401k Plan data: WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE plan

WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE 401k Plan overview

Plan Name	WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE
Plan identification number	501

WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE Benefits

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

401k Sponsoring company profile

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

Company Name: WHITECO INDUSTRIES, INC.

Employer identification number (EIN): 350753770

NAIC Classification: 713100
NAIC Description: Amusement Parks and Arcades

Additional information about WHITECO INDUSTRIES, INC.

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 1986-12-03

Company Identification Number: 0007110606

Legal Registered Office Address: 1000 E 80TH PL STE 420N

MERRILLVILLE
United States of America (USA)
46410

More information about WHITECO INDUSTRIES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2016-01-01 EDWARD F. FERGUSON CAROL ANN BOWMAN 2017-06-20
501 2015-01-01 EDWARD F. FERGUSON CAROL ANN BOWMAN 2016-07-13
501 2014-01-01 EDWARD F. FERGUSON CAROL ANN BOWMAN 2015-07-28
501 2013-01-01 EDWARD F. FERGUSON CAROL ANN BOWMAN 2014-07-24
501 2012-01-01 EDWARD F. FERGUSON CAROL ANN BOWMAN 2013-07-22
501 2011-01-01 EDWARD F FERGUSON CAROL ANN BOWMAN 2012-07-20
501 2010-01-01 EDWARD F FERGUSON CAROL ANN BOWMAN 2011-07-25
501 2009-01-01 EDWARD F FERGUSON CAROL ANN BOWMAN 2010-07-23

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2016-01-01	EDWARD F. FERGUSON	CAROL ANN BOWMAN	2017-06-20
501	2015-01-01	EDWARD F. FERGUSON	CAROL ANN BOWMAN	2016-07-13
501	2014-01-01	EDWARD F. FERGUSON	CAROL ANN BOWMAN	2015-07-28
501	2013-01-01	EDWARD F. FERGUSON	CAROL ANN BOWMAN	2014-07-24
501	2012-01-01	EDWARD F. FERGUSON	CAROL ANN BOWMAN	2013-07-22
501	2011-01-01	EDWARD F FERGUSON	CAROL ANN BOWMAN	2012-07-20
501	2010-01-01	EDWARD F FERGUSON	CAROL ANN BOWMAN	2011-07-25
501	2009-01-01	EDWARD F FERGUSON	CAROL ANN BOWMAN	2010-07-23

Plan Statistics for WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE

401k plan membership statisitcs for WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE

Measure Date Value
2016: WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE 2016 401k membership
Total participants, beginning-of-year 2016-01-01 180
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 167
Number of retired or separated participants receiving benefits 2016-01-01 2
Total of all active and inactive participants 2016-01-01 169
Total participants 2016-01-01 0
2015: WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE 2015 401k membership
Total participants, beginning-of-year 2015-01-01 178
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 179
Number of retired or separated participants receiving benefits 2015-01-01 1
Total of all active and inactive participants 2015-01-01 180
Total participants 2015-01-01 0
2014: WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE 2014 401k membership
Total participants, beginning-of-year 2014-01-01 133
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 175
Number of retired or separated participants receiving benefits 2014-01-01 3
Total of all active and inactive participants 2014-01-01 178
Total participants 2014-01-01 0
2013: WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE 2013 401k membership
Total participants, beginning-of-year 2013-01-01 138
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 132
Number of retired or separated participants receiving benefits 2013-01-01 1
Total of all active and inactive participants 2013-01-01 133
Total participants 2013-01-01 0
2012: WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE 2012 401k membership
Total participants, beginning-of-year 2012-01-01 141
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 135
Number of retired or separated participants receiving benefits 2012-01-01 3
Total of all active and inactive participants 2012-01-01 138
Total participants 2012-01-01 0
2011: WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE 2011 401k membership
Total participants, beginning-of-year 2011-01-01 153
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 136
Number of retired or separated participants receiving benefits 2011-01-01 5
Total of all active and inactive participants 2011-01-01 141
Total participants 2011-01-01 141
2010: WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE 2010 401k membership
Total participants, beginning-of-year 2010-01-01 213
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 142
Number of retired or separated participants receiving benefits 2010-01-01 11
Total of all active and inactive participants 2010-01-01 153
Total participants 2010-01-01 153
2009: WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE 2009 401k membership
Total participants, beginning-of-year 2009-01-01 218
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 200
Number of retired or separated participants receiving benefits 2009-01-01 13
Total of all active and inactive participants 2009-01-01 213
Total participants 2009-01-01 213

Measure	Date	Value
2016: WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE 2016 401k membership
Total participants, beginning-of-year	2016-01-01	180
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	167
Number of retired or separated participants receiving benefits	2016-01-01	2
Total of all active and inactive participants	2016-01-01	169
Total participants	2016-01-01	0
2015: WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE 2015 401k membership
Total participants, beginning-of-year	2015-01-01	178
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	179
Number of retired or separated participants receiving benefits	2015-01-01	1
Total of all active and inactive participants	2015-01-01	180
Total participants	2015-01-01	0
2014: WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE 2014 401k membership
Total participants, beginning-of-year	2014-01-01	133
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	175
Number of retired or separated participants receiving benefits	2014-01-01	3
Total of all active and inactive participants	2014-01-01	178
Total participants	2014-01-01	0
2013: WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE 2013 401k membership
Total participants, beginning-of-year	2013-01-01	138
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	132
Number of retired or separated participants receiving benefits	2013-01-01	1
Total of all active and inactive participants	2013-01-01	133
Total participants	2013-01-01	0
2012: WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE 2012 401k membership
Total participants, beginning-of-year	2012-01-01	141
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	135
Number of retired or separated participants receiving benefits	2012-01-01	3
Total of all active and inactive participants	2012-01-01	138
Total participants	2012-01-01	0
2011: WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE 2011 401k membership
Total participants, beginning-of-year	2011-01-01	153
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	136
Number of retired or separated participants receiving benefits	2011-01-01	5
Total of all active and inactive participants	2011-01-01	141
Total participants	2011-01-01	141
2010: WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE 2010 401k membership
Total participants, beginning-of-year	2010-01-01	213
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	142
Number of retired or separated participants receiving benefits	2010-01-01	11
Total of all active and inactive participants	2010-01-01	153
Total participants	2010-01-01	153
2009: WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE 2009 401k membership
Total participants, beginning-of-year	2009-01-01	218
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	200
Number of retired or separated participants receiving benefits	2009-01-01	13
Total of all active and inactive participants	2009-01-01	213
Total participants	2009-01-01	213

Form 5500 Responses for WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE

2016: WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE 2016 form 5500 responses
2016-01-01	Type of plan entity	Mulitple employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE 2015 form 5500 responses
2015-01-01	Type of plan entity	Mulitple employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE 2014 form 5500 responses
2014-01-01	Type of plan entity	Mulitple employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE 2013 form 5500 responses
2013-01-01	Type of plan entity	Mulitple employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE 2012 form 5500 responses
2012-01-01	Type of plan entity	Mulitple employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE 2011 form 5500 responses
2011-01-01	Type of plan entity	Mulitple employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE 2010 form 5500 responses
2010-01-01	Type of plan entity	Mulitple employer plan
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: WHITECO INDUSTRIES, INC. GROUP LIFE AND HEALTH INSURANCE 2009 form 5500 responses
2009-01-01	Type of plan entity	Mulitple employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

304063

Policy instance

Insurance contract or identification number	304063
Number of Individuals Covered	165
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $5,431
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $49,165
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,431
Insurance broker organization code?	3
Insurance broker name	REGIT INC.

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

0904033

Policy instance

Insurance contract or identification number	0904033
Number of Individuals Covered	256
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $63,539
Total amount of fees paid to insurance company	USD $19,518
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,662,522
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $63,539
Amount paid for insurance broker fees	19518
Additional information about fees paid to insurance broker	SERVICE FEE AGREEMENT
Insurance broker organization code?	3
Insurance broker name	REGIT INC.

AETNA HEALTH INC (National Association of Insurance Commissioners NAIC id number: 95397 )

Policy contract number

US396659

Policy instance

Insurance contract or identification number	US396659
Number of Individuals Covered	202
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $33,834
Welfare Benefit Premiums Paid to Carrier	USD $1,340,294
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $33,834
Insurance broker organization code?	3
Insurance broker name	REGIT INC.

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

877997

Policy instance

Insurance contract or identification number	877997
Number of Individuals Covered	89
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $1,922
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $18,898
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,922
Insurance broker organization code?	3
Insurance broker name	REGIT INC.

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

471506

Policy instance

Insurance contract or identification number	471506
Number of Individuals Covered	168
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $12,614
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $309,754
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $12,614
Insurance broker organization code?	3
Insurance broker name	REGIT INC.

AETNA HEALTH INC (National Association of Insurance Commissioners NAIC id number: 95397 )

Policy contract number

US396659

Policy instance

Insurance contract or identification number	US396659
Number of Individuals Covered	260
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $34,624
Welfare Benefit Premiums Paid to Carrier	USD $1,391,056
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $34,624
Insurance broker organization code?	3
Insurance broker name	REGIT INC.

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

471506

Policy instance

Insurance contract or identification number	471506
Number of Individuals Covered	182
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $8,190
Health Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $208,940
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,190
Insurance broker organization code?	3
Insurance broker name	REGIT INC.

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

877997

Policy instance

Insurance contract or identification number	877997
Number of Individuals Covered	117
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $1,958
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $20,426
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,958
Insurance broker organization code?	3
Insurance broker name	REGIT INC.

HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 )

Policy contract number

599289

Policy instance

Insurance contract or identification number	599289
Number of Individuals Covered	87
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $3,312
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $87,485
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,312
Insurance broker organization code?	3
Insurance broker name	DONNA J. FREESTATE

HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 )

Policy contract number

599289

Policy instance

Insurance contract or identification number	599289
Number of Individuals Covered	89
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $3,246
Total amount of fees paid to insurance company	USD $1,020
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $76,045
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1020
Additional information about fees paid to insurance broker	VOLUME INCENTIVES
Insurance broker organization code?	3
Commission paid to Insurance Broker	USD $3,246
Insurance broker name	DONNA J. FREESTATE

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

471506

Policy instance

Insurance contract or identification number	471506
Number of Individuals Covered	178
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $8,371
Health Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $212,873
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,371
Insurance broker organization code?	3
Insurance broker name	REGIT INC.

AETNA HEALTH INC (National Association of Insurance Commissioners NAIC id number: 95397 )

Policy contract number

US396659

Policy instance

Insurance contract or identification number	US396659
Number of Individuals Covered	264
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $33,478
Welfare Benefit Premiums Paid to Carrier	USD $1,349,295
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $33,478
Insurance broker organization code?	3
Insurance broker name	REGIT INC.

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

877997

Policy instance

Insurance contract or identification number	877997
Number of Individuals Covered	106
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $1,994
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $19,432
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,994
Insurance broker organization code?	3
Insurance broker name	REGIT INC.

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

877997

Policy instance

Insurance contract or identification number	877997
Number of Individuals Covered	109
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $1,770
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $17,862
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA HEALTH INC (National Association of Insurance Commissioners NAIC id number: 95397 )

Policy contract number

US396659

Policy instance

Insurance contract or identification number	US396659
Number of Individuals Covered	264
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $31,206
Welfare Benefit Premiums Paid to Carrier	USD $1,260,053
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

471506

Policy instance

Insurance contract or identification number	471506
Number of Individuals Covered	202
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $10,202
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $238,678
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

877997

Policy instance

Insurance contract or identification number	877997
Number of Individuals Covered	97
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $2,468
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $21,899
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,468
Insurance broker organization code?	3
Insurance broker name	REGIT INC.

AETNA HEALTH INC (National Association of Insurance Commissioners NAIC id number: 95397 )

Policy contract number

US396659

Policy instance

Insurance contract or identification number	US396659
Number of Individuals Covered	315
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $39,758
Total amount of fees paid to insurance company	USD $1,339
Welfare Benefit Premiums Paid to Carrier	USD $1,547,347
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1339
Additional information about fees paid to insurance broker	PM CROSS SALE
Insurance broker organization code?	3
Commission paid to Insurance Broker	USD $39,758
Insurance broker name	REGIT INC.

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

471506

Policy instance

Insurance contract or identification number	471506
Number of Individuals Covered	167
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $13,325
Total amount of fees paid to insurance company	USD $233
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $310,963
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	233
Additional information about fees paid to insurance broker	PM CROSS SALE
Insurance broker organization code?	3
Commission paid to Insurance Broker	USD $13,325
Insurance broker name	REGIT INC.

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Company Name:	WHITECO INDUSTRIES, INC.
Employer identification number (EIN):	350753770
NAIC Classification:	713100
NAIC Description:	Amusement Parks and Arcades

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	1986-12-03
Company Identification Number:	0007110606
Legal Registered Office Address:	1000 E 80TH PL STE 420N MERRILLVILLE United States of America (USA) 46410