ACCOMMODATION MOLLEN, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan ACCOMMODATION MOLLEN EMPLOYEE HEALTH PLAN
| Measure | Date | Value |
|---|
| 2015: ACCOMMODATION MOLLEN EMPLOYEE HEALTH PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-08-01 | 28 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-08-01 | 28 |
| Number of retired or separated participants receiving benefits | 2015-08-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-08-01 | 0 |
| Total of all active and inactive participants | 2015-08-01 | 28 |
| 2014: ACCOMMODATION MOLLEN EMPLOYEE HEALTH PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-08-01 | 32 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-08-01 | 28 |
| Number of retired or separated participants receiving benefits | 2014-08-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-08-01 | 0 |
| Total of all active and inactive participants | 2014-08-01 | 28 |
| Measure | Date | Value |
|---|
| 2015 : ACCOMMODATION MOLLEN EMPLOYEE HEALTH PLAN 2015 401k financial data |
|---|
| Total plan liabilities at end of year | 2015-12-31 | $122,447 |
| Total plan liabilities at beginning of year | 2015-12-31 | $85,518 |
| Total income from all sources | 2015-12-31 | $167,468 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $178,476 |
| Benefits paid (including direct rollovers) | 2015-12-31 | $128,721 |
| Total plan assets at end of year | 2015-12-31 | $41,908 |
| Total plan assets at beginning of year | 2015-12-31 | $15,987 |
| Value of fidelity bond covering the plan | 2015-12-31 | $350,000 |
| Expenses. Other expenses not covered elsewhere | 2015-12-31 | $39,628 |
| Contributions received from other sources (not participants or employers) | 2015-12-31 | $167,433 |
| Other income received | 2015-12-31 | $35 |
| Net income (gross income less expenses) | 2015-12-31 | $-11,008 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $-80,539 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $-69,531 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-12-31 | $10,127 |
| Total plan liabilities at end of year | 2015-07-31 | $85,518 |
| Total income from all sources | 2015-07-31 | $305,302 |
| Expenses. Total of all expenses incurred | 2015-07-31 | $374,833 |
| Benefits paid (including direct rollovers) | 2015-07-31 | $258,534 |
| Total plan assets at end of year | 2015-07-31 | $15,987 |
| Value of fidelity bond covering the plan | 2015-07-31 | $350,000 |
| Total contributions received or receivable from participants | 2015-07-31 | $16,560 |
| Expenses. Other expenses not covered elsewhere | 2015-07-31 | $102,478 |
| Other income received | 2015-07-31 | $10 |
| Net income (gross income less expenses) | 2015-07-31 | $-69,531 |
| Net plan assets at end of year (total assets less liabilities) | 2015-07-31 | $-69,531 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-07-31 | $0 |
| Total contributions received or receivable from employer(s) | 2015-07-31 | $288,732 |
| Value of certain deemed distributions of participant loans | 2015-07-31 | $0 |
| Value of corrective distributions | 2015-07-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-07-31 | $13,821 |
| 2015: ACCOMMODATION MOLLEN EMPLOYEE HEALTH PLAN 2015 form 5500 responses |
|---|
| 2015-08-01 | Type of plan entity | Single employer plan |
| 2015-08-01 | Submission has been amended | No |
| 2015-08-01 | This submission is the final filing | No |
| 2015-08-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2015-08-01 | Plan is a collectively bargained plan | No |
| 2015-08-01 | Plan funding arrangement – Insurance | Yes |
| 2015-08-01 | Plan funding arrangement – Trust | Yes |
| 2015-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-08-01 | Plan benefit arrangement - Trust | Yes |
| 2014: ACCOMMODATION MOLLEN EMPLOYEE HEALTH PLAN 2014 form 5500 responses |
|---|
| 2014-08-01 | Type of plan entity | Single employer plan |
| 2014-08-01 | First time form 5500 has been submitted | Yes |
| 2014-08-01 | Submission has been amended | No |
| 2014-08-01 | This submission is the final filing | No |
| 2014-08-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-08-01 | Plan is a collectively bargained plan | No |
| 2014-08-01 | Plan funding arrangement – Insurance | Yes |
| 2014-08-01 | Plan funding arrangement – Trust | Yes |
| 2014-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-08-01 | Plan benefit arrangement - Trust | Yes |
| EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | VERIS |
| Policy instance | 1 |
| Insurance contract or identification number | VERIS | | Number of Individuals Covered | 28 | | Insurance policy start date | 2015-08-01 | | Insurance policy end date | 2015-12-31 | | 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 | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | 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 $37,486 | | 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 number | VERIS |
| Policy instance | 1 |
| Insurance contract or identification number | VERIS | | Number of Individuals Covered | 28 | | Insurance policy start date | 2014-08-01 | | Insurance policy end date | 2015-07-31 | | 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 | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | 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 $89,653 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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