401k Plan data: V&S MIDWEST CARRIERS BENEFIT PLAN plan

V&S MIDWEST CARRIERS BENEFIT PLAN 401k Plan overview

Plan Name	V&S MIDWEST CARRIERS BENEFIT PLAN
Plan identification number	505

V&S MIDWEST CARRIERS BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Other welfare benefit cover

401k Sponsoring company profile

V&S MIDWEST CARRIERS CORP has sponsored the creation of one or more 401k plans.

Company Name: V&S MIDWEST CARRIERS CORP

Employer identification number (EIN): 010552460

NAIC Classification: 484120
NAIC Description: General Freight Trucking, Long-Distance

Form 5500 Filing Information

Submission information for form 5500 for 401k plan V&S MIDWEST CARRIERS BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
505 2022-01-01 MARGARET VAN HANDEL 2023-08-31
505 2021-01-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
505	2022-01-01	MARGARET VAN HANDEL	2023-08-31
505	2021-01-01

Plan Statistics for V&S MIDWEST CARRIERS BENEFIT PLAN

401k plan membership statisitcs for V&S MIDWEST CARRIERS BENEFIT PLAN

Measure Date Value
2022: V&S MIDWEST CARRIERS BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 151
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 193
Number of retired or separated participants receiving benefits 2022-01-01 1
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 194
2021: V&S MIDWEST CARRIERS BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 148
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 148
Total of all active and inactive participants 2021-01-01 148
Total participants 2021-01-01 148

Measure	Date	Value
2022: V&S MIDWEST CARRIERS BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	151
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	193
Number of retired or separated participants receiving benefits	2022-01-01	1
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	194
2021: V&S MIDWEST CARRIERS BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	148
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	148
Total of all active and inactive participants	2021-01-01	148
Total participants	2021-01-01	148

Form 5500 Responses for V&S MIDWEST CARRIERS BENEFIT PLAN

2022: V&S MIDWEST CARRIERS BENEFIT PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2021: V&S MIDWEST CARRIERS BENEFIT PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	First time form 5500 has been submitted	Yes
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

71013

Policy instance

Insurance contract or identification number	71013
Number of Individuals Covered	868
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $32
Are there contracts with allocated funds for individual policies?	0
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	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	BASIC & VOL AD&D, BASIC & VOL LIFE, VOL SPOUSE LIFE, AND VOL CHILD LIFE
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 $153,258
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	32
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker organization code?	5

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00571462

Policy instance

Insurance contract or identification number	00571462
Number of Individuals Covered	148
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Are there contracts with allocated funds for individual policies?	0
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	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 $109,943
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,387
Amount paid for insurance broker fees	3422

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Company Name:	V&S MIDWEST CARRIERS CORP
Employer identification number (EIN):	010552460
NAIC Classification:	484120
NAIC Description:	General Freight Trucking, Long-Distance