401k Plan data: WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN plan

WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 401k Plan overview

Plan Name	WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN
Plan identification number	001

WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
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.
Participant-directed brokerage accounts provided as an investment option under the plan.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

WOOD RIVER INSURANCE, INC. has sponsored the creation of one or more 401k plans.

Company Name: WOOD RIVER INSURANCE, INC.

Employer identification number (EIN): 820423501

NAIC Classification: 524210
NAIC Description: Insurance Agencies and Brokerages

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2012-01-01 MARK S. BALCOS
001 2011-01-01 GREG BLOOMFIELD
001 2009-01-01 GREG BLOOMFIELD GREG BLOOMFIELD 2010-09-20

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2012-01-01	MARK S. BALCOS
001	2011-01-01	GREG BLOOMFIELD
001	2009-01-01	GREG BLOOMFIELD	GREG BLOOMFIELD	2010-09-20

Plan Statistics for WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN

401k plan membership statisitcs for WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN

Measure Date Value
2012: WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 11
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 7
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 2
Total of all active and inactive participants 2012-01-01 9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 9
Number of participants with account balances 2012-01-01 9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 10
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 9
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 2
Total of all active and inactive participants 2011-01-01 11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 11
Number of participants with account balances 2011-01-01 11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 1
2009: WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 12
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 9
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 4
Total of all active and inactive participants 2009-01-01 13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 13
Number of participants with account balances 2009-01-01 13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2012: WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	11
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	7
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	2
Total of all active and inactive participants	2012-01-01	9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	9
Number of participants with account balances	2012-01-01	9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	10
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	9
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	2
Total of all active and inactive participants	2011-01-01	11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	11
Number of participants with account balances	2011-01-01	11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	1
2009: WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	12
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	9
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	4
Total of all active and inactive participants	2009-01-01	13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	13
Number of participants with account balances	2009-01-01	13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN

Measure	Date	Value
2012 : WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 2012 401k financial data
Transfers to/from the plan	2012-12-31	$0
Total plan liabilities at end of year	2012-12-31	$0
Total plan liabilities at beginning of year	2012-12-31	$0
Total income from all sources	2012-12-31	$103,014
Expenses. Total of all expenses incurred	2012-12-31	$4,390
Benefits paid (including direct rollovers)	2012-12-31	$4,145
Total plan assets at end of year	2012-12-31	$1,023,173
Total plan assets at beginning of year	2012-12-31	$924,549
Value of fidelity bond covering the plan	2012-12-31	$200,000
Total contributions received or receivable from participants	2012-12-31	$17,672
Expenses. Other expenses not covered elsewhere	2012-12-31	$0
Contributions received from other sources (not participants or employers)	2012-12-31	$0
Other income received	2012-12-31	$52,539
Noncash contributions received	2012-12-31	$0
Net income (gross income less expenses)	2012-12-31	$98,624
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$1,023,173
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$924,549
Total contributions received or receivable from employer(s)	2012-12-31	$32,803
Value of certain deemed distributions of participant loans	2012-12-31	$0
Value of corrective distributions	2012-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$245
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 2011 401k financial data
Transfers to/from the plan	2011-12-31	$0
Total plan liabilities at end of year	2011-12-31	$0
Total plan liabilities at beginning of year	2011-12-31	$0
Total income from all sources	2011-12-31	$51,079
Expenses. Total of all expenses incurred	2011-12-31	$1,558
Benefits paid (including direct rollovers)	2011-12-31	$1,398
Total plan assets at end of year	2011-12-31	$924,549
Total plan assets at beginning of year	2011-12-31	$875,028
Value of fidelity bond covering the plan	2011-12-31	$250,000
Total contributions received or receivable from participants	2011-12-31	$13,802
Expenses. Other expenses not covered elsewhere	2011-12-31	$0
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$-38,367
Noncash contributions received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$49,521
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$924,549
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$875,028
Total contributions received or receivable from employer(s)	2011-12-31	$75,644
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$160
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 2010 401k financial data
Transfers to/from the plan	2010-12-31	$0
Total plan liabilities at end of year	2010-12-31	$0
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$150,273
Expenses. Total of all expenses incurred	2010-12-31	$50,490
Benefits paid (including direct rollovers)	2010-12-31	$50,235
Total plan assets at end of year	2010-12-31	$875,028
Total plan assets at beginning of year	2010-12-31	$775,245
Value of fidelity bond covering the plan	2010-12-31	$100,000
Total contributions received or receivable from participants	2010-12-31	$10,100
Expenses. Other expenses not covered elsewhere	2010-12-31	$255
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$68,173
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$99,783
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$875,028
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$775,245
Total contributions received or receivable from employer(s)	2010-12-31	$72,000
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0

Form 5500 Responses for WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN

2012: WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	WOOD RIVER INSURANCE, INC.
Employer identification number (EIN):	820423501
NAIC Classification:	524210
NAIC Description:	Insurance Agencies and Brokerages