401k Plan data: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN plan

EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 401k Plan overview

Plan Name	EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN
Plan identification number	333

EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.

401k Sponsoring company profile

EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA has sponsored the creation of one or more 401k plans.

Company Name: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA

Employer identification number (EIN): 352025429

NAIC Classification: 561490

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
333 2020-01-01
333 2019-01-01
333 2018-01-01
333 2017-01-01 KENNETH LIZER KENNETH LIZER 2018-09-28
333 2016-01-01 KENNETH LIZER KENNETH LIZER 2017-09-27
333 2015-01-01 KENNETH LIZER KENNETH LIZER 2016-10-03
333 2014-01-01 KENNETH LIZER KENNETH LIZER 2015-10-05
333 2013-01-01 KENNETH LIZER KENNETH LIZER 2014-09-29
333 2012-01-01 KENNETH LIZER KENNETH LIZER 2013-10-14
333 2011-01-01 KENNETH C. LIZER KENNETH C. LIZER 2012-10-12
333 2010-01-01 KENNETH C. LIZER KENNETH C. LIZER 2011-09-30
333 2009-01-01 KENNETH C. LIZER KENNETH C. LIZER 2010-10-08

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
333	2020-01-01
333	2019-01-01
333	2018-01-01
333	2017-01-01	KENNETH LIZER	KENNETH LIZER	2018-09-28
333	2016-01-01	KENNETH LIZER	KENNETH LIZER	2017-09-27
333	2015-01-01	KENNETH LIZER	KENNETH LIZER	2016-10-03
333	2014-01-01	KENNETH LIZER	KENNETH LIZER	2015-10-05
333	2013-01-01	KENNETH LIZER	KENNETH LIZER	2014-09-29
333	2012-01-01	KENNETH LIZER	KENNETH LIZER	2013-10-14
333	2011-01-01	KENNETH C. LIZER	KENNETH C. LIZER	2012-10-12
333	2010-01-01	KENNETH C. LIZER	KENNETH C. LIZER	2011-09-30
333	2009-01-01	KENNETH C. LIZER	KENNETH C. LIZER	2010-10-08

Plan Statistics for EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN

401k plan membership statisitcs for EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN

Measure Date Value
2018: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 49
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 48
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 0
Total of all active and inactive participants 2018-01-01 48
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 48
Number of participants with account balances 2018-01-01 48
2017: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 67
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 46
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 3
Total of all active and inactive participants 2017-01-01 49
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 49
Number of participants with account balances 2017-01-01 49
2016: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 105
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 64
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 3
Total of all active and inactive participants 2016-01-01 67
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 67
Number of participants with account balances 2016-01-01 46
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 108
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 59
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 39
Total of all active and inactive participants 2015-01-01 98
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 98
Number of participants with account balances 2015-01-01 78
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 1
2014: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 158
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 92
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 12
Total of all active and inactive participants 2014-01-01 104
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 104
Number of participants with account balances 2014-01-01 77
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 1
2013: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 166
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 102
Number of retired or separated participants receiving benefits 2013-01-01 2
Number of other retired or separated participants entitled to future benefits 2013-01-01 58
Total of all active and inactive participants 2013-01-01 162
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 162
Number of participants with account balances 2013-01-01 97
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 4
2012: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 173
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 141
Number of retired or separated participants receiving benefits 2012-01-01 2
Number of other retired or separated participants entitled to future benefits 2012-01-01 25
Total of all active and inactive participants 2012-01-01 168
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 168
Number of participants with account balances 2012-01-01 139
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 5
2011: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 173
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 149
Number of retired or separated participants receiving benefits 2011-01-01 1
Number of other retired or separated participants entitled to future benefits 2011-01-01 14
Total of all active and inactive participants 2011-01-01 164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 164
Number of participants with account balances 2011-01-01 142
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 196
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 166
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 23
Total of all active and inactive participants 2010-01-01 189
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 189
Number of participants with account balances 2010-01-01 163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 4
2009: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 192
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 175
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 14
Total of all active and inactive participants 2009-01-01 189
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 189
Number of participants with account balances 2009-01-01 154
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 1

Measure	Date	Value
2018: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	49
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	48
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	48
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	48
Number of participants with account balances	2018-01-01	48
2017: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	67
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	46
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	3
Total of all active and inactive participants	2017-01-01	49
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	49
Number of participants with account balances	2017-01-01	49
2016: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	105
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	64
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	3
Total of all active and inactive participants	2016-01-01	67
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	67
Number of participants with account balances	2016-01-01	46
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	108
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	59
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	39
Total of all active and inactive participants	2015-01-01	98
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	98
Number of participants with account balances	2015-01-01	78
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	1
2014: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	158
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	92
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	12
Total of all active and inactive participants	2014-01-01	104
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	104
Number of participants with account balances	2014-01-01	77
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	1
2013: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	166
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	102
Number of retired or separated participants receiving benefits	2013-01-01	2
Number of other retired or separated participants entitled to future benefits	2013-01-01	58
Total of all active and inactive participants	2013-01-01	162
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	162
Number of participants with account balances	2013-01-01	97
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	4
2012: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	173
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	141
Number of retired or separated participants receiving benefits	2012-01-01	2
Number of other retired or separated participants entitled to future benefits	2012-01-01	25
Total of all active and inactive participants	2012-01-01	168
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	168
Number of participants with account balances	2012-01-01	139
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	5
2011: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	173
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	149
Number of retired or separated participants receiving benefits	2011-01-01	1
Number of other retired or separated participants entitled to future benefits	2011-01-01	14
Total of all active and inactive participants	2011-01-01	164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	164
Number of participants with account balances	2011-01-01	142
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	196
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	166
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	23
Total of all active and inactive participants	2010-01-01	189
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	189
Number of participants with account balances	2010-01-01	163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	4
2009: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	192
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	175
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	14
Total of all active and inactive participants	2009-01-01	189
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	189
Number of participants with account balances	2009-01-01	154
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	1

Financial Data on EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN

Measure	Date	Value
2018 : EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2018 401k financial data
Total income from all sources	2018-12-31	$5,693
Expenses. Total of all expenses incurred	2018-12-31	$110,600
Benefits paid (including direct rollovers)	2018-12-31	$96,171
Total plan assets at end of year	2018-12-31	$3,859,022
Total plan assets at beginning of year	2018-12-31	$3,963,929
Value of fidelity bond covering the plan	2018-12-31	$500,000
Total contributions received or receivable from participants	2018-12-31	$214,124
Other income received	2018-12-31	$-266,847
Net income (gross income less expenses)	2018-12-31	$-104,907
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$3,859,022
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$3,963,929
Assets. Value of participant loans	2018-12-31	$55,916
Total contributions received or receivable from employer(s)	2018-12-31	$58,416
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$14,429
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
2017 : EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2017 401k financial data
Total income from all sources	2017-12-31	$839,636
Expenses. Total of all expenses incurred	2017-12-31	$85,233
Benefits paid (including direct rollovers)	2017-12-31	$70,487
Total plan assets at end of year	2017-12-31	$3,963,929
Total plan assets at beginning of year	2017-12-31	$3,209,526
Value of fidelity bond covering the plan	2017-12-31	$500,000
Total contributions received or receivable from participants	2017-12-31	$201,138
Other income received	2017-12-31	$585,276
Net income (gross income less expenses)	2017-12-31	$754,403
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$3,963,929
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$3,209,526
Assets. Value of participant loans	2017-12-31	$20,239
Total contributions received or receivable from employer(s)	2017-12-31	$53,222
Value of certain deemed distributions of participant loans	2017-12-31	$14,746
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total transfer of assets from this plan	2016-12-31	$1,811,137
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$1,277
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$1,084
Total income from all sources (including contributions)	2016-12-31	$550,683
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$248,600
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$220,947
Value of total corrective distributions	2016-12-31	$3,373
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$237,397
Value of total assets at end of year	2016-12-31	$3,250,717
Value of total assets at beginning of year	2016-12-31	$4,759,578
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$24,280
Total interest from all sources	2016-12-31	$3,227
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$187,704
Participant contributions at end of year	2016-12-31	$41,188
Participant contributions at beginning of year	2016-12-31	$75,712
Participant contributions at end of year	2016-12-31	$3
Participant contributions at beginning of year	2016-12-31	$3
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-12-31	$1,277
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-12-31	$1,084
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$302,083
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$3,249,440
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$4,758,494
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in pooled separate accounts at end of year	2016-12-31	$3,209,526
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$4,591,321
Interest on participant loans	2016-12-31	$2,410
Interest earned on other investments	2016-12-31	$817
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$92,542
Net investment gain/loss from pooled separate accounts	2016-12-31	$310,059
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$49,693
Employer contributions (assets) at beginning of year	2016-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$220,947
Contract administrator fees	2016-12-31	$24,280
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	LTS CPA GROUP, LLC
Accountancy firm EIN	2016-12-31	273126302
2015 : EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$1,084
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$126,009
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$151,005
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$128,280
Value of total corrective distributions	2015-12-31	$2,802
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$290,821
Value of total assets at end of year	2015-12-31	$4,759,578
Value of total assets at beginning of year	2015-12-31	$4,783,490
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$19,923
Total interest from all sources	2015-12-31	$6,284
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$244,964
Participant contributions at end of year	2015-12-31	$75,712
Participant contributions at beginning of year	2015-12-31	$106,503
Participant contributions at end of year	2015-12-31	$3
Participant contributions at beginning of year	2015-12-31	$6,294
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$1,394
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2015-12-31	$1,084
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-24,996
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$4,758,494
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$4,783,490
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in pooled separate accounts at end of year	2015-12-31	$4,591,321
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$4,478,625
Interest on participant loans	2015-12-31	$4,485
Interest earned on other investments	2015-12-31	$1,799
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$92,542
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$85,999
Net investment gain/loss from pooled separate accounts	2015-12-31	$-171,096
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$45,857
Employer contributions (assets) at end of year	2015-12-31	$0
Employer contributions (assets) at beginning of year	2015-12-31	$104,675
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$128,280
Contract administrator fees	2015-12-31	$19,923
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	LTS CPA GROUP, LLC
Accountancy firm EIN	2015-12-31	273126302
2014 : EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total transfer of assets from this plan	2014-12-31	$985,463
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$490,425
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$1,946,912
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$1,919,901
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$364,419
Value of total assets at end of year	2014-12-31	$4,783,490
Value of total assets at beginning of year	2014-12-31	$7,225,440
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$27,011
Total interest from all sources	2014-12-31	$7,157
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$221,527
Participant contributions at end of year	2014-12-31	$106,503
Participant contributions at beginning of year	2014-12-31	$165,139
Participant contributions at end of year	2014-12-31	$6,294
Participant contributions at beginning of year	2014-12-31	$11,666
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$1,394
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$-1,456,487
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$4,783,490
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$7,225,440
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in pooled separate accounts at end of year	2014-12-31	$4,478,625
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$6,910,111
Interest on participant loans	2014-12-31	$5,533
Interest earned on other investments	2014-12-31	$1,624
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$85,999
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$80,227
Net investment gain/loss from pooled separate accounts	2014-12-31	$118,849
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$142,892
Employer contributions (assets) at end of year	2014-12-31	$104,675
Employer contributions (assets) at beginning of year	2014-12-31	$58,297
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$1,919,901
Contract administrator fees	2014-12-31	$27,011
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	LTS CPA GROUP, LLC
Accountancy firm EIN	2014-12-31	273126302
2013 : EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total transfer of assets from this plan	2013-12-31	$659,671
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$2,493
Total income from all sources (including contributions)	2013-12-31	$1,397,696
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$264,761
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$230,221
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$502,954
Value of total assets at end of year	2013-12-31	$7,225,440
Value of total assets at beginning of year	2013-12-31	$6,754,669
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$34,540
Total interest from all sources	2013-12-31	$10,087
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$344,706
Participant contributions at end of year	2013-12-31	$165,139
Participant contributions at beginning of year	2013-12-31	$201,642
Participant contributions at end of year	2013-12-31	$11,666
Participant contributions at beginning of year	2013-12-31	$9,031
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$19,722
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-12-31	$2,493
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$1,132,935
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$7,225,440
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$6,752,176
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in pooled separate accounts at end of year	2013-12-31	$6,910,111
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$6,437,473
Interest on participant loans	2013-12-31	$8,542
Interest earned on other investments	2013-12-31	$1,545
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$80,227
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$76,027
Net investment gain/loss from pooled separate accounts	2013-12-31	$884,655
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$138,526
Employer contributions (assets) at end of year	2013-12-31	$58,297
Employer contributions (assets) at beginning of year	2013-12-31	$30,496
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$230,221
Contract administrator fees	2013-12-31	$34,540
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	LTS CPA GROUP, LLC
Accountancy firm EIN	2013-12-31	273126302
2012 : EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$2,493
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$2,511
Total income from all sources (including contributions)	2012-12-31	$1,300,655
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$861,137
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$823,157
Expenses. Certain deemed distributions of participant loans	2012-12-31	$2,663
Value of total corrective distributions	2012-12-31	$667
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$654,796
Value of total assets at end of year	2012-12-31	$6,754,669
Value of total assets at beginning of year	2012-12-31	$6,315,169
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$34,650
Total interest from all sources	2012-12-31	$11,764
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$367,336
Participant contributions at end of year	2012-12-31	$201,642
Participant contributions at beginning of year	2012-12-31	$210,708
Participant contributions at end of year	2012-12-31	$9,031
Participant contributions at beginning of year	2012-12-31	$10,759
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$163,964
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$147
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-12-31	$2,493
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-12-31	$2,511
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$439,518
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$6,752,176
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$6,312,658
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in pooled separate accounts at end of year	2012-12-31	$6,437,473
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$6,009,651
Interest on participant loans	2012-12-31	$10,286
Interest earned on other investments	2012-12-31	$1,478
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$76,027
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$71,982
Net investment gain/loss from pooled separate accounts	2012-12-31	$634,095
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$123,496
Employer contributions (assets) at end of year	2012-12-31	$30,496
Employer contributions (assets) at beginning of year	2012-12-31	$11,922
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$823,157
Contract administrator fees	2012-12-31	$34,650
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	LTS CPA GROUP, LLC
Accountancy firm EIN	2012-12-31	273126302
2011 : EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total transfer of assets from this plan	2011-12-31	$439,002
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$2,511
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$212,210
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$382,500
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$323,080
Expenses. Certain deemed distributions of participant loans	2011-12-31	$16,499
Value of total corrective distributions	2011-12-31	$5,764
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$495,434
Value of total assets at end of year	2011-12-31	$6,315,169
Value of total assets at beginning of year	2011-12-31	$6,921,950
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$37,157
Total interest from all sources	2011-12-31	$14,254
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$374,592
Participant contributions at end of year	2011-12-31	$210,708
Participant contributions at beginning of year	2011-12-31	$251,079
Participant contributions at end of year	2011-12-31	$10,759
Participant contributions at beginning of year	2011-12-31	$23,815
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$147
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-12-31	$2,511
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$-170,290
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$6,312,658
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$6,921,950
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in pooled separate accounts at end of year	2011-12-31	$6,009,651
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$6,556,863
Interest on participant loans	2011-12-31	$12,865
Income. Interest from loans (other than to participants)	2011-12-31	$0
Interest earned on other investments	2011-12-31	$1,389
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$71,982
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$68,574
Net investment gain/loss from pooled separate accounts	2011-12-31	$-297,478
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$120,842
Employer contributions (assets) at end of year	2011-12-31	$11,922
Employer contributions (assets) at beginning of year	2011-12-31	$21,619
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$323,080
Contract administrator fees	2011-12-31	$37,157
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	LTS CPA GROUP, LLC
Accountancy firm EIN	2011-12-31	273126302
2010 : EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$1,299,762
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$393,192
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$374,608
Expenses. Certain deemed distributions of participant loans	2010-12-31	$16,744
Value of total corrective distributions	2010-12-31	$1,840
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$588,619
Value of total assets at end of year	2010-12-31	$6,921,950
Value of total assets at beginning of year	2010-12-31	$6,015,380
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$0
Total interest from all sources	2010-12-31	$17,602
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$408,564
Participant contributions at end of year	2010-12-31	$251,079
Participant contributions at beginning of year	2010-12-31	$318,362
Participant contributions at end of year	2010-12-31	$23,815
Participant contributions at beginning of year	2010-12-31	$6,355
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$906,570
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$6,921,950
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$6,015,380
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in pooled separate accounts at end of year	2010-12-31	$6,556,863
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$5,417,816
Interest on participant loans	2010-12-31	$16,608
Interest earned on other investments	2010-12-31	$994
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$68,574
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$252,769
Net investment gain/loss from pooled separate accounts	2010-12-31	$693,541
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$180,055
Employer contributions (assets) at end of year	2010-12-31	$21,619
Employer contributions (assets) at beginning of year	2010-12-31	$20,078
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$374,608
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	LTS CPA GROUP, LLC
Accountancy firm EIN	2010-12-31	273126302

Form 5500 Responses for EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN

2018: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Mulitple employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Mulitple employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Mulitple employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Mulitple employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Mulitple employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Mulitple employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Mulitple employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Mulitple employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Mulitple employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA RETIREMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Mulitple employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )

Policy contract number

E63 0351

Policy instance

Insurance contract or identification number	E63 0351
Number of Individuals Covered	49
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $9,208
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 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?	Yes
Health Insurance Welfare Benefit	No
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
Amount paid for insurance broker fees	7228
Additional information about fees paid to insurance broker	BROKERAGE
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )

Policy contract number

300044

Policy instance

Insurance contract or identification number	300044
Number of Individuals Covered	48
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $17,121
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 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?	Yes
Health Insurance Welfare Benefit	No
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
Amount paid for insurance broker fees	12464
Additional information about fees paid to insurance broker	BROKERAGE
Insurance broker organization code?	3
Insurance broker name	JACOB HAXTON & BOORD, LLC

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )

Policy contract number

300044

Policy instance

Insurance contract or identification number	300044
Number of Individuals Covered	78
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $16,354
Total amount of fees paid to insurance company	USD $6,663
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?	Yes
Health Insurance Welfare Benefit	No
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
Commission paid to Insurance Broker	USD $16,354
Insurance broker organization code?	3
Amount paid for insurance broker fees	3302
Additional information about fees paid to insurance broker	WHOLESALE SERVICE
Insurance broker name	SWBC INVESTMENT ADVISORY SERVICES

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )

Policy contract number

300044

Policy instance

Insurance contract or identification number	300044
Number of Individuals Covered	119
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $16,427
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?	Yes
Health Insurance Welfare Benefit	No
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
Commission paid to Insurance Broker	USD $16,427
Insurance broker organization code?	3
Insurance broker name	RMFS BENEFIT SOLUTIONS

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )

Policy contract number

300044

Policy instance

Insurance contract or identification number	300044
Number of Individuals Covered	137
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $19,877
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?	Yes
Health Insurance Welfare Benefit	No
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
Commission paid to Insurance Broker	USD $19,877
Insurance broker organization code?	3
Insurance broker name	RMFS BENEFIT SOLUTIONS

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )

Policy contract number

300044

Policy instance

Insurance contract or identification number	300044
Number of Individuals Covered	140
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
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?	Yes
Health Insurance Welfare Benefit	No
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

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )

Policy contract number

300044

Policy instance

Insurance contract or identification number	300044
Number of Individuals Covered	162
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
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?	Yes
Health Insurance Welfare Benefit	No
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

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )

Policy contract number

300044

Policy instance

Insurance contract or identification number	300044
Number of Individuals Covered	179
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
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?	Yes
Health Insurance Welfare Benefit	No
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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

VARIOUS

Policy instance

Insurance contract or identification number	VARIOUS
Number of Individuals Covered	0
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $5,253
Total amount of fees paid to insurance company	USD $180
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?	Yes
Health Insurance Welfare Benefit	No
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
Commission paid to Insurance Broker	USD $5,253
Amount paid for insurance broker fees	180
Additional information about fees paid to insurance broker	NON-MONETARY COMPENSATION TO SALES REP
Insurance broker organization code?	4
Insurance broker name	LINCOLN FINANCIAL ADVISORS

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Company Name:	EMPLOYERS ADMINISTRATIVE SERVICES OF INDIANA
Employer identification number (EIN):	352025429
NAIC Classification:	561490