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SCHLETTER INC. 401(K) PLAN 401k Plan overview

Plan NameSCHLETTER INC. 401(K) PLAN
Plan identification number 001

SCHLETTER INC. 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

SCHLETTER INC. has sponsored the creation of one or more 401k plans.

Company Name:SCHLETTER INC.
Employer identification number (EIN):223967572
NAIC Classification:332900

Additional information about SCHLETTER INC.

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 4410128

More information about SCHLETTER INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SCHLETTER INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012016-01-01
0012015-01-01DENNIS BRICE
0012014-01-01DENNIS BRICE
0012013-01-01DENNIS BRICE
0012012-01-01MARTIN HAUSNER2013-04-23
0012011-01-01MARTIN HAUSNER2012-05-07
0012010-01-01MARTIN HAUSNER

Plan Statistics for SCHLETTER INC. 401(K) PLAN

401k plan membership statisitcs for SCHLETTER INC. 401(K) PLAN

Measure Date Value
2016: SCHLETTER INC. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01194
Total number of active participants reported on line 7a of the Form 55002016-01-01156
Number of retired or separated participants receiving benefits2016-01-0125
Number of other retired or separated participants entitled to future benefits2016-01-0145
Total of all active and inactive participants2016-01-01226
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01226
Number of participants with account balances2016-01-01199
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-0125
2015: SCHLETTER INC. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01183
Total number of active participants reported on line 7a of the Form 55002015-01-01135
Number of retired or separated participants receiving benefits2015-01-0122
Number of other retired or separated participants entitled to future benefits2015-01-0135
Total of all active and inactive participants2015-01-01192
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01192
Number of participants with account balances2015-01-01192
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-0157
2014: SCHLETTER INC. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01201
Total number of active participants reported on line 7a of the Form 55002014-01-01164
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0161
Total of all active and inactive participants2014-01-01225
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01225
Number of participants with account balances2014-01-01206
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-0148
2013: SCHLETTER INC. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01124
Total number of active participants reported on line 7a of the Form 55002013-01-01176
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0125
Total of all active and inactive participants2013-01-01201
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01201
Number of participants with account balances2013-01-01201
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-0131
2010: SCHLETTER INC. 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0121
Total number of active participants reported on line 7a of the Form 55002010-01-0145
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-0145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0145
Number of participants with account balances2010-01-0145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010

Financial Data on SCHLETTER INC. 401(K) PLAN

Measure Date Value
2016 : SCHLETTER INC. 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$10,076
Total income from all sources (including contributions)2016-12-31$388,306
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$122,731
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$120,164
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$246,388
Value of total assets at end of year2016-12-31$2,480,947
Value of total assets at beginning of year2016-12-31$2,225,448
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$2,567
Total interest from all sources2016-12-31$-400
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Administrative expenses professional fees incurred2016-12-31$2,567
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$250,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$246,388
Participant contributions at end of year2016-12-31$0
Participant contributions at beginning of year2016-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$50
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$10,076
Other income not declared elsewhere2016-12-31$194
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$265,575
Value of net assets at end of year (total assets less liabilities)2016-12-31$2,480,947
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$2,215,372
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$2,480,897
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$2,123,800
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$101,648
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$101,648
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$-400
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$142,124
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$120,164
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31RUSS KIMBERLIN, CPA PLLC
Accountancy firm EIN2016-12-31455497718
2015 : SCHLETTER INC. 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$10,076
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$223,047
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$448,521
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$422,416
Value of total corrective distributions2015-12-31$11,815
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$251,923
Value of total assets at end of year2015-12-31$2,225,448
Value of total assets at beginning of year2015-12-31$2,440,846
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$14,290
Total interest from all sources2015-12-31$-1,071
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$250,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$223,127
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$28,796
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$10,076
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-225,474
Value of net assets at end of year (total assets less liabilities)2015-12-31$2,215,372
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$2,440,846
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Investment advisory and management fees2015-12-31$14,290
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$2,123,800
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$2,317,223
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$101,648
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$123,623
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$123,623
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$-1,071
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-27,805
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Employer contributions (assets) at end of year2015-12-31$0
Employer contributions (assets) at beginning of year2015-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$422,416
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31RUSS KIMBERLIN, CPA PLLC
Accountancy firm EIN2015-12-31455497718
2014 : SCHLETTER INC. 401(K) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$527,778
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$291,016
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$279,306
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$403,737
Value of total assets at end of year2014-12-31$2,440,846
Value of total assets at beginning of year2014-12-31$2,204,084
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$11,710
Total interest from all sources2014-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Administrative expenses professional fees incurred2014-12-31$11,710
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$400,000
If this is an individual account plan, was there a blackout period2014-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$251,087
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$152,650
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$236,762
Value of net assets at end of year (total assets less liabilities)2014-12-31$2,440,846
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$2,204,084
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$2,317,223
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$2,104,259
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$123,623
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$73,425
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$73,425
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$124,041
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Employer contributions (assets) at end of year2014-12-31$0
Employer contributions (assets) at beginning of year2014-12-31$26,400
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$279,306
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31RUSS KIMBERLIN, CPA PLLC
Accountancy firm EIN2014-12-31455497718
2013 : SCHLETTER INC. 401(K) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total income from all sources (including contributions)2013-12-31$624,760
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$51,054
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$43,136
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$333,710
Value of total assets at end of year2013-12-31$2,204,084
Value of total assets at beginning of year2013-12-31$1,630,378
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$7,918
Total interest from all sources2013-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$350,000
If this is an individual account plan, was there a blackout period2013-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$255,592
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$51,718
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$573,706
Value of net assets at end of year (total assets less liabilities)2013-12-31$2,204,084
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$1,630,378
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$2,104,259
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$1,214,133
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$73,425
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$46,245
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$46,245
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$291,050
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$26,400
Employer contributions (assets) at end of year2013-12-31$26,400
Employer contributions (assets) at beginning of year2013-12-31$370,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$43,136
Contract administrator fees2013-12-31$7,918
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31RUSS KIMBERLIN, CPA PLLC
Accountancy firm EIN2013-12-31455497718
2010 : SCHLETTER INC. 401(K) PLAN 2010 401k financial data
Total income from all sources2010-12-31$158,214
Expenses. Total of all expenses incurred2010-12-31$110
Total plan assets at end of year2010-12-31$158,104
Total plan assets at beginning of year2010-12-31$0
Value of fidelity bond covering the plan2010-12-31$30,000
Total contributions received or receivable from participants2010-12-31$6,043
Expenses. Other expenses not covered elsewhere2010-12-31$110
Contributions received from other sources (not participants or employers)2010-12-31$1,885
Other income received2010-12-31$286
Net income (gross income less expenses)2010-12-31$158,104
Net plan assets at end of year (total assets less liabilities)2010-12-31$158,104
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$0
Total contributions received or receivable from employer(s)2010-12-31$150,000

Form 5500 Responses for SCHLETTER INC. 401(K) PLAN

2016: SCHLETTER INC. 401(K) PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: SCHLETTER INC. 401(K) PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2014: SCHLETTER INC. 401(K) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement - TrustYes
2013: SCHLETTER INC. 401(K) PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement - TrustYes
2010: SCHLETTER INC. 401(K) PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01First time form 5500 has been submittedYes
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number636-80186
Policy instance 1
Insurance contract or identification number636-80186
Number of Individuals Covered192
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,742
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,742
Insurance broker organization code?6
Insurance broker nameRAYMOND JAMES FINANCIAL SERVICES
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number636-80119
Policy instance 1
Insurance contract or identification number636-80119
Number of Individuals Covered206
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $674
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $674
Insurance broker organization code?6
Insurance broker nameRAYMOND JAMES FINANCIAL SERVICES
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number636-80186
Policy instance 2
Insurance contract or identification number636-80186
Number of Individuals Covered206
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $891
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $891
Insurance broker organization code?6
Insurance broker nameRAYMOND JAMES FINANCIAL SERVICES

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