OZARKS COCA-COLA/DR PEPPER BOTTLING COMPANY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan OZARKS COCA-COLA/DR PEPPER BOTTLING COMPANY GROUP HEALTH PLAN
401k plan membership statisitcs for OZARKS COCA-COLA/DR PEPPER BOTTLING COMPANY GROUP HEALTH PLAN
| Measure | Date | Value |
|---|
| 2022 : OZARKS COCA-COLA/DR PEPPER BOTTLING COMPANY GROUP HEALTH PLAN 2022 401k financial data |
|---|
| Total income from all sources (including contributions) | 2022-12-31 | $10,232,844 |
| Total of all expenses incurred | 2022-12-31 | $10,038,409 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-12-31 | $9,645,298 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-12-31 | $10,131,224 |
| Value of total assets at end of year | 2022-12-31 | $8,025,743 |
| Value of total assets at beginning of year | 2022-12-31 | $7,831,308 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-12-31 | $393,111 |
| Total interest from all sources | 2022-12-31 | $101,620 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-12-31 | No |
| Was this plan covered by a fidelity bond | 2022-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2022-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2022-12-31 | No |
| Contributions received from participants | 2022-12-31 | $982,987 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2022-12-31 | $896,074 |
| Administrative expenses (other) incurred | 2022-12-31 | $254,884 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
| Value of net income/loss | 2022-12-31 | $194,435 |
| Value of net assets at end of year (total assets less liabilities) | 2022-12-31 | $8,025,743 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-12-31 | $7,831,308 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2022-12-31 | $8,025,743 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2022-12-31 | $7,831,308 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2022-12-31 | $7,831,308 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2022-12-31 | $101,620 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-12-31 | $1,419,412 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2022-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-12-31 | No |
| Contributions received in cash from employer | 2022-12-31 | $8,252,163 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-12-31 | $8,225,886 |
| Contract administrator fees | 2022-12-31 | $138,227 |
| Did the plan have assets held for investment | 2022-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-12-31 | No |
| Aggregate proceeds on sale of assets | 2022-12-31 | $10,038,409 |
| Aggregate carrying amount (costs) on sale of assets | 2022-12-31 | $10,038,409 |
| Opinion of an independent qualified public accountant for this plan | 2022-12-31 | Unqualified |
| Accountancy firm name | 2022-12-31 | KPM CPAS, PC |
| Accountancy firm EIN | 2022-12-31 | 431109768 |
| 2021 : OZARKS COCA-COLA/DR PEPPER BOTTLING COMPANY GROUP HEALTH PLAN 2021 401k financial data |
|---|
| Total income from all sources (including contributions) | 2021-12-31 | $12,060,028 |
| Total of all expenses incurred | 2021-12-31 | $9,339,095 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-12-31 | $8,970,625 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-12-31 | $12,057,174 |
| Value of total assets at end of year | 2021-12-31 | $7,831,308 |
| Value of total assets at beginning of year | 2021-12-31 | $5,110,375 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-12-31 | $368,470 |
| Total interest from all sources | 2021-12-31 | $2,854 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-12-31 | No |
| Was this plan covered by a fidelity bond | 2021-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2021-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2021-12-31 | No |
| Contributions received from participants | 2021-12-31 | $1,260,508 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2021-12-31 | $587,970 |
| Administrative expenses (other) incurred | 2021-12-31 | $234,838 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
| Value of net income/loss | 2021-12-31 | $2,720,933 |
| Value of net assets at end of year (total assets less liabilities) | 2021-12-31 | $7,831,308 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-12-31 | $5,110,375 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2021-12-31 | $7,831,308 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2021-12-31 | $5,110,375 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2021-12-31 | $5,110,375 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2021-12-31 | $2,854 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2021-12-31 | $1,357,092 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2021-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2021-12-31 | No |
| Contributions received in cash from employer | 2021-12-31 | $10,208,696 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2021-12-31 | $7,613,533 |
| Contract administrator fees | 2021-12-31 | $133,632 |
| Did the plan have assets held for investment | 2021-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-12-31 | No |
| Aggregate proceeds on sale of assets | 2021-12-31 | $9,339,095 |
| Aggregate carrying amount (costs) on sale of assets | 2021-12-31 | $9,339,095 |
| Opinion of an independent qualified public accountant for this plan | 2021-12-31 | Unqualified |
| Accountancy firm name | 2021-12-31 | KPM CPAS, PC |
| Accountancy firm EIN | 2021-12-31 | 431109768 |
| 2020 : OZARKS COCA-COLA/DR PEPPER BOTTLING COMPANY GROUP HEALTH PLAN 2020 401k financial data |
|---|
| Total income from all sources (including contributions) | 2020-12-31 | $10,785,830 |
| Total of all expenses incurred | 2020-12-31 | $9,332,403 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-12-31 | $9,001,021 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-12-31 | $10,760,543 |
| Value of total assets at end of year | 2020-12-31 | $5,110,375 |
| Value of total assets at beginning of year | 2020-12-31 | $3,656,948 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-12-31 | $331,382 |
| Total interest from all sources | 2020-12-31 | $25,287 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-12-31 | No |
| Was this plan covered by a fidelity bond | 2020-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2020-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2020-12-31 | No |
| Contributions received from participants | 2020-12-31 | $971,341 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2020-12-31 | $1,443,641 |
| Administrative expenses (other) incurred | 2020-12-31 | $163,085 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
| Value of net income/loss | 2020-12-31 | $1,453,427 |
| Value of net assets at end of year (total assets less liabilities) | 2020-12-31 | $5,110,375 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-12-31 | $3,656,948 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2020-12-31 | $5,110,375 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2020-12-31 | $3,656,948 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2020-12-31 | $3,656,948 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2020-12-31 | $25,287 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-12-31 | $1,204,305 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2020-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-12-31 | No |
| Contributions received in cash from employer | 2020-12-31 | $8,345,561 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-12-31 | $7,796,716 |
| Contract administrator fees | 2020-12-31 | $168,297 |
| Did the plan have assets held for investment | 2020-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-12-31 | No |
| Aggregate proceeds on sale of assets | 2020-12-31 | $9,332,403 |
| Aggregate carrying amount (costs) on sale of assets | 2020-12-31 | $9,332,403 |
| Opinion of an independent qualified public accountant for this plan | 2020-12-31 | Unqualified |
| Accountancy firm name | 2020-12-31 | KPM CPAS, PC |
| Accountancy firm EIN | 2020-12-31 | 431109768 |
| 2019 : OZARKS COCA-COLA/DR PEPPER BOTTLING COMPANY GROUP HEALTH PLAN 2019 401k financial data |
|---|
| Total income from all sources (including contributions) | 2019-12-31 | $9,591,844 |
| Total income from all sources (including contributions) | 2019-12-31 | $9,591,844 |
| Total of all expenses incurred | 2019-12-31 | $9,065,869 |
| Total of all expenses incurred | 2019-12-31 | $9,065,869 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $8,741,086 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $8,741,086 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-12-31 | $9,491,815 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-12-31 | $9,491,815 |
| Value of total assets at end of year | 2019-12-31 | $3,656,948 |
| Value of total assets at beginning of year | 2019-12-31 | $3,130,973 |
| Value of total assets at beginning of year | 2019-12-31 | $3,130,973 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $324,783 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $324,783 |
| Total interest from all sources | 2019-12-31 | $100,029 |
| Total interest from all sources | 2019-12-31 | $100,029 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
| Was this plan covered by a fidelity bond | 2019-12-31 | No |
| Was this plan covered by a fidelity bond | 2019-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2019-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2019-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
| Contributions received from participants | 2019-12-31 | $993,725 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2019-12-31 | $1,311,963 |
| Administrative expenses (other) incurred | 2019-12-31 | $143,401 |
| Administrative expenses (other) incurred | 2019-12-31 | $143,401 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Value of net income/loss | 2019-12-31 | $525,975 |
| Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $3,656,948 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $3,130,973 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $3,130,973 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-12-31 | No |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-12-31 | $3,656,948 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-12-31 | $3,130,973 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-12-31 | $3,130,973 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-12-31 | $3,130,973 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-12-31 | $3,130,973 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2019-12-31 | $100,029 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2019-12-31 | $100,029 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $997,824 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | No |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
| Contributions received in cash from employer | 2019-12-31 | $7,186,127 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-12-31 | $7,743,262 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-12-31 | $7,743,262 |
| Contract administrator fees | 2019-12-31 | $181,382 |
| Contract administrator fees | 2019-12-31 | $181,382 |
| Did the plan have assets held for investment | 2019-12-31 | No |
| Did the plan have assets held for investment | 2019-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-12-31 | No |
| Aggregate proceeds on sale of assets | 2019-12-31 | $9,065,869 |
| Aggregate proceeds on sale of assets | 2019-12-31 | $9,065,869 |
| Aggregate carrying amount (costs) on sale of assets | 2019-12-31 | $9,065,869 |
| Aggregate carrying amount (costs) on sale of assets | 2019-12-31 | $9,065,869 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Unqualified |
| Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Unqualified |
| Accountancy firm name | 2019-12-31 | KPM CPAS, PC |
| Accountancy firm name | 2019-12-31 | KPM CPAS, PC |
| Accountancy firm EIN | 2019-12-31 | 431109768 |
| Accountancy firm EIN | 2019-12-31 | 431109768 |
| 2018 : OZARKS COCA-COLA/DR PEPPER BOTTLING COMPANY GROUP HEALTH PLAN 2018 401k financial data |
|---|
| Total income from all sources (including contributions) | 2018-12-31 | $7,351,245 |
| Total of all expenses incurred | 2018-12-31 | $6,805,952 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-12-31 | $6,523,647 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-12-31 | $7,301,096 |
| Value of total assets at end of year | 2018-12-31 | $3,130,973 |
| Value of total assets at beginning of year | 2018-12-31 | $2,585,680 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-12-31 | $282,305 |
| Total interest from all sources | 2018-12-31 | $50,149 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-12-31 | No |
| Was this plan covered by a fidelity bond | 2018-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2018-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2018-12-31 | No |
| Contributions received from participants | 2018-12-31 | $913,670 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2018-12-31 | $141,708 |
| Administrative expenses (other) incurred | 2018-12-31 | $137,654 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
| Value of net income/loss | 2018-12-31 | $545,293 |
| Value of net assets at end of year (total assets less liabilities) | 2018-12-31 | $3,130,973 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-12-31 | $2,585,680 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2018-12-31 | $3,130,973 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2018-12-31 | $2,585,680 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2018-12-31 | $2,585,680 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2018-12-31 | $50,149 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-12-31 | $958,137 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2018-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-12-31 | No |
| Contributions received in cash from employer | 2018-12-31 | $6,245,718 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-12-31 | $5,565,510 |
| Contract administrator fees | 2018-12-31 | $144,651 |
| Did the plan have assets held for investment | 2018-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-12-31 | No |
| Aggregate proceeds on sale of assets | 2018-12-31 | $6,805,952 |
| Aggregate carrying amount (costs) on sale of assets | 2018-12-31 | $6,805,952 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2018-12-31 | Unqualified |
| Accountancy firm name | 2018-12-31 | KPM CPAS, PC |
| Accountancy firm EIN | 2018-12-31 | 431109768 |
| 2017 : OZARKS COCA-COLA/DR PEPPER BOTTLING COMPANY GROUP HEALTH PLAN 2017 401k financial data |
|---|
| Total income from all sources (including contributions) | 2017-12-31 | $5,969,818 |
| Total of all expenses incurred | 2017-12-31 | $5,356,948 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-12-31 | $5,118,681 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-12-31 | $5,950,314 |
| Value of total assets at end of year | 2017-12-31 | $2,585,680 |
| Value of total assets at beginning of year | 2017-12-31 | $1,972,810 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-12-31 | $238,267 |
| Total interest from all sources | 2017-12-31 | $19,504 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-12-31 | No |
| Was this plan covered by a fidelity bond | 2017-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2017-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2017-12-31 | No |
| Contributions received from participants | 2017-12-31 | $656,649 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2017-12-31 | $577,372 |
| Administrative expenses (other) incurred | 2017-12-31 | $112,880 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
| Value of net income/loss | 2017-12-31 | $612,870 |
| Value of net assets at end of year (total assets less liabilities) | 2017-12-31 | $2,585,680 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-12-31 | $1,972,810 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-12-31 | $2,585,680 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2017-12-31 | $1,972,810 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2017-12-31 | $1,972,810 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2017-12-31 | $19,504 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-12-31 | $753,993 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2017-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-12-31 | No |
| Contributions received in cash from employer | 2017-12-31 | $4,716,293 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-12-31 | $4,364,688 |
| Contract administrator fees | 2017-12-31 | $125,387 |
| Did the plan have assets held for investment | 2017-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-12-31 | No |
| Aggregate proceeds on sale of assets | 2017-12-31 | $5,356,948 |
| Aggregate carrying amount (costs) on sale of assets | 2017-12-31 | $5,356,948 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2017-12-31 | Unqualified |
| Accountancy firm name | 2017-12-31 | KPM CPAS, PC |
| Accountancy firm EIN | 2017-12-31 | 431109768 |
| 2016 : OZARKS COCA-COLA/DR PEPPER BOTTLING COMPANY GROUP HEALTH PLAN 2016 401k financial data |
|---|
| Total income from all sources (including contributions) | 2016-12-31 | $7,323,214 |
| Total of all expenses incurred | 2016-12-31 | $5,647,606 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-12-31 | $5,415,354 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-12-31 | $7,318,671 |
| Value of total assets at end of year | 2016-12-31 | $1,972,810 |
| Value of total assets at beginning of year | 2016-12-31 | $297,202 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-12-31 | $232,252 |
| Total interest from all sources | 2016-12-31 | $4,543 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-12-31 | No |
| Was this plan covered by a fidelity bond | 2016-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2016-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2016-12-31 | No |
| Contributions received from participants | 2016-12-31 | $1,236,883 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2016-12-31 | $356,858 |
| Administrative expenses (other) incurred | 2016-12-31 | $96,084 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
| Value of net income/loss | 2016-12-31 | $1,675,608 |
| Value of net assets at end of year (total assets less liabilities) | 2016-12-31 | $1,972,810 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-12-31 | $297,202 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2016-12-31 | $1,972,810 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2016-12-31 | $297,202 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2016-12-31 | $297,202 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2016-12-31 | $4,543 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-12-31 | $607,670 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2016-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-12-31 | No |
| Contributions received in cash from employer | 2016-12-31 | $5,724,930 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-12-31 | $4,807,684 |
| Contract administrator fees | 2016-12-31 | $136,168 |
| Did the plan have assets held for investment | 2016-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-12-31 | No |
| Aggregate proceeds on sale of assets | 2016-12-31 | $5,647,606 |
| Aggregate carrying amount (costs) on sale of assets | 2016-12-31 | $5,647,606 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2016-12-31 | Unqualified |
| Accountancy firm name | 2016-12-31 | KPM CPAS, PC |
| Accountancy firm EIN | 2016-12-31 | 431109768 |
| 2015 : OZARKS COCA-COLA/DR PEPPER BOTTLING COMPANY GROUP HEALTH PLAN 2015 401k financial data |
|---|
| Total income from all sources (including contributions) | 2015-12-31 | $3,828,037 |
| Total of all expenses incurred | 2015-12-31 | $3,621,305 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-12-31 | $3,339,174 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-12-31 | $3,827,815 |
| Value of total assets at end of year | 2015-12-31 | $297,202 |
| Value of total assets at beginning of year | 2015-12-31 | $90,470 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-12-31 | $282,131 |
| Total interest from all sources | 2015-12-31 | $222 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-12-31 | No |
| Was this plan covered by a fidelity bond | 2015-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2015-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2015-12-31 | No |
| Contributions received from participants | 2015-12-31 | $572,690 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2015-12-31 | $53,229 |
| Administrative expenses (other) incurred | 2015-12-31 | $87,708 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
| Value of net income/loss | 2015-12-31 | $206,732 |
| Value of net assets at end of year (total assets less liabilities) | 2015-12-31 | $297,202 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-12-31 | $90,470 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2015-12-31 | $297,202 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2015-12-31 | $90,470 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2015-12-31 | $90,470 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2015-12-31 | $222 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-12-31 | $271,498 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2015-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-12-31 | No |
| Contributions received in cash from employer | 2015-12-31 | $3,201,896 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-12-31 | $3,067,676 |
| Contract administrator fees | 2015-12-31 | $194,423 |
| Did the plan have assets held for investment | 2015-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-12-31 | No |
| Aggregate proceeds on sale of assets | 2015-12-31 | $3,621,305 |
| Aggregate carrying amount (costs) on sale of assets | 2015-12-31 | $3,621,305 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2015-12-31 | Unqualified |
| Accountancy firm name | 2015-12-31 | KPM CPAS, PC |
| Accountancy firm EIN | 2015-12-31 | 431109768 |
| 2014 : OZARKS COCA-COLA/DR PEPPER BOTTLING COMPANY GROUP HEALTH PLAN 2014 401k financial data |
|---|
| Total income from all sources (including contributions) | 2014-12-31 | $4,567,059 |
| Total loss/gain on sale of assets | 2014-12-31 | $0 |
| Total of all expenses incurred | 2014-12-31 | $4,476,843 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-12-31 | $4,371,920 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-12-31 | $4,566,985 |
| Value of total assets at end of year | 2014-12-31 | $90,470 |
| Value of total assets at beginning of year | 2014-12-31 | $254 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-12-31 | $104,923 |
| Total interest from all sources | 2014-12-31 | $74 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-12-31 | No |
| Was this plan covered by a fidelity bond | 2014-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2014-12-31 | No |
| Contributions received from participants | 2014-12-31 | $552,053 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2014-12-31 | $162,356 |
| Administrative expenses (other) incurred | 2014-12-31 | $52,458 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
| Value of net income/loss | 2014-12-31 | $90,216 |
| Value of net assets at end of year (total assets less liabilities) | 2014-12-31 | $90,470 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-12-31 | $254 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2014-12-31 | $90,470 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2014-12-31 | $254 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2014-12-31 | $254 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2014-12-31 | $74 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-12-31 | $390,856 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2014-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-12-31 | No |
| Contributions received in cash from employer | 2014-12-31 | $3,852,576 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-12-31 | $3,981,064 |
| Contract administrator fees | 2014-12-31 | $52,465 |
| Did the plan have assets held for investment | 2014-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-12-31 | No |
| Aggregate proceeds on sale of assets | 2014-12-31 | $4,476,843 |
| Aggregate carrying amount (costs) on sale of assets | 2014-12-31 | $4,476,843 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2014-12-31 | Unqualified |
| Accountancy firm name | 2014-12-31 | KPM CPAS, PC |
| Accountancy firm EIN | 2014-12-31 | 431109768 |
| 2013 : OZARKS COCA-COLA/DR PEPPER BOTTLING COMPANY GROUP HEALTH PLAN 2013 401k financial data |
|---|
| Total income from all sources (including contributions) | 2013-12-31 | $3,316,963 |
| Total loss/gain on sale of assets | 2013-12-31 | $0 |
| Total of all expenses incurred | 2013-12-31 | $3,338,441 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-12-31 | $3,236,907 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-12-31 | $3,316,949 |
| Value of total assets at end of year | 2013-12-31 | $254 |
| Value of total assets at beginning of year | 2013-12-31 | $21,732 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-12-31 | $101,534 |
| Total interest from all sources | 2013-12-31 | $14 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-12-31 | No |
| Was this plan covered by a fidelity bond | 2013-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2013-12-31 | No |
| Contributions received from participants | 2013-12-31 | $515,692 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2013-12-31 | $122,129 |
| Administrative expenses (other) incurred | 2013-12-31 | $50,162 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
| Value of net income/loss | 2013-12-31 | $-21,478 |
| Value of net assets at end of year (total assets less liabilities) | 2013-12-31 | $254 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-12-31 | $21,732 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2013-12-31 | $254 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2013-12-31 | $21,732 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2013-12-31 | $21,732 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2013-12-31 | $14 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-12-31 | $349,803 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2013-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-12-31 | No |
| Contributions received in cash from employer | 2013-12-31 | $2,679,128 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-12-31 | $2,887,104 |
| Contract administrator fees | 2013-12-31 | $51,372 |
| Did the plan have assets held for investment | 2013-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-12-31 | No |
| Aggregate proceeds on sale of assets | 2013-12-31 | $3,338,441 |
| Aggregate carrying amount (costs) on sale of assets | 2013-12-31 | $3,338,441 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2013-12-31 | Unqualified |
| Accountancy firm name | 2013-12-31 | KPM CPAS, PC |
| Accountancy firm EIN | 2013-12-31 | 431109768 |
| 2012 : OZARKS COCA-COLA/DR PEPPER BOTTLING COMPANY GROUP HEALTH PLAN 2012 401k financial data |
|---|
| Total income from all sources (including contributions) | 2012-12-31 | $3,059,776 |
| Total loss/gain on sale of assets | 2012-12-31 | $0 |
| Total of all expenses incurred | 2012-12-31 | $3,099,051 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-12-31 | $2,994,167 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-12-31 | $3,059,740 |
| Value of total assets at end of year | 2012-12-31 | $21,732 |
| Value of total assets at beginning of year | 2012-12-31 | $61,007 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-12-31 | $104,884 |
| Total interest from all sources | 2012-12-31 | $36 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-12-31 | No |
| Was this plan covered by a fidelity bond | 2012-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2012-12-31 | No |
| Contributions received from participants | 2012-12-31 | $512,443 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2012-12-31 | $81,625 |
| Administrative expenses (other) incurred | 2012-12-31 | $54,256 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
| Value of net income/loss | 2012-12-31 | $-39,275 |
| Value of net assets at end of year (total assets less liabilities) | 2012-12-31 | $21,732 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-12-31 | $61,007 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2012-12-31 | $21,732 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2012-12-31 | $61,007 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2012-12-31 | $61,007 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2012-12-31 | $36 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-12-31 | $360,575 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2012-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-12-31 | No |
| Contributions received in cash from employer | 2012-12-31 | $2,465,672 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-12-31 | $2,633,592 |
| Contract administrator fees | 2012-12-31 | $50,628 |
| Did the plan have assets held for investment | 2012-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-12-31 | No |
| Aggregate proceeds on sale of assets | 2012-12-31 | $3,098,941 |
| Aggregate carrying amount (costs) on sale of assets | 2012-12-31 | $3,098,941 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2012-12-31 | Unqualified |
| Accountancy firm name | 2012-12-31 | KPM CPAS, PC |
| Accountancy firm EIN | 2012-12-31 | 431109768 |
| 2011 : OZARKS COCA-COLA/DR PEPPER BOTTLING COMPANY GROUP HEALTH PLAN 2011 401k financial data |
|---|
| Total income from all sources (including contributions) | 2011-12-31 | $3,309,207 |
| Total loss/gain on sale of assets | 2011-12-31 | $0 |
| Total of all expenses incurred | 2011-12-31 | $3,291,218 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-12-31 | $3,188,055 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-12-31 | $3,309,181 |
| Value of total assets at end of year | 2011-12-31 | $61,007 |
| Value of total assets at beginning of year | 2011-12-31 | $43,018 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-12-31 | $103,163 |
| Total interest from all sources | 2011-12-31 | $26 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-12-31 | No |
| Was this plan covered by a fidelity bond | 2011-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2011-12-31 | No |
| Contributions received from participants | 2011-12-31 | $520,904 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2011-12-31 | $445,139 |
| Administrative expenses (other) incurred | 2011-12-31 | $51,818 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
| Value of net income/loss | 2011-12-31 | $17,989 |
| Value of net assets at end of year (total assets less liabilities) | 2011-12-31 | $61,007 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-12-31 | $43,018 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2011-12-31 | $61,007 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2011-12-31 | $43,018 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2011-12-31 | $43,018 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2011-12-31 | $26 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2011-12-31 | $339,525 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2011-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-12-31 | No |
| Contributions received in cash from employer | 2011-12-31 | $2,343,138 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-12-31 | $2,848,530 |
| Contract administrator fees | 2011-12-31 | $51,345 |
| Did the plan have assets held for investment | 2011-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-12-31 | No |
| Aggregate proceeds on sale of assets | 2011-12-31 | $3,169,461 |
| Aggregate carrying amount (costs) on sale of assets | 2011-12-31 | $3,169,461 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2011-12-31 | Unqualified |
| Accountancy firm name | 2011-12-31 | KPM CPAS, PC |
| Accountancy firm EIN | 2011-12-31 | 431109768 |
| 2010 : OZARKS COCA-COLA/DR PEPPER BOTTLING COMPANY GROUP HEALTH PLAN 2010 401k financial data |
|---|
| Total income from all sources (including contributions) | 2010-12-31 | $3,043,858 |
| Total loss/gain on sale of assets | 2010-12-31 | $0 |
| Total of all expenses incurred | 2010-12-31 | $3,001,790 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2010-12-31 | $2,892,690 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2010-12-31 | $3,043,832 |
| Value of total assets at end of year | 2010-12-31 | $43,018 |
| Value of total assets at beginning of year | 2010-12-31 | $950 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2010-12-31 | $109,100 |
| Total interest from all sources | 2010-12-31 | $26 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2010-12-31 | No |
| Was this plan covered by a fidelity bond | 2010-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2010-12-31 | No |
| Contributions received from participants | 2010-12-31 | $528,808 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2010-12-31 | $144,587 |
| Administrative expenses (other) incurred | 2010-12-31 | $56,717 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
| Value of net income/loss | 2010-12-31 | $42,068 |
| Value of net assets at end of year (total assets less liabilities) | 2010-12-31 | $43,018 |
| Value of net assets at beginning of year (total assets less liabilities) | 2010-12-31 | $950 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2010-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2010-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2010-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2010-12-31 | $43,018 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2010-12-31 | $950 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2010-12-31 | $950 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2010-12-31 | $26 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2010-12-31 | $325,096 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2010-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2010-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2010-12-31 | No |
| Contributions received in cash from employer | 2010-12-31 | $2,370,437 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2010-12-31 | $2,567,594 |
| Contract administrator fees | 2010-12-31 | $52,383 |
| Did the plan have assets held for investment | 2010-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2010-12-31 | No |
| Aggregate proceeds on sale of assets | 2010-12-31 | $2,972,198 |
| Aggregate carrying amount (costs) on sale of assets | 2010-12-31 | $2,972,198 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2010-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2010-12-31 | Unqualified |
| Accountancy firm name | 2010-12-31 | KIRKPATRICK PHILLIPS & MILLER CPAS |
| Accountancy firm EIN | 2010-12-31 | 431109768 |
| SIRIUS AMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 38776 ) |
| Policy contract number | ESL109122 |
| Policy instance | 5 |
| Insurance contract or identification number | ESL109122 | | Number of Individuals Covered | 687 | | Insurance policy start date | 2022-08-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $67,861 | | Welfare Benefit Premiums Paid to Carrier | USD $519,852 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $67,861 |
|
| IRONSHORE INDEMNITY INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | ERR000391-03 |
| Policy instance | 4 |
| Insurance contract or identification number | ERR000391-03 | | Number of Individuals Covered | 687 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-07-31 | | Total amount of commissions paid to insurance broker | USD $101,189 | | Welfare Benefit Premiums Paid to Carrier | USD $779,504 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $101,189 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860050687 |
| Policy instance | 3 |
| Insurance contract or identification number | 000860050687 | | Number of Individuals Covered | 378 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $8,448 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $76,031 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,448 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 0000860056195 |
| Policy instance | 2 |
| Insurance contract or identification number | 0000860056195 | | Number of Individuals Covered | 218 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $2,994 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $26,943 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,994 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860056196 |
| Policy instance | 1 |
| Insurance contract or identification number | 000860056196 | | Number of Individuals Covered | 686 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $1,898 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,082 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,898 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860056196 |
| Policy instance | 1 |
| Insurance contract or identification number | 000860056196 | | Number of Individuals Covered | 613 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $1,927 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,340 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,927 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 0000860056195 |
| Policy instance | 2 |
| Insurance contract or identification number | 0000860056195 | | Number of Individuals Covered | 199 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $2,800 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $25,202 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,800 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860050687 |
| Policy instance | 3 |
| Insurance contract or identification number | 000860050687 | | Number of Individuals Covered | 613 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $7,599 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $68,396 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,599 | | Insurance broker organization code? | 3 |
|
| IRONSHORE INDEMNITY INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | ERR000391-03 |
| Policy instance | 4 |
| Insurance contract or identification number | ERR000391-03 | | Number of Individuals Covered | 614 | | Insurance policy start date | 2021-08-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $65,842 | | Welfare Benefit Premiums Paid to Carrier | USD $532,703 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $65,842 | | Insurance broker organization code? | 3 |
|
| IRONSHORE INDEMNITY INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | ERR000391-02 |
| Policy instance | 5 |
| Insurance contract or identification number | ERR000391-02 | | Number of Individuals Covered | 614 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-07-31 | | Total amount of commissions paid to insurance broker | USD $88,175 | | Welfare Benefit Premiums Paid to Carrier | USD $713,451 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $88,175 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860056196 |
| Policy instance | 1 |
| Insurance contract or identification number | 000860056196 | | Number of Individuals Covered | 626 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $1,838 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $18,380 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,838 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 0000860056195 |
| Policy instance | 2 |
| Insurance contract or identification number | 0000860056195 | | Number of Individuals Covered | 202 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $2,871 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $28,715 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,871 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860050687 |
| Policy instance | 3 |
| Insurance contract or identification number | 000860050687 | | Number of Individuals Covered | 631 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $7,915 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $79,150 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,915 | | Insurance broker organization code? | 3 |
|
| IRONSHORE INDEMNITY INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | ERR000391-01 |
| Policy instance | 4 |
| Insurance contract or identification number | ERR000391-01 | | Number of Individuals Covered | 642 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-07-31 | | Total amount of commissions paid to insurance broker | USD $75,205 | | Welfare Benefit Premiums Paid to Carrier | USD $550,086 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $75,205 | | Insurance broker organization code? | 3 |
|
| IRONSHORE INDEMNITY INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | ERR000391-02 |
| Policy instance | 5 |
| Insurance contract or identification number | ERR000391-02 | | Number of Individuals Covered | 642 | | Insurance policy start date | 2020-08-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $75,256 | | Welfare Benefit Premiums Paid to Carrier | USD $527,974 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $75,256 |
|
| AMERICAN NATIONAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60739 ) |
| Policy contract number | ANTX-44261 |
| Policy instance | 1 |
| Insurance contract or identification number | ANTX-44261 | | Number of Individuals Covered | 611 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-07-31 | | Total amount of commissions paid to insurance broker | USD $75,202 | | Welfare Benefit Premiums Paid to Carrier | USD $503,264 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $75,202 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860056196 |
| Policy instance | 2 |
| Insurance contract or identification number | 000860056196 | | Number of Individuals Covered | 623 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $1,763 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,630 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,763 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860050687 |
| Policy instance | 4 |
| Insurance contract or identification number | 000860050687 | | Number of Individuals Covered | 614 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $7,136 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $71,360 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,136 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 0000860056195 |
| Policy instance | 3 |
| Insurance contract or identification number | 0000860056195 | | Number of Individuals Covered | 204 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $2,650 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $26,501 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,650 | | Insurance broker organization code? | 3 |
|
| IRONSHORE INDEMNITY INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | ERR000391-01 |
| Policy instance | 5 |
| Insurance contract or identification number | ERR000391-01 | | Number of Individuals Covered | 611 | | Insurance policy start date | 2019-08-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $56,650 | | Welfare Benefit Premiums Paid to Carrier | USD $379,069 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $56,650 | | Insurance broker organization code? | 3 |
|
| AMERICAN NATIONAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60739 ) |
| Policy contract number | ANTX-44261 |
| Policy instance | 1 |
| Insurance contract or identification number | ANTX-44261 | | Number of Individuals Covered | 593 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $126,526 | | Welfare Benefit Premiums Paid to Carrier | USD $846,861 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $126,526 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860056196 |
| Policy instance | 2 |
| Insurance contract or identification number | 000860056196 | | Number of Individuals Covered | 580 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $1,686 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,858 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,686 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 0000860056195 |
| Policy instance | 3 |
| Insurance contract or identification number | 0000860056195 | | Number of Individuals Covered | 203 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $2,621 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $26,211 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,621 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860050687 |
| Policy instance | 4 |
| Insurance contract or identification number | 000860050687 | | Number of Individuals Covered | 588 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $6,821 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $68,207 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,821 | | Insurance broker organization code? | 3 |
|
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | 406101A |
| Policy instance | 5 |
| Insurance contract or identification number | 406101A | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-07-01 | | Total amount of commissions paid to insurance broker | USD $52,951 | | Welfare Benefit Premiums Paid to Carrier | USD $354,471 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $52,951 | | Insurance broker organization code? | 3 | | Insurance broker name | MED-PAY, INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860050687 |
| Policy instance | 4 |
| Insurance contract or identification number | 000860050687 | | Number of Individuals Covered | 591 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $6,050 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $60,501 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,050 | | Insurance broker organization code? | 3 | | Insurance broker name | MED-PAY, INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 0000860056195 |
| Policy instance | 3 |
| Insurance contract or identification number | 0000860056195 | | Number of Individuals Covered | 191 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $2,363 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $23,627 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,363 | | Insurance broker organization code? | 3 | | Insurance broker name | MED-PAY, INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860056196 |
| Policy instance | 2 |
| Insurance contract or identification number | 000860056196 | | Number of Individuals Covered | 554 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $1,359 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $13,593 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,359 | | Insurance broker organization code? | 3 | | Insurance broker name | MED-PAY, INC. |
|
| AMERICAN NATIONAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60739 ) |
| Policy contract number | ANTX-44261 |
| Policy instance | 1 |
| Insurance contract or identification number | ANTX-44261 | | Number of Individuals Covered | 560 | | Insurance policy start date | 2017-08-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $50,157 | | Welfare Benefit Premiums Paid to Carrier | USD $293,395 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $50,157 | | Insurance broker organization code? | 3 | | Insurance broker name | MED-PAY, INC. |
|
| QBE INSURANCE (National Association of Insurance Commissioners NAIC id number: 10219 ) |
| Policy contract number | LGS00870-15 |
| Policy instance | 1 |
| Insurance contract or identification number | LGS00870-15 | | Number of Individuals Covered | 373 | | Insurance policy start date | 2014-08-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $81,627 | | Welfare Benefit Premiums Paid to Carrier | USD $210,688 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $81,627 | | Insurance broker organization code? | 3 | | Insurance broker name | MED-PAY, INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860056196 |
| Policy instance | 2 |
| Insurance contract or identification number | 000860056196 | | Number of Individuals Covered | 242 | | Insurance policy start date | 2014-08-01 | | Insurance policy end date | 2015-07-31 | | Total amount of commissions paid to insurance broker | USD $718 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,183 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $718 | | Insurance broker organization code? | 3 | | Insurance broker name | MED-PAY, INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 0000860050687 |
| Policy instance | 4 |
| Insurance contract or identification number | 0000860050687 | | Number of Individuals Covered | 242 | | Insurance policy start date | 2014-08-01 | | Insurance policy end date | 2015-07-31 | | Total amount of commissions paid to insurance broker | USD $2,212 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $22,118 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,212 | | Insurance broker organization code? | 3 | | Insurance broker name | MED-PAY, INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 0000860050687 |
| Policy instance | 5 |
| Insurance contract or identification number | 0000860050687 | | Number of Individuals Covered | 369 | | Insurance policy start date | 2015-08-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $1,099 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $10,993 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,099 | | Insurance broker organization code? | 3 | | Insurance broker name | MED-PAY, INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860056195 |
| Policy instance | 6 |
| Insurance contract or identification number | 000860056195 | | Number of Individuals Covered | 93 | | Insurance policy start date | 2014-08-01 | | Insurance policy end date | 2015-07-31 | | Total amount of commissions paid to insurance broker | USD $1,138 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $11,382 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,138 | | Insurance broker organization code? | 3 | | Insurance broker name | MED-PAY, INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860056195 |
| Policy instance | 7 |
| Insurance contract or identification number | 000860056195 | | Number of Individuals Covered | 140 | | Insurance policy start date | 2015-08-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $558 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $5,577 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $558 | | Insurance broker organization code? | 3 | | Insurance broker name | MED-PAY, INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860056196 |
| Policy instance | 3 |
| Insurance contract or identification number | 000860056196 | | Number of Individuals Covered | 369 | | Insurance policy start date | 2015-08-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $356 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,557 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $356 | | Insurance broker organization code? | 3 | | Insurance broker name | MED-PAY, INC. |
|
| QBE INSURANCE (National Association of Insurance Commissioners NAIC id number: 10219 ) |
| Policy contract number | LGS00870-12 |
| Policy instance | 1 |
| Insurance contract or identification number | LGS00870-12 | | Number of Individuals Covered | 256 | | Insurance policy start date | 2013-08-01 | | Insurance policy end date | 2014-07-31 | | Total amount of commissions paid to insurance broker | USD $48,251 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $355,967 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $48,251 | | Insurance broker organization code? | 3 | | Insurance broker name | MED-PAY, INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860056195-00 |
| Policy instance | 2 |
| Insurance contract or identification number | 000860056195-00 | | Number of Individuals Covered | 93 | | Insurance policy start date | 2013-08-01 | | Insurance policy end date | 2014-07-31 | | Total amount of commissions paid to insurance broker | USD $1,153 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $2,473 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,153 | | Insurance broker organization code? | 3 | | Insurance broker name | MED-PAY, INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860056196-00 |
| Policy instance | 3 |
| Insurance contract or identification number | 000860056196-00 | | Number of Individuals Covered | 244 | | Insurance policy start date | 2013-08-01 | | Insurance policy end date | 2014-07-31 | | Total amount of commissions paid to insurance broker | USD $718 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,186 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $718 | | Insurance broker organization code? | 3 | | Insurance broker name | MED-PAY, INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860050687-00 |
| Policy instance | 4 |
| Insurance contract or identification number | 000860050687-00 | | Number of Individuals Covered | 244 | | Insurance policy start date | 2013-08-01 | | Insurance policy end date | 2014-07-31 | | Total amount of commissions paid to insurance broker | USD $2,336 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $25,230 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,336 | | Insurance broker organization code? | 3 | | Insurance broker name | MED-PAY, INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860050687-00 |
| Policy instance | 4 |
| Insurance contract or identification number | 000860050687-00 | | Number of Individuals Covered | 233 | | Insurance policy start date | 2012-08-01 | | Insurance policy end date | 2013-07-31 | | Total amount of commissions paid to insurance broker | USD $2,238 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $22,337 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,238 | | Insurance broker organization code? | 3 | | Insurance broker name | MED-PAY, INC. |
|
| QBE INSURANCE (National Association of Insurance Commissioners NAIC id number: 10219 ) |
| Policy contract number | LGS00870-12 |
| Policy instance | 1 |
| Insurance contract or identification number | LGS00870-12 | | Number of Individuals Covered | 251 | | Insurance policy start date | 2012-08-01 | | Insurance policy end date | 2013-07-31 | | Total amount of commissions paid to insurance broker | USD $46,118 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $309,414 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $46,118 | | Insurance broker organization code? | 3 | | Insurance broker name | MED-PAY, INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860056195-00 |
| Policy instance | 2 |
| Insurance contract or identification number | 000860056195-00 | | Number of Individuals Covered | 90 | | Insurance policy start date | 2012-08-01 | | Insurance policy end date | 2013-07-31 | | Total amount of commissions paid to insurance broker | USD $1,125 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $11,241 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,125 | | Insurance broker organization code? | 3 | | Insurance broker name | MED-PAY, INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860056196-00 |
| Policy instance | 3 |
| Insurance contract or identification number | 000860056196-00 | | Number of Individuals Covered | 233 | | Insurance policy start date | 2012-08-01 | | Insurance policy end date | 2013-07-31 | | Total amount of commissions paid to insurance broker | USD $681 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,811 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $681 | | Insurance broker organization code? | 3 | | Insurance broker name | MED-PAY, INC. |
|
| AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) |
| Policy contract number | A1086-9 |
| Policy instance | 1 |
| Insurance contract or identification number | A1086-9 | | Number of Individuals Covered | 236 | | Insurance policy start date | 2011-08-01 | | Insurance policy end date | 2012-07-31 | | Total amount of commissions paid to insurance broker | USD $50,139 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $321,701 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $50,139 | | Insurance broker organization code? | 3 | | Insurance broker name | MED-PAY, INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860056195-00 |
| Policy instance | 2 |
| Insurance contract or identification number | 000860056195-00 | | Number of Individuals Covered | 89 | | Insurance policy start date | 2011-08-01 | | Insurance policy end date | 2012-07-31 | | Total amount of commissions paid to insurance broker | USD $1,128 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $11,275 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,128 | | Insurance broker organization code? | 3 | | Insurance broker name | MED-PAY, INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860056196-00 |
| Policy instance | 3 |
| Insurance contract or identification number | 000860056196-00 | | Number of Individuals Covered | 225 | | Insurance policy start date | 2011-08-01 | | Insurance policy end date | 2012-07-31 | | Total amount of commissions paid to insurance broker | USD $694 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,943 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $694 | | Insurance broker organization code? | 3 | | Insurance broker name | MED-PAY, INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860050687-00 |
| Policy instance | 4 |
| Insurance contract or identification number | 000860050687-00 | | Number of Individuals Covered | 223 | | Insurance policy start date | 2011-08-01 | | Insurance policy end date | 2012-07-31 | | Total amount of commissions paid to insurance broker | USD $2,295 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $20,656 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,295 | | Insurance broker organization code? | 3 | | Insurance broker name | MED-PAY, INC. |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860056195-00 |
| Policy instance | 2 |
| Insurance contract or identification number | 000860056195-00 | | Number of Individuals Covered | 89 | | Insurance policy start date | 2010-08-01 | | Insurance policy end date | 2011-07-31 | | Total amount of commissions paid to insurance broker | USD $1,131 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $10,183 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) |
| Policy contract number | A1086-9 |
| Policy instance | 1 |
| Insurance contract or identification number | A1086-9 | | Number of Individuals Covered | 246 | | Insurance policy start date | 2010-08-01 | | Insurance policy end date | 2011-07-31 | | Total amount of commissions paid to insurance broker | USD $47,625 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $301,783 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860050687-00 |
| Policy instance | 4 |
| Insurance contract or identification number | 000860050687-00 | | Number of Individuals Covered | 233 | | Insurance policy start date | 2010-08-01 | | Insurance policy end date | 2011-07-31 | | Total amount of commissions paid to insurance broker | USD $2,347 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $21,125 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860056196-00 |
| Policy instance | 3 |
| Insurance contract or identification number | 000860056196-00 | | Number of Individuals Covered | 238 | | Insurance policy start date | 2010-08-01 | | Insurance policy end date | 2011-07-31 | | Total amount of commissions paid to insurance broker | USD $715 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,434 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) |
| Policy contract number | A1086-9 |
| Policy instance | 1 |
| Insurance contract or identification number | A1086-9 | | Number of Individuals Covered | 249 | | Insurance policy start date | 2009-08-01 | | Insurance policy end date | 2010-07-31 | | Total amount of commissions paid to insurance broker | USD $51,518 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $286,623 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860056195-00 |
| Policy instance | 2 |
| Insurance contract or identification number | 000860056195-00 | | Number of Individuals Covered | 88 | | Insurance policy start date | 2009-08-01 | | Insurance policy end date | 2010-07-31 | | Total amount of commissions paid to insurance broker | USD $1,339 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $9,864 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860050687-00 |
| Policy instance | 4 |
| Insurance contract or identification number | 000860050687-00 | | Number of Individuals Covered | 244 | | Insurance policy start date | 2009-08-01 | | Insurance policy end date | 2010-07-31 | | Total amount of commissions paid to insurance broker | USD $2,853 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $21,019 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000860056196-00 |
| Policy instance | 3 |
| Insurance contract or identification number | 000860056196-00 | | Number of Individuals Covered | 245 | | Insurance policy start date | 2009-08-01 | | Insurance policy end date | 2010-07-31 | | Total amount of commissions paid to insurance broker | USD $1,007 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,590 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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