401k Plan data: WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN plan

WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 401k Plan overview

Plan Name	WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN
Plan identification number	001

WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Participant-directed brokerage accounts provided as an investment option under the plan.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

WOOD RIVER INSURANCE, INC. has sponsored the creation of one or more 401k plans.

Company Name: WOOD RIVER INSURANCE, INC.

Employer identification number (EIN): 461400466

NAIC Classification: 524210
NAIC Description: Insurance Agencies and Brokerages

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2016-01-01 MARK S. BALCOS
001 2015-01-01 MARK S. BALCOS
001 2014-01-01 MARK S. BALCOS
001 2013-01-01 MARK S. BALCOS

Plan id#	Filing Submission Date	Name of Administrator
001	2016-01-01	MARK S. BALCOS
001	2015-01-01	MARK S. BALCOS
001	2014-01-01	MARK S. BALCOS
001	2013-01-01	MARK S. BALCOS

Plan Statistics for WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN

401k plan membership statisitcs for WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN

Measure Date Value
2016: WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 12
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 0
Number of participants with account balances 2016-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 11
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 10
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 2
Total of all active and inactive participants 2015-01-01 12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 12
Number of participants with account balances 2015-01-01 12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 10
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 9
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 2
Total of all active and inactive participants 2014-01-01 11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 11
Number of participants with account balances 2014-01-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 9
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 7
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 3
Total of all active and inactive participants 2013-01-01 10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 10
Number of participants with account balances 2013-01-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0

Measure	Date	Value
2016: WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	12
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	0
Number of participants with account balances	2016-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	11
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	10
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	2
Total of all active and inactive participants	2015-01-01	12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	12
Number of participants with account balances	2015-01-01	12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	10
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	9
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	2
Total of all active and inactive participants	2014-01-01	11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	11
Number of participants with account balances	2014-01-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	9
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	7
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	3
Total of all active and inactive participants	2013-01-01	10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	10
Number of participants with account balances	2013-01-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0

Financial Data on WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN

Measure	Date	Value
2016 : WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 2016 401k financial data
Transfers to/from the plan	2016-12-31	$0
Total plan liabilities at end of year	2016-12-31	$0
Total plan liabilities at beginning of year	2016-12-31	$0
Total income from all sources	2016-12-31	$53,490
Expenses. Total of all expenses incurred	2016-12-31	$286,313
Benefits paid (including direct rollovers)	2016-12-31	$285,633
Total plan assets at end of year	2016-12-31	$0
Total plan assets at beginning of year	2016-12-31	$232,823
Value of fidelity bond covering the plan	2016-12-31	$100,000
Total contributions received or receivable from participants	2016-12-31	$34,980
Expenses. Other expenses not covered elsewhere	2016-12-31	$0
Contributions received from other sources (not participants or employers)	2016-12-31	$0
Other income received	2016-12-31	$5,800
Noncash contributions received	2016-12-31	$0
Net income (gross income less expenses)	2016-12-31	$-232,823
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$232,823
Total contributions received or receivable from employer(s)	2016-12-31	$12,710
Value of certain deemed distributions of participant loans	2016-12-31	$0
Value of corrective distributions	2016-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$680
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 2015 401k financial data
Transfers to/from the plan	2015-12-31	$0
Total plan liabilities at end of year	2015-12-31	$0
Total plan liabilities at beginning of year	2015-12-31	$0
Total income from all sources	2015-12-31	$48,191
Expenses. Total of all expenses incurred	2015-12-31	$171,965
Benefits paid (including direct rollovers)	2015-12-31	$171,856
Total plan assets at end of year	2015-12-31	$232,823
Total plan assets at beginning of year	2015-12-31	$356,597
Value of fidelity bond covering the plan	2015-12-31	$100,000
Total contributions received or receivable from participants	2015-12-31	$36,500
Expenses. Other expenses not covered elsewhere	2015-12-31	$0
Contributions received from other sources (not participants or employers)	2015-12-31	$0
Other income received	2015-12-31	$-2,312
Noncash contributions received	2015-12-31	$0
Net income (gross income less expenses)	2015-12-31	$-123,774
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$232,823
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$356,597
Total contributions received or receivable from employer(s)	2015-12-31	$14,003
Value of certain deemed distributions of participant loans	2015-12-31	$0
Value of corrective distributions	2015-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$109
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 2014 401k financial data
Transfers to/from the plan	2014-12-31	$0
Total plan liabilities at end of year	2014-12-31	$0
Total plan liabilities at beginning of year	2014-12-31	$1,526
Total income from all sources	2014-12-31	$49,844
Expenses. Total of all expenses incurred	2014-12-31	$200,075
Benefits paid (including direct rollovers)	2014-12-31	$200,000
Total plan assets at end of year	2014-12-31	$356,597
Total plan assets at beginning of year	2014-12-31	$508,354
Value of fidelity bond covering the plan	2014-12-31	$100,000
Total contributions received or receivable from participants	2014-12-31	$23,080
Expenses. Other expenses not covered elsewhere	2014-12-31	$0
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$24,964
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$-150,231
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$356,597
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$506,828
Total contributions received or receivable from employer(s)	2014-12-31	$1,800
Value of certain deemed distributions of participant loans	2014-12-31	$0
Value of corrective distributions	2014-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$75
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 2013 401k financial data
Transfers to/from the plan	2013-12-31	$0
Total plan liabilities at end of year	2013-12-31	$1,526
Total plan liabilities at beginning of year	2013-12-31	$0
Total income from all sources	2013-12-31	$52,483
Expenses. Total of all expenses incurred	2013-12-31	$568,828
Benefits paid (including direct rollovers)	2013-12-31	$567,384
Total plan assets at end of year	2013-12-31	$508,354
Total plan assets at beginning of year	2013-12-31	$1,023,173
Value of fidelity bond covering the plan	2013-12-31	$1,000,000
Total contributions received or receivable from participants	2013-12-31	$4,800
Expenses. Other expenses not covered elsewhere	2013-12-31	$0
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$47,683
Noncash contributions received	2013-12-31	$0
Net income (gross income less expenses)	2013-12-31	$-516,345
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$506,828
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$1,023,173
Total contributions received or receivable from employer(s)	2013-12-31	$0
Value of certain deemed distributions of participant loans	2013-12-31	$0
Value of corrective distributions	2013-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$1,444
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0

Form 5500 Responses for WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN

2016: WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	Yes
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: WOOD RIVER INSURANCE, INC. PROFIT SHARING 401K PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	WOOD RIVER INSURANCE, INC.
Employer identification number (EIN):	461400466
NAIC Classification:	524210
NAIC Description:	Insurance Agencies and Brokerages