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JIM'S MANAGEMENT CO., INC. 401(K) PLAN 401k Plan overview

Plan NameJIM'S MANAGEMENT CO., INC. 401(K) PLAN
Plan identification number 001

JIM'S MANAGEMENT CO., INC. 401(K) 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.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • 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

JIMS MANAGEMENT CO., INC. has sponsored the creation of one or more 401k plans.

Company Name:JIMS MANAGEMENT CO., INC.
Employer identification number (EIN):431930023
NAIC Classification:722511
NAIC Description:Full-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JIM'S MANAGEMENT CO., INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01JIM W WAGY2023-09-19
0012021-01-01JIM W WAGY2022-10-07
0012020-01-01JIM W WAGY2021-09-27
0012019-01-01JIM W WAGY2020-06-23
0012019-01-01JIM W WAGY2021-04-23
0012018-01-01JIM W WAGY2019-04-19
0012017-01-01
0012016-01-01
0012015-01-01
0012014-01-01JIM W WAGY2015-10-13
0012013-01-01JIM W WAGY2014-05-29
0012012-01-01JIM W WAGY2013-04-24
0012011-01-01JIM W WAGY2012-10-04
0012010-01-01JIM W WAGY2011-10-11

Plan Statistics for JIM'S MANAGEMENT CO., INC. 401(K) PLAN

401k plan membership statisitcs for JIM'S MANAGEMENT CO., INC. 401(K) PLAN

Measure Date Value
2022: JIM'S MANAGEMENT CO., INC. 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01128
Total number of active participants reported on line 7a of the Form 55002022-01-01101
Number of retired or separated participants receiving benefits2022-01-012
Number of other retired or separated participants entitled to future benefits2022-01-014
Total of all active and inactive participants2022-01-01107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01107
Number of participants with account balances2022-01-0127
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-012
2021: JIM'S MANAGEMENT CO., INC. 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01112
Total number of active participants reported on line 7a of the Form 55002021-01-01107
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-018
Total of all active and inactive participants2021-01-01115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01115
Number of participants with account balances2021-01-0113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: JIM'S MANAGEMENT CO., INC. 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01132
Total number of active participants reported on line 7a of the Form 55002020-01-01107
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-015
Total of all active and inactive participants2020-01-01112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01112
Number of participants with account balances2020-01-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: JIM'S MANAGEMENT CO., INC. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01114
Total number of active participants reported on line 7a of the Form 55002019-01-01106
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-014
Total of all active and inactive participants2019-01-01110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01110
Number of participants with account balances2019-01-0118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: JIM'S MANAGEMENT CO., INC. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01109
Total number of active participants reported on line 7a of the Form 55002018-01-0197
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-011
Total of all active and inactive participants2018-01-0198
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0198
Number of participants with account balances2018-01-0113
2017: JIM'S MANAGEMENT CO., INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01120
Total number of active participants reported on line 7a of the Form 55002017-01-0190
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-017
Total of all active and inactive participants2017-01-0197
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0197
Number of participants with account balances2017-01-0119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: JIM'S MANAGEMENT CO., INC. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01120
Total number of active participants reported on line 7a of the Form 55002016-01-0199
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-012
Total of all active and inactive participants2016-01-01101
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01101
Number of participants with account balances2016-01-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: JIM'S MANAGEMENT CO., INC. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01127
Total number of active participants reported on line 7a of the Form 55002015-01-01104
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-013
Total of all active and inactive participants2015-01-01107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01107
Number of participants with account balances2015-01-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010

Financial Data on JIM'S MANAGEMENT CO., INC. 401(K) PLAN

Measure Date Value
2022 : JIM'S MANAGEMENT CO., INC. 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$-55,375
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$5,650
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$58,521
Value of total assets at end of year2022-12-31$517,089
Value of total assets at beginning of year2022-12-31$578,114
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$5,650
Total interest from all sources2022-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$13,087
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$13,087
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$100,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$49,923
Participant contributions at end of year2022-12-31$0
Participant contributions at beginning of year2022-12-31$0
Participant contributions at end of year2022-12-31$20
Participant contributions at beginning of year2022-12-31$4,339
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$625
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-61,025
Value of net assets at end of year (total assets less liabilities)2022-12-31$517,089
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$578,114
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Investment advisory and management fees2022-12-31$5,650
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$498,377
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$559,897
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$10,719
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$9,528
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-126,983
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$7,973
Employer contributions (assets) at end of year2022-12-31$7,973
Employer contributions (assets) at beginning of year2022-12-31$4,350
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31FORVIS, LLP
Accountancy firm EIN2022-12-31440160260
2021 : JIM'S MANAGEMENT CO., INC. 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$123,305
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$187,431
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$177,742
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$39,164
Value of total assets at end of year2021-12-31$578,114
Value of total assets at beginning of year2021-12-31$642,240
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$9,689
Total interest from all sources2021-12-31$131
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$15,519
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$15,519
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$100,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$34,814
Participant contributions at end of year2021-12-31$0
Participant contributions at beginning of year2021-12-31$5,771
Participant contributions at end of year2021-12-31$4,339
Participant contributions at beginning of year2021-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$-64,126
Value of net assets at end of year (total assets less liabilities)2021-12-31$578,114
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$642,240
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Investment advisory and management fees2021-12-31$9,689
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$559,897
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$624,468
Interest on participant loans2021-12-31$131
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$9,528
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$6,954
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$68,491
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31Yes
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$4,350
Employer contributions (assets) at end of year2021-12-31$4,350
Employer contributions (assets) at beginning of year2021-12-31$5,047
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$177,742
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31FORVIS, LLP
Accountancy firm EIN2021-12-31440160260
2020 : JIM'S MANAGEMENT CO., INC. 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$163,706
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$55,604
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$46,132
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$54,048
Value of total assets at end of year2020-12-31$642,240
Value of total assets at beginning of year2020-12-31$534,138
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$9,472
Total interest from all sources2020-12-31$705
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$15,837
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$15,837
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$100,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$49,001
Participant contributions at end of year2020-12-31$5,771
Participant contributions at beginning of year2020-12-31$18,785
Participant contributions at end of year2020-12-31$0
Participant contributions at beginning of year2020-12-31$1,636
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$108,102
Value of net assets at end of year (total assets less liabilities)2020-12-31$642,240
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$534,138
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Investment advisory and management fees2020-12-31$8,313
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$624,468
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$504,384
Interest on participant loans2020-12-31$705
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$6,954
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$4,590
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$93,116
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31Yes
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$5,047
Employer contributions (assets) at end of year2020-12-31$5,047
Employer contributions (assets) at beginning of year2020-12-31$4,743
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$46,132
Contract administrator fees2020-12-31$1,159
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31BKD, LLP
Accountancy firm EIN2020-12-31440160260
2019 : JIM'S MANAGEMENT CO., INC. 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$91
Total income from all sources (including contributions)2019-12-31$132,698
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$7,762
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$50,247
Value of total assets at end of year2019-12-31$534,138
Value of total assets at beginning of year2019-12-31$409,293
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$7,762
Total interest from all sources2019-12-31$1,181
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$15,108
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$15,108
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$100,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$45,504
Participant contributions at end of year2019-12-31$18,785
Participant contributions at beginning of year2019-12-31$28,878
Participant contributions at end of year2019-12-31$1,636
Participant contributions at beginning of year2019-12-31$1,270
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$91
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$124,936
Value of net assets at end of year (total assets less liabilities)2019-12-31$534,138
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$409,202
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Investment advisory and management fees2019-12-31$7,762
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$504,384
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$359,684
Interest on participant loans2019-12-31$1,130
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$11,539
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$11,539
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$51
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$4,590
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$66,162
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$4,743
Employer contributions (assets) at end of year2019-12-31$4,743
Employer contributions (assets) at beginning of year2019-12-31$7,922
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31BKD, LLP
Accountancy firm EIN2019-12-31440160260
2018 : JIM'S MANAGEMENT CO., INC. 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$91
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$13,821
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$91,841
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$84,384
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$37,465
Value of total assets at end of year2018-12-31$409,293
Value of total assets at beginning of year2018-12-31$487,222
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$7,457
Total interest from all sources2018-12-31$1,139
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$10,738
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$10,738
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$100,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$32,833
Participant contributions at end of year2018-12-31$28,878
Participant contributions at beginning of year2018-12-31$36,156
Participant contributions at end of year2018-12-31$1,270
Participant contributions at beginning of year2018-12-31$921
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$91
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$0
Other income not declared elsewhere2018-12-31$242
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-78,020
Value of net assets at end of year (total assets less liabilities)2018-12-31$409,202
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$487,222
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Investment advisory and management fees2018-12-31$7,457
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$359,684
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$433,996
Income. Interest from loans (other than to participants)2018-12-31$1,139
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$11,539
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$12,363
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$12,363
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-35,763
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31Yes
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$4,632
Employer contributions (assets) at end of year2018-12-31$7,922
Employer contributions (assets) at beginning of year2018-12-31$3,786
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$84,384
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31BKD, LLP
Accountancy firm EIN2018-12-31440160260
2017 : JIM'S MANAGEMENT CO., INC. 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$89,605
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$20,149
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$13,777
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$27,280
Value of total assets at end of year2017-12-31$487,222
Value of total assets at beginning of year2017-12-31$417,766
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$6,372
Total interest from all sources2017-12-31$1,891
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$24,261
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$24,261
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$100,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$23,494
Participant contributions at end of year2017-12-31$36,156
Participant contributions at beginning of year2017-12-31$45,488
Participant contributions at end of year2017-12-31$921
Participant contributions at beginning of year2017-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$69,456
Value of net assets at end of year (total assets less liabilities)2017-12-31$487,222
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$417,766
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Investment advisory and management fees2017-12-31$6,372
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$433,996
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$359,328
Interest on participant loans2017-12-31$1,891
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$12,363
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$9,881
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$9,881
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$36,173
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31Yes
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$3,786
Employer contributions (assets) at end of year2017-12-31$3,786
Employer contributions (assets) at beginning of year2017-12-31$3,069
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$13,777
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31BKD, LLP
Accountancy firm EIN2017-12-31440160260
2016 : JIM'S MANAGEMENT CO., INC. 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total income from all sources (including contributions)2016-12-31$38,222
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$29,830
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$21,363
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$17,440
Value of total assets at end of year2016-12-31$417,766
Value of total assets at beginning of year2016-12-31$409,374
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$8,467
Total interest from all sources2016-12-31$1,101
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$9,528
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$9,528
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$100,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$14,371
Participant contributions at end of year2016-12-31$45,488
Participant contributions at beginning of year2016-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$8,392
Value of net assets at end of year (total assets less liabilities)2016-12-31$417,766
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$409,374
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Investment advisory and management fees2016-12-31$6,096
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$359,328
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$352,183
Interest on participant loans2016-12-31$1,100
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$9,881
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$54,338
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$54,338
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$1
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$10,153
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$3,069
Employer contributions (assets) at end of year2016-12-31$3,069
Employer contributions (assets) at beginning of year2016-12-31$2,853
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$21,363
Contract administrator fees2016-12-31$2,371
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31BKD, LLP
Accountancy firm EIN2016-12-31440160260
2015 : JIM'S MANAGEMENT CO., INC. 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$-853
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$12,241
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$14,621
Value of total assets at end of year2015-12-31$409,374
Value of total assets at beginning of year2015-12-31$422,468
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$12,241
Total interest from all sources2015-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Administrative expenses professional fees incurred2015-12-31$5,308
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$100,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$11,768
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-13,094
Value of net assets at end of year (total assets less liabilities)2015-12-31$409,374
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$422,468
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Investment advisory and management fees2015-12-31$6,933
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$352,183
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$419,831
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$54,338
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-15,474
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$2,853
Employer contributions (assets) at end of year2015-12-31$2,853
Employer contributions (assets) at beginning of year2015-12-31$2,637
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31BKD, LLP
Accountancy firm EIN2015-12-31440160260

Form 5500 Responses for JIM'S MANAGEMENT CO., INC. 401(K) PLAN

2022: JIM'S MANAGEMENT CO., INC. 401(K) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement - TrustYes
2021: JIM'S MANAGEMENT CO., INC. 401(K) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement - TrustYes
2020: JIM'S MANAGEMENT CO., INC. 401(K) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement - TrustYes
2019: JIM'S MANAGEMENT CO., INC. 401(K) 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 - TrustYes
2018: JIM'S MANAGEMENT CO., INC. 401(K) 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: JIM'S MANAGEMENT CO., INC. 401(K) 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: JIM'S MANAGEMENT CO., INC. 401(K) 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: JIM'S MANAGEMENT CO., INC. 401(K) 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

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-CP-LS2W
Policy instance 1
Insurance contract or identification numberGAP-CP-LS2W
Number of Individuals Covered27
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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?Yes
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
Insurance broker organization code?3
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-CP-LS2W
Policy instance 1
Insurance contract or identification numberGAP-CP-LS2W
Number of Individuals Covered13
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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?Yes
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
Insurance broker organization code?3
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-CP-LS2W
Policy instance 1
Insurance contract or identification numberGAP-CP-LS2W
Number of Individuals Covered16
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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?Yes
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
Insurance broker organization code?3
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-CP-LS2W
Policy instance 1
Insurance contract or identification numberGAP-CP-LS2W
Number of Individuals Covered18
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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?Yes
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
Insurance broker organization code?3

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