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SHIPLEY GROUP, L.P. GROUP MEDICAL PLAN 401k Plan overview

Plan NameSHIPLEY GROUP, L.P. GROUP MEDICAL PLAN
Plan identification number 502

SHIPLEY GROUP, L.P. GROUP MEDICAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

SHIPLEY GROUP, L.P. has sponsored the creation of one or more 401k plans.

Company Name:SHIPLEY GROUP, L.P.
Employer identification number (EIN):260016210
NAIC Classification:221500

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SHIPLEY GROUP, L.P. GROUP MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022020-01-01GINA RUHL2021-04-28
5022019-01-01GINA RUHL2020-11-04
5022018-01-01GINA RUHL2019-10-10
5022017-01-01MATTHEW SOMMER

Plan Statistics for SHIPLEY GROUP, L.P. GROUP MEDICAL PLAN

401k plan membership statisitcs for SHIPLEY GROUP, L.P. GROUP MEDICAL PLAN

Measure Date Value
2020: SHIPLEY GROUP, L.P. GROUP MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-010
Total number of active participants reported on line 7a of the Form 55002020-01-010
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-010
Number of employers contributing to the scheme2020-01-010
2019: SHIPLEY GROUP, L.P. GROUP MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01231
Total number of active participants reported on line 7a of the Form 55002019-01-01232
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01232
Number of employers contributing to the scheme2019-01-010
2018: SHIPLEY GROUP, L.P. GROUP MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01247
Total number of active participants reported on line 7a of the Form 55002018-01-01225
Number of retired or separated participants receiving benefits2018-01-016
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01231
Number of employers contributing to the scheme2018-01-010
2017: SHIPLEY GROUP, L.P. GROUP MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01223
Total number of active participants reported on line 7a of the Form 55002017-01-01239
Number of retired or separated participants receiving benefits2017-01-012
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01241

Financial Data on SHIPLEY GROUP, L.P. GROUP MEDICAL PLAN

Measure Date Value
2020 : SHIPLEY GROUP, L.P. GROUP MEDICAL PLAN 2020 401k financial data
Transfers to/from the plan2020-07-31$-113,721
Total plan liabilities at end of year2020-07-31$0
Total plan liabilities at beginning of year2020-07-31$375,851
Total income from all sources2020-07-31$1,207
Expenses. Total of all expenses incurred2020-07-31$1,323
Total plan assets at end of year2020-07-31$0
Total plan assets at beginning of year2020-07-31$489,688
Value of fidelity bond covering the plan2020-07-31$50,000
Other income received2020-07-31$1,207
Net income (gross income less expenses)2020-07-31$-116
Net plan assets at end of year (total assets less liabilities)2020-07-31$0
Net plan assets at beginning of year (total assets less liabilities)2020-07-31$113,837
Expenses. Administrative service providers (salaries,fees and commissions)2020-07-31$1,323
2019 : SHIPLEY GROUP, L.P. GROUP MEDICAL PLAN 2019 401k financial data
Total transfer of assets from this plan2019-12-31$238,236
Total transfer of assets from this plan2019-12-31$238,236
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$375,851
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$375,851
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$168,261
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$168,261
Total income from all sources (including contributions)2019-12-31$3,210,638
Total income from all sources (including contributions)2019-12-31$3,210,638
Total of all expenses incurred2019-12-31$3,378,007
Total of all expenses incurred2019-12-31$3,378,007
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$3,218,787
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$3,218,787
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$3,205,084
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$3,205,084
Value of total assets at end of year2019-12-31$489,688
Value of total assets at end of year2019-12-31$489,688
Value of total assets at beginning of year2019-12-31$687,703
Value of total assets at beginning of year2019-12-31$687,703
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$159,220
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$159,220
Total interest from all sources2019-12-31$5,554
Total interest from all sources2019-12-31$5,554
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31Yes
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2019-12-31$238,236
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2019-12-31$238,236
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$5,000,000
Value of fidelity bond cover2019-12-31$5,000,000
If this is an individual account plan, was there a blackout period2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$840,739
Contributions received from participants2019-12-31$840,739
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$5,284
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$5,284
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$50,023
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$50,023
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$40,040
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$40,040
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$-167,369
Value of net income/loss2019-12-31$-167,369
Value of net assets at end of year (total assets less liabilities)2019-12-31$113,837
Value of net assets at end of year (total assets less liabilities)2019-12-31$113,837
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$519,442
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$519,442
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Investment advisory and management fees2019-12-31$159,220
Investment advisory and management fees2019-12-31$159,220
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$439,665
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$439,665
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$647,663
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$647,663
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$647,663
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$647,663
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$5,554
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$5,554
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$550,479
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$550,479
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$2,359,061
Contributions received in cash from employer2019-12-31$2,359,061
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$2,668,308
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$2,668,308
Liabilities. Value of benefit claims payable at end of year2019-12-31$375,851
Liabilities. Value of benefit claims payable at end of year2019-12-31$375,851
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$168,261
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$168,261
Did the plan have assets held for investment2019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31RKL LLP
Accountancy firm name2019-12-31RKL LLP
Accountancy firm EIN2019-12-31232108173
Accountancy firm EIN2019-12-31232108173
2018 : SHIPLEY GROUP, L.P. GROUP MEDICAL PLAN 2018 401k financial data
Unrealized appreciation/depreciation of real estate assets2018-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2018-12-31$0
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$168,261
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$135,972
Expenses. Interest paid2018-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022018-12-31$0
Total income from all sources (including contributions)2018-12-31$2,897,101
Total of all expenses incurred2018-12-31$2,651,477
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$2,441,272
Expenses. Certain deemed distributions of participant loans2018-12-31$0
Value of total corrective distributions2018-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$2,890,973
Value of total assets at end of year2018-12-31$687,703
Value of total assets at beginning of year2018-12-31$409,790
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$210,205
Total income from rents2018-12-31$0
Total interest from all sources2018-12-31$6,128
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$0
Assets. Real estate other than employer real property at end of year2018-12-31$0
Assets. Real estate other than employer real property at beginning of year2018-12-31$0
Administrative expenses professional fees incurred2018-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2018-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2018-12-31$0
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$5,000,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$740,519
Participant contributions at end of year2018-12-31$0
Participant contributions at beginning of year2018-12-31$0
Participant contributions at end of year2018-12-31$0
Participant contributions at beginning of year2018-12-31$0
Assets. Other investments not covered elsewhere at end of year2018-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2018-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$23,618
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$40,040
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$21,202
Assets. Loans (other than to participants) at end of year2018-12-31$0
Assets. Loans (other than to participants) at beginning of year2018-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$0
Other income not declared elsewhere2018-12-31$0
Administrative expenses (other) incurred2018-12-31$0
Liabilities. Value of operating payables at end of year2018-12-31$0
Liabilities. Value of operating payables at beginning of year2018-12-31$0
Total non interest bearing cash at end of year2018-12-31$0
Total non interest bearing cash at beginning of year2018-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Income. Non cash contributions2018-12-31$0
Value of net income/loss2018-12-31$245,624
Value of net assets at end of year (total assets less liabilities)2018-12-31$519,442
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$273,818
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Assets. partnership/joint venture interests at end of year2018-12-31$0
Assets. partnership/joint venture interests at beginning of year2018-12-31$0
Investment advisory and management fees2018-12-31$210,205
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$0
Value of interest in pooled separate accounts at end of year2018-12-31$0
Value of interest in pooled separate accounts at beginning of year2018-12-31$0
Interest on participant loans2018-12-31$0
Income. Interest from loans (other than to participants)2018-12-31$0
Interest earned on other investments2018-12-31$0
Income. Interest from US Government securities2018-12-31$0
Income. Interest from corporate debt instruments2018-12-31$0
Value of interest in master investment trust accounts at end of year2018-12-31$0
Value of interest in master investment trust accounts at beginning of year2018-12-31$0
Value of interest in common/collective trusts at end of year2018-12-31$0
Value of interest in common/collective trusts at beginning of year2018-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$647,663
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$388,588
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$388,588
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$6,128
Assets. Value of investments in 103.12 investment entities at end of year2018-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2018-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$773,600
Asset value of US Government securities at end of year2018-12-31$0
Asset value of US Government securities at beginning of year2018-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$0
Net investment gain/loss from pooled separate accounts2018-12-31$0
Net investment gain or loss from common/collective trusts2018-12-31$0
Net gain/loss from 103.12 investment entities2018-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31Yes
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Assets. Invements in employer securities at end of year2018-12-31$0
Assets. Invements in employer securities at beginning of year2018-12-31$0
Assets. Value of employer real property at end of year2018-12-31$0
Assets. Value of employer real property at beginning of year2018-12-31$0
Contributions received in cash from employer2018-12-31$2,126,836
Employer contributions (assets) at end of year2018-12-31$0
Employer contributions (assets) at beginning of year2018-12-31$0
Income. Dividends from preferred stock2018-12-31$0
Income. Dividends from common stock2018-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$1,667,672
Asset. Corporate debt instrument preferred debt at end of year2018-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2018-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2018-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2018-12-31$0
Contract administrator fees2018-12-31$0
Assets. Corporate common stocks other than exployer securities at end of year2018-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2018-12-31$0
Liabilities. Value of benefit claims payable at end of year2018-12-31$168,261
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$135,972
Assets. Value of buildings and other operty used in plan operation at end of year2018-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2018-12-31$0
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Aggregate proceeds on sale of assets2018-12-31$0
Aggregate carrying amount (costs) on sale of assets2018-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2018-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2018-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31RKL LLP
Accountancy firm EIN2018-12-31232108173
2017 : SHIPLEY GROUP, L.P. GROUP MEDICAL PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total transfer of assets to this plan2017-12-31$401,338
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$135,972
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$2,031,073
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$2,158,593
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$1,964,497
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$2,028,702
Value of total assets at end of year2017-12-31$409,790
Value of total assets at beginning of year2017-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$194,096
Total interest from all sources2017-12-31$2,371
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$661,439
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$20,410
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$21,202
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$0
Administrative expenses (other) incurred2017-12-31$194,096
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$-127,520
Value of net assets at end of year (total assets less liabilities)2017-12-31$273,818
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$388,588
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$2,371
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$669,198
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31Yes
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$1,346,853
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$1,295,299
Liabilities. Value of benefit claims payable at end of year2017-12-31$135,972
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$0
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31RKL LLP
Accountancy firm EIN2017-12-31232108173

Form 5500 Responses for SHIPLEY GROUP, L.P. GROUP MEDICAL PLAN

2020: SHIPLEY GROUP, L.P. GROUP MEDICAL PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01This submission is the final filingYes
2020-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: SHIPLEY GROUP, L.P. GROUP MEDICAL PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: SHIPLEY GROUP, L.P. GROUP MEDICAL PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: SHIPLEY GROUP, L.P. GROUP MEDICAL PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01First time form 5500 has been submittedYes
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberSL30400027-181
Policy instance 1
Insurance contract or identification numberSL30400027-181
Number of Individuals Covered0
Insurance policy start date2020-01-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberSL30400027-181
Policy instance 1
Insurance contract or identification numberSL30400027-181
Number of Individuals Covered5
Insurance policy start date2019-01-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $185,445
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16-014733-000
Policy instance 2
Insurance contract or identification number16-014733-000
Number of Individuals Covered239
Insurance policy start date2019-04-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $5,358
Welfare Benefit Premiums Paid to CarrierUSD $370,231
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees5358
Additional information about fees paid to insurance brokerGROUP VOLUME BONUS
Insurance broker organization code?3
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberSL30400027-181
Policy instance 1
Insurance contract or identification numberSL30400027-181
Number of Individuals Covered231
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $723,029
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 numberKBP
Policy instance 1
Insurance contract or identification numberKBP
Number of Individuals Covered241
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
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 $641,205
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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