401k Plan data: HOLLSTADT AND ASSOCIATES, INC. plan

HOLLSTADT AND ASSOCIATES, INC. 401k Plan overview

Plan Name	HOLLSTADT AND ASSOCIATES, INC.
Plan identification number	501

HOLLSTADT AND ASSOCIATES, INC. Benefits

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

401k Sponsoring company profile

HOLLSTADT & ASSOCIATES, INC. DBA HOLLSTADT CONSULTING has sponsored the creation of one or more 401k plans.

Company Name: HOLLSTADT & ASSOCIATES, INC. DBA HOLLSTADT CONSULTING

Employer identification number (EIN): 411673112

NAIC Classification: 541511
NAIC Description: Custom Computer Programming Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HOLLSTADT AND ASSOCIATES, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2014-01-01 MOLLY JUNGBAUER
501 2014-01-01 MOLLY JUNGBAUER
501 2013-01-01 MOLLY JUNGBAUER
501 2012-01-01 MOLLY JUNGBAUER
501 2011-01-01 MOLLY JUNGBAUER

Plan id#	Filing Submission Date	Name of Administrator
501	2014-01-01	MOLLY JUNGBAUER
501	2014-01-01	MOLLY JUNGBAUER
501	2013-01-01	MOLLY JUNGBAUER
501	2012-01-01	MOLLY JUNGBAUER
501	2011-01-01	MOLLY JUNGBAUER

Plan Statistics for HOLLSTADT AND ASSOCIATES, INC.

401k plan membership statisitcs for HOLLSTADT AND ASSOCIATES, INC.

Measure Date Value
2014: HOLLSTADT AND ASSOCIATES, INC. 2014 401k membership
Total participants, beginning-of-year 2014-01-01 160
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 168
Number of retired or separated participants receiving benefits 2014-01-01 4
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 172
2013: HOLLSTADT AND ASSOCIATES, INC. 2013 401k membership
Total participants, beginning-of-year 2013-01-01 120
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 160
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 2013-01-01 160
2012: HOLLSTADT AND ASSOCIATES, INC. 2012 401k membership
Total participants, beginning-of-year 2012-01-01 123
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 120
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 2012-01-01 120
2011: HOLLSTADT AND ASSOCIATES, INC. 2011 401k membership
Total participants, beginning-of-year 2011-01-01 99
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 123
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 2011-01-01 123

Measure	Date	Value
2014: HOLLSTADT AND ASSOCIATES, INC. 2014 401k membership
Total participants, beginning-of-year	2014-01-01	160
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	168
Number of retired or separated participants receiving benefits	2014-01-01	4
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	172
2013: HOLLSTADT AND ASSOCIATES, INC. 2013 401k membership
Total participants, beginning-of-year	2013-01-01	120
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	160
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	160
2012: HOLLSTADT AND ASSOCIATES, INC. 2012 401k membership
Total participants, beginning-of-year	2012-01-01	123
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	120
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	120
2011: HOLLSTADT AND ASSOCIATES, INC. 2011 401k membership
Total participants, beginning-of-year	2011-01-01	99
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	123
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	123

Form 5500 Responses for HOLLSTADT AND ASSOCIATES, INC.

2014: HOLLSTADT AND ASSOCIATES, INC. 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	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: HOLLSTADT AND ASSOCIATES, INC. 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: HOLLSTADT AND ASSOCIATES, INC. 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: HOLLSTADT AND ASSOCIATES, INC. 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 – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )

Policy contract number

5465214

Policy instance

Insurance contract or identification number	5465214
Number of Individuals Covered	168
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $8,341
Total amount of fees paid to insurance company	USD $2,391
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	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 $57,825
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,341
Amount paid for insurance broker fees	2391
Additional information about fees paid to insurance broker	PRODUCER BONUS PROGRAM NON-MONETARY COMPENSATION
Insurance broker organization code?	3
Insurance broker name	WELLS FARGO INSURANCE SERVICES

UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )

Policy contract number

5465214

Policy instance

Insurance contract or identification number	5465214
Number of Individuals Covered	160
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $8,678
Total amount of fees paid to insurance company	USD $1,836
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	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 $60,263
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,309
Amount paid for insurance broker fees	1836
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3
Insurance broker name	KNW GROUP, LLC

MHN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

SGM601409

Policy instance

Insurance contract or identification number	SGM601409
Number of Individuals Covered	120
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $2,215
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	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 $24,495
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $2,215
Insurance broker organization code?	3
Insurance broker name	KNW GROUP, LLC

MHN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

SGM601409

Policy instance

Insurance contract or identification number	SGM601409
Number of Individuals Covered	123
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $2,053
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	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 $22,183
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

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Company Name:	HOLLSTADT & ASSOCIATES, INC. DBA HOLLSTADT CONSULTING
Employer identification number (EIN):	411673112
NAIC Classification:	541511
NAIC Description:	Custom Computer Programming Services