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TOBIES ENTERPRISES, INC. PROFIT SHARING PLAN AND TRUST 401k Plan overview

Plan NameTOBIES ENTERPRISES, INC. PROFIT SHARING PLAN AND TRUST
Plan identification number 001

TOBIES ENTERPRISES, INC. PROFIT SHARING PLAN AND TRUST Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • 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.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

TOBIES ENTERPRISES, INC. has sponsored the creation of one or more 401k plans.

Company Name:TOBIES ENTERPRISES, INC.
Employer identification number (EIN):411253854
NAIC Classification:722511
NAIC Description:Full-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TOBIES ENTERPRISES, INC. PROFIT SHARING PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012021-01-01
0012020-01-01
0012019-01-01SUSAN HICKLE2020-07-13
0012018-01-01SUSAN HICKLE2019-06-29
0012017-01-01SUSAN HICKLE2018-07-14
0012016-01-01SUSAN HICKLE2017-09-12
0012015-01-01SUSAN HICKLE2016-08-29
0012014-01-01SUSAN HICKLE2015-08-03
0012013-01-01SUSAN HICKLE2014-10-15
0012012-01-01SUSAN HICKLE
0012011-01-01SUSAN HICKLE
0012010-01-01SUSAN HICKLE
0012009-01-01SUSAN HICKLE

Plan Statistics for TOBIES ENTERPRISES, INC. PROFIT SHARING PLAN AND TRUST

401k plan membership statisitcs for TOBIES ENTERPRISES, INC. PROFIT SHARING PLAN AND TRUST

Measure Date Value
2012: TOBIES ENTERPRISES, INC. PROFIT SHARING PLAN AND TRUST 2012 401k membership
Total participants, beginning-of-year2012-01-01113
Total number of active participants reported on line 7a of the Form 55002012-01-0175
Number of retired or separated participants receiving benefits2012-01-013
Number of other retired or separated participants entitled to future benefits2012-01-0112
Total of all active and inactive participants2012-01-0190
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-011
Total participants2012-01-0191
Number of participants with account balances2012-01-0191
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: TOBIES ENTERPRISES, INC. PROFIT SHARING PLAN AND TRUST 2011 401k membership
Total participants, beginning-of-year2011-01-01108
Total number of active participants reported on line 7a of the Form 55002011-01-0178
Number of retired or separated participants receiving benefits2011-01-012
Number of other retired or separated participants entitled to future benefits2011-01-0113
Total of all active and inactive participants2011-01-0193
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0193
Number of participants with account balances2011-01-0193
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-014
2010: TOBIES ENTERPRISES, INC. PROFIT SHARING PLAN AND TRUST 2010 401k membership
Total participants, beginning-of-year2010-01-01110
Total number of active participants reported on line 7a of the Form 55002010-01-0185
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-0121
Total of all active and inactive participants2010-01-01106
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-012
Total participants2010-01-01108
Number of participants with account balances2010-01-01103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-0111
2009: TOBIES ENTERPRISES, INC. PROFIT SHARING PLAN AND TRUST 2009 401k membership
Total participants, beginning-of-year2009-01-01108
Total number of active participants reported on line 7a of the Form 55002009-01-0191
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-019
Total of all active and inactive participants2009-01-01100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-012
Total participants2009-01-01102
Number of participants with account balances2009-01-0195
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-012

Financial Data on TOBIES ENTERPRISES, INC. PROFIT SHARING PLAN AND TRUST

Measure Date Value
2012 : TOBIES ENTERPRISES, INC. PROFIT SHARING PLAN AND TRUST 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total income from all sources (including contributions)2012-12-31$182,835
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$568,262
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$568,182
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$40,000
Value of total assets at end of year2012-12-31$1,637,452
Value of total assets at beginning of year2012-12-31$2,022,879
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$80
Total interest from all sources2012-12-31$10,675
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$300,000
If this is an individual account plan, was there a blackout period2012-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$39,930
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$2,580
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$-385,427
Value of net assets at end of year (total assets less liabilities)2012-12-31$1,637,452
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$2,022,879
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$362,899
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$862,615
Value of interest in pooled separate accounts at end of year2012-12-31$550,594
Value of interest in pooled separate accounts at beginning of year2012-12-31$499,888
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$644,029
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$587,796
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$587,796
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$10,675
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$81,454
Net investment gain/loss from pooled separate accounts2012-12-31$50,706
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31Yes
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$40,000
Employer contributions (assets) at end of year2012-12-31$40,000
Employer contributions (assets) at beginning of year2012-12-31$70,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$568,182
Contract administrator fees2012-12-31$80
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2012-12-31410746749
2011 : TOBIES ENTERPRISES, INC. PROFIT SHARING PLAN AND TRUST 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2011-12-31$-5,990
Total unrealized appreciation/depreciation of assets2011-12-31$-5,990
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total income from all sources (including contributions)2011-12-31$54,848
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$258,634
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$258,554
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$70,000
Value of total assets at end of year2011-12-31$2,022,879
Value of total assets at beginning of year2011-12-31$2,226,665
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$80
Total interest from all sources2011-12-31$12,552
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$300,000
If this is an individual account plan, was there a blackout period2011-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$2,580
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$3,796
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-203,786
Value of net assets at end of year (total assets less liabilities)2011-12-31$2,022,879
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$2,226,665
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$862,615
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$1,029,418
Value of interest in pooled separate accounts at end of year2011-12-31$499,888
Value of interest in pooled separate accounts at beginning of year2011-12-31$504,799
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$587,796
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$618,652
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$618,652
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$12,552
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$-16,803
Net investment gain/loss from pooled separate accounts2011-12-31$-4,911
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$70,000
Employer contributions (assets) at end of year2011-12-31$70,000
Employer contributions (assets) at beginning of year2011-12-31$70,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$258,554
Contract administrator fees2011-12-31$80
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2011-12-31410746749
2010 : TOBIES ENTERPRISES, INC. PROFIT SHARING PLAN AND TRUST 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$-849
Total unrealized appreciation/depreciation of assets2010-12-31$-849
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total income from all sources (including contributions)2010-12-31$284,516
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$57,636
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$57,556
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$70,000
Value of total assets at end of year2010-12-31$2,226,665
Value of total assets at beginning of year2010-12-31$1,999,785
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$80
Total interest from all sources2010-12-31$18,471
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$300,000
If this is an individual account plan, was there a blackout period2010-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$3,796
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$4,979
Administrative expenses (other) incurred2010-12-31$80
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$226,880
Value of net assets at end of year (total assets less liabilities)2010-12-31$2,226,665
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$1,999,785
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$1,029,418
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$878,151
Value of interest in pooled separate accounts at end of year2010-12-31$504,799
Value of interest in pooled separate accounts at beginning of year2010-12-31$459,172
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$618,652
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$587,483
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$587,483
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$18,471
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$151,267
Net investment gain/loss from pooled separate accounts2010-12-31$45,627
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$70,000
Employer contributions (assets) at end of year2010-12-31$70,000
Employer contributions (assets) at beginning of year2010-12-31$70,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$57,556
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31LARSONALLEN LLP
Accountancy firm EIN2010-12-31410746749
2009 : TOBIES ENTERPRISES, INC. PROFIT SHARING PLAN AND TRUST 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 TOBIES ENTERPRISES, INC. PROFIT SHARING PLAN AND TRUST

2012: TOBIES ENTERPRISES, INC. PROFIT SHARING PLAN AND TRUST 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 – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: TOBIES ENTERPRISES, INC. PROFIT SHARING PLAN AND TRUST 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 – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: TOBIES ENTERPRISES, INC. PROFIT SHARING PLAN AND TRUST 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 – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: TOBIES ENTERPRISES, INC. PROFIT SHARING PLAN AND TRUST 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 – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90425 )
Policy contract number2532583
Policy instance 1
Insurance contract or identification number2532583
Number of Individuals Covered91
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
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 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
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
JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90425 )
Policy contract number2532583
Policy instance 1
Insurance contract or identification number2532583
Number of Individuals Covered93
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
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 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
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
JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90425 )
Policy contract number2532583
Policy instance 1
Insurance contract or identification number2532583
Number of Individuals Covered103
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
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 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
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

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