401k Plan data: MTS SERVICES, INC. DENTAL, MEDICAL AND VISION PLAN plan

MTS SERVICES, INC. DENTAL, MEDICAL AND VISION PLAN 401k Plan overview

Plan Name	MTS SERVICES, INC. DENTAL, MEDICAL AND VISION PLAN
Plan identification number	502

MTS SERVICES, INC. DENTAL, MEDICAL AND VISION PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

MTS SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name: MTS SERVICES, INC.

Employer identification number (EIN): 042861100

NAIC Classification: 238210
NAIC Description: Electrical Contractors and Other Wiring Installation Contractors

Additional information about MTS SERVICES, INC.

Jurisdiction of Incorporation: Nevada Department of State

Incorporation Date: 2010-06-22

Company Identification Number: 20101468408

Legal Registered Office Address: 4650 WEDEKIND RD STE 2

SPARKS
United States of America (USA)
89431-7722

More information about MTS SERVICES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MTS SERVICES, INC. DENTAL, MEDICAL AND VISION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2016-10-01 CRAIG GILROY
502 2015-10-01 CRAIG GILROY
502 2014-10-01 CRAIG GILROY
502 2013-10-01 RICK GALLIN

Plan id#	Filing Submission Date	Name of Administrator
502	2016-10-01	CRAIG GILROY
502	2015-10-01	CRAIG GILROY
502	2014-10-01	CRAIG GILROY
502	2013-10-01	RICK GALLIN

Plan Statistics for MTS SERVICES, INC. DENTAL, MEDICAL AND VISION PLAN

401k plan membership statisitcs for MTS SERVICES, INC. DENTAL, MEDICAL AND VISION PLAN

Measure Date Value
2016: MTS SERVICES, INC. DENTAL, MEDICAL AND VISION PLAN 2016 401k membership
Total participants, beginning-of-year 2016-10-01 113
Total number of active participants reported on line 7a of the Form 5500 2016-10-01 82
Number of retired or separated participants receiving benefits 2016-10-01 2
Number of other retired or separated participants entitled to future benefits 2016-10-01 0
Total of all active and inactive participants 2016-10-01 84
2015: MTS SERVICES, INC. DENTAL, MEDICAL AND VISION PLAN 2015 401k membership
Total participants, beginning-of-year 2015-10-01 118
Total number of active participants reported on line 7a of the Form 5500 2015-10-01 129
Number of retired or separated participants receiving benefits 2015-10-01 0
Number of other retired or separated participants entitled to future benefits 2015-10-01 0
Total of all active and inactive participants 2015-10-01 129
2014: MTS SERVICES, INC. DENTAL, MEDICAL AND VISION PLAN 2014 401k membership
Total participants, beginning-of-year 2014-10-01 114
Total number of active participants reported on line 7a of the Form 5500 2014-10-01 105
Number of retired or separated participants receiving benefits 2014-10-01 2
Number of other retired or separated participants entitled to future benefits 2014-10-01 0
Total of all active and inactive participants 2014-10-01 107
2013: MTS SERVICES, INC. DENTAL, MEDICAL AND VISION PLAN 2013 401k membership
Total participants, beginning-of-year 2013-10-01 108
Total number of active participants reported on line 7a of the Form 5500 2013-10-01 114
Number of retired or separated participants receiving benefits 2013-10-01 0
Number of other retired or separated participants entitled to future benefits 2013-10-01 0
Total of all active and inactive participants 2013-10-01 114

Measure	Date	Value
2016: MTS SERVICES, INC. DENTAL, MEDICAL AND VISION PLAN 2016 401k membership
Total participants, beginning-of-year	2016-10-01	113
Total number of active participants reported on line 7a of the Form 5500	2016-10-01	82
Number of retired or separated participants receiving benefits	2016-10-01	2
Number of other retired or separated participants entitled to future benefits	2016-10-01	0
Total of all active and inactive participants	2016-10-01	84
2015: MTS SERVICES, INC. DENTAL, MEDICAL AND VISION PLAN 2015 401k membership
Total participants, beginning-of-year	2015-10-01	118
Total number of active participants reported on line 7a of the Form 5500	2015-10-01	129
Number of retired or separated participants receiving benefits	2015-10-01	0
Number of other retired or separated participants entitled to future benefits	2015-10-01	0
Total of all active and inactive participants	2015-10-01	129
2014: MTS SERVICES, INC. DENTAL, MEDICAL AND VISION PLAN 2014 401k membership
Total participants, beginning-of-year	2014-10-01	114
Total number of active participants reported on line 7a of the Form 5500	2014-10-01	105
Number of retired or separated participants receiving benefits	2014-10-01	2
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	107
2013: MTS SERVICES, INC. DENTAL, MEDICAL AND VISION PLAN 2013 401k membership
Total participants, beginning-of-year	2013-10-01	108
Total number of active participants reported on line 7a of the Form 5500	2013-10-01	114
Number of retired or separated participants receiving benefits	2013-10-01	0
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	114

Form 5500 Responses for MTS SERVICES, INC. DENTAL, MEDICAL AND VISION PLAN

2016: MTS SERVICES, INC. DENTAL, MEDICAL AND VISION PLAN 2016 form 5500 responses
2016-10-01	Type of plan entity	Single employer plan
2016-10-01	Submission has been amended	No
2016-10-01	This submission is the final filing	No
2016-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-10-01	Plan is a collectively bargained plan	No
2016-10-01	Plan funding arrangement – Insurance	Yes
2016-10-01	Plan benefit arrangement – Insurance	Yes
2015: MTS SERVICES, INC. DENTAL, MEDICAL AND VISION PLAN 2015 form 5500 responses
2015-10-01	Type of plan entity	Single employer plan
2015-10-01	Submission has been amended	No
2015-10-01	This submission is the final filing	No
2015-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-10-01	Plan is a collectively bargained plan	No
2015-10-01	Plan funding arrangement – Insurance	Yes
2015-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-10-01	Plan benefit arrangement – Insurance	Yes
2015-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: MTS SERVICES, INC. DENTAL, MEDICAL AND VISION PLAN 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 funding arrangement – General assets of the sponsor	Yes
2014-10-01	Plan benefit arrangement – Insurance	Yes
2014-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: MTS SERVICES, INC. DENTAL, MEDICAL AND VISION PLAN 2013 form 5500 responses
2013-10-01	Type of plan entity	Single employer plan
2013-10-01	First time form 5500 has been submitted	Yes
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

Insurance Providers Used on plan

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

0611750

Policy instance

Insurance contract or identification number	0611750
Number of Individuals Covered	123
Insurance policy start date	2014-10-01
Insurance policy end date	2015-09-30
Total amount of commissions paid to insurance broker	USD $5,679
Total amount of fees paid to insurance company	USD $0
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	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
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 $106,063
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,679
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	CRONIN & GERVINO INSURANCE

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

1038285

Policy instance

Insurance contract or identification number	1038285
Number of Individuals Covered	228
Insurance policy start date	2013-10-01
Insurance policy end date	2014-09-30
Total amount of commissions paid to insurance broker	USD $11,444
Total amount of fees paid to insurance company	USD $0
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	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
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 $98,621
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,854
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	MANN & WATTERS INC

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Company Name:	MTS SERVICES, INC.
Employer identification number (EIN):	042861100
NAIC Classification:	238210
NAIC Description:	Electrical Contractors and Other Wiring Installation Contractors

Jurisdiction of Incorporation:	Nevada Department of State
Incorporation Date:	2010-06-22
Company Identification Number:	20101468408
Legal Registered Office Address:	4650 WEDEKIND RD STE 2 SPARKS United States of America (USA) 89431-7722