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D.C. HUMPHRYS CO. EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan NameD.C. HUMPHRYS CO. EMPLOYEE BENEFIT PLAN
Plan identification number 501

D.C. HUMPHRYS CO. EMPLOYEE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

D.C. HUMPHRYS CO. has sponsored the creation of one or more 401k plans.

Company Name:D.C. HUMPHRYS CO.
Employer identification number (EIN):230716790
NAIC Classification:314000
NAIC Description: Textile Product Mills

Form 5500 Filing Information

Submission information for form 5500 for 401k plan D.C. HUMPHRYS CO. EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-05-01
5012021-05-01
5012021-05-01
5012020-05-01
5012019-05-01PAUL BOYLE2021-01-06

Plan Statistics for D.C. HUMPHRYS CO. EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for D.C. HUMPHRYS CO. EMPLOYEE BENEFIT PLAN

Measure Date Value
2022: D.C. HUMPHRYS CO. EMPLOYEE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-05-01119
Total number of active participants reported on line 7a of the Form 55002022-05-01118
Number of retired or separated participants receiving benefits2022-05-010
Number of other retired or separated participants entitled to future benefits2022-05-010
Total of all active and inactive participants2022-05-01118
2021: D.C. HUMPHRYS CO. EMPLOYEE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-05-01105
Total number of active participants reported on line 7a of the Form 55002021-05-01119
Number of retired or separated participants receiving benefits2021-05-010
Number of other retired or separated participants entitled to future benefits2021-05-010
Total of all active and inactive participants2021-05-01119
2020: D.C. HUMPHRYS CO. EMPLOYEE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-05-01111
Total number of active participants reported on line 7a of the Form 55002020-05-01120
Number of retired or separated participants receiving benefits2020-05-010
Number of other retired or separated participants entitled to future benefits2020-05-010
Total of all active and inactive participants2020-05-01120
2019: D.C. HUMPHRYS CO. EMPLOYEE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-05-01100
Total number of active participants reported on line 7a of the Form 55002019-05-01111
Number of retired or separated participants receiving benefits2019-05-010
Number of other retired or separated participants entitled to future benefits2019-05-010
Total of all active and inactive participants2019-05-01111
Number of employers contributing to the scheme2019-05-010

Financial Data on D.C. HUMPHRYS CO. EMPLOYEE BENEFIT PLAN

Measure Date Value
2022 : D.C. HUMPHRYS CO. EMPLOYEE BENEFIT PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-06-30$68,634
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-06-30$5,955
Total income from all sources (including contributions)2022-06-30$150,659
Total loss/gain on sale of assets2022-06-30$0
Total of all expenses incurred2022-06-30$124,623
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-06-30$112,191
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-06-30$150,659
Value of total assets at end of year2022-06-30$211,952
Value of total assets at beginning of year2022-06-30$123,237
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-06-30$12,432
Total interest from all sources2022-06-30$0
Total dividends received (eg from common stock, registered investment company shares)2022-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-06-30No
Was this plan covered by a fidelity bond2022-06-30Yes
Value of fidelity bond cover2022-06-30$200,000
If this is an individual account plan, was there a blackout period2022-06-30No
Were there any nonexempt tranactions with any party-in-interest2022-06-30No
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-06-30$41,226
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-06-30$0
Total non interest bearing cash at end of year2022-06-30$170,726
Total non interest bearing cash at beginning of year2022-06-30$123,237
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-06-30No
Value of net income/loss2022-06-30$26,036
Value of net assets at end of year (total assets less liabilities)2022-06-30$143,318
Value of net assets at beginning of year (total assets less liabilities)2022-06-30$117,282
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2022-06-30No
Were any leases to which the plan was party in default or uncollectible2022-06-30No
Expenses. Payments to insurance carriers foe the provision of benefits2022-06-30$39,240
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-06-30No
Was there a failure to transmit to the plan any participant contributions2022-06-30No
Has the plan failed to provide any benefit when due under the plan2022-06-30No
Contributions received in cash from employer2022-06-30$150,659
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-06-30$72,951
Contract administrator fees2022-06-30$12,432
Liabilities. Value of benefit claims payable at end of year2022-06-30$68,634
Liabilities. Value of benefit claims payable at beginning of year2022-06-30$5,955
Did the plan have assets held for investment2022-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-06-30No
Opinion of an independent qualified public accountant for this plan2022-06-30Unqualified
Accountancy firm name2022-06-30BRINKER SIMPSON & COMPANY, LLC
Accountancy firm EIN2022-06-30263838358
Total unrealized appreciation/depreciation of assets2022-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-04-30$5,955
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-04-30$0
Total income from all sources (including contributions)2022-04-30$870,570
Total loss/gain on sale of assets2022-04-30$0
Total of all expenses incurred2022-04-30$753,288
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-04-30$683,180
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-04-30$870,570
Value of total assets at end of year2022-04-30$123,237
Value of total assets at beginning of year2022-04-30$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-04-30$70,108
Total interest from all sources2022-04-30$0
Total dividends received (eg from common stock, registered investment company shares)2022-04-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-04-30No
Was this plan covered by a fidelity bond2022-04-30Yes
Value of fidelity bond cover2022-04-30$200,000
If this is an individual account plan, was there a blackout period2022-04-30No
Were there any nonexempt tranactions with any party-in-interest2022-04-30No
Total non interest bearing cash at end of year2022-04-30$123,237
Total non interest bearing cash at beginning of year2022-04-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-04-30No
Value of net income/loss2022-04-30$117,282
Value of net assets at end of year (total assets less liabilities)2022-04-30$117,282
Value of net assets at beginning of year (total assets less liabilities)2022-04-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2022-04-30No
Were any leases to which the plan was party in default or uncollectible2022-04-30No
Expenses. Payments to insurance carriers foe the provision of benefits2022-04-30$227,223
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-04-30No
Was there a failure to transmit to the plan any participant contributions2022-04-30No
Has the plan failed to provide any benefit when due under the plan2022-04-30No
Contributions received in cash from employer2022-04-30$870,570
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-04-30$455,957
Contract administrator fees2022-04-30$70,108
Liabilities. Value of benefit claims payable at end of year2022-04-30$5,955
Liabilities. Value of benefit claims payable at beginning of year2022-04-30$0
Did the plan have assets held for investment2022-04-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-04-30No

Form 5500 Responses for D.C. HUMPHRYS CO. EMPLOYEE BENEFIT PLAN

2022: D.C. HUMPHRYS CO. EMPLOYEE BENEFIT PLAN 2022 form 5500 responses
2022-05-01Type of plan entitySingle employer plan
2022-05-01Submission has been amendedNo
2022-05-01This submission is the final filingNo
2022-05-01This return/report is a short plan year return/report (less than 12 months)Yes
2022-05-01Plan is a collectively bargained planNo
2022-05-01Plan funding arrangement – InsuranceYes
2022-05-01Plan funding arrangement – TrustYes
2022-05-01Plan benefit arrangement – InsuranceYes
2022-05-01Plan benefit arrangement - TrustYes
2021: D.C. HUMPHRYS CO. EMPLOYEE BENEFIT PLAN 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01Submission has been amendedNo
2021-05-01This submission is the final filingNo
2021-05-01This return/report is a short plan year return/report (less than 12 months)No
2021-05-01Plan is a collectively bargained planNo
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan funding arrangement – General assets of the sponsorYes
2021-05-01Plan benefit arrangement – InsuranceYes
2021-05-01Plan benefit arrangement – General assets of the sponsorYes
2020: D.C. HUMPHRYS CO. EMPLOYEE BENEFIT PLAN 2020 form 5500 responses
2020-05-01Type of plan entitySingle employer plan
2020-05-01Submission has been amendedNo
2020-05-01This submission is the final filingNo
2020-05-01This return/report is a short plan year return/report (less than 12 months)No
2020-05-01Plan is a collectively bargained planNo
2020-05-01Plan funding arrangement – InsuranceYes
2020-05-01Plan benefit arrangement – InsuranceYes
2019: D.C. HUMPHRYS CO. EMPLOYEE BENEFIT PLAN 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01First time form 5500 has been submittedYes
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number31000208
Policy instance 1
Insurance contract or identification number31000208
Number of Individuals Covered118
Insurance policy start date2022-05-01
Insurance policy end date2022-06-30
Are there contracts with allocated funds for individual policies?0
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?No
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
Welfare Benefit Premiums Paid to CarrierUSD $39,241
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number31000208
Policy instance 1
Insurance contract or identification number31000208
Number of Individuals Covered119
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Are there contracts with allocated funds for individual policies?0
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?No
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
Welfare Benefit Premiums Paid to CarrierUSD $227,223
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERIHEALTH HMO, INC. (National Association of Insurance Commissioners NAIC id number: 95044 )
Policy contract number826822
Policy instance 1
Insurance contract or identification number826822
Number of Individuals Covered1
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $574
Total amount of fees paid to insurance companyUSD $128
Are there contracts with allocated funds for individual policies?0
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?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
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 $574
Amount paid for insurance broker fees128
Additional information about fees paid to insurance brokerOVERRIDE/NON-MONETARY COMMISSIONS
Insurance broker organization code?3
KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 )
Policy contract number826822
Policy instance 2
Insurance contract or identification number826822
Number of Individuals Covered130
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $55,104
Total amount of fees paid to insurance companyUSD $12,440
Are there contracts with allocated funds for individual policies?0
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?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
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 $55,104
Amount paid for insurance broker fees12440
Additional information about fees paid to insurance brokerOVERRIDE/NON-MONETARY COMISSIONS
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00561733
Policy instance 3
Insurance contract or identification number00561733
Number of Individuals Covered120
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $9,466
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
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?No
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 BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D, OPTIONAL LIFE & AD&D
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 CarrierUSD $73,019
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,998
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerNONE
Insurance broker organization code?3
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 )
Policy contract number826822
Policy instance 1
Insurance contract or identification number826822
Number of Individuals Covered2
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $861
Total amount of fees paid to insurance companyUSD $228
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $861
Amount paid for insurance broker fees228
Additional information about fees paid to insurance brokerOVERRIDE/NON-MONETARY COMMISSIONS
Insurance broker organization code?3
KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 )
Policy contract number826822
Policy instance 2
Insurance contract or identification number826822
Number of Individuals Covered132
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $55,145
Total amount of fees paid to insurance companyUSD $14,103
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $55,145
Amount paid for insurance broker fees14103
Additional information about fees paid to insurance brokerOVERRIDE/NON-MONETARY COMMISSIONS
Insurance broker organization code?3

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