401k Plan data: TRACHTE BUILDING SYSTEMS HEALTH PLAN plan

TRACHTE BUILDING SYSTEMS HEALTH PLAN 401k Plan overview

Plan Name	TRACHTE BUILDING SYSTEMS HEALTH PLAN
Plan identification number	503

TRACHTE BUILDING SYSTEMS HEALTH PLAN Benefits

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

401k Sponsoring company profile

TRACHTE BUILDING SYSTEMS, INC. has sponsored the creation of one or more 401k plans.

Company Name: TRACHTE BUILDING SYSTEMS, INC.

Employer identification number (EIN): 390662360

NAIC Classification: 332900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TRACHTE BUILDING SYSTEMS HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2013-01-01 JIM MUTSCH
503 2012-01-01 PAMELA KLUTE
503 2011-01-01 PAMELA KLUTE
503 2010-01-01 PAMELA KLUTE
503 2009-01-01 PAMELA KLUTE
503 2009-01-01 PAMELA KLUTE 2010-10-06

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
503	2013-01-01	JIM MUTSCH
503	2012-01-01	PAMELA KLUTE
503	2011-01-01	PAMELA KLUTE
503	2010-01-01	PAMELA KLUTE
503	2009-01-01	PAMELA KLUTE
503	2009-01-01		PAMELA KLUTE	2010-10-06

Plan Statistics for TRACHTE BUILDING SYSTEMS HEALTH PLAN

401k plan membership statisitcs for TRACHTE BUILDING SYSTEMS HEALTH PLAN

Measure Date Value
2013: TRACHTE BUILDING SYSTEMS HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 121
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 121
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 2013-01-01 121
2012: TRACHTE BUILDING SYSTEMS HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 89
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 82
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 82
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 82
2011: TRACHTE BUILDING SYSTEMS HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 104
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 89
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 89
Total participants 2011-01-01 89
2010: TRACHTE BUILDING SYSTEMS HEALTH PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 110
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 104
Total of all active and inactive participants 2010-01-01 104
Total participants 2010-01-01 104
2009: TRACHTE BUILDING SYSTEMS HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 140
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 117
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 2009-01-01 117
Total participants 2009-01-01 117

Measure	Date	Value
2013: TRACHTE BUILDING SYSTEMS HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	121
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	121
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	121
2012: TRACHTE BUILDING SYSTEMS HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	89
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	82
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	82
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	82
2011: TRACHTE BUILDING SYSTEMS HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	104
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	89
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	89
Total participants	2011-01-01	89
2010: TRACHTE BUILDING SYSTEMS HEALTH PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	110
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	104
Total of all active and inactive participants	2010-01-01	104
Total participants	2010-01-01	104
2009: TRACHTE BUILDING SYSTEMS HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	140
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	117
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	117
Total participants	2009-01-01	117

Form 5500 Responses for TRACHTE BUILDING SYSTEMS HEALTH PLAN

2013: TRACHTE BUILDING SYSTEMS HEALTH 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: TRACHTE BUILDING SYSTEMS HEALTH PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	First time form 5500 has been submitted	Yes
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 – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: TRACHTE BUILDING SYSTEMS HEALTH PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	First time form 5500 has been submitted	Yes
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: TRACHTE BUILDING SYSTEMS HEALTH PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	Yes
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: TRACHTE BUILDING SYSTEMS HEALTH PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
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 – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )

Policy contract number

F017415

Policy instance

Insurance contract or identification number	F017415
Number of Individuals Covered	121
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $5,900
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	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&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 Carrier	USD $44,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,900
Insurance broker organization code?	3
Insurance broker name	JOHNSON INSURANCE SERVICES, LLC

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Company Name:	TRACHTE BUILDING SYSTEMS, INC.
Employer identification number (EIN):	390662360
NAIC Classification:	332900