401k Plan data: MOUNTAIN STATES MUTUAL CASUALTY COMPANY 401(K) PLAN AND TRUST plan

MOUNTAIN STATES MUTUAL CASUALTY COMPANY 401(K) PLAN AND TRUST 401k Plan overview

Plan Name	MOUNTAIN STATES MUTUAL CASUALTY COMPANY 401(K) PLAN AND TRUST
Plan identification number	002

MOUNTAIN STATES MUTUAL CASUALTY COMPANY 401(K) PLAN AND TRUST 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
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.
Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
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

MOUNTAIN STATES MUTUAL CASUALTY COMPANY has sponsored the creation of one or more 401k plans.

Company Name: MOUNTAIN STATES MUTUAL CASUALTY COMPANY

Employer identification number (EIN): 850080680

NAIC Classification: 524290

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MOUNTAIN STATES MUTUAL CASUALTY COMPANY 401(K) PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2016-01-01 MELBA BAUM 2017-06-19 MELBA BAUM 2017-06-19
002 2015-01-01 MELBA BAUM 2016-03-18 MELBA BAUM 2016-03-18
002 2014-01-01 MELBA BAUM 2015-04-06 MELBA BAUM 2015-04-06
002 2013-01-01 MELBA BAUM 2014-03-13 MELBA BAUM 2014-03-13
002 2012-01-01 MELBA BAUM 2013-05-03 MELBA BAUM 2013-05-03
002 2011-01-01 MELBA BAUM MELBA BAUM 2012-09-12
002 2010-01-01 MELBA BAUM MELBA BAUM 2011-09-22
002 2009-01-01 MELBA BAUM

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2016-01-01	MELBA BAUM	2017-06-19	MELBA BAUM	2017-06-19
002	2015-01-01	MELBA BAUM	2016-03-18	MELBA BAUM	2016-03-18
002	2014-01-01	MELBA BAUM	2015-04-06	MELBA BAUM	2015-04-06
002	2013-01-01	MELBA BAUM	2014-03-13	MELBA BAUM	2014-03-13
002	2012-01-01	MELBA BAUM	2013-05-03	MELBA BAUM	2013-05-03
002	2011-01-01	MELBA BAUM		MELBA BAUM	2012-09-12
002	2010-01-01	MELBA BAUM		MELBA BAUM	2011-09-22
002	2009-01-01	MELBA BAUM

Plan Statistics for MOUNTAIN STATES MUTUAL CASUALTY COMPANY 401(K) PLAN AND TRUST

401k plan membership statisitcs for MOUNTAIN STATES MUTUAL CASUALTY COMPANY 401(K) PLAN AND TRUST

Measure Date Value
2011: MOUNTAIN STATES MUTUAL CASUALTY COMPANY 401(K) PLAN AND TRUST 2011 401k membership
Total participants, beginning-of-year 2011-01-01 109
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 75
Number of retired or separated participants receiving benefits 2011-01-01 20
Total of all active and inactive participants 2011-01-01 95
Total participants 2011-01-01 95
Number of participants with account balances 2011-01-01 94
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: MOUNTAIN STATES MUTUAL CASUALTY COMPANY 401(K) PLAN AND TRUST 2010 401k membership
Total participants, beginning-of-year 2010-01-01 113
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 91
Number of other retired or separated participants entitled to future benefits 2010-01-01 13
Total of all active and inactive participants 2010-01-01 104
Total participants 2010-01-01 104
Number of participants with account balances 2010-01-01 104
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 3
2009: MOUNTAIN STATES MUTUAL CASUALTY COMPANY 401(K) PLAN AND TRUST 2009 401k membership
Total participants, beginning-of-year 2009-01-01 114
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 93
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 18
Total of all active and inactive participants 2009-01-01 111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 111
Number of participants with account balances 2009-01-01 111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 1

Measure	Date	Value
2011: MOUNTAIN STATES MUTUAL CASUALTY COMPANY 401(K) PLAN AND TRUST 2011 401k membership
Total participants, beginning-of-year	2011-01-01	109
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	75
Number of retired or separated participants receiving benefits	2011-01-01	20
Total of all active and inactive participants	2011-01-01	95
Total participants	2011-01-01	95
Number of participants with account balances	2011-01-01	94
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: MOUNTAIN STATES MUTUAL CASUALTY COMPANY 401(K) PLAN AND TRUST 2010 401k membership
Total participants, beginning-of-year	2010-01-01	113
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	91
Number of other retired or separated participants entitled to future benefits	2010-01-01	13
Total of all active and inactive participants	2010-01-01	104
Total participants	2010-01-01	104
Number of participants with account balances	2010-01-01	104
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	3
2009: MOUNTAIN STATES MUTUAL CASUALTY COMPANY 401(K) PLAN AND TRUST 2009 401k membership
Total participants, beginning-of-year	2009-01-01	114
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	93
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	18
Total of all active and inactive participants	2009-01-01	111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	111
Number of participants with account balances	2009-01-01	111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	1

Financial Data on MOUNTAIN STATES MUTUAL CASUALTY COMPANY 401(K) PLAN AND TRUST

Measure	Date	Value
2011 : MOUNTAIN STATES MUTUAL CASUALTY COMPANY 401(K) PLAN AND TRUST 2011 401k financial data
Total income from all sources (including contributions)	2011-12-31	$624,512
Total of all expenses incurred	2011-12-31	$729,765
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$729,758
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$627,936
Value of total assets at end of year	2011-12-31	$4,054,934
Value of total assets at beginning of year	2011-12-31	$4,160,187
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$7
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$75,928
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$75,928
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$2,000,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$367,138
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$4,200
Administrative expenses (other) incurred	2011-12-31	$7
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$-105,253
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$4,054,934
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$4,160,187
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$3,404,256
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$3,575,337
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$646,336
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$584,064
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$584,064
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-79,352
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$256,598
Employer contributions (assets) at end of year	2011-12-31	$4,342
Employer contributions (assets) at beginning of year	2011-12-31	$786
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$729,758
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	REDW, LLC
Accountancy firm EIN	2011-12-31	850203421
2010 : MOUNTAIN STATES MUTUAL CASUALTY COMPANY 401(K) PLAN AND TRUST 2010 401k financial data
Total income from all sources (including contributions)	2010-12-31	$984,209
Total of all expenses incurred	2010-12-31	$892,002
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$892,002
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$677,163
Value of total assets at end of year	2010-12-31	$4,160,187
Value of total assets at beginning of year	2010-12-31	$4,067,980
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$82,048
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$82,048
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$2,000,000
If this is an individual account plan, was there a blackout period	2010-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$400,733
Other income not declared elsewhere	2010-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$92,207
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$4,160,187
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$4,067,980
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$3,575,337
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$3,548,945
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$584,064
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$401,652
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$401,652
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$224,998
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$276,430
Employer contributions (assets) at end of year	2010-12-31	$786
Employer contributions (assets) at beginning of year	2010-12-31	$117,383
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$892,002
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2010-12-31	Yes
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	REDW, LLC
Accountancy firm EIN	2010-12-31	850203421
2009 : MOUNTAIN STATES MUTUAL CASUALTY COMPANY 401(K) PLAN AND TRUST 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for MOUNTAIN STATES MUTUAL CASUALTY COMPANY 401(K) PLAN AND TRUST

2011: MOUNTAIN STATES MUTUAL CASUALTY COMPANY 401(K) PLAN AND TRUST 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 – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: MOUNTAIN STATES MUTUAL CASUALTY COMPANY 401(K) PLAN AND TRUST 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	Yes
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: MOUNTAIN STATES MUTUAL CASUALTY COMPANY 401(K) PLAN AND TRUST 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
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 – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	MOUNTAIN STATES MUTUAL CASUALTY COMPANY
Employer identification number (EIN):	850080680
NAIC Classification:	524290