-27	202
Total number of active participants reported on line 7a of the Form 5500	2011-09-27	213
Number of retired or separated participants receiving benefits	2011-09-27	0
Number of other retired or separated participants entitled to future benefits	2011-09-27	0
Total of all active and inactive participants	2011-09-27	213
2009: GROUP TRAVEL ACCIDENT INSURANCE 2009 401k membership
Total participants, beginning-of-year	2009-09-27	199
Total number of active participants reported on line 7a of the Form 5500	2009-09-27	198
Number of retired or separated participants receiving benefits	2009-09-27	0
Number of other retired or separated participants entitled to future benefits	2009-09-27	0
Total of all active and inactive participants	2009-09-27	198
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-09-27	0
Total participants	2009-09-27	198

Form 5500 Responses for GROUP TRAVEL ACCIDENT INSURANCE

2014: GROUP TRAVEL ACCIDENT INSURANCE 2014 form 5500 responses
2014-09-27	Type of plan entity	Single employer plan
2014-09-27	Submission has been amended	No
2014-09-27	This submission is the final filing	Yes
2014-09-27	This return/report is a short plan year return/report (less than 12 months)	Yes
2014-09-27	Plan is a collectively bargained plan	No
2014-09-27	Plan funding arrangement – Insurance	Yes
2014-09-27	Plan benefit arrangement – Insurance	Yes
2013: GROUP TRAVEL ACCIDENT INSURANCE 2013 form 5500 responses
2013-09-27	Type of plan entity	Single employer plan
2013-09-27	Submission has been amended	No
2013-09-27	This submission is the final filing	No
2013-09-27	This return/report is a short plan year return/report (less than 12 months)	No
2013-09-27	Plan is a collectively bargained plan	No
2013-09-27	Plan funding arrangement – Insurance	Yes
2013-09-27	Plan benefit arrangement – Insurance	Yes
2012: GROUP TRAVEL ACCIDENT INSURANCE 2012 form 5500 responses
2012-09-27	Type of plan entity	Single employer plan
2012-09-27	Submission has been amended	No
2012-09-27	This submission is the final filing	No
2012-09-27	This return/report is a short plan year return/report (less than 12 months)	No
2012-09-27	Plan is a collectively bargained plan	No
2012-09-27	Plan funding arrangement – Insurance	Yes
2012-09-27	Plan benefit arrangement – Insurance	Yes
2011: GROUP TRAVEL ACCIDENT INSURANCE 2011 form 5500 responses
2011-09-27	Type of plan entity	Single employer plan
2011-09-27	Submission has been amended	No
2011-09-27	This submission is the final filing	No
2011-09-27	This return/report is a short plan year return/report (less than 12 months)	No
2011-09-27	Plan is a collectively bargained plan	No
2011-09-27	Plan funding arrangement – Insurance	Yes
2011-09-27	Plan benefit arrangement – Insurance	Yes
2009: GROUP TRAVEL ACCIDENT INSURANCE 2009 form 5500 responses
2009-09-27	Type of plan entity	Single employer plan
2009-09-27	Submission has been amended	No
2009-09-27	This submission is the final filing	No
2009-09-27	This return/report is a short plan year return/report (less than 12 months)	No
2009-09-27	Plan is a collectively bargained plan	No
2009-09-27	Plan funding arrangement – Insurance	Yes
2009-09-27	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )

Policy contract number

GTP0009120630

Policy instance

Insurance contract or identification number	GTP0009120630
Number of Individuals Covered	228
Insurance policy start date	2014-09-27
Insurance policy end date	2015-08-19
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	BUSINESS TRAVEL ACCIDENT
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

NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )

Policy contract number

GTP0009120630

Policy instance

Insurance contract or identification number	GTP0009120630
Number of Individuals Covered	172
Insurance policy start date	2013-09-27
Insurance policy end date	2014-09-26
Total amount of commissions paid to insurance broker	USD $331
Total amount of fees paid to insurance company	USD $0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	BUSINESS TRAVEL ACCIDENT
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $2,208
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $331
Insurance broker organization code?	3
Insurance broker name	ASSURED NEACE LUKENS

NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )

Policy contract number

GTP0009120630

Policy instance

Insurance contract or identification number	GTP0009120630
Number of Individuals Covered	209
Insurance policy start date	2012-09-27
Insurance policy end date	2013-09-26
Total amount of commissions paid to insurance broker	USD $320
Total amount of fees paid to insurance company	USD $0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	BUSINESS TRAVEL ACCIDENT
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $2,131
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $320
Insurance broker organization code?	3
Insurance broker name	NEACE LUKENS, INC.

NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )

Policy contract number

GTP0009120630

Policy instance

Insurance contract or identification number	GTP0009120630
Number of Individuals Covered	213
Insurance policy start date	2011-09-27
Insurance policy end date	2012-09-26
Total amount of commissions paid to insurance broker	USD $320
Total amount of fees paid to insurance company	USD $0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	BUSINESS TRAVEL ACCIDENT
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $2,131
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )

Policy contract number

GTP0009120630

Policy instance

Insurance contract or identification number	GTP0009120630
Number of Individuals Covered	202
Insurance policy start date	2010-09-27
Insurance policy end date	2011-09-26
Total amount of commissions paid to insurance broker	USD $320
Total amount of fees paid to insurance company	USD $0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	BUSINESS TRAVEL ACCIDENT
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $2,131
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	NATIONAL TOBACCO COMPANY, L.P.
Employer identification number (EIN):	611133037
NAIC Classification:	312200
NAIC Description:	Tobacco Manufacturing

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	1989-03-20
Company Identification Number:	0005495111
Legal Registered Office Address:	5201 INTERCHANGE WAY LOUISVILLE United States of America (USA) 40229