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EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 401k Plan overview

Plan NameEBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL
Plan identification number 501

EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

EBY-BROWN COMPANY, LLC has sponsored the creation of one or more 401k plans.

Company Name:EBY-BROWN COMPANY, LLC
Employer identification number (EIN):364382177
NAIC Classification:424940
NAIC Description:Tobacco and Tobacco Product Merchant Wholesalers

Additional information about EBY-BROWN COMPANY, LLC

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 3240751

More information about EBY-BROWN COMPANY, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-01-01RYAN SEALOCK RYAN SEALOCK
5012020-01-01BONNIE CHLEBEK2021-10-12 BONNIE CHLEBEK2021-10-12
5012019-01-01
5012018-01-01BONNIE CHLEBEK2019-10-07 BONNIE CHLEBEK2019-10-07
5012017-01-01
5012016-01-01
5012015-01-01
5012014-01-01
5012013-01-01
5012012-01-01GARY SKARR
5012011-01-01GARY SKARR
5012010-01-01JOAN M NAUMAN
5012009-01-01JOAN M NAUMAN

Plan Statistics for EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL

401k plan membership statisitcs for EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL

Measure Date Value
2021: EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2021 401k membership
Total participants, beginning-of-year2021-01-012
Total number of active participants reported on line 7a of the Form 55002021-01-010
Total of all active and inactive participants2021-01-010
2020: EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2020 401k membership
Total participants, beginning-of-year2020-01-011,425
Total number of active participants reported on line 7a of the Form 55002020-01-011,340
Total of all active and inactive participants2020-01-011,340
2019: EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2019 401k membership
Total participants, beginning-of-year2019-01-011,414
Total number of active participants reported on line 7a of the Form 55002019-01-011,425
Total of all active and inactive participants2019-01-011,425
2018: EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2018 401k membership
Total participants, beginning-of-year2018-01-011,427
Total number of active participants reported on line 7a of the Form 55002018-01-011,414
Total of all active and inactive participants2018-01-011,414
2017: EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2017 401k membership
Total participants, beginning-of-year2017-01-011,433
Total number of active participants reported on line 7a of the Form 55002017-01-011,427
Total of all active and inactive participants2017-01-011,427
2016: EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2016 401k membership
Total participants, beginning-of-year2016-01-011,451
Total number of active participants reported on line 7a of the Form 55002016-01-011,433
Total of all active and inactive participants2016-01-011,433
2015: EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2015 401k membership
Total participants, beginning-of-year2015-01-011,397
Total number of active participants reported on line 7a of the Form 55002015-01-011,451
Total of all active and inactive participants2015-01-011,451
2014: EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2014 401k membership
Total participants, beginning-of-year2014-01-011,471
Total number of active participants reported on line 7a of the Form 55002014-01-011,397
Total of all active and inactive participants2014-01-011,397
2013: EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2013 401k membership
Total participants, beginning-of-year2013-01-011,624
Total number of active participants reported on line 7a of the Form 55002013-01-011,471
Total of all active and inactive participants2013-01-011,471
2012: EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2012 401k membership
Total participants, beginning-of-year2012-01-011,555
Total number of active participants reported on line 7a of the Form 55002012-01-011,624
Total of all active and inactive participants2012-01-011,624
2011: EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2011 401k membership
Total participants, beginning-of-year2011-01-011,458
Total number of active participants reported on line 7a of the Form 55002011-01-011,555
Number of retired or separated participants receiving benefits2011-01-010
Total of all active and inactive participants2011-01-011,555
2010: EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2010 401k membership
Total participants, beginning-of-year2010-01-011,496
Total number of active participants reported on line 7a of the Form 55002010-01-011,442
Number of retired or separated participants receiving benefits2010-01-0116
Total of all active and inactive participants2010-01-011,458
2009: EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2009 401k membership
Total participants, beginning-of-year2009-01-011,618
Total number of active participants reported on line 7a of the Form 55002009-01-011,485
Number of retired or separated participants receiving benefits2009-01-0111
Total of all active and inactive participants2009-01-011,496

Financial Data on EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL

Measure Date Value
2021 : EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2021 401k financial data
Total plan liabilities at end of year2021-12-31$0
Total plan liabilities at beginning of year2021-12-31$2,295,354
Total income from all sources2021-12-31$2,501,008
Expenses. Total of all expenses incurred2021-12-31$1,361,075
Benefits paid (including direct rollovers)2021-12-31$1,275,190
Total plan assets at end of year2021-12-31$0
Total plan assets at beginning of year2021-12-31$1,155,421
Value of fidelity bond covering the plan2021-12-31$10,000,000
Net income (gross income less expenses)2021-12-31$1,139,933
Net plan assets at end of year (total assets less liabilities)2021-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$-1,139,933
Total contributions received or receivable from employer(s)2021-12-31$2,501,008
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$85,885
2020 : EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2020 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$2,295,354
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$3,100,409
Total income from all sources (including contributions)2020-12-31$14,653,482
Total of all expenses incurred2020-12-31$13,939,875
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$12,844,301
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$14,653,482
Value of total assets at end of year2020-12-31$1,155,421
Value of total assets at beginning of year2020-12-31$1,246,869
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$1,095,574
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$10,000,000
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$4,946,719
Participant contributions at beginning of year2020-12-31$144,530
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$800,235
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$70,980
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$55,640
Liabilities. Value of operating payables at end of year2020-12-31$86,993
Liabilities. Value of operating payables at beginning of year2020-12-31$91,813
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$713,607
Value of net assets at end of year (total assets less liabilities)2020-12-31$-1,139,933
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$-1,853,540
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$897,842
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$8,906,528
Employer contributions (assets) at end of year2020-12-31$1,155,421
Employer contributions (assets) at beginning of year2020-12-31$1,102,339
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$11,946,459
Contract administrator fees2020-12-31$1,095,574
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-12-31No
Liabilities. Value of benefit claims payable at end of year2020-12-31$2,137,381
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$2,952,956
Did the plan have assets held for investment2020-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31PKF MUELLER
Accountancy firm EIN2020-12-31362658780
2019 : EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2019 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$3,100,409
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$3,100,409
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$3,270,521
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$3,270,521
Total income from all sources (including contributions)2019-12-31$15,556,114
Total income from all sources (including contributions)2019-12-31$15,556,114
Total of all expenses incurred2019-12-31$15,894,055
Total of all expenses incurred2019-12-31$15,894,055
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$14,752,784
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$14,752,784
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$15,556,114
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$15,556,114
Value of total assets at end of year2019-12-31$1,246,869
Value of total assets at end of year2019-12-31$1,246,869
Value of total assets at beginning of year2019-12-31$1,754,922
Value of total assets at beginning of year2019-12-31$1,754,922
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$1,141,271
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$1,141,271
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$10,000,000
Value of fidelity bond cover2019-12-31$10,000,000
If this is an individual account plan, was there a blackout period2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$4,928,173
Contributions received from participants2019-12-31$4,928,173
Participant contributions at end of year2019-12-31$144,530
Participant contributions at end of year2019-12-31$144,530
Participant contributions at beginning of year2019-12-31$117,947
Participant contributions at beginning of year2019-12-31$117,947
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$191,847
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$191,847
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$55,640
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$55,640
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$52,558
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$52,558
Liabilities. Value of operating payables at end of year2019-12-31$91,813
Liabilities. Value of operating payables at end of year2019-12-31$91,813
Liabilities. Value of operating payables at beginning of year2019-12-31$70,078
Liabilities. Value of operating payables at beginning of year2019-12-31$70,078
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$-337,941
Value of net income/loss2019-12-31$-337,941
Value of net assets at end of year (total assets less liabilities)2019-12-31$-1,853,540
Value of net assets at end of year (total assets less liabilities)2019-12-31$-1,853,540
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$-1,515,599
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$-1,515,599
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$684,117
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$684,117
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$10,436,094
Contributions received in cash from employer2019-12-31$10,436,094
Employer contributions (assets) at end of year2019-12-31$1,102,339
Employer contributions (assets) at end of year2019-12-31$1,102,339
Employer contributions (assets) at beginning of year2019-12-31$1,636,975
Employer contributions (assets) at beginning of year2019-12-31$1,636,975
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$14,068,667
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$14,068,667
Contract administrator fees2019-12-31$1,141,271
Contract administrator fees2019-12-31$1,141,271
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-12-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-12-31No
Liabilities. Value of benefit claims payable at end of year2019-12-31$2,952,956
Liabilities. Value of benefit claims payable at end of year2019-12-31$2,952,956
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$3,147,885
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$3,147,885
Did the plan have assets held for investment2019-12-31No
Did the plan have assets held for investment2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31MUELLER & CO. LLP
Accountancy firm name2019-12-31MUELLER & CO. LLP
Accountancy firm EIN2019-12-31362658780
Accountancy firm EIN2019-12-31362658780
2018 : EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2018 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$3,270,521
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$2,271,779
Total income from all sources (including contributions)2018-12-31$15,109,969
Total of all expenses incurred2018-12-31$15,510,840
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$14,635,293
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$15,109,969
Value of total assets at end of year2018-12-31$1,754,922
Value of total assets at beginning of year2018-12-31$1,157,051
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$875,547
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$10,000,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$4,862,684
Participant contributions at end of year2018-12-31$117,947
Participant contributions at beginning of year2018-12-31$100,431
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-12-31$998,673
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$52,558
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$47,362
Liabilities. Value of operating payables at end of year2018-12-31$70,078
Liabilities. Value of operating payables at beginning of year2018-12-31$70,009
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-400,871
Value of net assets at end of year (total assets less liabilities)2018-12-31$-1,515,599
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$-1,114,728
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$656,608
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$10,247,285
Employer contributions (assets) at end of year2018-12-31$1,636,975
Employer contributions (assets) at beginning of year2018-12-31$1,056,620
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$12,980,012
Contract administrator fees2018-12-31$875,547
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31No
Liabilities. Value of benefit claims payable at end of year2018-12-31$3,147,885
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$2,154,408
Did the plan have assets held for investment2018-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31MUELLER & CO, LLP
Accountancy firm EIN2018-12-31362658780
2017 : EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2017 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$2,271,779
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$1,799,576
Total income from all sources (including contributions)2017-12-31$11,474,119
Total of all expenses incurred2017-12-31$11,615,712
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$10,759,928
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$11,474,119
Value of total assets at end of year2017-12-31$1,157,051
Value of total assets at beginning of year2017-12-31$826,441
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$855,784
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$10,000,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$6,051,543
Participant contributions at end of year2017-12-31$100,431
Participant contributions at beginning of year2017-12-31$99,028
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2017-12-31$477,224
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$47,362
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$41,356
Liabilities. Value of operating payables at end of year2017-12-31$70,009
Liabilities. Value of operating payables at beginning of year2017-12-31$75,031
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$-141,593
Value of net assets at end of year (total assets less liabilities)2017-12-31$-1,114,728
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$-973,135
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$575,747
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$5,422,576
Employer contributions (assets) at end of year2017-12-31$1,056,620
Employer contributions (assets) at beginning of year2017-12-31$727,413
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$9,706,957
Contract administrator fees2017-12-31$855,784
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
Liabilities. Value of benefit claims payable at end of year2017-12-31$2,154,408
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$1,683,189
Did the plan have assets held for investment2017-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31MUELLER & CO. LLP
Accountancy firm EIN2017-12-31362658780
2016 : EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$1,799,576
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$2,261,136
Total income from all sources (including contributions)2016-12-31$11,486,792
Total of all expenses incurred2016-12-31$11,511,188
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$10,599,510
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$11,023,781
Value of total assets at end of year2016-12-31$826,441
Value of total assets at beginning of year2016-12-31$1,312,397
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$911,678
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$10,000,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$4,692,578
Participant contributions at end of year2016-12-31$99,028
Participant contributions at beginning of year2016-12-31$71,130
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$41,356
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$35,912
Other income not declared elsewhere2016-12-31$463,011
Liabilities. Value of operating payables at end of year2016-12-31$75,031
Liabilities. Value of operating payables at beginning of year2016-12-31$73,580
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$-24,396
Value of net assets at end of year (total assets less liabilities)2016-12-31$-973,135
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$-948,739
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$501,702
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$6,331,203
Employer contributions (assets) at end of year2016-12-31$727,413
Employer contributions (assets) at beginning of year2016-12-31$1,241,267
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$10,097,808
Contract administrator fees2016-12-31$911,678
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
Liabilities. Value of benefit claims payable at end of year2016-12-31$1,683,189
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$2,151,644
Did the plan have assets held for investment2016-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31MUELLER & CO. LLP
Accountancy firm EIN2016-12-31362658780
2015 : EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$2,261,136
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$1,736,578
Total income from all sources (including contributions)2015-12-31$10,717,206
Total of all expenses incurred2015-12-31$11,016,526
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$10,160,592
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$10,717,206
Value of total assets at end of year2015-12-31$1,312,397
Value of total assets at beginning of year2015-12-31$1,087,159
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$855,934
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$5,000,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$4,038,080
Participant contributions at end of year2015-12-31$71,130
Participant contributions at beginning of year2015-12-31$126,971
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2015-12-31$521,820
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$35,912
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$31,041
Liabilities. Value of operating payables at end of year2015-12-31$73,580
Liabilities. Value of operating payables at beginning of year2015-12-31$70,842
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-299,320
Value of net assets at end of year (total assets less liabilities)2015-12-31$-948,739
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$-649,419
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$416,419
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$6,679,126
Employer contributions (assets) at end of year2015-12-31$1,241,267
Employer contributions (assets) at beginning of year2015-12-31$960,188
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$9,222,353
Contract administrator fees2015-12-31$855,934
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-12-31No
Liabilities. Value of benefit claims payable at end of year2015-12-31$2,151,644
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$1,634,695
Did the plan have assets held for investment2015-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31MUELLER & CO. LLP
Accountancy firm EIN2015-12-31362658780
2014 : EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$1,736,578
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$1,634,700
Total income from all sources (including contributions)2014-12-31$11,160,993
Total of all expenses incurred2014-12-31$10,916,180
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$10,029,005
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$11,263,223
Value of total assets at end of year2014-12-31$1,087,159
Value of total assets at beginning of year2014-12-31$740,468
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$887,175
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$5,000,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$4,248,648
Participant contributions at end of year2014-12-31$126,971
Participant contributions at beginning of year2014-12-31$131,958
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$31,041
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-12-31$27,640
Other income not declared elsewhere2014-12-31$-102,230
Liabilities. Value of operating payables at end of year2014-12-31$70,842
Liabilities. Value of operating payables at beginning of year2014-12-31$71,194
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$244,813
Value of net assets at end of year (total assets less liabilities)2014-12-31$-649,419
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$-894,232
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$388,894
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$7,014,575
Employer contributions (assets) at end of year2014-12-31$960,188
Employer contributions (assets) at beginning of year2014-12-31$608,510
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$9,640,111
Contract administrator fees2014-12-31$887,175
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-12-31No
Liabilities. Value of benefit claims payable at end of year2014-12-31$1,634,695
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$1,535,866
Did the plan have assets held for investment2014-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31MUELLER & CO. LLP
Accountancy firm EIN2014-12-31362658780
2013 : EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$1,634,700
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$2,405,075
Total income from all sources (including contributions)2013-12-31$11,714,698
Total of all expenses incurred2013-12-31$10,980,459
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$10,131,594
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$10,942,739
Value of total assets at end of year2013-12-31$740,468
Value of total assets at beginning of year2013-12-31$776,604
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$848,865
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$5,000,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$4,118,056
Participant contributions at end of year2013-12-31$131,958
Participant contributions at beginning of year2013-12-31$105,355
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-12-31$27,640
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$27,132
Other income not declared elsewhere2013-12-31$771,959
Liabilities. Value of operating payables at end of year2013-12-31$71,194
Liabilities. Value of operating payables at beginning of year2013-12-31$69,610
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$734,239
Value of net assets at end of year (total assets less liabilities)2013-12-31$-894,232
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$-1,628,471
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$333,251
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$6,824,683
Employer contributions (assets) at end of year2013-12-31$608,510
Employer contributions (assets) at beginning of year2013-12-31$671,249
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$9,798,343
Contract administrator fees2013-12-31$848,865
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-12-31No
Liabilities. Value of benefit claims payable at end of year2013-12-31$1,535,866
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$2,308,333
Did the plan have assets held for investment2013-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31MUELLER & CO. LLP
Accountancy firm EIN2013-12-31362658780
2012 : EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$2,405,075
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$1,478,258
Total income from all sources (including contributions)2012-12-31$11,196,396
Total of all expenses incurred2012-12-31$10,740,207
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$9,675,809
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$11,196,396
Value of total assets at end of year2012-12-31$776,604
Value of total assets at beginning of year2012-12-31$315,546
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$1,064,398
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$5,000,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$4,521,069
Participant contributions at end of year2012-12-31$105,355
Participant contributions at beginning of year2012-12-31$87,273
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-12-31$27,132
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$21,801
Liabilities. Value of operating payables at end of year2012-12-31$69,610
Liabilities. Value of operating payables at beginning of year2012-12-31$61,854
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$456,189
Value of net assets at end of year (total assets less liabilities)2012-12-31$-1,628,471
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$-1,162,712
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$326,893
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$6,675,327
Employer contributions (assets) at end of year2012-12-31$671,249
Employer contributions (assets) at beginning of year2012-12-31$228,273
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$9,348,916
Contract administrator fees2012-12-31$1,064,398
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-12-31No
Liabilities. Value of benefit claims payable at end of year2012-12-31$2,308,333
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$1,394,603
Did the plan have assets held for investment2012-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31MUELLER & CO LLP
Accountancy firm EIN2012-12-31362658780
2011 : EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$1,478,258
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$1,090,561
Total income from all sources (including contributions)2011-12-31$8,423,551
Total of all expenses incurred2011-12-31$8,462,182
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$7,755,792
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$8,423,551
Value of total assets at end of year2011-12-31$315,546
Value of total assets at beginning of year2011-12-31$380,781
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$706,390
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$5,000,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$3,961,014
Participant contributions at end of year2011-12-31$87,273
Participant contributions at beginning of year2011-12-31$110,543
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-12-31$21,801
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-12-31$12,041
Liabilities. Value of operating payables at end of year2011-12-31$61,854
Liabilities. Value of operating payables at beginning of year2011-12-31$80,463
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-38,631
Value of net assets at end of year (total assets less liabilities)2011-12-31$-1,162,712
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$-709,780
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$244,116
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$4,462,537
Employer contributions (assets) at end of year2011-12-31$228,273
Employer contributions (assets) at beginning of year2011-12-31$270,238
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$7,511,676
Contract administrator fees2011-12-31$706,390
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-12-31No
Liabilities. Value of benefit claims payable at end of year2011-12-31$1,394,603
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$998,057
Did the plan have assets held for investment2011-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31MUELLER & CO LLP
Accountancy firm EIN2011-12-31362658780
2010 : EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2010 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$1,090,561
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$884,295
Total income from all sources (including contributions)2010-12-31$9,797,623
Total of all expenses incurred2010-12-31$9,622,516
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$8,810,945
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$9,797,623
Value of total assets at end of year2010-12-31$380,781
Value of total assets at beginning of year2010-12-31$202,328
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$811,571
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$3,000,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$3,964,977
Participant contributions at end of year2010-12-31$110,543
Participant contributions at beginning of year2010-12-31$64,421
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2010-12-31$12,041
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$4,174
Liabilities. Value of operating payables at end of year2010-12-31$80,463
Liabilities. Value of operating payables at beginning of year2010-12-31$77,118
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$175,107
Value of net assets at end of year (total assets less liabilities)2010-12-31$-709,780
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$-681,967
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$144,731
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$5,832,646
Employer contributions (assets) at end of year2010-12-31$270,238
Employer contributions (assets) at beginning of year2010-12-31$137,907
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$8,666,214
Contract administrator fees2010-12-31$811,571
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31No
Liabilities. Value of benefit claims payable at end of year2010-12-31$998,057
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$803,003
Did the plan have assets held for investment2010-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31MUELLER & CO LLP
Accountancy firm EIN2010-12-31362658780

Form 5500 Responses for EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL

2021: EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01This submission is the final filingYes
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: EBY-BROWN CO. SELF-INSURANCE PLAN HOSPITAL AND SURGICAL 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/N/078599
Policy instance 1
Insurance contract or identification numberP/N/078599
Number of Individuals Covered0
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $40,249
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $106
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees40249
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/N/078599
Policy instance 1
Insurance contract or identification numberP/N/078599
Number of Individuals Covered2296
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $75,000
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $927,183
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $56,250
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/N/078599
Policy instance 1
Insurance contract or identification numberP/N/078599
Number of Individuals Covered2484
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $93,564
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $684,117
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $75,000
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/N/078599
Policy instance 1
Insurance contract or identification numberP/N/078599
Number of Individuals Covered2498
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $23,679
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $656,608
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,564
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/N/078599
Policy instance 1
Insurance contract or identification numberP/N/078599
Number of Individuals Covered2525
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $45,642
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $575,747
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,642
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERVICES
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/N/078599
Policy instance 1
Insurance contract or identification numberP/N/078599
Number of Individuals Covered2667
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $75,000
Total amount of fees paid to insurance companyUSD $12,681
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $416,419
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $75,000
Amount paid for insurance broker fees12681
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERVICES
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/N/078599
Policy instance 1
Insurance contract or identification numberP/N/078599
Number of Individuals Covered2594
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $75,000
Total amount of fees paid to insurance companyUSD $13,257
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $388,894
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $75,000
Amount paid for insurance broker fees13257
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERVICES
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/N/078599
Policy instance 1
Insurance contract or identification numberP/N/078599
Number of Individuals Covered2746
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $75,000
Total amount of fees paid to insurance companyUSD $16,189
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $333,251
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $75,000
Amount paid for insurance broker fees16189
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERVICES
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/N/078599
Policy instance 1
Insurance contract or identification numberP/N/078599
Number of Individuals Covered2888
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $75,000
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
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $326,893
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $56,250
Insurance broker organization code?3
Insurance broker nameWILLIS OF ILLINOIS INC.
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/N/078599
Policy instance 1
Insurance contract or identification numberP/N/078599
Number of Individuals Covered2789
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $81,250
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
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $244,116
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/N/078599
Policy instance 1
Insurance contract or identification numberP/N/078599
Number of Individuals Covered1784
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $75,000
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
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $144,731
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $75,000
Insurance broker organization code?3
Insurance broker nameWILLIS OF ILLINOIS INC.

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