401k Plan data: PURPLE LAND MANAGEMENT HEALTH & WELFARE PLAN plan

PURPLE LAND MANAGEMENT HEALTH & WELFARE PLAN 401k Plan overview

Plan Name	PURPLE LAND MANAGEMENT HEALTH & WELFARE PLAN
Plan identification number	501

PURPLE LAND MANAGEMENT HEALTH & WELFARE PLAN Benefits

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

401k Sponsoring company profile

PURPLE LAND MANAGEMENT LLC has sponsored the creation of one or more 401k plans.

Company Name: PURPLE LAND MANAGEMENT LLC

Employer identification number (EIN): 271770690

NAIC Classification: 541990
NAIC Description: All Other Professional, Scientific, and Technical Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PURPLE LAND MANAGEMENT HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2016-07-01
501 2015-07-01

Plan Statistics for PURPLE LAND MANAGEMENT HEALTH & WELFARE PLAN

401k plan membership statisitcs for PURPLE LAND MANAGEMENT HEALTH & WELFARE PLAN

Measure Date Value
2016: PURPLE LAND MANAGEMENT HEALTH & WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year 2016-07-01 140
Total number of active participants reported on line 7a of the Form 5500 2016-07-01 139
Number of retired or separated participants receiving benefits 2016-07-01 3
Number of other retired or separated participants entitled to future benefits 2016-07-01 6
Total of all active and inactive participants 2016-07-01 148
2015: PURPLE LAND MANAGEMENT HEALTH & WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 199
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 137
Number of retired or separated participants receiving benefits 2015-07-01 4
Number of other retired or separated participants entitled to future benefits 2015-07-01 4
Total of all active and inactive participants 2015-07-01 145

Measure	Date	Value
2016: PURPLE LAND MANAGEMENT HEALTH & WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year	2016-07-01	140
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	139
Number of retired or separated participants receiving benefits	2016-07-01	3
Number of other retired or separated participants entitled to future benefits	2016-07-01	6
Total of all active and inactive participants	2016-07-01	148
2015: PURPLE LAND MANAGEMENT HEALTH & WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	199
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	137
Number of retired or separated participants receiving benefits	2015-07-01	4
Number of other retired or separated participants entitled to future benefits	2015-07-01	4
Total of all active and inactive participants	2015-07-01	145

Form 5500 Responses for PURPLE LAND MANAGEMENT HEALTH & WELFARE PLAN

2016: PURPLE LAND MANAGEMENT HEALTH & WELFARE PLAN 2016 form 5500 responses
2016-07-01	Type of plan entity	Single employer plan
2016-07-01	Submission has been amended	No
2016-07-01	This submission is the final filing	No
2016-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-07-01	Plan is a collectively bargained plan	No
2016-07-01	Plan funding arrangement – Insurance	Yes
2016-07-01	Plan benefit arrangement – Insurance	Yes
2015: PURPLE LAND MANAGEMENT HEALTH & WELFARE PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	First time form 5500 has been submitted	Yes
2015-07-01	Submission has been amended	No
2015-07-01	This submission is the final filing	No
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-07-01	Plan is a collectively bargained plan	No
2015-07-01	Plan funding arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

109610 109956

Policy instance

Insurance contract or identification number	109610 109956
Number of Individuals Covered	150
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $35,990
Total amount of fees paid to insurance company	USD $1,488
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	Yes
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 $607,796
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $29,728
Amount paid for insurance broker fees	1488
Additional information about fees paid to insurance broker	SPECIAL PROGRAMS
Insurance broker organization code?	3
Insurance broker name	CENTERSTONE INSURANCE & FIN. SVCS.

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30059181

Policy instance

Insurance contract or identification number	30059181
Number of Individuals Covered	79
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $940
Total amount of fees paid to insurance company	USD $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 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	Yes
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 $6,899
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $595
Insurance broker organization code?	3
Insurance broker name	CENTERSTONE IINSURANCE AND

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

298584

Policy instance

Insurance contract or identification number	298584
Number of Individuals Covered	131
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $14,422
Total amount of fees paid to insurance company	USD $1,083
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	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	STD, 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 Carrier	USD $61,900
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,422
Amount paid for insurance broker fees	1083
Additional information about fees paid to insurance broker	ADDITIONAL COMPENSATION
Insurance broker organization code?	3
Insurance broker name	A.G. INSURANCE AGENCIES, INC

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Company Name:	PURPLE LAND MANAGEMENT LLC
Employer identification number (EIN):	271770690
NAIC Classification:	541990
NAIC Description:	All Other Professional, Scientific, and Technical Services