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JENSEN INTERNATIONAL, INC. SAVINGS & RETIREMENT 401(K) PLAN & TRUST 401k Plan overview

Plan NameJENSEN INTERNATIONAL, INC. SAVINGS & RETIREMENT 401(K) PLAN & TRUST
Plan identification number 001

JENSEN INTERNATIONAL, INC. SAVINGS & RETIREMENT 401(K) PLAN & TRUST Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • 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

JENSEN INTERNATIONAL, INC. has sponsored the creation of one or more 401k plans.

Company Name:JENSEN INTERNATIONAL, INC.
Employer identification number (EIN):480921821
NAIC Classification:331200

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JENSEN INTERNATIONAL, INC. SAVINGS & RETIREMENT 401(K) PLAN & TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012015-07-01DIANA S. KNISLEY
0012014-07-01DIANA S. KNISLEY
0012013-07-01DIANA S. KNISLEY DIANA S. KNISLEY2015-04-13
0012012-07-01DIANA S KNISLEY DIANA S KNISLEY2014-04-14
0012011-07-01DIANA S KNISLEY DIANA S KNISLEY2013-04-12
0012009-07-01DIANA KNISLEY DIANA KNISLEY2011-03-22
0012009-07-01DIANA KNISLEY DIANA KNISLEY2011-03-22
0012009-07-01DIANA KNISLEY DIANA KNISLEY2011-03-22
0012009-07-01DIANA KNISLEY DIANA KNISLEY2011-03-22

Plan Statistics for JENSEN INTERNATIONAL, INC. SAVINGS & RETIREMENT 401(K) PLAN & TRUST

401k plan membership statisitcs for JENSEN INTERNATIONAL, INC. SAVINGS & RETIREMENT 401(K) PLAN & TRUST

Measure Date Value
2015: JENSEN INTERNATIONAL, INC. SAVINGS & RETIREMENT 401(K) PLAN & TRUST 2015 401k membership
Total participants, beginning-of-year2015-07-01211
Total number of active participants reported on line 7a of the Form 55002015-07-0199
Number of retired or separated participants receiving benefits2015-07-016
Number of other retired or separated participants entitled to future benefits2015-07-0187
Total of all active and inactive participants2015-07-01192
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-07-010
Total participants2015-07-01192
Number of participants with account balances2015-07-01181
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-07-014
2014: JENSEN INTERNATIONAL, INC. SAVINGS & RETIREMENT 401(K) PLAN & TRUST 2014 401k membership
Total participants, beginning-of-year2014-07-01225
Total number of active participants reported on line 7a of the Form 55002014-07-01138
Number of retired or separated participants receiving benefits2014-07-014
Number of other retired or separated participants entitled to future benefits2014-07-0175
Total of all active and inactive participants2014-07-01217
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-07-010
Total participants2014-07-01217
Number of participants with account balances2014-07-01191
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-07-0117
2013: JENSEN INTERNATIONAL, INC. SAVINGS & RETIREMENT 401(K) PLAN & TRUST 2013 401k membership
Total participants, beginning-of-year2013-07-01188
Total number of active participants reported on line 7a of the Form 55002013-07-01104
Number of retired or separated participants receiving benefits2013-07-014
Number of other retired or separated participants entitled to future benefits2013-07-0182
Total of all active and inactive participants2013-07-01190
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-07-010
Total participants2013-07-01190
Number of participants with account balances2013-07-01185
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-07-016
2012: JENSEN INTERNATIONAL, INC. SAVINGS & RETIREMENT 401(K) PLAN & TRUST 2012 401k membership
Total participants, beginning-of-year2012-07-01204
Total number of active participants reported on line 7a of the Form 55002012-07-01112
Number of retired or separated participants receiving benefits2012-07-010
Number of other retired or separated participants entitled to future benefits2012-07-0172
Total of all active and inactive participants2012-07-01184
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-07-010
Total participants2012-07-01184
Number of participants with account balances2012-07-01172
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-07-016
2011: JENSEN INTERNATIONAL, INC. SAVINGS & RETIREMENT 401(K) PLAN & TRUST 2011 401k membership
Total participants, beginning-of-year2011-07-01168
Total number of active participants reported on line 7a of the Form 55002011-07-01124
Number of retired or separated participants receiving benefits2011-07-010
Number of other retired or separated participants entitled to future benefits2011-07-0157
Total of all active and inactive participants2011-07-01181
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-07-010
Total participants2011-07-01181
Number of participants with account balances2011-07-01170
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-07-015
2009: JENSEN INTERNATIONAL, INC. SAVINGS & RETIREMENT 401(K) PLAN & TRUST 2009 401k membership
Total participants, beginning-of-year2009-07-01149
Total number of active participants reported on line 7a of the Form 55002009-07-01115
Number of retired or separated participants receiving benefits2009-07-010
Number of other retired or separated participants entitled to future benefits2009-07-0129
Total of all active and inactive participants2009-07-01144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-07-010
Total participants2009-07-01144
Number of participants with account balances2009-07-01135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-07-017

Financial Data on JENSEN INTERNATIONAL, INC. SAVINGS & RETIREMENT 401(K) PLAN & TRUST

Measure Date Value
2016 : JENSEN INTERNATIONAL, INC. SAVINGS & RETIREMENT 401(K) PLAN & TRUST 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-06-30$0
Total income from all sources (including contributions)2016-06-30$134,476
Total loss/gain on sale of assets2016-06-30$0
Total of all expenses incurred2016-06-30$354,361
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-06-30$343,186
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-06-30$131,233
Value of total assets at end of year2016-06-30$1,286,823
Value of total assets at beginning of year2016-06-30$1,506,708
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-06-30$11,175
Total interest from all sources2016-06-30$1,527
Total dividends received (eg from common stock, registered investment company shares)2016-06-30$0
Administrative expenses professional fees incurred2016-06-30$11,175
Was this plan covered by a fidelity bond2016-06-30Yes
Value of fidelity bond cover2016-06-30$175,000
If this is an individual account plan, was there a blackout period2016-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-06-30$0
Were there any nonexempt tranactions with any party-in-interest2016-06-30No
Contributions received from participants2016-06-30$111,063
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-06-30No
Value of net income/loss2016-06-30$-219,885
Value of net assets at end of year (total assets less liabilities)2016-06-30$1,286,823
Value of net assets at beginning of year (total assets less liabilities)2016-06-30$1,506,708
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2016-06-30No
Were any leases to which the plan was party in default or uncollectible2016-06-30No
Value of interest in pooled separate accounts at end of year2016-06-30$1,175,852
Value of interest in pooled separate accounts at beginning of year2016-06-30$1,423,690
Interest earned on other investments2016-06-30$1,527
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-06-30$90,801
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-06-30$63,270
Net investment gain/loss from pooled separate accounts2016-06-30$1,716
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-06-30No
Was there a failure to transmit to the plan any participant contributions2016-06-30No
Has the plan failed to provide any benefit when due under the plan2016-06-30No
Contributions received in cash from employer2016-06-30$20,170
Employer contributions (assets) at end of year2016-06-30$20,170
Employer contributions (assets) at beginning of year2016-06-30$19,748
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-06-30$343,186
Did the plan have assets held for investment2016-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-06-30Yes
Opinion of an independent qualified public accountant for this plan2016-06-30Disclaimer
Accountancy firm name2016-06-30PICKETT CHANEY & MCMULLEN LLP
Accountancy firm EIN2016-06-30481246310
2015 : JENSEN INTERNATIONAL, INC. SAVINGS & RETIREMENT 401(K) PLAN & TRUST 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-06-30$0
Total income from all sources (including contributions)2015-06-30$185,894
Total loss/gain on sale of assets2015-06-30$0
Total of all expenses incurred2015-06-30$365,681
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-06-30$365,681
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-06-30$155,976
Value of total assets at end of year2015-06-30$1,506,708
Value of total assets at beginning of year2015-06-30$1,686,495
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-06-30$0
Total interest from all sources2015-06-30$804
Total dividends received (eg from common stock, registered investment company shares)2015-06-30$0
Was this plan covered by a fidelity bond2015-06-30Yes
Value of fidelity bond cover2015-06-30$170,000
If this is an individual account plan, was there a blackout period2015-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-06-30$0
Were there any nonexempt tranactions with any party-in-interest2015-06-30No
Contributions received from participants2015-06-30$136,228
Participant contributions at end of year2015-06-30$0
Participant contributions at beginning of year2015-06-30$4,716
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-06-30No
Value of net income/loss2015-06-30$-179,787
Value of net assets at end of year (total assets less liabilities)2015-06-30$1,506,708
Value of net assets at beginning of year (total assets less liabilities)2015-06-30$1,686,495
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2015-06-30No
Were any leases to which the plan was party in default or uncollectible2015-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-06-30$1,423,690
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-06-30$1,614,359
Interest earned on other investments2015-06-30$804
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-06-30$63,270
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-06-30$43,354
Net investment gain/loss from pooled separate accounts2015-06-30$29,114
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-06-30No
Was there a failure to transmit to the plan any participant contributions2015-06-30No
Has the plan failed to provide any benefit when due under the plan2015-06-30No
Contributions received in cash from employer2015-06-30$19,748
Employer contributions (assets) at end of year2015-06-30$19,748
Employer contributions (assets) at beginning of year2015-06-30$24,066
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-06-30$365,681
Did the plan have assets held for investment2015-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-06-30Yes
Opinion of an independent qualified public accountant for this plan2015-06-30Disclaimer
Accountancy firm name2015-06-30PICKETT CHANEY & MCMULLEN LLP
Accountancy firm EIN2015-06-30481246310
2014 : JENSEN INTERNATIONAL, INC. SAVINGS & RETIREMENT 401(K) PLAN & TRUST 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-06-30$0
Total income from all sources (including contributions)2014-06-30$399,893
Total loss/gain on sale of assets2014-06-30$0
Total of all expenses incurred2014-06-30$369,212
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-06-30$368,612
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-06-30$156,793
Value of total assets at end of year2014-06-30$1,686,495
Value of total assets at beginning of year2014-06-30$1,655,814
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-06-30$600
Total interest from all sources2014-06-30$10,730
Total dividends received (eg from common stock, registered investment company shares)2014-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-06-30No
Was this plan covered by a fidelity bond2014-06-30Yes
Value of fidelity bond cover2014-06-30$170,000
If this is an individual account plan, was there a blackout period2014-06-30Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-06-30$0
Were there any nonexempt tranactions with any party-in-interest2014-06-30No
Contributions received from participants2014-06-30$132,727
Participant contributions at end of year2014-06-30$4,716
Participant contributions at beginning of year2014-06-30$4,746
Other income not declared elsewhere2014-06-30$6,772
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-06-30No
Value of net income/loss2014-06-30$30,681
Value of net assets at end of year (total assets less liabilities)2014-06-30$1,686,495
Value of net assets at beginning of year (total assets less liabilities)2014-06-30$1,655,814
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2014-06-30No
Were any leases to which the plan was party in default or uncollectible2014-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-06-30$1,614,359
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-06-30$1,349,949
Interest earned on other investments2014-06-30$30
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-06-30$10,700
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-06-30$43,354
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-06-30$282,039
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-06-30$208,108
Net investment gain/loss from pooled separate accounts2014-06-30$17,490
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-06-30No
Was there a failure to transmit to the plan any participant contributions2014-06-30No
Has the plan failed to provide any benefit when due under the plan2014-06-30No
Contributions received in cash from employer2014-06-30$24,066
Employer contributions (assets) at end of year2014-06-30$24,066
Employer contributions (assets) at beginning of year2014-06-30$19,080
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-06-30$368,612
Contract administrator fees2014-06-30$600
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-06-30Yes
Did the plan have assets held for investment2014-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-06-30Yes
Opinion of an independent qualified public accountant for this plan2014-06-30Disclaimer
Accountancy firm name2014-06-30PICKETT CHANEY & MCMULLEN LLP
Accountancy firm EIN2014-06-30481246310
2013 : JENSEN INTERNATIONAL, INC. SAVINGS & RETIREMENT 401(K) PLAN & TRUST 2013 401k financial data
Unrealized appreciation/depreciation of real estate assets2013-06-30$0
Unrealized appreciation/depreciation of other (non real estate) assets2013-06-30$0
Total unrealized appreciation/depreciation of assets2013-06-30$0
Total transfer of assets to this plan2013-06-30$0
Total transfer of assets from this plan2013-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-06-30$0
Expenses. Interest paid2013-06-30$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022013-06-30$0
Total income from all sources (including contributions)2013-06-30$341,489
Total loss/gain on sale of assets2013-06-30$0
Total of all expenses incurred2013-06-30$531,804
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-06-30$530,404
Expenses. Certain deemed distributions of participant loans2013-06-30$0
Value of total corrective distributions2013-06-30$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-06-30$152,672
Value of total assets at end of year2013-06-30$1,655,814
Value of total assets at beginning of year2013-06-30$1,846,129
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-06-30$1,400
Total income from rents2013-06-30$0
Total interest from all sources2013-06-30$10,020
Total dividends received (eg from common stock, registered investment company shares)2013-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2013-06-30$0
Assets. Real estate other than employer real property at end of year2013-06-30$0
Assets. Real estate other than employer real property at beginning of year2013-06-30$0
Administrative expenses professional fees incurred2013-06-30$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2013-06-30$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2013-06-30$0
Was this plan covered by a fidelity bond2013-06-30Yes
Value of fidelity bond cover2013-06-30$2,000,000
If this is an individual account plan, was there a blackout period2013-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-06-30$0
Were there any nonexempt tranactions with any party-in-interest2013-06-30No
Contributions received from participants2013-06-30$131,526
Participant contributions at end of year2013-06-30$0
Participant contributions at beginning of year2013-06-30$0
Participant contributions at end of year2013-06-30$4,746
Participant contributions at beginning of year2013-06-30$4,944
Assets. Other investments not covered elsewhere at end of year2013-06-30$0
Assets. Other investments not covered elsewhere at beginning of year2013-06-30$0
Income. Received or receivable in cash from other sources (including rollovers)2013-06-30$2,066
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-06-30$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-06-30$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-06-30$0
Assets. Loans (other than to participants) at end of year2013-06-30$0
Assets. Loans (other than to participants) at beginning of year2013-06-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-06-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-06-30$0
Other income not declared elsewhere2013-06-30$0
Administrative expenses (other) incurred2013-06-30$1,400
Liabilities. Value of operating payables at end of year2013-06-30$0
Liabilities. Value of operating payables at beginning of year2013-06-30$0
Total non interest bearing cash at end of year2013-06-30$0
Total non interest bearing cash at beginning of year2013-06-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-06-30No
Income. Non cash contributions2013-06-30$0
Value of net income/loss2013-06-30$-190,315
Value of net assets at end of year (total assets less liabilities)2013-06-30$1,655,814
Value of net assets at beginning of year (total assets less liabilities)2013-06-30$1,846,129
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2013-06-30No
Were any leases to which the plan was party in default or uncollectible2013-06-30No
Assets. partnership/joint venture interests at end of year2013-06-30$0
Assets. partnership/joint venture interests at beginning of year2013-06-30$0
Investment advisory and management fees2013-06-30$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-06-30$1,349,949
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-06-30$1,386,327
Value of interest in pooled separate accounts at end of year2013-06-30$0
Value of interest in pooled separate accounts at beginning of year2013-06-30$0
Interest on participant loans2013-06-30$0
Income. Interest from loans (other than to participants)2013-06-30$0
Interest earned on other investments2013-06-30$0
Income. Interest from US Government securities2013-06-30$0
Income. Interest from corporate debt instruments2013-06-30$0
Value of interest in master investment trust accounts at end of year2013-06-30$0
Value of interest in master investment trust accounts at beginning of year2013-06-30$0
Value of interest in common/collective trusts at end of year2013-06-30$0
Value of interest in common/collective trusts at beginning of year2013-06-30$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-06-30$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-06-30$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-06-30$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-06-30$10,020
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-06-30$282,039
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-06-30$435,108
Expenses. Payments to insurance carriers foe the provision of benefits2013-06-30$0
Asset value of US Government securities at end of year2013-06-30$0
Asset value of US Government securities at beginning of year2013-06-30$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-06-30$178,797
Net investment gain/loss from pooled separate accounts2013-06-30$0
Net investment gain or loss from common/collective trusts2013-06-30$0
Net gain/loss from 103.12 investment entities2013-06-30$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-06-30No
Was there a failure to transmit to the plan any participant contributions2013-06-30No
Has the plan failed to provide any benefit when due under the plan2013-06-30No
Assets. Invements in employer securities at end of year2013-06-30$0
Assets. Invements in employer securities at beginning of year2013-06-30$0
Assets. Value of employer real property at end of year2013-06-30$0
Assets. Value of employer real property at beginning of year2013-06-30$0
Contributions received in cash from employer2013-06-30$19,080
Employer contributions (assets) at end of year2013-06-30$19,080
Employer contributions (assets) at beginning of year2013-06-30$19,750
Income. Dividends from preferred stock2013-06-30$0
Income. Dividends from common stock2013-06-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-06-30$530,404
Asset. Corporate debt instrument preferred debt at end of year2013-06-30$0
Asset. Corporate debt instrument preferred debt at beginning of year2013-06-30$0
Asset. Corporate debt instrument debt (other) at end of year2013-06-30$0
Asset. Corporate debt instrument debt (other) at beginning of year2013-06-30$0
Contract administrator fees2013-06-30$0
Assets. Corporate common stocks other than exployer securities at end of year2013-06-30$0
Assets. Corporate common stocks other than exployer securities at beginning of year2013-06-30$0
Liabilities. Value of benefit claims payable at end of year2013-06-30$0
Liabilities. Value of benefit claims payable at beginning of year2013-06-30$0
Assets. Value of buildings and other operty used in plan operation at end of year2013-06-30$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2013-06-30$0
Did the plan have assets held for investment2013-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-06-30No
Aggregate proceeds on sale of assets2013-06-30$0
Aggregate carrying amount (costs) on sale of assets2013-06-30$0
Liabilities. Value of acquisition indebtedness at end of year2013-06-30$0
Liabilities. Value of acquisition indebtedness at beginning of year2013-06-30$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-06-30Yes
Opinion of an independent qualified public accountant for this plan2013-06-30Disclaimer
Accountancy firm name2013-06-30PICKETT CHANEY & MCMULLEN LLP
Accountancy firm EIN2013-06-30481246310
2012 : JENSEN INTERNATIONAL, INC. SAVINGS & RETIREMENT 401(K) PLAN & TRUST 2012 401k financial data
Unrealized appreciation/depreciation of real estate assets2012-06-30$0
Unrealized appreciation/depreciation of other (non real estate) assets2012-06-30$0
Total unrealized appreciation/depreciation of assets2012-06-30$0
Total transfer of assets to this plan2012-06-30$0
Total transfer of assets from this plan2012-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-06-30$0
Expenses. Interest paid2012-06-30$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022012-06-30$0
Total income from all sources (including contributions)2012-06-30$161,220
Total loss/gain on sale of assets2012-06-30$0
Total of all expenses incurred2012-06-30$128,202
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-06-30$127,442
Expenses. Certain deemed distributions of participant loans2012-06-30$0
Value of total corrective distributions2012-06-30$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-06-30$155,341
Value of total assets at end of year2012-06-30$1,846,129
Value of total assets at beginning of year2012-06-30$1,813,111
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-06-30$760
Total income from rents2012-06-30$0
Total interest from all sources2012-06-30$15,126
Total dividends received (eg from common stock, registered investment company shares)2012-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2012-06-30$0
Assets. Real estate other than employer real property at end of year2012-06-30$0
Assets. Real estate other than employer real property at beginning of year2012-06-30$0
Administrative expenses professional fees incurred2012-06-30$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2012-06-30$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2012-06-30$0
Was this plan covered by a fidelity bond2012-06-30Yes
Value of fidelity bond cover2012-06-30$2,000,000
If this is an individual account plan, was there a blackout period2012-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-06-30$0
Were there any nonexempt tranactions with any party-in-interest2012-06-30No
Contributions received from participants2012-06-30$135,591
Participant contributions at end of year2012-06-30$0
Participant contributions at beginning of year2012-06-30$0
Participant contributions at end of year2012-06-30$4,944
Participant contributions at beginning of year2012-06-30$4,734
Assets. Other investments not covered elsewhere at end of year2012-06-30$0
Assets. Other investments not covered elsewhere at beginning of year2012-06-30$0
Income. Received or receivable in cash from other sources (including rollovers)2012-06-30$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2012-06-30$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-06-30$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-06-30$0
Assets. Loans (other than to participants) at end of year2012-06-30$0
Assets. Loans (other than to participants) at beginning of year2012-06-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-06-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-06-30$0
Other income not declared elsewhere2012-06-30$0
Administrative expenses (other) incurred2012-06-30$760
Liabilities. Value of operating payables at end of year2012-06-30$0
Liabilities. Value of operating payables at beginning of year2012-06-30$0
Total non interest bearing cash at end of year2012-06-30$0
Total non interest bearing cash at beginning of year2012-06-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-06-30No
Income. Non cash contributions2012-06-30$0
Value of net income/loss2012-06-30$33,018
Value of net assets at end of year (total assets less liabilities)2012-06-30$1,846,129
Value of net assets at beginning of year (total assets less liabilities)2012-06-30$1,813,111
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2012-06-30No
Were any leases to which the plan was party in default or uncollectible2012-06-30No
Assets. partnership/joint venture interests at end of year2012-06-30$0
Assets. partnership/joint venture interests at beginning of year2012-06-30$0
Investment advisory and management fees2012-06-30$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-06-30$1,386,327
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-06-30$1,331,285
Value of interest in pooled separate accounts at end of year2012-06-30$0
Value of interest in pooled separate accounts at beginning of year2012-06-30$0
Interest on participant loans2012-06-30$0
Income. Interest from loans (other than to participants)2012-06-30$0
Interest earned on other investments2012-06-30$0
Income. Interest from US Government securities2012-06-30$0
Income. Interest from corporate debt instruments2012-06-30$0
Value of interest in master investment trust accounts at end of year2012-06-30$0
Value of interest in master investment trust accounts at beginning of year2012-06-30$0
Value of interest in common/collective trusts at end of year2012-06-30$0
Value of interest in common/collective trusts at beginning of year2012-06-30$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-06-30$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-06-30$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-06-30$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-06-30$15,126
Assets. Value of investments in 103.12 investment entities at end of year2012-06-30$0
Assets. Value of investments in 103.12 investment entities at beginning of year2012-06-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-06-30$435,108
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-06-30$455,536
Expenses. Payments to insurance carriers foe the provision of benefits2012-06-30$0
Asset value of US Government securities at end of year2012-06-30$0
Asset value of US Government securities at beginning of year2012-06-30$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-06-30$-9,247
Net investment gain/loss from pooled separate accounts2012-06-30$0
Net investment gain or loss from common/collective trusts2012-06-30$0
Net gain/loss from 103.12 investment entities2012-06-30$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-06-30No
Was there a failure to transmit to the plan any participant contributions2012-06-30No
Has the plan failed to provide any benefit when due under the plan2012-06-30No
Assets. Invements in employer securities at end of year2012-06-30$0
Assets. Invements in employer securities at beginning of year2012-06-30$0
Assets. Value of employer real property at end of year2012-06-30$0
Assets. Value of employer real property at beginning of year2012-06-30$0
Contributions received in cash from employer2012-06-30$19,750
Employer contributions (assets) at end of year2012-06-30$19,750
Employer contributions (assets) at beginning of year2012-06-30$21,556
Income. Dividends from preferred stock2012-06-30$0
Income. Dividends from common stock2012-06-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-06-30$127,442
Asset. Corporate debt instrument preferred debt at end of year2012-06-30$0
Asset. Corporate debt instrument preferred debt at beginning of year2012-06-30$0
Asset. Corporate debt instrument debt (other) at end of year2012-06-30$0
Asset. Corporate debt instrument debt (other) at beginning of year2012-06-30$0
Contract administrator fees2012-06-30$0
Assets. Corporate common stocks other than exployer securities at end of year2012-06-30$0
Assets. Corporate common stocks other than exployer securities at beginning of year2012-06-30$0
Liabilities. Value of benefit claims payable at end of year2012-06-30$0
Liabilities. Value of benefit claims payable at beginning of year2012-06-30$0
Assets. Value of buildings and other operty used in plan operation at end of year2012-06-30$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2012-06-30$0
Did the plan have assets held for investment2012-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-06-30No
Aggregate proceeds on sale of assets2012-06-30$0
Aggregate carrying amount (costs) on sale of assets2012-06-30$0
Liabilities. Value of acquisition indebtedness at end of year2012-06-30$0
Liabilities. Value of acquisition indebtedness at beginning of year2012-06-30$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-06-30Yes
Opinion of an independent qualified public accountant for this plan2012-06-30Disclaimer
Accountancy firm name2012-06-30PICKETT CHANEY & MCMULLEN LLP
Accountancy firm EIN2012-06-30481246310
2011 : JENSEN INTERNATIONAL, INC. SAVINGS & RETIREMENT 401(K) PLAN & TRUST 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-06-30$0
Total income from all sources (including contributions)2011-06-30$446,400
Total loss/gain on sale of assets2011-06-30$0
Total of all expenses incurred2011-06-30$419,610
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-06-30$418,730
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-06-30$163,838
Value of total assets at end of year2011-06-30$1,813,111
Value of total assets at beginning of year2011-06-30$1,786,321
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-06-30$880
Total interest from all sources2011-06-30$21,897
Total dividends received (eg from common stock, registered investment company shares)2011-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-06-30No
Was this plan covered by a fidelity bond2011-06-30Yes
Value of fidelity bond cover2011-06-30$2,000,000
If this is an individual account plan, was there a blackout period2011-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-06-30$0
Were there any nonexempt tranactions with any party-in-interest2011-06-30No
Contributions received from participants2011-06-30$142,282
Participant contributions at end of year2011-06-30$4,734
Participant contributions at beginning of year2011-06-30$0
Administrative expenses (other) incurred2011-06-30$880
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-06-30No
Value of net income/loss2011-06-30$26,790
Value of net assets at end of year (total assets less liabilities)2011-06-30$1,813,111
Value of net assets at beginning of year (total assets less liabilities)2011-06-30$1,786,321
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2011-06-30No
Were any leases to which the plan was party in default or uncollectible2011-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-06-30$1,331,285
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-06-30$1,095,540
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-06-30$21,897
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-06-30$455,536
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-06-30$666,554
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-06-30$260,665
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-06-30No
Was there a failure to transmit to the plan any participant contributions2011-06-30No
Has the plan failed to provide any benefit when due under the plan2011-06-30No
Contributions received in cash from employer2011-06-30$21,556
Employer contributions (assets) at end of year2011-06-30$21,556
Employer contributions (assets) at beginning of year2011-06-30$24,227
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-06-30$418,730
Did the plan have assets held for investment2011-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-06-30Yes
Opinion of an independent qualified public accountant for this plan2011-06-30Disclaimer
Accountancy firm name2011-06-30PICKETT, CHANEY, & MCMULLEN LLP
Accountancy firm EIN2011-06-30481246310
2010 : JENSEN INTERNATIONAL, INC. SAVINGS & RETIREMENT 401(K) PLAN & TRUST 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-06-30$0

Form 5500 Responses for JENSEN INTERNATIONAL, INC. SAVINGS & RETIREMENT 401(K) PLAN & TRUST

2015: JENSEN INTERNATIONAL, INC. SAVINGS & RETIREMENT 401(K) PLAN & TRUST 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan funding arrangement – TrustYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-07-01Plan benefit arrangement - TrustYes
2014: JENSEN INTERNATIONAL, INC. SAVINGS & RETIREMENT 401(K) PLAN & TRUST 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan funding arrangement – TrustYes
2014-07-01Plan benefit arrangement – InsuranceYes
2014-07-01Plan benefit arrangement - TrustYes
2013: JENSEN INTERNATIONAL, INC. SAVINGS & RETIREMENT 401(K) PLAN & TRUST 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan funding arrangement – TrustYes
2013-07-01Plan benefit arrangement – InsuranceYes
2013-07-01Plan benefit arrangement - TrustYes
2012: JENSEN INTERNATIONAL, INC. SAVINGS & RETIREMENT 401(K) PLAN & TRUST 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan benefit arrangement - TrustYes
2011: JENSEN INTERNATIONAL, INC. SAVINGS & RETIREMENT 401(K) PLAN & TRUST 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan benefit arrangement - TrustYes
2009: JENSEN INTERNATIONAL, INC. SAVINGS & RETIREMENT 401(K) PLAN & TRUST 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedYes
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan funding arrangement – TrustYes
2009-07-01Plan benefit arrangement – InsuranceYes
2009-07-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberE322031
Policy instance 1
Insurance contract or identification numberE322031
Number of Individuals Covered181
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $2,508
Total amount of fees paid to insurance companyUSD $627
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,508
Insurance broker organization code?3
Amount paid for insurance broker fees627
Additional information about fees paid to insurance brokerSERVICE FEES
Insurance broker nameTAX FAVORED BENEFITS, INC.
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberE322031
Policy instance 1
Insurance contract or identification numberE322031
Number of Individuals Covered191
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $6,227
Total amount of fees paid to insurance companyUSD $1,557
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,227
Insurance broker organization code?3
Amount paid for insurance broker fees1557
Additional information about fees paid to insurance brokerSERVICE FEES
Insurance broker nameTAX FAVORED BENEFITS, INC.
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG35681
Policy instance 1
Insurance contract or identification numberG35681
Number of Individuals Covered0
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $5,260
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,260
Insurance broker organization code?3
Insurance broker nameAMERITAS INVESTMENT CORP.
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberE322031
Policy instance 2
Insurance contract or identification numberE322031
Number of Individuals Covered186
Insurance policy start date2014-06-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $65,705
Total amount of fees paid to insurance companyUSD $16,426
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $65,705
Insurance broker organization code?3
Amount paid for insurance broker fees16426
Additional information about fees paid to insurance brokerSERVICE FEES
Insurance broker nameTAX FAVORED BENEFITS, INC.
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG35681
Policy instance 1
Insurance contract or identification numberG35681
Number of Individuals Covered172
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $5,972
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,972
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameAMERITAS INVESTMENT CORP
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG35681
Policy instance 1
Insurance contract or identification numberG35681
Number of Individuals Covered170
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $6,173
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG35681
Policy instance 1
Insurance contract or identification numberG35681
Number of Individuals Covered143
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $6,867
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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