401k Plan data: FARRELL DISTRIBUTING CORPORATION, INC. plan

FARRELL DISTRIBUTING CORPORATION, INC. 401k Plan overview

Plan Name	FARRELL DISTRIBUTING CORPORATION, INC.
Plan identification number	504

FARRELL DISTRIBUTING CORPORATION, INC. 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 Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

FARRELL DISTRIBUTING CORPORATION, INC. has sponsored the creation of one or more 401k plans.

Company Name: FARRELL DISTRIBUTING CORPORATION, INC.

Employer identification number (EIN): 030214188

NAIC Classification: 424800

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FARRELL DISTRIBUTING CORPORATION, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
504 2022-01-01 CATHY CAMPBELL 2023-04-10
504 2021-01-01 CATHY CAMPBELL 2022-07-07

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
504	2022-01-01	CATHY CAMPBELL	2023-04-10
504	2021-01-01	CATHY CAMPBELL	2022-07-07

Plan Statistics for FARRELL DISTRIBUTING CORPORATION, INC.

401k plan membership statisitcs for FARRELL DISTRIBUTING CORPORATION, INC.

Measure Date Value
2022: FARRELL DISTRIBUTING CORPORATION, INC. 2022 401k membership
Total participants, beginning-of-year 2022-01-01 307
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 314
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 314
Number of employers contributing to the scheme 2022-01-01 0
2021: FARRELL DISTRIBUTING CORPORATION, INC. 2021 401k membership
Total participants, beginning-of-year 2021-01-01 304
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 307
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 307
Number of employers contributing to the scheme 2021-01-01 0

Measure	Date	Value
2022: FARRELL DISTRIBUTING CORPORATION, INC. 2022 401k membership
Total participants, beginning-of-year	2022-01-01	307
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	314
Number of retired or separated participants receiving benefits	2022-01-01	0
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	314
Number of employers contributing to the scheme	2022-01-01	0
2021: FARRELL DISTRIBUTING CORPORATION, INC. 2021 401k membership
Total participants, beginning-of-year	2021-01-01	304
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	307
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	307
Number of employers contributing to the scheme	2021-01-01	0

Form 5500 Responses for FARRELL DISTRIBUTING CORPORATION, INC.

2022: FARRELL DISTRIBUTING CORPORATION, INC. 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: FARRELL DISTRIBUTING CORPORATION, INC. 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	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLUG0BJPY

Policy instance

Insurance contract or identification number	GLUG0BJPY
Number of Individuals Covered	314
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $10,058
Total amount of fees paid to insurance company	USD $0
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	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $103,451
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,058
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

751509

Policy instance

Insurance contract or identification number	751509
Number of Individuals Covered	141
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $11,369
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $11,369
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

751509

Policy instance

Insurance contract or identification number	751509
Number of Individuals Covered	146
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $10,866
Total amount of fees paid to insurance company	USD $906
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,866
Amount paid for insurance broker fees	906
Additional information about fees paid to insurance broker	CONTINGENT COMPENSATION
Insurance broker organization code?	3

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLUG0BJPY

Policy instance

Insurance contract or identification number	GLUG0BJPY
Number of Individuals Covered	307
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $9,562
Total amount of fees paid to insurance company	USD $4,303
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	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $96,747
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,562
Amount paid for insurance broker fees	4303
Additional information about fees paid to insurance broker	OTHER COMPENSATION
Insurance broker organization code?	3

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Company Name:	FARRELL DISTRIBUTING CORPORATION, INC.
Employer identification number (EIN):	030214188
NAIC Classification:	424800