401k Plan data: NSMG SHARED SERVICES, LLC AND VALLEY OF THE TEMPLES, LLC plan

NSMG SHARED SERVICES, LLC AND VALLEY OF THE TEMPLES, LLC 401k Plan overview

Plan Name	NSMG SHARED SERVICES, LLC AND VALLEY OF THE TEMPLES, LLC
Plan identification number	504

NSMG SHARED SERVICES, LLC AND VALLEY OF THE TEMPLES, LLC Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Dental Vision

401k Sponsoring company profile

NSMG SHARED SERVICES, LLC has sponsored the creation of one or more 401k plans.

Company Name: NSMG SHARED SERVICES, LLC

Employer identification number (EIN): 208729143

NAIC Classification: 812210
NAIC Description: Funeral Homes and Funeral Services

Additional information about NSMG SHARED SERVICES, LLC

Jurisdiction of Incorporation: State of Delaware Division of Corporations

Incorporation Date: 2007-03-27

Company Identification Number: 4324557

Legal Registered Office Address: Corporation Trust Center
1209 Orange St
Wilmington
United States of America (USA)
19801

More information about NSMG SHARED SERVICES, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NSMG SHARED SERVICES, LLC AND VALLEY OF THE TEMPLES, LLC

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
504 2014-01-01 NIKI SESSIONS

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
504	2014-01-01	NIKI SESSIONS

Plan Statistics for NSMG SHARED SERVICES, LLC AND VALLEY OF THE TEMPLES, LLC

401k plan membership statisitcs for NSMG SHARED SERVICES, LLC AND VALLEY OF THE TEMPLES, LLC

Measure Date Value
2014: NSMG SHARED SERVICES, LLC AND VALLEY OF THE TEMPLES, LLC 2014 401k membership
Total participants, beginning-of-year 2014-01-01 0
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 0
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 0

Measure	Date	Value
2014: NSMG SHARED SERVICES, LLC AND VALLEY OF THE TEMPLES, LLC 2014 401k membership
Total participants, beginning-of-year	2014-01-01	0
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	0
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	0

Form 5500 Responses for NSMG SHARED SERVICES, LLC AND VALLEY OF THE TEMPLES, LLC

2014: NSMG SHARED SERVICES, LLC AND VALLEY OF THE TEMPLES, LLC 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	First time form 5500 has been submitted	Yes
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	Yes
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )

Policy contract number

17598

Policy instance

Insurance contract or identification number	17598
Number of Individuals Covered	0
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
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	Yes
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 $598,963
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3
Insurance broker name	ASCENDE, INC

HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )

Policy contract number

17592

Policy instance

Insurance contract or identification number	17592
Number of Individuals Covered	0
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
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	Yes
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 $172,879
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3
Insurance broker name	ASCENDE, INC.

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Company Name:	NSMG SHARED SERVICES, LLC
Employer identification number (EIN):	208729143
NAIC Classification:	812210
NAIC Description:	Funeral Homes and Funeral Services

Jurisdiction of Incorporation:	State of Delaware Division of Corporations
Incorporation Date:	2007-03-27
Company Identification Number:	4324557
Legal Registered Office Address:	Corporation Trust Center 1209 Orange St Wilmington United States of America (USA) 19801