401k Plan data: NC, INC. WELFARE BENEFIT PLAN plan

NC, INC. WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	NC, INC. WELFARE BENEFIT PLAN
Plan identification number	502

NC, INC. WELFARE BENEFIT 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

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

Company Name: NC, INC.

Employer identification number (EIN): 350548790

NAIC Classification: 444110
NAIC Description: Home Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NC, INC. WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2023-04-01 MICHAEL ADAMS 2024-10-22
502 2022-04-01 MICHAEL ADAMS 2024-02-19
502 2021-04-01 MICHAEL ADAMS 2023-01-10
502 2020-04-01 MICHAEL ADAMS 2021-12-16
502 2019-04-01 MICHAEL ADAMS 2020-10-15
502 2018-04-01 MICHAEL ADAMS 2019-10-17
502 2017-04-01
502 2016-04-01
502 2015-04-01
502 2014-04-01
502 2013-04-01
502 2012-04-01 MICHAEL ADAMS
502 2011-04-01 MICHAEL ADAMS
502 2010-04-01 MICHAEL ADAMS
502 2009-04-01 MICHAEL ADAMS

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
502	2023-04-01	MICHAEL ADAMS	2024-10-22
502	2022-04-01	MICHAEL ADAMS	2024-02-19
502	2021-04-01	MICHAEL ADAMS	2023-01-10
502	2020-04-01	MICHAEL ADAMS	2021-12-16
502	2019-04-01	MICHAEL ADAMS	2020-10-15
502	2018-04-01	MICHAEL ADAMS	2019-10-17
502	2017-04-01
502	2016-04-01
502	2015-04-01
502	2014-04-01
502	2013-04-01
502	2012-04-01	MICHAEL ADAMS
502	2011-04-01	MICHAEL ADAMS
502	2010-04-01	MICHAEL ADAMS
502	2009-04-01	MICHAEL ADAMS

Form 5500 Responses for NC, INC. WELFARE BENEFIT PLAN

2023: NC, INC. WELFARE BENEFIT PLAN 2023 form 5500 responses
2023-04-01	Type of plan entity	Single employer plan
2023-04-01	Plan funding arrangement – Insurance	Yes
2023-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2023-04-01	Plan benefit arrangement – Insurance	Yes
2023-04-01	Plan benefit arrangement – General assets of the sponsor	Yes
2022: NC, INC. WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-04-01	Type of plan entity	Single employer plan
2022-04-01	Plan funding arrangement – Insurance	Yes
2022-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-04-01	Plan benefit arrangement – Insurance	Yes
2022-04-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: NC, INC. WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-04-01	Type of plan entity	Single employer plan
2021-04-01	Submission has been amended	Yes
2021-04-01	Plan funding arrangement – Insurance	Yes
2021-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-04-01	Plan benefit arrangement – Insurance	Yes
2021-04-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: NC, INC. WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-04-01	Type of plan entity	Single employer plan
2020-04-01	Plan funding arrangement – Insurance	Yes
2020-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-04-01	Plan benefit arrangement – Insurance	Yes
2020-04-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: NC, INC. WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-04-01	Type of plan entity	Single employer plan
2019-04-01	Plan funding arrangement – Insurance	Yes
2019-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-04-01	Plan benefit arrangement – Insurance	Yes
2019-04-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: NC, INC. WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-04-01	Type of plan entity	Single employer plan
2018-04-01	Plan funding arrangement – Insurance	Yes
2018-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-04-01	Plan benefit arrangement – Insurance	Yes
2018-04-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: NC, INC. WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-04-01	Type of plan entity	Single employer plan
2017-04-01	Plan funding arrangement – Insurance	Yes
2017-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-04-01	Plan benefit arrangement – Insurance	Yes
2017-04-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: NC, INC. WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-04-01	Type of plan entity	Single employer plan
2016-04-01	Plan funding arrangement – Insurance	Yes
2016-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-04-01	Plan benefit arrangement – Insurance	Yes
2016-04-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: NC, INC. WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-04-01	Type of plan entity	Single employer plan
2015-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-04-01	Plan benefit arrangement – Insurance	Yes
2015-04-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: NC, INC. WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-04-01	Type of plan entity	Single employer plan
2014-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-04-01	Plan benefit arrangement – Insurance	Yes
2014-04-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: NC, INC. WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-04-01	Type of plan entity	Single employer plan
2013-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-04-01	Plan benefit arrangement – Insurance	Yes
2012: NC, INC. WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-04-01	Type of plan entity	Single employer plan
2012-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-04-01	Plan benefit arrangement – Insurance	Yes
2011: NC, INC. WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-04-01	Type of plan entity	Single employer plan
2011-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-04-01	Plan benefit arrangement – Insurance	Yes
2010: NC, INC. WELFARE BENEFIT PLAN 2010 form 5500 responses
2010-04-01	Type of plan entity	Single employer plan
2010-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-04-01	Plan benefit arrangement – Insurance	Yes
2009: NC, INC. WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-04-01	Type of plan entity	Single employer plan
2009-04-01	This submission is the final filing	No
2009-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-04-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

822723296

Policy instance

Insurance contract or identification number	822723296
Number of Individuals Covered	23
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $2,751
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $22,819
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

GL166979

Policy instance

Insurance contract or identification number	GL166979
Number of Individuals Covered	215
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $5,408
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $27,039
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

12211491

Policy instance

Insurance contract or identification number	12211491
Number of Individuals Covered	91
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $887
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $13,568
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )

Policy contract number

521123221010

Policy instance

Insurance contract or identification number	521123221010
Number of Individuals Covered	162
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $5,095
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $50,951
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )

Policy contract number

W11570

Policy instance

HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )

Policy contract number

521123221010

Policy instance

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

Policy contract number

12211491

Policy instance

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G00607452

Policy instance

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

822723296

Policy instance

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

Policy contract number

12211491

Policy instance

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

82-2723296

Policy instance

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G 00607452

Policy instance

HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )

Policy contract number

521123221010

Policy instance

ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )

Policy contract number

W11570

Policy instance

ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )

Policy contract number

W11570

Policy instance

HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )

Policy contract number

521123221010

Policy instance

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G 00607452

Policy instance

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

82-2723296

Policy instance

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

Policy contract number

12211491

Policy instance

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

Policy contract number

12211491

Policy instance

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

82-2723296

Policy instance

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G 00607452

Policy instance

HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )

Policy contract number

521123221010

Policy instance

ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )

Policy contract number

W11570

Policy instance

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

Policy contract number

12211491

Policy instance

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

82-2723296

Policy instance

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G 00607452

Policy instance

HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )

Policy contract number

521123221010

Policy instance

ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )

Policy contract number

00244319

Policy instance

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

DN192

Policy instance

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G 00607452

Policy instance

HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )

Policy contract number

521123221010

Policy instance

ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )

Policy contract number

00244319

Policy instance

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )

Policy contract number

12211491

Policy instance

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Company Name:	NC, INC.
Employer identification number (EIN):	350548790
NAIC Classification:	444110
NAIC Description:	Home Centers