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PAVLIC VENDING SERVICE, INC. 401K PLAN 401k Plan overview

Plan NamePAVLIC VENDING SERVICE, INC. 401K PLAN
Plan identification number 001

PAVLIC VENDING SERVICE, INC. 401K PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

PAVLIC VENDING SERVICE, INC. has sponsored the creation of one or more 401k plans.

Company Name:PAVLIC VENDING SERVICE, INC.
Employer identification number (EIN):391143309
NAIC Classification:454210
NAIC Description:Vending Machine Operators

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PAVLIC VENDING SERVICE, INC. 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01RICHARD PAVLIC2023-08-23
0012021-01-01RICHARD PAVLIC2022-10-11
0012020-01-01RICHARD PAVLIC2021-10-13
0012020-01-01RICHARD PAVLIC2022-11-18
0012019-01-01
0012018-01-01
0012018-01-01
0012017-01-01RICHARD PAVLIC
0012016-01-01RICHARD PAVLIC
0012015-01-01RICHARD PAVLIC
0012014-01-01RICHARD PAVLIC
0012013-01-01RICHARD PAVLIC
0012012-01-01RICHARD PAVLIC
0012011-01-01RICHARD PAVLIC
0012010-01-01RICHARD PAVLIC
0012009-01-01RICHARD PAVLIC

Plan Statistics for PAVLIC VENDING SERVICE, INC. 401K PLAN

401k plan membership statisitcs for PAVLIC VENDING SERVICE, INC. 401K PLAN

Measure Date Value
2019: PAVLIC VENDING SERVICE, INC. 401K PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0118
Total number of active participants reported on line 7a of the Form 55002019-01-0116
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-013
Total of all active and inactive participants2019-01-0119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0119
Number of participants with account balances2019-01-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: PAVLIC VENDING SERVICE, INC. 401K PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0116
Total number of active participants reported on line 7a of the Form 55002018-01-0116
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-012
Total of all active and inactive participants2018-01-0118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0118
Number of participants with account balances2018-01-0114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: PAVLIC VENDING SERVICE, INC. 401K PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0113
Total number of active participants reported on line 7a of the Form 55002017-01-0112
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-012
Total of all active and inactive participants2017-01-0114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0114
Number of participants with account balances2017-01-0114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: PAVLIC VENDING SERVICE, INC. 401K PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0115
Total number of active participants reported on line 7a of the Form 55002016-01-0112
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-011
Total of all active and inactive participants2016-01-0113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0113
Number of participants with account balances2016-01-0113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: PAVLIC VENDING SERVICE, INC. 401K PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0115
Total number of active participants reported on line 7a of the Form 55002015-01-0114
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-011
Total of all active and inactive participants2015-01-0115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0115
Number of participants with account balances2015-01-0113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: PAVLIC VENDING SERVICE, INC. 401K PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0116
Total number of active participants reported on line 7a of the Form 55002014-01-0114
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-011
Total of all active and inactive participants2014-01-0115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0115
Number of participants with account balances2014-01-0113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: PAVLIC VENDING SERVICE, INC. 401K PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0116
Total number of active participants reported on line 7a of the Form 55002013-01-0115
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-011
Total of all active and inactive participants2013-01-0116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0116
Number of participants with account balances2013-01-0114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: PAVLIC VENDING SERVICE, INC. 401K PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0118
Total number of active participants reported on line 7a of the Form 55002012-01-0115
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-011
Total of all active and inactive participants2012-01-0116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0116
Number of participants with account balances2012-01-0114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: PAVLIC VENDING SERVICE, INC. 401K PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0118
Total number of active participants reported on line 7a of the Form 55002011-01-0117
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-011
Total of all active and inactive participants2011-01-0118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0118
Number of participants with account balances2011-01-0114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: PAVLIC VENDING SERVICE, INC. 401K PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0119
Total number of active participants reported on line 7a of the Form 55002010-01-0117
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-011
Total of all active and inactive participants2010-01-0118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0118
Number of participants with account balances2010-01-0114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: PAVLIC VENDING SERVICE, INC. 401K PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0118
Total number of active participants reported on line 7a of the Form 55002009-01-0118
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-011
Total of all active and inactive participants2009-01-0119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0119
Number of participants with account balances2009-01-0115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on PAVLIC VENDING SERVICE, INC. 401K PLAN

Measure Date Value
2019 : PAVLIC VENDING SERVICE, INC. 401K PLAN 2019 401k financial data
Total income from all sources2019-12-31$196,013
Expenses. Total of all expenses incurred2019-12-31$5,412
Total plan assets at end of year2019-12-31$1,099,065
Total plan assets at beginning of year2019-12-31$908,464
Value of fidelity bond covering the plan2019-12-31$100,000
Total contributions received or receivable from participants2019-12-31$57,450
Contributions received from other sources (not participants or employers)2019-12-31$0
Other income received2019-12-31$106,250
Net income (gross income less expenses)2019-12-31$190,601
Net plan assets at end of year (total assets less liabilities)2019-12-31$1,099,065
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$908,464
Total contributions received or receivable from employer(s)2019-12-31$32,313
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$5,412
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
2018 : PAVLIC VENDING SERVICE, INC. 401K PLAN 2018 401k financial data
Total income from all sources2018-12-31$67,204
Expenses. Total of all expenses incurred2018-12-31$7,232
Total plan assets at end of year2018-12-31$908,464
Total plan assets at beginning of year2018-12-31$848,492
Value of fidelity bond covering the plan2018-12-31$100,000
Total contributions received or receivable from participants2018-12-31$49,806
Other income received2018-12-31$-5,103
Net income (gross income less expenses)2018-12-31$59,972
Net plan assets at end of year (total assets less liabilities)2018-12-31$908,464
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$848,492
Total contributions received or receivable from employer(s)2018-12-31$22,501
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$7,232
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
2017 : PAVLIC VENDING SERVICE, INC. 401K PLAN 2017 401k financial data
Total income from all sources2017-12-31$84,909
Expenses. Total of all expenses incurred2017-12-31$8,952
Total plan assets at end of year2017-12-31$848,492
Total plan assets at beginning of year2017-12-31$772,535
Value of fidelity bond covering the plan2017-12-31$100,000
Total contributions received or receivable from participants2017-12-31$44,406
Other income received2017-12-31$28,789
Net income (gross income less expenses)2017-12-31$75,957
Net plan assets at end of year (total assets less liabilities)2017-12-31$848,492
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$772,535
Total contributions received or receivable from employer(s)2017-12-31$11,714
Value of corrective distributions2017-12-31$2,120
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$6,832
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : PAVLIC VENDING SERVICE, INC. 401K PLAN 2016 401k financial data
Total income from all sources2016-12-31$61,520
Expenses. Total of all expenses incurred2016-12-31$9,332
Total plan assets at end of year2016-12-31$772,535
Total plan assets at beginning of year2016-12-31$720,347
Value of fidelity bond covering the plan2016-12-31$100,000
Total contributions received or receivable from participants2016-12-31$43,624
Other income received2016-12-31$17,896
Net income (gross income less expenses)2016-12-31$52,188
Net plan assets at end of year (total assets less liabilities)2016-12-31$772,535
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$720,347
Value of corrective distributions2016-12-31$2,838
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$6,494
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : PAVLIC VENDING SERVICE, INC. 401K PLAN 2015 401k financial data
Total income from all sources2015-12-31$48,141
Expenses. Total of all expenses incurred2015-12-31$48,910
Benefits paid (including direct rollovers)2015-12-31$41,179
Total plan assets at end of year2015-12-31$720,347
Total plan assets at beginning of year2015-12-31$721,116
Value of fidelity bond covering the plan2015-12-31$100,000
Total contributions received or receivable from participants2015-12-31$44,977
Expenses. Other expenses not covered elsewhere2015-12-31$6,495
Other income received2015-12-31$3,164
Net income (gross income less expenses)2015-12-31$-769
Net plan assets at end of year (total assets less liabilities)2015-12-31$720,347
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$721,116
Value of corrective distributions2015-12-31$1,236
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : PAVLIC VENDING SERVICE, INC. 401K PLAN 2014 401k financial data
Total income from all sources2014-12-31$66,379
Expenses. Total of all expenses incurred2014-12-31$25,206
Benefits paid (including direct rollovers)2014-12-31$19,051
Total plan assets at end of year2014-12-31$721,116
Total plan assets at beginning of year2014-12-31$679,943
Value of fidelity bond covering the plan2014-12-31$100,000
Total contributions received or receivable from participants2014-12-31$40,496
Other income received2014-12-31$25,883
Net income (gross income less expenses)2014-12-31$41,173
Net plan assets at end of year (total assets less liabilities)2014-12-31$721,116
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$679,943
Assets. Value of participant loans2014-12-31$1,645
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$6,155
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : PAVLIC VENDING SERVICE, INC. 401K PLAN 2013 401k financial data
Total income from all sources2013-12-31$42,217
Expenses. Total of all expenses incurred2013-12-31$5,732
Total plan assets at end of year2013-12-31$679,943
Total plan assets at beginning of year2013-12-31$643,458
Value of fidelity bond covering the plan2013-12-31$100,000
Total contributions received or receivable from participants2013-12-31$39,904
Other income received2013-12-31$2,313
Net income (gross income less expenses)2013-12-31$36,485
Net plan assets at end of year (total assets less liabilities)2013-12-31$679,943
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$643,458
Assets. Value of participant loans2013-12-31$3,321
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$5,732
2012 : PAVLIC VENDING SERVICE, INC. 401K PLAN 2012 401k financial data
Total income from all sources2012-12-31$74,985
Expenses. Total of all expenses incurred2012-12-31$262,861
Benefits paid (including direct rollovers)2012-12-31$255,872
Total plan assets at end of year2012-12-31$643,458
Total plan assets at beginning of year2012-12-31$831,334
Value of fidelity bond covering the plan2012-12-31$100,000
Total contributions received or receivable from participants2012-12-31$42,024
Other income received2012-12-31$32,961
Net income (gross income less expenses)2012-12-31$-187,876
Net plan assets at end of year (total assets less liabilities)2012-12-31$643,458
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$831,334
Assets. Value of participant loans2012-12-31$14,552
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$6,989
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : PAVLIC VENDING SERVICE, INC. 401K PLAN 2011 401k financial data
Total income from all sources2011-12-31$-21,623
Expenses. Total of all expenses incurred2011-12-31$19,831
Benefits paid (including direct rollovers)2011-12-31$12,500
Total plan assets at end of year2011-12-31$831,334
Total plan assets at beginning of year2011-12-31$872,788
Value of fidelity bond covering the plan2011-12-31$100,000
Total contributions received or receivable from participants2011-12-31$51,759
Other income received2011-12-31$-73,382
Net income (gross income less expenses)2011-12-31$-41,454
Net plan assets at end of year (total assets less liabilities)2011-12-31$831,334
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$872,788
Assets. Value of participant loans2011-12-31$21,134
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$7,331
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : PAVLIC VENDING SERVICE, INC. 401K PLAN 2010 401k financial data
Total income from all sources2010-12-31$68,725
Expenses. Total of all expenses incurred2010-12-31$28,116
Benefits paid (including direct rollovers)2010-12-31$21,224
Total plan assets at end of year2010-12-31$872,788
Total plan assets at beginning of year2010-12-31$832,179
Value of fidelity bond covering the plan2010-12-31$100,000
Total contributions received or receivable from participants2010-12-31$51,546
Other income received2010-12-31$17,179
Net income (gross income less expenses)2010-12-31$40,609
Net plan assets at end of year (total assets less liabilities)2010-12-31$872,788
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$832,179
Assets. Value of participant loans2010-12-31$27,288
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$6,892
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
2009 : PAVLIC VENDING SERVICE, INC. 401K PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for PAVLIC VENDING SERVICE, INC. 401K PLAN

2019: PAVLIC VENDING SERVICE, INC. 401K PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: PAVLIC VENDING SERVICE, INC. 401K PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement - TrustYes
2017: PAVLIC VENDING SERVICE, INC. 401K PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement - TrustYes
2016: PAVLIC VENDING SERVICE, INC. 401K PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: PAVLIC VENDING SERVICE, INC. 401K PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2014: PAVLIC VENDING SERVICE, INC. 401K PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement - TrustYes
2013: PAVLIC VENDING SERVICE, INC. 401K PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement - TrustYes
2012: PAVLIC VENDING SERVICE, INC. 401K PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement - TrustYes
2011: PAVLIC VENDING SERVICE, INC. 401K PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement - TrustYes
2010: PAVLIC VENDING SERVICE, INC. 401K PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement - TrustYes
2009: PAVLIC VENDING SERVICE, INC. 401K PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number809953-000
Policy instance 1
Insurance contract or identification number809953-000
Number of Individuals Covered16
Insurance policy start date2019-03-28
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $2,480
Total amount of fees paid to insurance companyUSD $2,778
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?Yes
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
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees2778
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker organization code?5
Commission paid to Insurance BrokerUSD $2,480

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