401k Plan data: NAC-FLEXIBLE BENEFIT PLAN plan

NAC-FLEXIBLE BENEFIT PLAN 401k Plan overview

Plan Name	NAC-FLEXIBLE BENEFIT PLAN
Plan identification number	504

NAC-FLEXIBLE 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) Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

NEWSPAPER AGENCY COMPANY, LLC has sponsored the creation of one or more 401k plans.

Company Name: NEWSPAPER AGENCY COMPANY, LLC

Employer identification number (EIN): 204927331

NAIC Classification: 511110
NAIC Description: Newspaper Publishers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NAC-FLEXIBLE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
504 2012-01-01 DAVID CURTIS
504 2011-01-01 DAVID CURTIS
504 2009-01-01 DAVID CURTIS

Plan id#	Filing Submission Date	Name of Administrator
504	2012-01-01	DAVID CURTIS
504	2011-01-01	DAVID CURTIS
504	2009-01-01	DAVID CURTIS

Plan Statistics for NAC-FLEXIBLE BENEFIT PLAN

401k plan membership statisitcs for NAC-FLEXIBLE BENEFIT PLAN

Measure Date Value
2012: NAC-FLEXIBLE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 482
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 326
Number of retired or separated participants receiving benefits 2012-01-01 137
Total of all active and inactive participants 2012-01-01 463
Total participants 2012-01-01 0
2011: NAC-FLEXIBLE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 499
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 334
Number of retired or separated participants receiving benefits 2011-01-01 148
Total of all active and inactive participants 2011-01-01 482
Total participants 2011-01-01 482
2009: NAC-FLEXIBLE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 555
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 387
Number of retired or separated participants receiving benefits 2009-01-01 158
Total of all active and inactive participants 2009-01-01 545
Total participants 2009-01-01 545

Measure	Date	Value
2012: NAC-FLEXIBLE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	482
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	326
Number of retired or separated participants receiving benefits	2012-01-01	137
Total of all active and inactive participants	2012-01-01	463
Total participants	2012-01-01	0
2011: NAC-FLEXIBLE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	499
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	334
Number of retired or separated participants receiving benefits	2011-01-01	148
Total of all active and inactive participants	2011-01-01	482
Total participants	2011-01-01	482
2009: NAC-FLEXIBLE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	555
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	387
Number of retired or separated participants receiving benefits	2009-01-01	158
Total of all active and inactive participants	2009-01-01	545
Total participants	2009-01-01	545

Form 5500 Responses for NAC-FLEXIBLE BENEFIT PLAN

2012: NAC-FLEXIBLE BENEFIT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: NAC-FLEXIBLE BENEFIT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: NAC-FLEXIBLE BENEFIT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

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

Policy contract number

10135140

Policy instance

Insurance contract or identification number	10135140
Number of Individuals Covered	326
Total amount of commissions paid to insurance broker	USD $2,699
Total amount of fees paid to insurance company	USD $2,275
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $39,444
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,699
Amount paid for insurance broker fees	2275
Additional information about fees paid to insurance broker	NON-MONETARY COMPENSATION, BONUSES, OVERRIDES AND AWARDS
Insurance broker organization code?	3
Insurance broker name	MORETON & COMPANY

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

Policy contract number

10138929

Policy instance

Insurance contract or identification number	10138929
Number of Individuals Covered	149
Total amount of commissions paid to insurance broker	USD $2,394
Total amount of fees paid to insurance company	USD $1,082
Other welfare benefits provided	WEEKLY INCOME
Welfare Benefit Premiums Paid to Carrier	USD $15,959
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,394
Amount paid for insurance broker fees	1082
Additional information about fees paid to insurance broker	NON-MONETARY COMPENSATION, BONUSES, OVERRIDES AND AWARDS
Insurance broker organization code?	3
Insurance broker name	MORETON & COMPANY

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

Policy contract number

400001000 12518

Policy instance

Insurance contract or identification number	400001000 12518
Number of Individuals Covered	137
Total amount of commissions paid to insurance broker	USD $5,258
Total amount of fees paid to insurance company	USD $2,118
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $35,053
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,258
Amount paid for insurance broker fees	2118
Additional information about fees paid to insurance broker	NON-MONETARY COMPENSATION, BONUSES, OVERRIDES AND AWARDS
Insurance broker organization code?	3
Insurance broker name	MORETON & COMPANY

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

9808320

Policy instance

Insurance contract or identification number	9808320
Number of Individuals Covered	591
Total amount of commissions paid to insurance broker	USD $3,307
Total amount of fees paid to insurance company	USD $1,653
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $33,107
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $255
Insurance broker organization code?	3
Amount paid for insurance broker fees	1653
Additional information about fees paid to insurance broker	MARKETING FEE
Insurance broker name	MORETON & COMPANY

ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )

Policy contract number

12000028

Policy instance

Insurance contract or identification number	12000028
Number of Individuals Covered	242
Total amount of commissions paid to insurance broker	USD $14,692
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $212,217
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,692
Insurance broker organization code?	3
Insurance broker name	DIVERSIFIED INSURANCE BENEFIT SERVI

SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 )

Policy contract number

G1012509 1001

Policy instance

Insurance contract or identification number	G1012509 1001
Number of Individuals Covered	596
Total amount of commissions paid to insurance broker	USD $23,442
Total amount of fees paid to insurance company	USD $7,970
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,855,830
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,829
Amount paid for insurance broker fees	622
Additional information about fees paid to insurance broker	NON-MONETARY COMPENSATION, BONUSES, OVERRIDES, AWARDS
Insurance broker organization code?	3
Insurance broker name	MORETON & COMPANY

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

Policy contract number

400001000 12518

Policy instance

Insurance contract or identification number	400001000 12518
Number of Individuals Covered	148
Total amount of commissions paid to insurance broker	USD $5,619
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $37,461
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

ADDS07188

Policy instance

Insurance contract or identification number	ADDS07188
Number of Individuals Covered	404
Total amount of commissions paid to insurance broker	USD $71
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $470
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

9808320

Policy instance

Insurance contract or identification number	9808320
Number of Individuals Covered	579
Total amount of commissions paid to insurance broker	USD $2,855
Total amount of fees paid to insurance company	USD $1,427
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $31,100
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )

Policy contract number

12000028

Policy instance

Insurance contract or identification number	12000028
Number of Individuals Covered	260
Total amount of commissions paid to insurance broker	USD $14,288
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $205,280
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

864417G

Policy instance

Insurance contract or identification number	864417G
Number of Individuals Covered	404
Total amount of fees paid to insurance company	USD $645
Life Insurance Welfare Benefit	Yes
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

10138929

Policy instance

Insurance contract or identification number	10138929
Number of Individuals Covered	161
Total amount of commissions paid to insurance broker	USD $2,872
Other welfare benefits provided	WEEKLY INCOME
Welfare Benefit Premiums Paid to Carrier	USD $19,149
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

10135140

Policy instance

Insurance contract or identification number	10135140
Number of Individuals Covered	334
Total amount of commissions paid to insurance broker	USD $2,715
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $40,240
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 )

Policy contract number

G1012509 1001

Policy instance

Insurance contract or identification number	G1012509 1001
Number of Individuals Covered	618
Total amount of commissions paid to insurance broker	USD $23,468
Total amount of fees paid to insurance company	USD $7,317
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,700,060
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

REGENCE BLUECROSS BLUESHIELD OF UTAH (National Association of Insurance Commissioners NAIC id number: 54550 )

Policy contract number

02089

Policy instance

Insurance contract or identification number	02089
Number of Individuals Covered	597
Total amount of commissions paid to insurance broker	USD $27,960
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,650,869
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $27,960
Insurance broker organization code?	3
Insurance broker name	MORETON & COMPANY

ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )

Policy contract number

12000028

Policy instance

Insurance contract or identification number	12000028
Number of Individuals Covered	254
Total amount of commissions paid to insurance broker	USD $14,126
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $199,192
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,126
Insurance broker organization code?	3
Insurance broker name	MORETON & COMPANY - BRAD KUPFER

OPTICARE OF UTAH (National Association of Insurance Commissioners NAIC id number: 12533 )

Policy contract number

NEWSAGEN

Policy instance

Insurance contract or identification number	NEWSAGEN
Number of Individuals Covered	253
Total amount of commissions paid to insurance broker	USD $1,668
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $16,682
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,668
Insurance broker organization code?	3
Insurance broker name	FRED A. MORETON & CO.

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

ADDS07188

Policy instance

Insurance contract or identification number	ADDS07188
Number of Individuals Covered	73
Total amount of commissions paid to insurance broker	USD $806
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $5,374
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $806
Insurance broker organization code?	3
Insurance broker name	MORETON & CO.

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

864417G

Policy instance

Insurance contract or identification number	864417G
Number of Individuals Covered	349
Total amount of commissions paid to insurance broker	USD $8,767
Total amount of fees paid to insurance company	USD $1,111
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $78,344
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,767
Amount paid for insurance broker fees	1111
Additional information about fees paid to insurance broker	NON-MONETARY COMPENSATION, BONUSES, OVERRIDES AND AWARDS
Insurance broker organization code?	3
Insurance broker name	MORETON & COMPANY

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Company Name:	NEWSPAPER AGENCY COMPANY, LLC
Employer identification number (EIN):	204927331
NAIC Classification:	511110
NAIC Description:	Newspaper Publishers