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CCS CONTRACTOR EQUIPMENT & SUPPLY, INC. GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE PLAN 401k Plan overview

Plan NameCCS CONTRACTOR EQUIPMENT & SUPPLY, INC. GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE PLAN
Plan identification number 501

CCS CONTRACTOR EQUIPMENT & SUPPLY, INC. GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)

401k Sponsoring company profile

CCS CONTRACTOR EQUIPMENT & SUPPLY, INC. has sponsored the creation of one or more 401k plans.

Company Name:CCS CONTRACTOR EQUIPMENT & SUPPLY, INC.
Employer identification number (EIN):362865410
NAIC Classification:444190
NAIC Description:Other Building Material Dealers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CCS CONTRACTOR EQUIPMENT & SUPPLY, INC. GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012014-08-01LEIGH HAMM
5012013-08-01
5012012-08-01RAY BARTHOLOMAE

Plan Statistics for CCS CONTRACTOR EQUIPMENT & SUPPLY, INC. GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE PLAN

401k plan membership statisitcs for CCS CONTRACTOR EQUIPMENT & SUPPLY, INC. GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE PLAN

Measure Date Value
2014: CCS CONTRACTOR EQUIPMENT & SUPPLY, INC. GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-08-01198
Total of all active and inactive participants2014-08-010
2013: CCS CONTRACTOR EQUIPMENT & SUPPLY, INC. GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-08-01145
Total number of active participants reported on line 7a of the Form 55002013-08-01188
Number of retired or separated participants receiving benefits2013-08-010
Number of other retired or separated participants entitled to future benefits2013-08-010
Total of all active and inactive participants2013-08-01188
2012: CCS CONTRACTOR EQUIPMENT & SUPPLY, INC. GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-08-01126
Total number of active participants reported on line 7a of the Form 55002012-08-01145
Number of retired or separated participants receiving benefits2012-08-010
Number of other retired or separated participants entitled to future benefits2012-08-010
Total of all active and inactive participants2012-08-01145

Form 5500 Responses for CCS CONTRACTOR EQUIPMENT & SUPPLY, INC. GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE PLAN

2014: CCS CONTRACTOR EQUIPMENT & SUPPLY, INC. GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE PLAN 2014 form 5500 responses
2014-08-01Type of plan entitySingle employer plan
2014-08-01Submission has been amendedNo
2014-08-01This submission is the final filingYes
2014-08-01This return/report is a short plan year return/report (less than 12 months)No
2014-08-01Plan is a collectively bargained planNo
2014-08-01Plan funding arrangement – InsuranceYes
2014-08-01Plan benefit arrangement – InsuranceYes
2013: CCS CONTRACTOR EQUIPMENT & SUPPLY, INC. GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE PLAN 2013 form 5500 responses
2013-08-01Type of plan entitySingle employer plan
2013-08-01Plan funding arrangement – General assets of the sponsorYes
2013-08-01Plan benefit arrangement – InsuranceYes
2012: CCS CONTRACTOR EQUIPMENT & SUPPLY, INC. GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE PLAN 2012 form 5500 responses
2012-08-01Type of plan entitySingle employer plan
2012-08-01First time form 5500 has been submittedYes
2012-08-01Plan funding arrangement – General assets of the sponsorYes
2012-08-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number158477
Policy instance 1
Insurance contract or identification number158477
Number of Individuals Covered206
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $6,537
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $2,144
Insurance broker organization code?3
Insurance broker nameMESIROW INS SRVCS INC
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF011058
Policy instance 1
Insurance contract or identification numberF011058
Number of Individuals Covered198
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $873
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $5,778
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $873
Insurance broker organization code?3
Insurance broker nameMESIROW CONSULTING SERVICES, INC
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF011058
Policy instance 1
Insurance contract or identification numberF011058
Number of Individuals Covered145
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $655
Total amount of fees paid to insurance companyUSD $64
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $4,445
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $655
Amount paid for insurance broker fees64
Additional information about fees paid to insurance brokerINCENTIVE PLAN PAYOUTS, OVERRIDES, THIRD PARTY ADMINISTRATION FEES AN
Insurance broker organization code?3
Insurance broker nameMESIROW CONSULTING SERVICES, INC

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