401k Plan data: TIME-O-MATIC GROUP LIFE AND ADD PLAN plan

TIME-O-MATIC GROUP LIFE AND ADD PLAN 401k Plan overview

Plan Name	TIME-O-MATIC GROUP LIFE AND ADD PLAN
Plan identification number	503

TIME-O-MATIC GROUP LIFE AND ADD PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

WATCHFIRE SIGNS, LLC has sponsored the creation of one or more 401k plans.

Company Name: WATCHFIRE SIGNS, LLC

Employer identification number (EIN): 370925634

NAIC Classification: 335900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TIME-O-MATIC GROUP LIFE AND ADD PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2014-01-01 MARLA HAGLER
503 2014-01-01 MARLA HAGLER
503 2013-01-01 REBECCA DEGNER
503 2012-01-01 REBECCA DEGNER
503 2011-01-01 REBECCADEGNER
503 2009-01-01 SARAH TUFTE

Plan id#	Filing Submission Date	Name of Administrator
503	2014-01-01	MARLA HAGLER
503	2014-01-01	MARLA HAGLER
503	2013-01-01	REBECCA DEGNER
503	2012-01-01	REBECCA DEGNER
503	2011-01-01	REBECCADEGNER
503	2009-01-01	SARAH TUFTE

Plan Statistics for TIME-O-MATIC GROUP LIFE AND ADD PLAN

401k plan membership statisitcs for TIME-O-MATIC GROUP LIFE AND ADD PLAN

Measure Date Value
2014: TIME-O-MATIC GROUP LIFE AND ADD PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 300
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 0
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 0
2013: TIME-O-MATIC GROUP LIFE AND ADD PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 207
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 300
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 300
2012: TIME-O-MATIC GROUP LIFE AND ADD PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 207
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 207
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 207
2011: TIME-O-MATIC GROUP LIFE AND ADD PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 177
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 207
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 207
2009: TIME-O-MATIC GROUP LIFE AND ADD PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 183
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 186
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 186
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 186

Measure	Date	Value
2014: TIME-O-MATIC GROUP LIFE AND ADD PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	300
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	0
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	0
2013: TIME-O-MATIC GROUP LIFE AND ADD PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	207
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	300
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	300
2012: TIME-O-MATIC GROUP LIFE AND ADD PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	207
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	207
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	207
2011: TIME-O-MATIC GROUP LIFE AND ADD PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	177
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	207
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	207
2009: TIME-O-MATIC GROUP LIFE AND ADD PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	183
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	186
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	186
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	186

Form 5500 Responses for TIME-O-MATIC GROUP LIFE AND ADD PLAN

2014: TIME-O-MATIC GROUP LIFE AND ADD PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	Yes
2014-01-01	This submission is the final filing	Yes
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: TIME-O-MATIC GROUP LIFE AND ADD PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: TIME-O-MATIC GROUP LIFE AND ADD PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: TIME-O-MATIC GROUP LIFE AND ADD PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: TIME-O-MATIC GROUP LIFE AND ADD PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

464584

Policy instance

Insurance contract or identification number	464584
Number of Individuals Covered	325
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $8,620
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $113,197
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,963
Insurance broker organization code?	3
Insurance broker name	USI INSURANCE SERVICES, LLC

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

464584

Policy instance

Insurance contract or identification number	464584
Number of Individuals Covered	300
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $6,071
Total amount of fees paid to insurance company	USD $5,667
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
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 Carrier	USD $279,220
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,071
Amount paid for insurance broker fees	5667
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3
Insurance broker name	WELLS FARGO INSURANCE SERVICES

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

464584

Policy instance

Insurance contract or identification number	464584
Number of Individuals Covered	265
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $5,175
Total amount of fees paid to insurance company	USD $6,201
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
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 Carrier	USD $74,817
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,175
Amount paid for insurance broker fees	6201
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3
Insurance broker name	WELLS FARGO INSURANCE SERVICES

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

GL145102

Policy instance

Insurance contract or identification number	GL145102
Number of Individuals Covered	207
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $1,590
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
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 Carrier	USD $17,053
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

GL145102

Policy instance

Insurance contract or identification number	GL145102
Number of Individuals Covered	177
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $1,808
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $16,640
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $227
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	RULLCORP FINANCIAL, INC.

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Company Name:	WATCHFIRE SIGNS, LLC
Employer identification number (EIN):	370925634
NAIC Classification:	335900