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LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan NameLEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN
Plan identification number 502

LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Temporary disability (accident and sickness)

401k Sponsoring company profile

LEWIS BROTHERS BAKERIES, INC. has sponsored the creation of one or more 401k plans.

Company Name:LEWIS BROTHERS BAKERIES, INC.
Employer identification number (EIN):370636783
NAIC Classification:311800
NAIC Description: Bakeries and Tortilla Manufacturing

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022021-04-01JEFFERY SANKOVITCH2023-01-19
5022020-04-01
5022019-04-01
5022018-04-01
5022017-04-01JEFF SANKOVITCH JEFF SANKOVITCH
5022017-04-01JEFF SANKOVITCH JEFF SANKOVITCH2019-01-11
5022016-04-01JEFF SANKOVITCH JEFF SANKOVITCH2017-12-11
5022015-04-01JEFF SANKOVITCH JEFF SANKOVITCH2016-12-09
5022014-04-01JEFF SANKOVITCH JEFF SANKOVITCH2015-11-23
5022013-04-01JEFF SANKOVITCH JEFF SANKOVITCH2015-01-05
5022012-04-01JEFF SANKOVITCH JEFF SANKOVITCH2013-12-23
5022011-04-01JEFF SANKOVITCH JEFF SANKOVITCH2013-01-11
5022009-04-01JEFF SANKOVITCH JEFF SANKOVITCH2011-01-11

Plan Statistics for LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN

Measure Date Value
2021: LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-04-01612
Total number of active participants reported on line 7a of the Form 55002021-04-01634
Number of retired or separated participants receiving benefits2021-04-013
Number of other retired or separated participants entitled to future benefits2021-04-010
Total of all active and inactive participants2021-04-01637
Total participants2021-04-01637
2020: LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-04-01625
Total number of active participants reported on line 7a of the Form 55002020-04-01637
Number of retired or separated participants receiving benefits2020-04-017
Number of other retired or separated participants entitled to future benefits2020-04-010
Total of all active and inactive participants2020-04-01644
2019: LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-04-01653
Total number of active participants reported on line 7a of the Form 55002019-04-01612
Number of retired or separated participants receiving benefits2019-04-0113
Number of other retired or separated participants entitled to future benefits2019-04-010
Total of all active and inactive participants2019-04-01625
2018: LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-04-01842
Total number of active participants reported on line 7a of the Form 55002018-04-01639
Number of retired or separated participants receiving benefits2018-04-0114
Number of other retired or separated participants entitled to future benefits2018-04-010
Total of all active and inactive participants2018-04-01653
2017: LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-04-01900
Total number of active participants reported on line 7a of the Form 55002017-04-01810
Number of retired or separated participants receiving benefits2017-04-0132
Number of other retired or separated participants entitled to future benefits2017-04-010
Total of all active and inactive participants2017-04-01842
2016: LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-04-01939
Total number of active participants reported on line 7a of the Form 55002016-04-01900
Number of retired or separated participants receiving benefits2016-04-0135
Number of other retired or separated participants entitled to future benefits2016-04-010
Total of all active and inactive participants2016-04-01935
2015: LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-04-01997
Total number of active participants reported on line 7a of the Form 55002015-04-01939
Number of retired or separated participants receiving benefits2015-04-0123
Number of other retired or separated participants entitled to future benefits2015-04-010
Total of all active and inactive participants2015-04-01962
2014: LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-04-011,054
Total number of active participants reported on line 7a of the Form 55002014-04-01947
Number of retired or separated participants receiving benefits2014-04-0150
Total of all active and inactive participants2014-04-01997
2013: LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-04-011,129
Total number of active participants reported on line 7a of the Form 55002013-04-011,004
Number of retired or separated participants receiving benefits2013-04-0150
Total of all active and inactive participants2013-04-011,054
2012: LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-04-011,092
Total number of active participants reported on line 7a of the Form 55002012-04-011,101
Number of retired or separated participants receiving benefits2012-04-0128
Total of all active and inactive participants2012-04-011,129
2011: LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-04-011,206
Total number of active participants reported on line 7a of the Form 55002011-04-011,048
Number of retired or separated participants receiving benefits2011-04-0144
Total of all active and inactive participants2011-04-011,092
2009: LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-04-011,298
Total number of active participants reported on line 7a of the Form 55002009-04-011,195
Number of retired or separated participants receiving benefits2009-04-0154
Total of all active and inactive participants2009-04-011,249

Financial Data on LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN

Measure Date Value
2022 : LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-03-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-03-31$0
Total income from all sources (including contributions)2022-03-31$11,362,952
Total loss/gain on sale of assets2022-03-31$0
Total of all expenses incurred2022-03-31$11,323,492
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-03-31$10,794,440
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-03-31$11,362,939
Value of total assets at end of year2022-03-31$908,093
Value of total assets at beginning of year2022-03-31$868,633
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-03-31$529,052
Total interest from all sources2022-03-31$13
Total dividends received (eg from common stock, registered investment company shares)2022-03-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-03-31No
Was this plan covered by a fidelity bond2022-03-31Yes
Value of fidelity bond cover2022-03-31$500,000
If this is an individual account plan, was there a blackout period2022-03-31No
Were there any nonexempt tranactions with any party-in-interest2022-03-31No
Contributions received from participants2022-03-31$978,192
Total non interest bearing cash at end of year2022-03-31$791,849
Total non interest bearing cash at beginning of year2022-03-31$752,402
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-03-31No
Value of net income/loss2022-03-31$39,460
Value of net assets at end of year (total assets less liabilities)2022-03-31$908,093
Value of net assets at beginning of year (total assets less liabilities)2022-03-31$868,633
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-03-31No
Were any leases to which the plan was party in default or uncollectible2022-03-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-03-31$116,244
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-03-31$116,231
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-03-31$116,231
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-03-31$13
Expenses. Payments to insurance carriers foe the provision of benefits2022-03-31$598,649
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-03-31No
Was there a failure to transmit to the plan any participant contributions2022-03-31No
Has the plan failed to provide any benefit when due under the plan2022-03-31No
Contributions received in cash from employer2022-03-31$10,384,747
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-03-31$10,195,791
Contract administrator fees2022-03-31$529,052
Did the plan have assets held for investment2022-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-03-31No
Opinion of an independent qualified public accountant for this plan2022-03-31Disclaimer
Accountancy firm name2022-03-31ATLAS CPAS & ADVISORS, PLLC
Accountancy firm EIN2022-03-31464296959
2021 : LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2021 401k financial data
Total income from all sources (including contributions)2021-03-31$10,008,181
Total of all expenses incurred2021-03-31$10,062,743
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-03-31$9,556,581
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-03-31$10,008,040
Value of total assets at end of year2021-03-31$868,633
Value of total assets at beginning of year2021-03-31$923,195
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-03-31$506,162
Total interest from all sources2021-03-31$141
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-03-31No
Was this plan covered by a fidelity bond2021-03-31Yes
Value of fidelity bond cover2021-03-31$500,000
If this is an individual account plan, was there a blackout period2021-03-31No
Were there any nonexempt tranactions with any party-in-interest2021-03-31No
Contributions received from participants2021-03-31$1,148,015
Total non interest bearing cash at end of year2021-03-31$752,402
Total non interest bearing cash at beginning of year2021-03-31$807,105
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-03-31No
Value of net income/loss2021-03-31$-54,562
Value of net assets at end of year (total assets less liabilities)2021-03-31$868,633
Value of net assets at beginning of year (total assets less liabilities)2021-03-31$923,195
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-03-31No
Were any leases to which the plan was party in default or uncollectible2021-03-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-03-31$116,231
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-03-31$116,090
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-03-31$116,090
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-03-31$141
Expenses. Payments to insurance carriers foe the provision of benefits2021-03-31$673,922
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-03-31No
Was there a failure to transmit to the plan any participant contributions2021-03-31No
Has the plan failed to provide any benefit when due under the plan2021-03-31No
Contributions received in cash from employer2021-03-31$8,860,025
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-03-31$8,882,659
Contract administrator fees2021-03-31$506,162
Did the plan have assets held for investment2021-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-03-31No
Opinion of an independent qualified public accountant for this plan2021-03-31Disclaimer
Accountancy firm name2021-03-31ATLAS CPAS & ADVISORS PLLC
Accountancy firm EIN2021-03-31464296959
2020 : LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2020 401k financial data
Total income from all sources (including contributions)2020-03-31$10,742,169
Total of all expenses incurred2020-03-31$10,597,160
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-03-31$10,086,233
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-03-31$10,739,953
Value of total assets at end of year2020-03-31$923,195
Value of total assets at beginning of year2020-03-31$778,186
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-03-31$510,927
Total interest from all sources2020-03-31$2,216
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-03-31No
Was this plan covered by a fidelity bond2020-03-31Yes
Value of fidelity bond cover2020-03-31$500,000
If this is an individual account plan, was there a blackout period2020-03-31No
Were there any nonexempt tranactions with any party-in-interest2020-03-31No
Contributions received from participants2020-03-31$1,234,937
Total non interest bearing cash at end of year2020-03-31$807,105
Total non interest bearing cash at beginning of year2020-03-31$664,311
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-03-31No
Value of net income/loss2020-03-31$145,009
Value of net assets at end of year (total assets less liabilities)2020-03-31$923,195
Value of net assets at beginning of year (total assets less liabilities)2020-03-31$778,186
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-03-31No
Were any leases to which the plan was party in default or uncollectible2020-03-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-03-31$116,090
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-03-31$113,875
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-03-31$113,875
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-03-31$2,216
Expenses. Payments to insurance carriers foe the provision of benefits2020-03-31$689,503
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-03-31No
Was there a failure to transmit to the plan any participant contributions2020-03-31No
Has the plan failed to provide any benefit when due under the plan2020-03-31No
Contributions received in cash from employer2020-03-31$9,505,016
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-03-31$9,396,730
Contract administrator fees2020-03-31$510,927
Did the plan have assets held for investment2020-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-03-31Yes
Opinion of an independent qualified public accountant for this plan2020-03-31Disclaimer
Accountancy firm name2020-03-31ATLAS CPAS & ADVISORS LLC
Accountancy firm EIN2020-03-31464296959
2019 : LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2019 401k financial data
Total income from all sources (including contributions)2019-03-31$12,155,667
Total of all expenses incurred2019-03-31$12,042,117
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-03-31$11,386,522
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-03-31$12,153,591
Value of total assets at end of year2019-03-31$778,186
Value of total assets at beginning of year2019-03-31$664,636
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-03-31$655,595
Total interest from all sources2019-03-31$2,076
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-03-31No
Was this plan covered by a fidelity bond2019-03-31Yes
Value of fidelity bond cover2019-03-31$500,000
If this is an individual account plan, was there a blackout period2019-03-31No
Were there any nonexempt tranactions with any party-in-interest2019-03-31No
Contributions received from participants2019-03-31$1,264,791
Administrative expenses (other) incurred2019-03-31$249
Total non interest bearing cash at end of year2019-03-31$664,311
Total non interest bearing cash at beginning of year2019-03-31$552,837
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-03-31No
Value of net income/loss2019-03-31$113,550
Value of net assets at end of year (total assets less liabilities)2019-03-31$778,186
Value of net assets at beginning of year (total assets less liabilities)2019-03-31$664,636
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-03-31No
Were any leases to which the plan was party in default or uncollectible2019-03-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-03-31$113,875
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-03-31$111,799
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-03-31$111,799
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-03-31$2,076
Expenses. Payments to insurance carriers foe the provision of benefits2019-03-31$759,762
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-03-31No
Was there a failure to transmit to the plan any participant contributions2019-03-31No
Has the plan failed to provide any benefit when due under the plan2019-03-31No
Contributions received in cash from employer2019-03-31$10,888,800
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-03-31$10,626,760
Contract administrator fees2019-03-31$655,346
Did the plan have assets held for investment2019-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-03-31Yes
Opinion of an independent qualified public accountant for this plan2019-03-31Disclaimer
Accountancy firm name2019-03-31ATLAS CPAS & ADVISORS LLC
Accountancy firm EIN2019-03-31464296959
2018 : LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2018 401k financial data
Total income from all sources (including contributions)2018-03-31$11,734,515
Total of all expenses incurred2018-03-31$12,163,542
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-03-31$11,430,968
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-03-31$11,733,564
Value of total assets at end of year2018-03-31$664,636
Value of total assets at beginning of year2018-03-31$1,093,663
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-03-31$732,574
Total interest from all sources2018-03-31$951
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-03-31No
Was this plan covered by a fidelity bond2018-03-31Yes
Value of fidelity bond cover2018-03-31$500,000
If this is an individual account plan, was there a blackout period2018-03-31No
Were there any nonexempt tranactions with any party-in-interest2018-03-31No
Contributions received from participants2018-03-31$1,250,991
Administrative expenses (other) incurred2018-03-31$32
Total non interest bearing cash at end of year2018-03-31$552,837
Total non interest bearing cash at beginning of year2018-03-31$982,816
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-03-31No
Value of net income/loss2018-03-31$-429,027
Value of net assets at end of year (total assets less liabilities)2018-03-31$664,636
Value of net assets at beginning of year (total assets less liabilities)2018-03-31$1,093,663
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-03-31No
Were any leases to which the plan was party in default or uncollectible2018-03-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-03-31$111,799
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-03-31$110,847
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-03-31$110,847
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-03-31$951
Expenses. Payments to insurance carriers foe the provision of benefits2018-03-31$641,569
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-03-31No
Was there a failure to transmit to the plan any participant contributions2018-03-31No
Has the plan failed to provide any benefit when due under the plan2018-03-31No
Contributions received in cash from employer2018-03-31$10,482,573
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-03-31$10,789,399
Contract administrator fees2018-03-31$732,542
Did the plan have assets held for investment2018-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-03-31Yes
Opinion of an independent qualified public accountant for this plan2018-03-31Disclaimer
Accountancy firm name2018-03-31ATLAS CPAS & ADVISORS LLC
Accountancy firm EIN2018-03-31464296959
2017 : LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2017 401k financial data
Total income from all sources (including contributions)2017-03-31$15,806,786
Total of all expenses incurred2017-03-31$15,286,137
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-03-31$14,490,582
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-03-31$15,806,396
Value of total assets at end of year2017-03-31$1,093,663
Value of total assets at beginning of year2017-03-31$573,014
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-03-31$795,555
Total interest from all sources2017-03-31$390
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-03-31No
Was this plan covered by a fidelity bond2017-03-31Yes
Value of fidelity bond cover2017-03-31$500,000
If this is an individual account plan, was there a blackout period2017-03-31No
Were there any nonexempt tranactions with any party-in-interest2017-03-31No
Contributions received from participants2017-03-31$1,318,429
Administrative expenses (other) incurred2017-03-31$207
Total non interest bearing cash at end of year2017-03-31$982,816
Total non interest bearing cash at beginning of year2017-03-31$462,558
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-03-31No
Value of net income/loss2017-03-31$520,649
Value of net assets at end of year (total assets less liabilities)2017-03-31$1,093,663
Value of net assets at beginning of year (total assets less liabilities)2017-03-31$573,014
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-03-31No
Were any leases to which the plan was party in default or uncollectible2017-03-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-03-31$110,847
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-03-31$110,456
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-03-31$110,456
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-03-31$390
Expenses. Payments to insurance carriers foe the provision of benefits2017-03-31$589,426
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-03-31Yes
Was there a failure to transmit to the plan any participant contributions2017-03-31No
Has the plan failed to provide any benefit when due under the plan2017-03-31No
Contributions received in cash from employer2017-03-31$14,487,967
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-03-31$13,901,156
Contract administrator fees2017-03-31$795,348
Did the plan have assets held for investment2017-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-03-31Yes
Opinion of an independent qualified public accountant for this plan2017-03-31Disclaimer
Accountancy firm name2017-03-31GRAY HUNTER STENN LLP
Accountancy firm EIN2017-03-31363077757
2016 : LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2016 401k financial data
Total income from all sources (including contributions)2016-03-31$14,716,147
Total of all expenses incurred2016-03-31$16,009,755
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-03-31$15,326,059
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-03-31$14,715,925
Value of total assets at end of year2016-03-31$573,014
Value of total assets at beginning of year2016-03-31$1,866,622
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-03-31$683,696
Total interest from all sources2016-03-31$222
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-03-31No
Was this plan covered by a fidelity bond2016-03-31Yes
Value of fidelity bond cover2016-03-31$500,000
If this is an individual account plan, was there a blackout period2016-03-31No
Were there any nonexempt tranactions with any party-in-interest2016-03-31No
Contributions received from participants2016-03-31$1,366,968
Administrative expenses (other) incurred2016-03-31$9
Total non interest bearing cash at end of year2016-03-31$462,558
Total non interest bearing cash at beginning of year2016-03-31$1,756,388
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-03-31No
Value of net income/loss2016-03-31$-1,293,608
Value of net assets at end of year (total assets less liabilities)2016-03-31$573,014
Value of net assets at beginning of year (total assets less liabilities)2016-03-31$1,866,622
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-03-31No
Were any leases to which the plan was party in default or uncollectible2016-03-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-03-31$110,456
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-03-31$110,234
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-03-31$110,234
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-03-31$222
Expenses. Payments to insurance carriers foe the provision of benefits2016-03-31$867,069
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-03-31No
Was there a failure to transmit to the plan any participant contributions2016-03-31No
Has the plan failed to provide any benefit when due under the plan2016-03-31No
Contributions received in cash from employer2016-03-31$13,348,957
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-03-31$14,458,990
Contract administrator fees2016-03-31$683,687
Did the plan have assets held for investment2016-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-03-31Yes
Opinion of an independent qualified public accountant for this plan2016-03-31Disclaimer
Accountancy firm name2016-03-31GRAY HUNTER STENN LLP
Accountancy firm EIN2016-03-31363077757
2015 : LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2015 401k financial data
Total income from all sources (including contributions)2015-03-31$17,332,443
Total of all expenses incurred2015-03-31$16,288,889
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-03-31$15,631,116
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-03-31$17,332,365
Value of total assets at end of year2015-03-31$1,866,622
Value of total assets at beginning of year2015-03-31$823,068
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-03-31$657,773
Total interest from all sources2015-03-31$78
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-03-31No
Was this plan covered by a fidelity bond2015-03-31Yes
Value of fidelity bond cover2015-03-31$500,000
If this is an individual account plan, was there a blackout period2015-03-31No
Were there any nonexempt tranactions with any party-in-interest2015-03-31No
Contributions received from participants2015-03-31$1,311,500
Administrative expenses (other) incurred2015-03-31$76
Total non interest bearing cash at end of year2015-03-31$1,756,388
Total non interest bearing cash at beginning of year2015-03-31$712,911
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-03-31No
Value of net income/loss2015-03-31$1,043,554
Value of net assets at end of year (total assets less liabilities)2015-03-31$1,866,622
Value of net assets at beginning of year (total assets less liabilities)2015-03-31$823,068
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-03-31No
Were any leases to which the plan was party in default or uncollectible2015-03-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-03-31$110,234
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-03-31$110,157
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-03-31$110,157
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-03-31$78
Expenses. Payments to insurance carriers foe the provision of benefits2015-03-31$777,507
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-03-31No
Was there a failure to transmit to the plan any participant contributions2015-03-31No
Has the plan failed to provide any benefit when due under the plan2015-03-31No
Contributions received in cash from employer2015-03-31$16,020,865
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-03-31$14,853,609
Contract administrator fees2015-03-31$657,697
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-03-31No
Did the plan have assets held for investment2015-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-03-31Yes
Opinion of an independent qualified public accountant for this plan2015-03-31Disclaimer
Accountancy firm name2015-03-31GRAY HUNTER STENN LLP
Accountancy firm EIN2015-03-31363077757
2014 : LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2014 401k financial data
Total income from all sources (including contributions)2014-03-31$15,670,777
Total of all expenses incurred2014-03-31$15,920,421
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-03-31$15,263,873
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-03-31$15,441,702
Value of total assets at end of year2014-03-31$823,068
Value of total assets at beginning of year2014-03-31$1,072,712
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-03-31$656,548
Total interest from all sources2014-03-31$78
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-03-31No
Was this plan covered by a fidelity bond2014-03-31Yes
Value of fidelity bond cover2014-03-31$500,000
If this is an individual account plan, was there a blackout period2014-03-31No
Were there any nonexempt tranactions with any party-in-interest2014-03-31No
Contributions received from participants2014-03-31$1,080,966
Other income not declared elsewhere2014-03-31$228,997
Administrative expenses (other) incurred2014-03-31$32
Total non interest bearing cash at end of year2014-03-31$712,911
Total non interest bearing cash at beginning of year2014-03-31$962,633
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-03-31No
Value of net income/loss2014-03-31$-249,644
Value of net assets at end of year (total assets less liabilities)2014-03-31$823,068
Value of net assets at beginning of year (total assets less liabilities)2014-03-31$1,072,712
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-03-31No
Were any leases to which the plan was party in default or uncollectible2014-03-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-03-31$110,157
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-03-31$110,079
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-03-31$110,079
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-03-31$78
Expenses. Payments to insurance carriers foe the provision of benefits2014-03-31$331,783
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-03-31No
Was there a failure to transmit to the plan any participant contributions2014-03-31No
Has the plan failed to provide any benefit when due under the plan2014-03-31No
Contributions received in cash from employer2014-03-31$14,360,736
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-03-31$14,932,090
Contract administrator fees2014-03-31$656,516
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-03-31No
Did the plan have assets held for investment2014-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-03-31Yes
Opinion of an independent qualified public accountant for this plan2014-03-31Disclaimer
Accountancy firm name2014-03-31GRAY HUNTER STENN LLP
Accountancy firm EIN2014-03-31363077757
2013 : LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2013 401k financial data
Total income from all sources (including contributions)2013-03-31$16,529,646
Total of all expenses incurred2013-03-31$16,215,855
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-03-31$15,512,566
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-03-31$16,346,567
Value of total assets at end of year2013-03-31$1,072,712
Value of total assets at beginning of year2013-03-31$758,921
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-03-31$703,289
Total interest from all sources2013-03-31$167
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-03-31No
Was this plan covered by a fidelity bond2013-03-31Yes
Value of fidelity bond cover2013-03-31$500,000
If this is an individual account plan, was there a blackout period2013-03-31No
Were there any nonexempt tranactions with any party-in-interest2013-03-31No
Contributions received from participants2013-03-31$990,850
Other income not declared elsewhere2013-03-31$182,912
Administrative expenses (other) incurred2013-03-31$137
Total non interest bearing cash at end of year2013-03-31$962,633
Total non interest bearing cash at beginning of year2013-03-31$649,009
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-03-31No
Value of net income/loss2013-03-31$313,791
Value of net assets at end of year (total assets less liabilities)2013-03-31$1,072,712
Value of net assets at beginning of year (total assets less liabilities)2013-03-31$758,921
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-03-31No
Were any leases to which the plan was party in default or uncollectible2013-03-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-03-31$110,079
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-03-31$109,912
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-03-31$109,912
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-03-31$167
Expenses. Payments to insurance carriers foe the provision of benefits2013-03-31$428,113
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-03-31No
Was there a failure to transmit to the plan any participant contributions2013-03-31No
Has the plan failed to provide any benefit when due under the plan2013-03-31No
Contributions received in cash from employer2013-03-31$15,355,717
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-03-31$15,084,453
Contract administrator fees2013-03-31$703,152
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-03-31No
Did the plan have assets held for investment2013-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-03-31Yes
Opinion of an independent qualified public accountant for this plan2013-03-31Disclaimer
Accountancy firm name2013-03-31GRAY HUNTER STENN LLP
Accountancy firm EIN2013-03-31363077757
2012 : LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2012 401k financial data
Total income from all sources (including contributions)2012-03-31$14,958,102
Total of all expenses incurred2012-03-31$15,040,194
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-03-31$14,357,182
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-03-31$14,719,301
Value of total assets at end of year2012-03-31$758,921
Value of total assets at beginning of year2012-03-31$841,013
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-03-31$683,012
Total interest from all sources2012-03-31$158
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-03-31No
Was this plan covered by a fidelity bond2012-03-31Yes
Value of fidelity bond cover2012-03-31$500,000
If this is an individual account plan, was there a blackout period2012-03-31No
Were there any nonexempt tranactions with any party-in-interest2012-03-31No
Contributions received from participants2012-03-31$870,708
Other income not declared elsewhere2012-03-31$238,643
Administrative expenses (other) incurred2012-03-31$5,008
Total non interest bearing cash at end of year2012-03-31$649,009
Total non interest bearing cash at beginning of year2012-03-31$731,260
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-03-31No
Value of net income/loss2012-03-31$-82,092
Value of net assets at end of year (total assets less liabilities)2012-03-31$758,921
Value of net assets at beginning of year (total assets less liabilities)2012-03-31$841,013
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-03-31No
Were any leases to which the plan was party in default or uncollectible2012-03-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-03-31$109,912
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-03-31$109,753
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-03-31$109,753
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-03-31$158
Expenses. Payments to insurance carriers foe the provision of benefits2012-03-31$189,341
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-03-31No
Was there a failure to transmit to the plan any participant contributions2012-03-31No
Has the plan failed to provide any benefit when due under the plan2012-03-31No
Contributions received in cash from employer2012-03-31$13,848,593
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-03-31$14,167,841
Contract administrator fees2012-03-31$678,004
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-03-31No
Did the plan have assets held for investment2012-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-03-31Yes
Opinion of an independent qualified public accountant for this plan2012-03-31Disclaimer
Accountancy firm name2012-03-31GRAY HUNTER STENN LLP
Accountancy firm EIN2012-03-31363077757
2011 : LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2011 401k financial data
Total income from all sources (including contributions)2011-03-31$13,906,900
Total of all expenses incurred2011-03-31$13,997,417
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-03-31$13,289,939
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-03-31$13,660,326
Value of total assets at end of year2011-03-31$841,013
Value of total assets at beginning of year2011-03-31$931,530
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-03-31$707,478
Total interest from all sources2011-03-31$193
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-03-31No
Was this plan covered by a fidelity bond2011-03-31Yes
Value of fidelity bond cover2011-03-31$500,000
If this is an individual account plan, was there a blackout period2011-03-31No
Were there any nonexempt tranactions with any party-in-interest2011-03-31No
Contributions received from participants2011-03-31$728,208
Other income not declared elsewhere2011-03-31$246,381
Administrative expenses (other) incurred2011-03-31$7,144
Total non interest bearing cash at end of year2011-03-31$731,260
Total non interest bearing cash at beginning of year2011-03-31$821,970
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-03-31No
Value of net income/loss2011-03-31$-90,517
Value of net assets at end of year (total assets less liabilities)2011-03-31$841,013
Value of net assets at beginning of year (total assets less liabilities)2011-03-31$931,530
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-03-31No
Were any leases to which the plan was party in default or uncollectible2011-03-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-03-31$109,753
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-03-31$109,560
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-03-31$109,560
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-03-31$193
Expenses. Payments to insurance carriers foe the provision of benefits2011-03-31$481,794
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-03-31No
Was there a failure to transmit to the plan any participant contributions2011-03-31No
Has the plan failed to provide any benefit when due under the plan2011-03-31No
Contributions received in cash from employer2011-03-31$12,932,118
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-03-31$12,808,145
Contract administrator fees2011-03-31$700,334
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-03-31No
Did the plan have assets held for investment2011-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-03-31Yes
Opinion of an independent qualified public accountant for this plan2011-03-31Disclaimer
Accountancy firm name2011-03-31GRAY HUNTER STENN LLP
Accountancy firm EIN2011-03-31363077757

Form 5500 Responses for LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN

2021: LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2021 form 5500 responses
2021-04-01Type of plan entitySingle employer plan
2021-04-01Submission has been amendedYes
2021-04-01This submission is the final filingNo
2021-04-01This return/report is a short plan year return/report (less than 12 months)No
2021-04-01Plan is a collectively bargained planNo
2021-04-01Plan funding arrangement – InsuranceYes
2021-04-01Plan funding arrangement – TrustYes
2021-04-01Plan benefit arrangement – InsuranceYes
2021-04-01Plan benefit arrangement - TrustYes
2020: LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2020 form 5500 responses
2020-04-01Type of plan entitySingle employer plan
2020-04-01Plan funding arrangement – InsuranceYes
2020-04-01Plan funding arrangement – TrustYes
2020-04-01Plan benefit arrangement – InsuranceYes
2020-04-01Plan benefit arrangement - TrustYes
2019: LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
2019-04-01Plan funding arrangement – InsuranceYes
2019-04-01Plan funding arrangement – TrustYes
2019-04-01Plan benefit arrangement – InsuranceYes
2019-04-01Plan benefit arrangement - TrustYes
2018: LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2018 form 5500 responses
2018-04-01Type of plan entitySingle employer plan
2018-04-01Plan funding arrangement – InsuranceYes
2018-04-01Plan funding arrangement – TrustYes
2018-04-01Plan benefit arrangement – InsuranceYes
2018-04-01Plan benefit arrangement - TrustYes
2017: LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2017 form 5500 responses
2017-04-01Type of plan entitySingle employer plan
2017-04-01Submission has been amendedYes
2017-04-01Plan funding arrangement – InsuranceYes
2017-04-01Plan funding arrangement – TrustYes
2017-04-01Plan benefit arrangement – InsuranceYes
2017-04-01Plan benefit arrangement - TrustYes
2016: LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2016 form 5500 responses
2016-04-01Type of plan entitySingle employer plan
2016-04-01Plan funding arrangement – InsuranceYes
2016-04-01Plan funding arrangement – TrustYes
2016-04-01Plan benefit arrangement – InsuranceYes
2016-04-01Plan benefit arrangement - TrustYes
2015: LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2015 form 5500 responses
2015-04-01Type of plan entitySingle employer plan
2015-04-01Plan funding arrangement – InsuranceYes
2015-04-01Plan funding arrangement – TrustYes
2015-04-01Plan benefit arrangement – InsuranceYes
2015-04-01Plan benefit arrangement - TrustYes
2014: LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2014 form 5500 responses
2014-04-01Type of plan entitySingle employer plan
2014-04-01Plan funding arrangement – InsuranceYes
2014-04-01Plan funding arrangement – TrustYes
2014-04-01Plan benefit arrangement – InsuranceYes
2014-04-01Plan benefit arrangement - TrustYes
2013: LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2013 form 5500 responses
2013-04-01Type of plan entitySingle employer plan
2013-04-01Plan funding arrangement – InsuranceYes
2013-04-01Plan funding arrangement – TrustYes
2013-04-01Plan benefit arrangement – InsuranceYes
2013-04-01Plan benefit arrangement - TrustYes
2012: LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2012 form 5500 responses
2012-04-01Type of plan entitySingle employer plan
2012-04-01Plan funding arrangement – InsuranceYes
2012-04-01Plan funding arrangement – TrustYes
2012-04-01Plan benefit arrangement – InsuranceYes
2012-04-01Plan benefit arrangement - TrustYes
2011: LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2011 form 5500 responses
2011-04-01Type of plan entitySingle employer plan
2011-04-01Plan funding arrangement – InsuranceYes
2011-04-01Plan funding arrangement – TrustYes
2011-04-01Plan benefit arrangement – InsuranceYes
2011-04-01Plan benefit arrangement - TrustYes
2009: LEWIS BROTHERS BAKERIES, INC. EMPLOYEE BENEFIT PLAN 2009 form 5500 responses
2009-04-01Type of plan entitySingle employer plan
2009-04-01This submission is the final filingNo
2009-04-01Plan funding arrangement – InsuranceYes
2009-04-01Plan funding arrangement – TrustYes
2009-04-01Plan benefit arrangement – InsuranceYes
2009-04-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number100023
Policy instance 3
Insurance contract or identification number100023
Number of Individuals Covered1502
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $6,038
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 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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedMANAGED ORGAN/TISSUE TRANSPLANT BENEFIT PROGRAM
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $75,475
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,038
Insurance broker organization code?4
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract numberAI-AL007
Policy instance 1
Insurance contract or identification numberAI-AL007
Number of Individuals Covered651
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 $0
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 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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $576,268
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees0
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract numberAI-AL007
Policy instance 3
Insurance contract or identification numberAI-AL007
Number of Individuals Covered651
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 $0
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 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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $576,268
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees0
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-017718-00
Policy instance 2
Insurance contract or identification number01-017718-00
Number of Individuals Covered877
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $19,327
Total amount of fees paid to insurance companyUSD $2,169
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 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
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $96,635
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,327
Amount paid for insurance broker fees2169
Additional information about fees paid to insurance brokerGROUP VOLUME BONUS
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number100023
Policy instance 1
Insurance contract or identification number100023
Number of Individuals Covered1502
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $6,038
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 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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedMANAGED ORGAN/TISSUE TRANSPLANT BENEFIT PROGRAM
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $75,475
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,038
Insurance broker organization code?4
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract numberAI-AL007
Policy instance 1
Insurance contract or identification numberAI-AL007
Number of Individuals Covered631
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $480,993
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number100023
Policy instance 2
Insurance contract or identification number100023
Number of Individuals Covered1580
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $6,076
Other welfare benefits providedMANAGED ORGAN/TISSUE TRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $75,948
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,076
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-017718-00
Policy instance 3
Insurance contract or identification number01-017718-00
Number of Individuals Covered924
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $19,350
Total amount of fees paid to insurance companyUSD $2,643
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $88,784
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,350
Amount paid for insurance broker fees2643
Additional information about fees paid to insurance brokerGROUP VOLUME BONUS
Insurance broker organization code?3
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract numberAI-AL007
Policy instance 1
Insurance contract or identification numberAI-AL007
Number of Individuals Covered627
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $6,001
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $528,399
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,001
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00423040
Policy instance 2
Insurance contract or identification number00423040
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number100023
Policy instance 3
Insurance contract or identification number100023
Number of Individuals Covered1568
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Other welfare benefits providedMANAGED ORGAN/TISSUE TRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $75,009
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-017718-00
Policy instance 4
Insurance contract or identification number01-017718-00
Number of Individuals Covered888
Insurance policy start date2019-03-01
Insurance policy end date2020-02-29
Total amount of commissions paid to insurance brokerUSD $19,040
Total amount of fees paid to insurance companyUSD $3,094
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $103,168
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,040
Amount paid for insurance broker fees3094
Additional information about fees paid to insurance brokerGROUP VOLUME BONUS
Insurance broker organization code?3
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract numberAI-AL007
Policy instance 1
Insurance contract or identification numberAI-AL007
Number of Individuals Covered765
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $593,681
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00423040
Policy instance 2
Insurance contract or identification number00423040
Number of Individuals Covered662
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,210
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number100023
Policy instance 3
Insurance contract or identification number100023
Number of Individuals Covered1649
Insurance policy start date2018-09-17
Insurance policy end date2019-08-31
Other welfare benefits providedMANAGED ORGAN/TISSUE TRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $83,660
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-017718-00
Policy instance 4
Insurance contract or identification number01-017718-00
Number of Individuals Covered893
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $19,283
Total amount of fees paid to insurance companyUSD $1,149
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $96,414
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,283
Amount paid for insurance broker fees1149
Additional information about fees paid to insurance brokerGROUP VOLUME BONUS
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number100023
Policy instance 4
Insurance contract or identification number100023
Number of Individuals Covered2189
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $7,742
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Other welfare benefits providedORGAN/TISSUE TRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $103,940
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,742
Insurance broker nameVMI ACQUISITION INC
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number402846G
Policy instance 3
Insurance contract or identification number402846G
Number of Individuals Covered996
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $23,623
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $107,865
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,623
Insurance broker organization code?3
Insurance broker nameHOUCHENS INSURANCE GROUP, INC
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract numberAI-AL007
Policy instance 1
Insurance contract or identification numberAI-AL007
Number of Individuals Covered900
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $30,354
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,648,670
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,354
Insurance broker organization code?3
Insurance broker nameANTHEM INSURANCE COMPANIES, INC.
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00423040
Policy instance 2
Insurance contract or identification number00423040
Number of Individuals Covered878
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $588,961
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameHOUCHENS INSURANCE GROUP
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number402846G
Policy instance 3
Insurance contract or identification number402846G
Number of Individuals Covered1040
Insurance policy start date2015-03-01
Insurance policy end date2016-02-29
Total amount of commissions paid to insurance brokerUSD $25,059
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $125,296
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,059
Insurance broker nameVAN METER INS AGENCY INC
BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 )
Policy contract numberERL L15100627 0
Policy instance 5
Insurance contract or identification numberERL L15100627 0
Number of Individuals Covered962
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $40,597
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $559,961
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $40,597
Insurance broker organization code?3
Insurance broker nameVAN METER INSURANCE AGENCY
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number100023
Policy instance 4
Insurance contract or identification number100023
Number of Individuals Covered2430
Insurance policy start date2015-09-01
Insurance policy end date2016-08-31
Total amount of commissions paid to insurance brokerUSD $11,002
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Other welfare benefits providedORGAN/TISSUE TRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $137,526
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,002
Insurance broker nameVMI ACQUISITION INC
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract numberAI-AL007
Policy instance 1
Insurance contract or identification numberAI-AL007
Number of Individuals Covered962
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $36,432
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,959,282
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,432
Insurance broker organization code?3
Insurance broker nameVAN METER INSURANCE AGENCY, INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00423040
Policy instance 2
Insurance contract or identification number00423040
Number of Individuals Covered962
Insurance policy start date2015-03-01
Insurance policy end date2016-02-29
Total amount of commissions paid to insurance brokerUSD $3,233
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $35,392
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,233
Insurance broker nameVAN METER INS AGENCY INC
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract number
Policy instance 2
Number of Individuals Covered997
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $0
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract numberAI-AL007
Policy instance 1
Insurance contract or identification numberAI-AL007
Number of Individuals Covered997
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $21,033
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
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $615,581
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,033
Amount paid for insurance broker fees0
Insurance broker nameVAN METER INSURANCE AGENCY
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number
Policy instance 3
Number of Individuals Covered997
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $0
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
Welfare Benefit Premiums Paid to CarrierUSD $146,279
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10139408
Policy instance 4
Insurance contract or identification number10139408
Number of Individuals Covered1097
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Total amount of commissions paid to insurance brokerUSD $17,451
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
Welfare Benefit Premiums Paid to CarrierUSD $116,338
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,451
Insurance broker organization code?3
Insurance broker nameVAN METER INSURANCE AGENCY
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number423040
Policy instance 6
Insurance contract or identification number423040
Number of Individuals Covered997
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,153
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $650,808
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees3153
Insurance broker nameVAN METER INSURANCE AGENCY
BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 )
Policy contract number
Policy instance 5
Number of Individuals Covered997
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $0
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
Welfare Benefit Premiums Paid to CarrierUSD $540,895
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 )
Policy contract number
Policy instance 5
Number of Individuals Covered1054
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $0
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
Welfare Benefit Premiums Paid to CarrierUSD $546,800
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number
Policy instance 3
Number of Individuals Covered1054
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $0
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
Welfare Benefit Premiums Paid to CarrierUSD $156,048
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number423040
Policy instance 6
Insurance contract or identification number423040
Number of Individuals Covered1054
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
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
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $704,750
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract number
Policy instance 2
Number of Individuals Covered1054
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $0
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberAI-AL007
Policy instance 1
Insurance contract or identification numberAI-AL007
Number of Individuals Covered1054
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $0
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
Welfare Benefit Premiums Paid to CarrierUSD $610,300
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10139408
Policy instance 4
Insurance contract or identification number10139408
Number of Individuals Covered1054
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $0
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
Welfare Benefit Premiums Paid to CarrierUSD $130,616
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 )
Policy contract number
Policy instance 5
Number of Individuals Covered1129
Insurance policy start date2013-02-02
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $0
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
Welfare Benefit Premiums Paid to CarrierUSD $570,679
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberAI-AL007
Policy instance 1
Insurance contract or identification numberAI-AL007
Number of Individuals Covered1129
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $0
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
Welfare Benefit Premiums Paid to CarrierUSD $655,275
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10139408
Policy instance 4
Insurance contract or identification number10139408
Number of Individuals Covered1129
Insurance policy start date2012-05-23
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $0
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
Welfare Benefit Premiums Paid to CarrierUSD $82,226
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number
Policy instance 3
Number of Individuals Covered1129
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $0
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
Welfare Benefit Premiums Paid to CarrierUSD $155,687
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract number
Policy instance 2
Number of Individuals Covered1129
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $0
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
Welfare Benefit Premiums Paid to CarrierUSD $68
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberAI-AL007
Policy instance 1
Insurance contract or identification numberAI-AL007
Number of Individuals Covered1092
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $0
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
Welfare Benefit Premiums Paid to CarrierUSD $633,738
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract number
Policy instance 2
Number of Individuals Covered1092
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $0
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
Welfare Benefit Premiums Paid to CarrierUSD $241
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number
Policy instance 3
Number of Individuals Covered1092
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $0
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
Welfare Benefit Premiums Paid to CarrierUSD $128,519
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10139408
Policy instance 4
Insurance contract or identification number10139408
Number of Individuals Covered1092
Insurance policy start date2011-05-23
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $0
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
Welfare Benefit Premiums Paid to CarrierUSD $79,931
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 )
Policy contract number
Policy instance 5
Number of Individuals Covered1092
Insurance policy start date2012-02-02
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $0
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
Welfare Benefit Premiums Paid to CarrierUSD $143,240
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract number
Policy instance 2
Number of Individuals Covered1206
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $0
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
Welfare Benefit Premiums Paid to CarrierUSD $52,419
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number
Policy instance 3
Number of Individuals Covered1206
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $0
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
Welfare Benefit Premiums Paid to CarrierUSD $120,472
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberAI-AL007
Policy instance 1
Insurance contract or identification numberAI-AL007
Number of Individuals Covered1206
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $0
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
Welfare Benefit Premiums Paid to CarrierUSD $659,217
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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