401k Plan data: BURLINGTON DRUG COMPANY, INC. LTD plan

BURLINGTON DRUG COMPANY, INC. LTD 401k Plan overview

Plan Name	BURLINGTON DRUG COMPANY, INC. LTD
Plan identification number	502

BURLINGTON DRUG COMPANY, INC. LTD Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Long-term disability cover

401k Sponsoring company profile

BURLINGTON DRUG COMPANY, INC. has sponsored the creation of one or more 401k plans.

Company Name: BURLINGTON DRUG COMPANY, INC.

Employer identification number (EIN): 030355423

NAIC Classification: 325410

Additional information about BURLINGTON DRUG COMPANY, INC.

Jurisdiction of Incorporation: Vermont Secretary of State Corporations Division

Incorporation Date: 1998-01-01

Company Identification Number: 117348

Legal Registered Office Address: 17 G W TATRO DR

JEFFERSONVILLE
United States of America (USA)
05464

More information about BURLINGTON DRUG COMPANY, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BURLINGTON DRUG COMPANY, INC. LTD

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2014-10-01 MARIA M. BURNS
502 2013-10-01 MARIA M. BURNS
502 2012-10-01 MARIA M. BURNS
502 2011-10-01 MARIA M. BURNS
502 2010-10-01 MARIA M. BURNS

Plan id#	Filing Submission Date	Name of Administrator
502	2014-10-01	MARIA M. BURNS
502	2013-10-01	MARIA M. BURNS
502	2012-10-01	MARIA M. BURNS
502	2011-10-01	MARIA M. BURNS
502	2010-10-01	MARIA M. BURNS

Plan Statistics for BURLINGTON DRUG COMPANY, INC. LTD

401k plan membership statisitcs for BURLINGTON DRUG COMPANY, INC. LTD

Measure Date Value
2014: BURLINGTON DRUG COMPANY, INC. LTD 2014 401k membership
Total participants, beginning-of-year 2014-10-01 115
Total number of active participants reported on line 7a of the Form 5500 2014-10-01 109
Number of retired or separated participants receiving benefits 2014-10-01 1
Number of other retired or separated participants entitled to future benefits 2014-10-01 0
Total of all active and inactive participants 2014-10-01 110
2013: BURLINGTON DRUG COMPANY, INC. LTD 2013 401k membership
Total participants, beginning-of-year 2013-10-01 109
Total number of active participants reported on line 7a of the Form 5500 2013-10-01 115
Number of retired or separated participants receiving benefits 2013-10-01 1
Number of other retired or separated participants entitled to future benefits 2013-10-01 0
Total of all active and inactive participants 2013-10-01 116
2012: BURLINGTON DRUG COMPANY, INC. LTD 2012 401k membership
Total participants, beginning-of-year 2012-10-01 122
Total number of active participants reported on line 7a of the Form 5500 2012-10-01 119
Number of retired or separated participants receiving benefits 2012-10-01 0
Number of other retired or separated participants entitled to future benefits 2012-10-01 0
Total of all active and inactive participants 2012-10-01 119
2011: BURLINGTON DRUG COMPANY, INC. LTD 2011 401k membership
Total participants, beginning-of-year 2011-10-01 115
Total number of active participants reported on line 7a of the Form 5500 2011-10-01 122
Number of retired or separated participants receiving benefits 2011-10-01 0
Number of other retired or separated participants entitled to future benefits 2011-10-01 0
Total of all active and inactive participants 2011-10-01 122
2010: BURLINGTON DRUG COMPANY, INC. LTD 2010 401k membership
Total participants, beginning-of-year 2010-10-01 115
Total number of active participants reported on line 7a of the Form 5500 2010-10-01 115
Number of retired or separated participants receiving benefits 2010-10-01 0
Number of other retired or separated participants entitled to future benefits 2010-10-01 0
Total of all active and inactive participants 2010-10-01 115

Measure	Date	Value
2014: BURLINGTON DRUG COMPANY, INC. LTD 2014 401k membership
Total participants, beginning-of-year	2014-10-01	115
Total number of active participants reported on line 7a of the Form 5500	2014-10-01	109
Number of retired or separated participants receiving benefits	2014-10-01	1
Number of other retired or separated participants entitled to future benefits	2014-10-01	0
Total of all active and inactive participants	2014-10-01	110
2013: BURLINGTON DRUG COMPANY, INC. LTD 2013 401k membership
Total participants, beginning-of-year	2013-10-01	109
Total number of active participants reported on line 7a of the Form 5500	2013-10-01	115
Number of retired or separated participants receiving benefits	2013-10-01	1
Number of other retired or separated participants entitled to future benefits	2013-10-01	0
Total of all active and inactive participants	2013-10-01	116
2012: BURLINGTON DRUG COMPANY, INC. LTD 2012 401k membership
Total participants, beginning-of-year	2012-10-01	122
Total number of active participants reported on line 7a of the Form 5500	2012-10-01	119
Number of retired or separated participants receiving benefits	2012-10-01	0
Number of other retired or separated participants entitled to future benefits	2012-10-01	0
Total of all active and inactive participants	2012-10-01	119
2011: BURLINGTON DRUG COMPANY, INC. LTD 2011 401k membership
Total participants, beginning-of-year	2011-10-01	115
Total number of active participants reported on line 7a of the Form 5500	2011-10-01	122
Number of retired or separated participants receiving benefits	2011-10-01	0
Number of other retired or separated participants entitled to future benefits	2011-10-01	0
Total of all active and inactive participants	2011-10-01	122
2010: BURLINGTON DRUG COMPANY, INC. LTD 2010 401k membership
Total participants, beginning-of-year	2010-10-01	115
Total number of active participants reported on line 7a of the Form 5500	2010-10-01	115
Number of retired or separated participants receiving benefits	2010-10-01	0
Number of other retired or separated participants entitled to future benefits	2010-10-01	0
Total of all active and inactive participants	2010-10-01	115

Form 5500 Responses for BURLINGTON DRUG COMPANY, INC. LTD

2014: BURLINGTON DRUG COMPANY, INC. LTD 2014 form 5500 responses
2014-10-01	Type of plan entity	Single employer plan
2014-10-01	Submission has been amended	No
2014-10-01	This submission is the final filing	No
2014-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-10-01	Plan is a collectively bargained plan	No
2014-10-01	Plan funding arrangement – Insurance	Yes
2014-10-01	Plan benefit arrangement – Insurance	Yes
2013: BURLINGTON DRUG COMPANY, INC. LTD 2013 form 5500 responses
2013-10-01	Type of plan entity	Single employer plan
2013-10-01	Submission has been amended	No
2013-10-01	This submission is the final filing	No
2013-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-10-01	Plan is a collectively bargained plan	No
2013-10-01	Plan funding arrangement – Insurance	Yes
2013-10-01	Plan benefit arrangement – Insurance	Yes
2012: BURLINGTON DRUG COMPANY, INC. LTD 2012 form 5500 responses
2012-10-01	Type of plan entity	Single employer plan
2012-10-01	Submission has been amended	No
2012-10-01	This submission is the final filing	No
2012-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-10-01	Plan is a collectively bargained plan	No
2012-10-01	Plan funding arrangement – Insurance	Yes
2012-10-01	Plan benefit arrangement – Insurance	Yes
2011: BURLINGTON DRUG COMPANY, INC. LTD 2011 form 5500 responses
2011-10-01	Type of plan entity	Single employer plan
2011-10-01	Submission has been amended	No
2011-10-01	This submission is the final filing	No
2011-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-10-01	Plan is a collectively bargained plan	No
2011-10-01	Plan funding arrangement – Insurance	Yes
2011-10-01	Plan benefit arrangement – Insurance	Yes
2010: BURLINGTON DRUG COMPANY, INC. LTD 2010 form 5500 responses
2010-10-01	Type of plan entity	Single employer plan
2010-10-01	First time form 5500 has been submitted	Yes
2010-10-01	Submission has been amended	No
2010-10-01	This submission is the final filing	No
2010-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-10-01	Plan is a collectively bargained plan	No
2010-10-01	Plan funding arrangement – Insurance	Yes
2010-10-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010164752

Policy instance

Insurance contract or identification number	000010164752
Number of Individuals Covered	109
Insurance policy start date	2014-10-01
Insurance policy end date	2015-09-30
Total amount of commissions paid to insurance broker	USD $2,665
Total amount of fees paid to insurance company	USD $2,665
Are there contracts with allocated funds for individual policies?	No
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	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
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 $17,766
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,665
Amount paid for insurance broker fees	2665
Additional information about fees paid to insurance broker	COMMISSION
Insurance broker organization code?	3
Insurance broker name	NORTHERN BENEFITS

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010164752

Policy instance

Insurance contract or identification number	000010164752
Number of Individuals Covered	115
Insurance policy start date	2013-10-01
Insurance policy end date	2014-09-30
Total amount of commissions paid to insurance broker	USD $2,598
Total amount of fees paid to insurance company	USD $2,598
Are there contracts with allocated funds for individual policies?	No
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	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
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 $17,322
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,598
Amount paid for insurance broker fees	2598
Additional information about fees paid to insurance broker	COMMISSION
Insurance broker organization code?	3
Insurance broker name	NORTHERN BENEFITS

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010164752

Policy instance

Insurance contract or identification number	000010164752
Number of Individuals Covered	119
Insurance policy start date	2012-10-01
Insurance policy end date	2013-09-30
Total amount of commissions paid to insurance broker	USD $2,844
Total amount of fees paid to insurance company	USD $2,844
Are there contracts with allocated funds for individual policies?	No
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	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
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 $18,958
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,844
Amount paid for insurance broker fees	2844
Additional information about fees paid to insurance broker	COMMISSION
Insurance broker organization code?	3
Insurance broker name	NORTHERN BENEFITS

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

Policy contract number

05579

Policy instance

Insurance contract or identification number	05579
Number of Individuals Covered	122
Insurance policy start date	2011-10-01
Insurance policy end date	2012-09-30
Are there contracts with allocated funds for individual policies?	No
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	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
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 $15,667
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

05579

Policy instance

Insurance contract or identification number	05579
Number of Individuals Covered	115
Insurance policy start date	2010-10-01
Insurance policy end date	2011-09-30
Total amount of commissions paid to insurance broker	USD $1,656
Total amount of fees paid to insurance company	USD $1,656
Are there contracts with allocated funds for individual policies?	No
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	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
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 $13,714
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $1,656
Amount paid for insurance broker fees	1656
Additional information about fees paid to insurance broker	COMMISION
Insurance broker organization code?	3
Insurance broker name	ANTELL & COMPANY FIN STRATEGIES

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Company Name:	BURLINGTON DRUG COMPANY, INC.
Employer identification number (EIN):	030355423
NAIC Classification:	325410

Jurisdiction of Incorporation:	Vermont Secretary of State Corporations Division
Incorporation Date:	1998-01-01
Company Identification Number:	117348
Legal Registered Office Address:	17 G W TATRO DR JEFFERSONVILLE United States of America (USA) 05464