401k Plan data: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF SDSE LLC plan

GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF SDSE LLC 401k Plan overview

Plan Name	GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF SDSE LLC
Plan identification number	502

GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF SDSE LLC Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Temporary disability (accident and sickness)

401k Sponsoring company profile

SDSE LLC has sponsored the creation of one or more 401k plans.

Company Name: SDSE LLC

Employer identification number (EIN): 201116171

NAIC Classification: 541600

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF SDSE LLC

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2014-05-01 DYMORR PHILLIPS
502 2013-05-01 LINDSAY MOORE
502 2012-05-01 LINDSAY MOORE
502 2011-05-01 LINDSAY MOORE

Plan id#	Filing Submission Date	Name of Administrator
502	2014-05-01	DYMORR PHILLIPS
502	2013-05-01	LINDSAY MOORE
502	2012-05-01	LINDSAY MOORE
502	2011-05-01	LINDSAY MOORE

Plan Statistics for GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF SDSE LLC

401k plan membership statisitcs for GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF SDSE LLC

Measure Date Value
2014: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF SDSE LLC 2014 401k membership
Total participants, beginning-of-year 2014-05-01 221
Total number of active participants reported on line 7a of the Form 5500 2014-05-01 137
Number of retired or separated participants receiving benefits 2014-05-01 0
Number of other retired or separated participants entitled to future benefits 2014-05-01 0
Total of all active and inactive participants 2014-05-01 137
2013: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF SDSE LLC 2013 401k membership
Total participants, beginning-of-year 2013-05-01 178
Total number of active participants reported on line 7a of the Form 5500 2013-05-01 221
Number of retired or separated participants receiving benefits 2013-05-01 0
Number of other retired or separated participants entitled to future benefits 2013-05-01 0
Total of all active and inactive participants 2013-05-01 221
2012: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF SDSE LLC 2012 401k membership
Total participants, beginning-of-year 2012-05-01 227
Total number of active participants reported on line 7a of the Form 5500 2012-05-01 203
Number of retired or separated participants receiving benefits 2012-05-01 0
Number of other retired or separated participants entitled to future benefits 2012-05-01 0
Total of all active and inactive participants 2012-05-01 203
2011: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF SDSE LLC 2011 401k membership
Total participants, beginning-of-year 2011-05-01 218
Total number of active participants reported on line 7a of the Form 5500 2011-05-01 238
Number of retired or separated participants receiving benefits 2011-05-01 0
Number of other retired or separated participants entitled to future benefits 2011-05-01 0
Total of all active and inactive participants 2011-05-01 238

Measure	Date	Value
2014: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF SDSE LLC 2014 401k membership
Total participants, beginning-of-year	2014-05-01	221
Total number of active participants reported on line 7a of the Form 5500	2014-05-01	137
Number of retired or separated participants receiving benefits	2014-05-01	0
Number of other retired or separated participants entitled to future benefits	2014-05-01	0
Total of all active and inactive participants	2014-05-01	137
2013: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF SDSE LLC 2013 401k membership
Total participants, beginning-of-year	2013-05-01	178
Total number of active participants reported on line 7a of the Form 5500	2013-05-01	221
Number of retired or separated participants receiving benefits	2013-05-01	0
Number of other retired or separated participants entitled to future benefits	2013-05-01	0
Total of all active and inactive participants	2013-05-01	221
2012: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF SDSE LLC 2012 401k membership
Total participants, beginning-of-year	2012-05-01	227
Total number of active participants reported on line 7a of the Form 5500	2012-05-01	203
Number of retired or separated participants receiving benefits	2012-05-01	0
Number of other retired or separated participants entitled to future benefits	2012-05-01	0
Total of all active and inactive participants	2012-05-01	203
2011: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF SDSE LLC 2011 401k membership
Total participants, beginning-of-year	2011-05-01	218
Total number of active participants reported on line 7a of the Form 5500	2011-05-01	238
Number of retired or separated participants receiving benefits	2011-05-01	0
Number of other retired or separated participants entitled to future benefits	2011-05-01	0
Total of all active and inactive participants	2011-05-01	238

Form 5500 Responses for GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF SDSE LLC

2014: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF SDSE LLC 2014 form 5500 responses
2014-05-01	Type of plan entity	Single employer plan
2014-05-01	Submission has been amended	No
2014-05-01	This submission is the final filing	No
2014-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-05-01	Plan is a collectively bargained plan	No
2014-05-01	Plan funding arrangement – Insurance	Yes
2014-05-01	Plan benefit arrangement – Insurance	Yes
2013: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF SDSE LLC 2013 form 5500 responses
2013-05-01	Type of plan entity	Single employer plan
2013-05-01	Submission has been amended	No
2013-05-01	This submission is the final filing	No
2013-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-05-01	Plan is a collectively bargained plan	No
2013-05-01	Plan funding arrangement – Insurance	Yes
2013-05-01	Plan benefit arrangement – Insurance	Yes
2012: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF SDSE LLC 2012 form 5500 responses
2012-05-01	Type of plan entity	Single employer plan
2012-05-01	Submission has been amended	No
2012-05-01	This submission is the final filing	No
2012-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-05-01	Plan is a collectively bargained plan	No
2012-05-01	Plan funding arrangement – Insurance	Yes
2012-05-01	Plan benefit arrangement – Insurance	Yes
2011: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF SDSE LLC 2011 form 5500 responses
2011-05-01	Type of plan entity	Single employer plan
2011-05-01	Submission has been amended	No
2011-05-01	This submission is the final filing	No
2011-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-05-01	Plan is a collectively bargained plan	No
2011-05-01	Plan funding arrangement – Insurance	Yes
2011-05-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

G656391

Policy instance

Insurance contract or identification number	G656391
Number of Individuals Covered	224
Insurance policy start date	2014-05-01
Insurance policy end date	2015-04-30
Total amount of commissions paid to insurance broker	USD $3,872
Total amount of fees paid to insurance company	USD $3,720
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	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 $40,760
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,872
Amount paid for insurance broker fees	933
Additional information about fees paid to insurance broker	ADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?	3
Insurance broker name	NFP INSURANCE SERVICES INC

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

G656391

Policy instance

Insurance contract or identification number	G656391
Number of Individuals Covered	209
Insurance policy start date	2013-05-01
Insurance policy end date	2014-04-30
Total amount of commissions paid to insurance broker	USD $2,243
Total amount of fees paid to insurance company	USD $1,626
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	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 $23,615
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,243
Amount paid for insurance broker fees	209
Additional information about fees paid to insurance broker	ADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?	3
Insurance broker name	KELLY & ASSOCIATES INSURANCE GROUP

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

G656391

Policy instance

Insurance contract or identification number	G656391
Number of Individuals Covered	209
Insurance policy start date	2012-05-01
Insurance policy end date	2013-04-30
Total amount of commissions paid to insurance broker	USD $2,481
Total amount of fees paid to insurance company	USD $2,236
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	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 $26,121
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,481
Amount paid for insurance broker fees	669
Additional information about fees paid to insurance broker	ADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?	3
Insurance broker name	KELLY & ASSOCIATES INSURANCE GROUP

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

Policy contract number

000010128139

Policy instance

Insurance contract or identification number	000010128139
Number of Individuals Covered	240
Insurance policy start date	2011-05-01
Insurance policy end date	2012-04-30
Total amount of commissions paid to insurance broker	USD $3,385
Total amount of fees paid to insurance company	USD $1,892
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	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 $29,736
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

000010128139

Policy instance

Insurance contract or identification number	000010128139
Number of Individuals Covered	238
Insurance policy start date	2010-05-01
Insurance policy end date	2011-04-30
Total amount of commissions paid to insurance broker	USD $4,409
Total amount of fees paid to insurance company	USD $1,163
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	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 $20,637
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	SDSE LLC
Employer identification number (EIN):	201116171
NAIC Classification:	541600