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SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan NameSOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN
Plan identification number 501

SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

SOUTHERN HILLS COUNTRY CLUB has sponsored the creation of one or more 401k plans.

Company Name:SOUTHERN HILLS COUNTRY CLUB
Employer identification number (EIN):730475850
NAIC Classification:713900

Additional information about SOUTHERN HILLS COUNTRY CLUB

Jurisdiction of Incorporation: South Dakota Secretary of State
Incorporation Date:
Company Identification Number: NS004582

More information about SOUTHERN HILLS COUNTRY CLUB

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-10-01
5012020-10-01
5012019-10-01
5012018-10-01
5012017-10-01
5012016-10-01NICHOLAS SIDORAKIS
5012015-10-01NICHOLAS SIDORAKIS
5012014-10-01NICHOLAS SIDORAKIS
5012013-10-01NICHOLAS SIDORAKIS
5012012-10-01NICHOLAS SIDORAKIS
5012011-10-01NICHOLAS SIDORAKIS
5012009-10-01NICHOLAS SIDORAKIS
5012009-10-01NICHOLAS SIDORAKIS

Plan Statistics for SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN

Measure Date Value
2021: SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-10-01119
Total number of active participants reported on line 7a of the Form 55002021-10-01125
Total of all active and inactive participants2021-10-01125
2020: SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-10-01117
Total number of active participants reported on line 7a of the Form 55002020-10-01119
Total of all active and inactive participants2020-10-01119
2019: SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-10-01112
Total number of active participants reported on line 7a of the Form 55002019-10-01117
Total of all active and inactive participants2019-10-01117
2018: SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-10-01119
Total number of active participants reported on line 7a of the Form 55002018-10-01112
Total of all active and inactive participants2018-10-01112
2017: SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-10-01117
Total number of active participants reported on line 7a of the Form 55002017-10-01119
Total of all active and inactive participants2017-10-01119
2016: SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-01117
Total number of active participants reported on line 7a of the Form 55002016-10-01122
Total of all active and inactive participants2016-10-01122
2015: SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-01124
Total number of active participants reported on line 7a of the Form 55002015-10-01117
Total of all active and inactive participants2015-10-01117
2014: SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-10-01110
Total number of active participants reported on line 7a of the Form 55002014-10-01124
Total of all active and inactive participants2014-10-01124
2013: SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-10-01108
Total number of active participants reported on line 7a of the Form 55002013-10-01110
Total of all active and inactive participants2013-10-01110
2012: SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-10-01127
Total number of active participants reported on line 7a of the Form 55002012-10-01108
Total of all active and inactive participants2012-10-01108
2011: SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-10-01127
Total number of active participants reported on line 7a of the Form 55002011-10-01127
Total of all active and inactive participants2011-10-01127
2009: SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-10-01133
Total number of active participants reported on line 7a of the Form 55002009-10-01127
Number of retired or separated participants receiving benefits2009-10-011
Total of all active and inactive participants2009-10-01128
Total participants2009-10-01128

Financial Data on SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN

Measure Date Value
2022 : SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2022 401k financial data
Total income from all sources (including contributions)2022-09-30$1,319,802
Total of all expenses incurred2022-09-30$1,175,381
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-09-30$830,882
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-09-30$1,319,387
Value of total assets at end of year2022-09-30$537,777
Value of total assets at beginning of year2022-09-30$393,356
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-09-30$344,499
Total interest from all sources2022-09-30$415
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-09-30No
Was this plan covered by a fidelity bond2022-09-30No
If this is an individual account plan, was there a blackout period2022-09-30No
Were there any nonexempt tranactions with any party-in-interest2022-09-30No
Contributions received from participants2022-09-30$348,829
Income. Received or receivable in cash from other sources (including rollovers)2022-09-30$13,488
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2022-09-30$88,469
Administrative expenses (other) incurred2022-09-30$344,499
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-09-30No
Value of net income/loss2022-09-30$144,421
Value of net assets at end of year (total assets less liabilities)2022-09-30$537,777
Value of net assets at beginning of year (total assets less liabilities)2022-09-30$393,356
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2022-09-30No
Were any leases to which the plan was party in default or uncollectible2022-09-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-09-30$537,777
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-09-30$393,356
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-09-30$393,356
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-09-30$415
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-09-30No
Was there a failure to transmit to the plan any participant contributions2022-09-30No
Has the plan failed to provide any benefit when due under the plan2022-09-30No
Contributions received in cash from employer2022-09-30$957,070
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-09-30$742,413
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32022-09-30No
Did the plan have assets held for investment2022-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-09-30No
Opinion of an independent qualified public accountant for this plan2022-09-30Unqualified
Accountancy firm name2022-09-30CARR, RIGGS & INGRAM, LLC
Accountancy firm EIN2022-09-30721396621
2021 : SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2021 401k financial data
Total income from all sources (including contributions)2021-09-30$1,234,149
Total of all expenses incurred2021-09-30$926,290
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-09-30$640,892
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-09-30$1,233,965
Value of total assets at end of year2021-09-30$393,356
Value of total assets at beginning of year2021-09-30$85,497
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-09-30$285,398
Total interest from all sources2021-09-30$184
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-09-30No
Was this plan covered by a fidelity bond2021-09-30No
If this is an individual account plan, was there a blackout period2021-09-30No
Were there any nonexempt tranactions with any party-in-interest2021-09-30No
Contributions received from participants2021-09-30$355,469
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2021-09-30$85,148
Administrative expenses (other) incurred2021-09-30$285,398
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-09-30No
Value of net income/loss2021-09-30$307,859
Value of net assets at end of year (total assets less liabilities)2021-09-30$393,356
Value of net assets at beginning of year (total assets less liabilities)2021-09-30$85,497
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2021-09-30No
Were any leases to which the plan was party in default or uncollectible2021-09-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-09-30$393,356
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-09-30$85,497
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-09-30$85,497
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-09-30$184
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-09-30No
Was there a failure to transmit to the plan any participant contributions2021-09-30No
Has the plan failed to provide any benefit when due under the plan2021-09-30No
Contributions received in cash from employer2021-09-30$878,496
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-09-30$555,744
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32021-09-30No
Did the plan have assets held for investment2021-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-09-30No
Opinion of an independent qualified public accountant for this plan2021-09-30Unqualified
Accountancy firm name2021-09-30STANFIELD + O'DELL, P.C.
Accountancy firm EIN2021-09-30731293433
2020 : SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2020 401k financial data
Total income from all sources (including contributions)2020-09-30$1,205,952
Total of all expenses incurred2020-09-30$1,125,672
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-09-30$842,727
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-09-30$1,205,835
Value of total assets at end of year2020-09-30$85,497
Value of total assets at beginning of year2020-09-30$5,217
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-09-30$282,945
Total interest from all sources2020-09-30$117
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-09-30No
Was this plan covered by a fidelity bond2020-09-30No
If this is an individual account plan, was there a blackout period2020-09-30No
Were there any nonexempt tranactions with any party-in-interest2020-09-30No
Contributions received from participants2020-09-30$335,503
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2020-09-30$91,148
Administrative expenses (other) incurred2020-09-30$282,945
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-09-30No
Value of net income/loss2020-09-30$80,280
Value of net assets at end of year (total assets less liabilities)2020-09-30$85,497
Value of net assets at beginning of year (total assets less liabilities)2020-09-30$5,217
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2020-09-30No
Were any leases to which the plan was party in default or uncollectible2020-09-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-09-30$85,497
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-09-30$5,217
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-09-30$5,217
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-09-30$117
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-09-30No
Was there a failure to transmit to the plan any participant contributions2020-09-30No
Has the plan failed to provide any benefit when due under the plan2020-09-30No
Contributions received in cash from employer2020-09-30$870,332
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-09-30$751,579
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-09-30No
Did the plan have assets held for investment2020-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-09-30No
Opinion of an independent qualified public accountant for this plan2020-09-30Unqualified
Accountancy firm name2020-09-30STANFIELD + O'DELL, P.C.
Accountancy firm EIN2020-09-30731293433
2019 : SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2019 401k financial data
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-09-30$26,109
Total income from all sources (including contributions)2019-09-30$1,050,719
Total of all expenses incurred2019-09-30$1,019,393
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-09-30$751,960
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-09-30$1,050,422
Value of total assets at end of year2019-09-30$5,217
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-09-30$267,433
Total interest from all sources2019-09-30$297
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-09-30No
Was this plan covered by a fidelity bond2019-09-30No
If this is an individual account plan, was there a blackout period2019-09-30No
Were there any nonexempt tranactions with any party-in-interest2019-09-30No
Contributions received from participants2019-09-30$276,500
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-09-30$82,990
Administrative expenses (other) incurred2019-09-30$267,433
Liabilities. Value of operating payables at beginning of year2019-09-30$26,109
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-09-30No
Value of net income/loss2019-09-30$31,326
Value of net assets at end of year (total assets less liabilities)2019-09-30$5,217
Value of net assets at beginning of year (total assets less liabilities)2019-09-30$-26,109
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2019-09-30No
Were any leases to which the plan was party in default or uncollectible2019-09-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-09-30$5,217
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-09-30$297
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-09-30No
Was there a failure to transmit to the plan any participant contributions2019-09-30No
Has the plan failed to provide any benefit when due under the plan2019-09-30No
Contributions received in cash from employer2019-09-30$773,922
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-09-30$668,970
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-09-30No
Did the plan have assets held for investment2019-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-09-30No
Opinion of an independent qualified public accountant for this plan2019-09-30Unqualified
Accountancy firm name2019-09-30STANFIELD + O'DELL, P.C.
Accountancy firm EIN2019-09-30731293433
2018 : SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2018 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-09-30$26,109
Total income from all sources (including contributions)2018-09-30$1,023,135
Total of all expenses incurred2018-09-30$1,061,870
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-09-30$791,850
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-09-30$1,022,831
Value of total assets at beginning of year2018-09-30$12,626
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-09-30$270,020
Total interest from all sources2018-09-30$304
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-09-30No
Was this plan covered by a fidelity bond2018-09-30No
If this is an individual account plan, was there a blackout period2018-09-30No
Were there any nonexempt tranactions with any party-in-interest2018-09-30No
Contributions received from participants2018-09-30$254,041
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-09-30$82,990
Administrative expenses (other) incurred2018-09-30$270,020
Liabilities. Value of operating payables at end of year2018-09-30$26,109
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-09-30No
Value of net income/loss2018-09-30$-38,735
Value of net assets at end of year (total assets less liabilities)2018-09-30$-26,109
Value of net assets at beginning of year (total assets less liabilities)2018-09-30$12,626
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2018-09-30No
Were any leases to which the plan was party in default or uncollectible2018-09-30No
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-09-30$12,626
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-09-30$12,626
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-09-30$304
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-09-30No
Was there a failure to transmit to the plan any participant contributions2018-09-30No
Has the plan failed to provide any benefit when due under the plan2018-09-30No
Contributions received in cash from employer2018-09-30$768,790
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-09-30$708,860
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-09-30No
Did the plan have assets held for investment2018-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-09-30No
Opinion of an independent qualified public accountant for this plan2018-09-30Unqualified
Accountancy firm name2018-09-30STANFIELD + O'DELL, P.C.
Accountancy firm EIN2018-09-30731293433
2017 : SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2017 401k financial data
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-09-30$8,775
Total income from all sources (including contributions)2017-09-30$935,389
Total of all expenses incurred2017-09-30$913,988
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-09-30$657,732
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-09-30$935,257
Value of total assets at end of year2017-09-30$12,626
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-09-30$256,256
Total interest from all sources2017-09-30$132
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-09-30No
Was this plan covered by a fidelity bond2017-09-30No
If this is an individual account plan, was there a blackout period2017-09-30No
Were there any nonexempt tranactions with any party-in-interest2017-09-30No
Contributions received from participants2017-09-30$233,189
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2017-09-30$82,990
Administrative expenses (other) incurred2017-09-30$256,256
Liabilities. Value of operating payables at beginning of year2017-09-30$8,775
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-09-30No
Value of net income/loss2017-09-30$21,401
Value of net assets at end of year (total assets less liabilities)2017-09-30$12,626
Value of net assets at beginning of year (total assets less liabilities)2017-09-30$-8,775
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2017-09-30No
Were any leases to which the plan was party in default or uncollectible2017-09-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-09-30$12,626
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-09-30$132
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-09-30No
Was there a failure to transmit to the plan any participant contributions2017-09-30No
Has the plan failed to provide any benefit when due under the plan2017-09-30No
Contributions received in cash from employer2017-09-30$702,068
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-09-30$574,742
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-09-30No
Did the plan have assets held for investment2017-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-09-30No
Opinion of an independent qualified public accountant for this plan2017-09-30Unqualified
Accountancy firm name2017-09-30STANFIELD O'DELL, P.C.
Accountancy firm EIN2017-09-30731293433
2016 : SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-09-30$8,775
Total income from all sources (including contributions)2016-09-30$916,962
Total of all expenses incurred2016-09-30$1,078,931
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-09-30$821,028
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-09-30$916,891
Value of total assets at beginning of year2016-09-30$153,194
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-09-30$257,903
Total interest from all sources2016-09-30$71
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-09-30No
Was this plan covered by a fidelity bond2016-09-30No
If this is an individual account plan, was there a blackout period2016-09-30No
Were there any nonexempt tranactions with any party-in-interest2016-09-30No
Contributions received from participants2016-09-30$223,808
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2016-09-30$92,990
Administrative expenses (other) incurred2016-09-30$257,903
Liabilities. Value of operating payables at end of year2016-09-30$8,775
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-09-30No
Value of net income/loss2016-09-30$-161,969
Value of net assets at end of year (total assets less liabilities)2016-09-30$-8,775
Value of net assets at beginning of year (total assets less liabilities)2016-09-30$153,194
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2016-09-30No
Were any leases to which the plan was party in default or uncollectible2016-09-30No
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-09-30$153,194
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-09-30$153,194
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-09-30$71
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-09-30No
Was there a failure to transmit to the plan any participant contributions2016-09-30No
Has the plan failed to provide any benefit when due under the plan2016-09-30No
Contributions received in cash from employer2016-09-30$693,083
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-09-30$728,038
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-09-30No
Did the plan have assets held for investment2016-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-09-30No
Opinion of an independent qualified public accountant for this plan2016-09-30Unqualified
Accountancy firm name2016-09-30STANFIELD O'DELL, P.C.
Accountancy firm EIN2016-09-30731293433
2015 : SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2015 401k financial data
Total income from all sources (including contributions)2015-09-30$668,859
Total of all expenses incurred2015-09-30$799,288
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-09-30$578,603
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-09-30$668,403
Value of total assets at end of year2015-09-30$153,194
Value of total assets at beginning of year2015-09-30$283,623
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-09-30$220,685
Total interest from all sources2015-09-30$456
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-09-30No
Was this plan covered by a fidelity bond2015-09-30No
If this is an individual account plan, was there a blackout period2015-09-30No
Were there any nonexempt tranactions with any party-in-interest2015-09-30No
Contributions received from participants2015-09-30$187,819
Income. Received or receivable in cash from other sources (including rollovers)2015-09-30$537
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2015-09-30$82,989
Administrative expenses (other) incurred2015-09-30$220,685
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-09-30No
Value of net income/loss2015-09-30$-130,429
Value of net assets at end of year (total assets less liabilities)2015-09-30$153,194
Value of net assets at beginning of year (total assets less liabilities)2015-09-30$283,623
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2015-09-30No
Were any leases to which the plan was party in default or uncollectible2015-09-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-09-30$153,194
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-09-30$283,623
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-09-30$283,623
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-09-30$456
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-09-30No
Was there a failure to transmit to the plan any participant contributions2015-09-30No
Has the plan failed to provide any benefit when due under the plan2015-09-30No
Contributions received in cash from employer2015-09-30$480,047
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-09-30$495,614
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-09-30No
Did the plan have assets held for investment2015-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-09-30No
Opinion of an independent qualified public accountant for this plan2015-09-30Unqualified
Accountancy firm name2015-09-30STANFIELD & O'DELL, P.C.
Accountancy firm EIN2015-09-30731293433
2014 : SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2014 401k financial data
Total income from all sources (including contributions)2014-09-30$752,249
Total of all expenses incurred2014-09-30$775,494
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-09-30$685,222
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-09-30$751,917
Value of total assets at end of year2014-09-30$283,623
Value of total assets at beginning of year2014-09-30$306,868
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-09-30$90,272
Total interest from all sources2014-09-30$332
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-09-30No
Was this plan covered by a fidelity bond2014-09-30No
If this is an individual account plan, was there a blackout period2014-09-30No
Were there any nonexempt tranactions with any party-in-interest2014-09-30No
Contributions received from participants2014-09-30$185,781
Income. Received or receivable in cash from other sources (including rollovers)2014-09-30$6,529
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2014-09-30$97,711
Administrative expenses (other) incurred2014-09-30$90,272
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-09-30No
Value of net income/loss2014-09-30$-23,245
Value of net assets at end of year (total assets less liabilities)2014-09-30$283,623
Value of net assets at beginning of year (total assets less liabilities)2014-09-30$306,868
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2014-09-30No
Were any leases to which the plan was party in default or uncollectible2014-09-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-09-30$283,623
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-09-30$306,868
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-09-30$306,868
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-09-30$332
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-09-30No
Was there a failure to transmit to the plan any participant contributions2014-09-30No
Has the plan failed to provide any benefit when due under the plan2014-09-30No
Contributions received in cash from employer2014-09-30$559,607
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-09-30$587,511
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-09-30No
Did the plan have assets held for investment2014-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-09-30No
Opinion of an independent qualified public accountant for this plan2014-09-30Unqualified
Accountancy firm name2014-09-30STANFIELD & O'DELL, P.C.
Accountancy firm EIN2014-09-30731293433
2013 : SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2013 401k financial data
Total income from all sources (including contributions)2013-09-30$710,612
Total of all expenses incurred2013-09-30$780,064
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-09-30$597,322
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-09-30$709,983
Value of total assets at end of year2013-09-30$306,868
Value of total assets at beginning of year2013-09-30$376,320
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-09-30$182,742
Total interest from all sources2013-09-30$629
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-09-30No
Was this plan covered by a fidelity bond2013-09-30No
If this is an individual account plan, was there a blackout period2013-09-30No
Were there any nonexempt tranactions with any party-in-interest2013-09-30No
Contributions received from participants2013-09-30$177,639
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-09-30$69,367
Administrative expenses (other) incurred2013-09-30$182,742
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-09-30No
Value of net income/loss2013-09-30$-69,452
Value of net assets at end of year (total assets less liabilities)2013-09-30$306,868
Value of net assets at beginning of year (total assets less liabilities)2013-09-30$376,320
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2013-09-30No
Were any leases to which the plan was party in default or uncollectible2013-09-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-09-30$306,868
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-09-30$376,320
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-09-30$376,320
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-09-30$629
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-09-30No
Was there a failure to transmit to the plan any participant contributions2013-09-30No
Has the plan failed to provide any benefit when due under the plan2013-09-30No
Contributions received in cash from employer2013-09-30$532,344
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-09-30$527,955
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-09-30No
Did the plan have assets held for investment2013-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-09-30No
Opinion of an independent qualified public accountant for this plan2013-09-30Unqualified
Accountancy firm name2013-09-30STANFIELD & O'DELL, P.C.
Accountancy firm EIN2013-09-30731293433
2012 : SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2012 401k financial data
Total income from all sources (including contributions)2012-09-30$721,211
Total of all expenses incurred2012-09-30$624,225
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-09-30$471,137
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-09-30$719,820
Value of total assets at end of year2012-09-30$376,320
Value of total assets at beginning of year2012-09-30$279,334
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-09-30$153,088
Total interest from all sources2012-09-30$1,391
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-09-30No
Was this plan covered by a fidelity bond2012-09-30No
If this is an individual account plan, was there a blackout period2012-09-30No
Were there any nonexempt tranactions with any party-in-interest2012-09-30No
Contributions received from participants2012-09-30$176,396
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2012-09-30$73,355
Administrative expenses (other) incurred2012-09-30$153,088
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-09-30No
Value of net income/loss2012-09-30$96,986
Value of net assets at end of year (total assets less liabilities)2012-09-30$376,320
Value of net assets at beginning of year (total assets less liabilities)2012-09-30$279,334
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2012-09-30No
Were any leases to which the plan was party in default or uncollectible2012-09-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-09-30$376,320
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-09-30$279,334
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-09-30$279,334
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-09-30$1,391
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-09-30No
Was there a failure to transmit to the plan any participant contributions2012-09-30No
Has the plan failed to provide any benefit when due under the plan2012-09-30No
Contributions received in cash from employer2012-09-30$543,424
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-09-30$397,782
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-09-30No
Did the plan have assets held for investment2012-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-09-30No
Opinion of an independent qualified public accountant for this plan2012-09-30Unqualified
Accountancy firm name2012-09-30STANFIELD & O'DELL, P.C.
Accountancy firm EIN2012-09-30731293433
2011 : SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2011 401k financial data
Total income from all sources (including contributions)2011-09-30$763,862
Total of all expenses incurred2011-09-30$830,828
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-09-30$637,709
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-09-30$683,790
Value of total assets at end of year2011-09-30$279,334
Value of total assets at beginning of year2011-09-30$346,300
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-09-30$193,119
Total interest from all sources2011-09-30$1,695
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-09-30No
Administrative expenses professional fees incurred2011-09-30$30,830
Was this plan covered by a fidelity bond2011-09-30No
Were there any nonexempt tranactions with any party-in-interest2011-09-30No
Contributions received from participants2011-09-30$169,723
Income. Received or receivable in cash from other sources (including rollovers)2011-09-30$566
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2011-09-30$66,993
Other income not declared elsewhere2011-09-30$78,377
Administrative expenses (other) incurred2011-09-30$162,289
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-09-30No
Value of net income/loss2011-09-30$-66,966
Value of net assets at end of year (total assets less liabilities)2011-09-30$279,334
Value of net assets at beginning of year (total assets less liabilities)2011-09-30$346,300
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2011-09-30No
Were any leases to which the plan was party in default or uncollectible2011-09-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-09-30$279,334
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-09-30$346,300
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-09-30$346,300
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-09-30$1,695
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-09-30No
Was there a failure to transmit to the plan any participant contributions2011-09-30No
Has the plan failed to provide any benefit when due under the plan2011-09-30No
Contributions received in cash from employer2011-09-30$513,501
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-09-30$570,716
Did the plan have assets held for investment2011-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-09-30No
Opinion of an independent qualified public accountant for this plan2011-09-30Unqualified
Accountancy firm name2011-09-30STANFIELD & O'DELL, P.C.
Accountancy firm EIN2011-09-30731293433

Form 5500 Responses for SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN

2021: SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2021 form 5500 responses
2021-10-01Type of plan entitySingle employer plan
2021-10-01Plan funding arrangement – TrustYes
2021-10-01Plan benefit arrangement – InsuranceYes
2021-10-01Plan benefit arrangement - TrustYes
2020: SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2020 form 5500 responses
2020-10-01Type of plan entitySingle employer plan
2020-10-01Plan funding arrangement – TrustYes
2020-10-01Plan benefit arrangement – InsuranceYes
2020-10-01Plan benefit arrangement - TrustYes
2019: SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01Plan funding arrangement – TrustYes
2019-10-01Plan benefit arrangement – InsuranceYes
2019-10-01Plan benefit arrangement - TrustYes
2018: SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2018 form 5500 responses
2018-10-01Type of plan entitySingle employer plan
2018-10-01Plan funding arrangement – TrustYes
2018-10-01Plan benefit arrangement – InsuranceYes
2018-10-01Plan benefit arrangement - TrustYes
2017: SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01Plan funding arrangement – TrustYes
2017-10-01Plan benefit arrangement – InsuranceYes
2017-10-01Plan benefit arrangement - TrustYes
2016: SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Plan funding arrangement – TrustYes
2016-10-01Plan benefit arrangement – InsuranceYes
2016-10-01Plan benefit arrangement - TrustYes
2015: SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Plan funding arrangement – TrustYes
2015-10-01Plan benefit arrangement – InsuranceYes
2015-10-01Plan benefit arrangement - TrustYes
2014: SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Plan funding arrangement – TrustYes
2014-10-01Plan benefit arrangement – InsuranceYes
2014-10-01Plan benefit arrangement - TrustYes
2013: SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Plan funding arrangement – TrustYes
2013-10-01Plan benefit arrangement – InsuranceYes
2013-10-01Plan benefit arrangement - TrustYes
2012: SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Plan funding arrangement – TrustYes
2012-10-01Plan benefit arrangement – InsuranceYes
2012-10-01Plan benefit arrangement - TrustYes
2011: SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2011 form 5500 responses
2011-10-01Type of plan entitySingle employer plan
2011-10-01Plan funding arrangement – TrustYes
2011-10-01Plan benefit arrangement – InsuranceYes
2011-10-01Plan benefit arrangement - TrustYes
2009: SOUTHERN HILLS COUNTRY CLUB EMPLOYEE BENEFIT PLAN 2009 form 5500 responses
2009-10-01Type of plan entitySingle employer plan
2009-10-01Submission has been amendedYes
2009-10-01Plan funding arrangement – TrustYes
2009-10-01Plan benefit arrangement – InsuranceYes
2009-10-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: )
Policy contract number
Policy instance 1
Number of Individuals Covered125
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $248,037
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: )
Policy contract number
Policy instance 1
Number of Individuals Covered119
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $208,576
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: )
Policy contract number
Policy instance 1
Number of Individuals Covered117
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $202,040
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: )
Policy contract number
Policy instance 1
Number of Individuals Covered112
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $190,433
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: )
Policy contract number
Policy instance 1
Number of Individuals Covered119
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $197,628
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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