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LIFE & DISABILITY INSURANCE PLAN OF HEMPT BROS., INC. 401k Plan overview

Plan NameLIFE & DISABILITY INSURANCE PLAN OF HEMPT BROS., INC.
Plan identification number 502

LIFE & DISABILITY INSURANCE PLAN OF HEMPT BROS., INC. Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Other welfare benefit cover

401k Sponsoring company profile

HEMPT BROS., INC. has sponsored the creation of one or more 401k plans.

Company Name:HEMPT BROS., INC.
Employer identification number (EIN):231509517
NAIC Classification:237310
NAIC Description:Highway, Street, and Bridge Construction

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LIFE & DISABILITY INSURANCE PLAN OF HEMPT BROS., INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022015-01-01PATRICK HOSPODAVIS
5022014-01-01PATRICK HOSPODAVIS PATRICK HOSPODAVIS2015-09-14
5022013-01-01PATRICK HOSPODAVIS PATRICK HOSPODAVIS2014-10-14
5022012-01-01PATRICK HOSPODAVIS PATRICK HOSPODAVIS2013-10-08
5022011-01-01JOE THEURER JOE THEURER2012-08-24
5022010-01-01JOE THEURER
5022009-01-01JOSEPH THEURER

Plan Statistics for LIFE & DISABILITY INSURANCE PLAN OF HEMPT BROS., INC.

401k plan membership statisitcs for LIFE & DISABILITY INSURANCE PLAN OF HEMPT BROS., INC.

Measure Date Value
2015: LIFE & DISABILITY INSURANCE PLAN OF HEMPT BROS., INC. 2015 401k membership
Total participants, beginning-of-year2015-01-01233
Total number of active participants reported on line 7a of the Form 55002015-01-01225
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01225
2014: LIFE & DISABILITY INSURANCE PLAN OF HEMPT BROS., INC. 2014 401k membership
Total participants, beginning-of-year2014-01-01256
Total number of active participants reported on line 7a of the Form 55002014-01-01139
Number of retired or separated participants receiving benefits2014-01-0194
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01233
2013: LIFE & DISABILITY INSURANCE PLAN OF HEMPT BROS., INC. 2013 401k membership
Total participants, beginning-of-year2013-01-01264
Total number of active participants reported on line 7a of the Form 55002013-01-01165
Number of retired or separated participants receiving benefits2013-01-0191
Total of all active and inactive participants2013-01-01256
2012: LIFE & DISABILITY INSURANCE PLAN OF HEMPT BROS., INC. 2012 401k membership
Total participants, beginning-of-year2012-01-01270
Total number of active participants reported on line 7a of the Form 55002012-01-01176
Number of retired or separated participants receiving benefits2012-01-0188
Total of all active and inactive participants2012-01-01264
Total participants2012-01-01264
2011: LIFE & DISABILITY INSURANCE PLAN OF HEMPT BROS., INC. 2011 401k membership
Total participants, beginning-of-year2011-01-01284
Total number of active participants reported on line 7a of the Form 55002011-01-01187
Number of retired or separated participants receiving benefits2011-01-0183
Total of all active and inactive participants2011-01-01270
Total participants2011-01-01270
2010: LIFE & DISABILITY INSURANCE PLAN OF HEMPT BROS., INC. 2010 401k membership
Total participants, beginning-of-year2010-01-01289
Total number of active participants reported on line 7a of the Form 55002010-01-01196
Number of retired or separated participants receiving benefits2010-01-0188
Total of all active and inactive participants2010-01-01284
Total participants2010-01-01284
2009: LIFE & DISABILITY INSURANCE PLAN OF HEMPT BROS., INC. 2009 401k membership
Total participants, beginning-of-year2009-01-01302
Total number of active participants reported on line 7a of the Form 55002009-01-01193
Number of retired or separated participants receiving benefits2009-01-0196
Total of all active and inactive participants2009-01-01289
Total participants2009-01-01289

Form 5500 Responses for LIFE & DISABILITY INSURANCE PLAN OF HEMPT BROS., INC.

2015: LIFE & DISABILITY INSURANCE PLAN OF HEMPT BROS., INC. 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)Yes
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: LIFE & DISABILITY INSURANCE PLAN OF HEMPT BROS., INC. 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: LIFE & DISABILITY INSURANCE PLAN OF HEMPT BROS., INC. 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: LIFE & DISABILITY INSURANCE PLAN OF HEMPT BROS., INC. 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: LIFE & DISABILITY INSURANCE PLAN OF HEMPT BROS., INC. 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: LIFE & DISABILITY INSURANCE PLAN OF HEMPT BROS., INC. 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedYes
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: LIFE & DISABILITY INSURANCE PLAN OF HEMPT BROS., INC. 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AQC2
Policy instance 1
Insurance contract or identification numberG000AQC2
Number of Individuals Covered225
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $1,707
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?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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&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 $17,070
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,707
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerNONE
Insurance broker organization code?3
Insurance broker nameKR MACDONALD INCORPORATED
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AQC2
Policy instance 2
Insurance contract or identification numberG000AQC2
Number of Individuals Covered125
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $1,293
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?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 BenefitYes
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 $12,928
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,293
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerNONE
Insurance broker organization code?3
Insurance broker nameK.R. MACDONALD INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AQC2
Policy instance 1
Insurance contract or identification numberG000AQC2
Number of Individuals Covered144
Insurance policy start date2013-08-01
Insurance policy end date2014-08-01
Total amount of commissions paid to insurance brokerUSD $1,482
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,817
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,482
Insurance broker organization code?3
Insurance broker nameKR MACDONALD INCORPORATED
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AQC2
Policy instance 2
Insurance contract or identification numberG000AQC2
Number of Individuals Covered242
Insurance policy start date2013-08-01
Insurance policy end date2014-08-01
Total amount of commissions paid to insurance brokerUSD $1,865
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $18,646
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,865
Insurance broker organization code?3
Insurance broker nameK.R. MACDONALD INC
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF011610
Policy instance 1
Insurance contract or identification numberF011610
Number of Individuals Covered256
Insurance policy start date2013-01-01
Insurance policy end date2013-07-31
Total amount of commissions paid to insurance brokerUSD $2,359
Total amount of fees paid to insurance companyUSD $1,147
Welfare Benefit Premiums Paid to CarrierUSD $25,517
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,359
Insurance broker organization code?3
Amount paid for insurance broker fees1147
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker nameCONSOLIDATED BENEFITS
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberFO11610
Policy instance 1
Insurance contract or identification numberFO11610
Number of Individuals Covered264
Insurance policy start date2011-10-01
Insurance policy end date2012-09-30
Total amount of commissions paid to insurance brokerUSD $4,286
Total amount of fees paid to insurance companyUSD $2,322
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $47,038
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,286
Insurance broker organization code?3
Amount paid for insurance broker fees2322
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker nameCONSOLIDATED BENEFITS, INC.
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberFO11610
Policy instance 1
Insurance contract or identification numberFO11610
Number of Individuals Covered270
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Total amount of commissions paid to insurance brokerUSD $4,316
Total amount of fees paid to insurance companyUSD $2,572
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $47,771
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberFO11610
Policy instance 1
Insurance contract or identification numberFO11610
Number of Individuals Covered284
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $4,366
Total amount of fees paid to insurance companyUSD $2,605
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $49,601
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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