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SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 401k Plan overview

Plan NameSMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN
Plan identification number 501

SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

SMITH & LOVELESS, INC. has sponsored the creation of one or more 401k plans.

Company Name:SMITH & LOVELESS, INC.
Employer identification number (EIN):480924021
NAIC Classification:333900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-10-01KEN HARTMAN2023-07-13
5012020-10-01KEN HARTMAN2022-07-15
5012019-10-01FRANK J. REBORI2021-07-15
5012018-10-01FRANK REBORI2020-07-15
5012017-10-01FRANK J. REBORI2019-07-12
5012016-10-01
5012016-10-01FRANK J. REBORI2018-07-16
5012016-10-01FRANK J. REBORI2018-07-16
5012016-10-01FRANK REBORI2019-07-12
5012015-10-01DAVID FERBEZAR
5012014-10-01DAVID B FERBEZAR
5012013-10-01DAVID B FERBEZAR
5012012-10-01DAVID B FERBEZAR
5012011-10-01DAVID FERBEZAR
5012009-10-01DAVID FERBEZAR
5012008-10-01

Plan Statistics for SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN

401k plan membership statisitcs for SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN

Measure Date Value
2021: SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-10-01123
Total number of active participants reported on line 7a of the Form 55002021-10-01110
Number of retired or separated participants receiving benefits2021-10-011
Number of other retired or separated participants entitled to future benefits2021-10-010
Total of all active and inactive participants2021-10-01111
Number of employers contributing to the scheme2021-10-010
2020: SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-10-01123
Total number of active participants reported on line 7a of the Form 55002020-10-01110
Number of retired or separated participants receiving benefits2020-10-011
Number of other retired or separated participants entitled to future benefits2020-10-010
Total of all active and inactive participants2020-10-01111
Number of employers contributing to the scheme2020-10-010
2019: SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-10-01143
Total number of active participants reported on line 7a of the Form 55002019-10-01123
Number of retired or separated participants receiving benefits2019-10-013
Number of other retired or separated participants entitled to future benefits2019-10-010
Total of all active and inactive participants2019-10-01126
Number of employers contributing to the scheme2019-10-010
2018: SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-10-01144
Total number of active participants reported on line 7a of the Form 55002018-10-01134
Number of retired or separated participants receiving benefits2018-10-013
Number of other retired or separated participants entitled to future benefits2018-10-010
Total of all active and inactive participants2018-10-01137
Number of employers contributing to the scheme2018-10-010
2017: SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-10-01129
Total number of active participants reported on line 7a of the Form 55002017-10-01137
Number of retired or separated participants receiving benefits2017-10-013
Number of other retired or separated participants entitled to future benefits2017-10-011
Total of all active and inactive participants2017-10-01141
Number of employers contributing to the scheme2017-10-010
2016: SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-01139
Total number of active participants reported on line 7a of the Form 55002016-10-01136
Number of retired or separated participants receiving benefits2016-10-014
Number of other retired or separated participants entitled to future benefits2016-10-011
Total of all active and inactive participants2016-10-01141
Number of employers contributing to the scheme2016-10-010
2015: SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-01292
Total number of active participants reported on line 7a of the Form 55002015-10-01137
Number of retired or separated participants receiving benefits2015-10-010
Number of other retired or separated participants entitled to future benefits2015-10-010
Total of all active and inactive participants2015-10-01137
2014: SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2014 401k membership
Total participants, beginning-of-year2014-10-01205
Total number of active participants reported on line 7a of the Form 55002014-10-01137
Number of retired or separated participants receiving benefits2014-10-0167
Number of other retired or separated participants entitled to future benefits2014-10-010
Total of all active and inactive participants2014-10-01204
2013: SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2013 401k membership
Total participants, beginning-of-year2013-10-01139
Total number of active participants reported on line 7a of the Form 55002013-10-01147
Number of retired or separated participants receiving benefits2013-10-010
Number of other retired or separated participants entitled to future benefits2013-10-010
Total of all active and inactive participants2013-10-01147
2012: SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2012 401k membership
Total participants, beginning-of-year2012-10-01144
Total number of active participants reported on line 7a of the Form 55002012-10-01209
Number of retired or separated participants receiving benefits2012-10-010
Number of other retired or separated participants entitled to future benefits2012-10-010
Total of all active and inactive participants2012-10-01209
2011: SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2011 401k membership
Total participants, beginning-of-year2011-10-01309
Total number of active participants reported on line 7a of the Form 55002011-10-01135
Number of retired or separated participants receiving benefits2011-10-019
Number of other retired or separated participants entitled to future benefits2011-10-010
Total of all active and inactive participants2011-10-01144
Total participants2011-10-01144
2009: SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2009 401k membership
Total participants, beginning-of-year2009-10-01312
Total number of active participants reported on line 7a of the Form 55002009-10-01297
Number of retired or separated participants receiving benefits2009-10-0155
Total of all active and inactive participants2009-10-01352

Financial Data on SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN

Measure Date Value
2022 : SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2022 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-09-30$89,856
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-09-30$0
Total income from all sources (including contributions)2022-09-30$1,463,921
Total of all expenses incurred2022-09-30$1,397,506
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-09-30$1,292,002
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-09-30$1,394,336
Value of total assets at end of year2022-09-30$186,143
Value of total assets at beginning of year2022-09-30$29,872
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-09-30$105,504
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-09-30No
Was this plan covered by a fidelity bond2022-09-30Yes
Value of fidelity bond cover2022-09-30$999,999
If this is an individual account plan, was there a blackout period2022-09-30No
Were there any nonexempt tranactions with any party-in-interest2022-09-30No
Contributions received from participants2022-09-30$326,939
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2022-09-30$324,313
Other income not declared elsewhere2022-09-30$69,585
Liabilities. Value of operating payables at end of year2022-09-30$89,856
Liabilities. Value of operating payables at beginning of year2022-09-30$0
Total non interest bearing cash at end of year2022-09-30$96,287
Total non interest bearing cash at beginning of year2022-09-30$29,872
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-09-30No
Value of net income/loss2022-09-30$66,415
Value of net assets at end of year (total assets less liabilities)2022-09-30$96,287
Value of net assets at beginning of year (total assets less liabilities)2022-09-30$29,872
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2022-09-30No
Were any leases to which the plan was party in default or uncollectible2022-09-30No
Expenses. Payments to insurance carriers foe the provision of benefits2022-09-30$912,666
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-09-30No
Was there a failure to transmit to the plan any participant contributions2022-09-30No
Has the plan failed to provide any benefit when due under the plan2022-09-30No
Contributions received in cash from employer2022-09-30$1,067,397
Employer contributions (assets) at end of year2022-09-30$89,856
Employer contributions (assets) at beginning of year2022-09-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-09-30$55,023
Contract administrator fees2022-09-30$105,504
Did the plan have assets held for investment2022-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-09-30No
Opinion of an independent qualified public accountant for this plan2022-09-30Unqualified
Accountancy firm name2022-09-30A.C. EVANS LLC
Accountancy firm EIN2022-09-30263421158
2021 : SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2021 401k financial data
Total income from all sources (including contributions)2021-09-30$1,497,174
Total of all expenses incurred2021-09-30$1,480,046
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-09-30$1,370,958
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-09-30$1,381,785
Value of total assets at end of year2021-09-30$29,872
Value of total assets at beginning of year2021-09-30$12,744
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-09-30$109,088
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-09-30No
Was this plan covered by a fidelity bond2021-09-30Yes
Value of fidelity bond cover2021-09-30$999,999
If this is an individual account plan, was there a blackout period2021-09-30No
Were there any nonexempt tranactions with any party-in-interest2021-09-30No
Contributions received from participants2021-09-30$324,453
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2021-09-30$347,512
Other income not declared elsewhere2021-09-30$115,389
Total non interest bearing cash at end of year2021-09-30$29,872
Total non interest bearing cash at beginning of year2021-09-30$12,744
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-09-30No
Value of net income/loss2021-09-30$17,128
Value of net assets at end of year (total assets less liabilities)2021-09-30$29,872
Value of net assets at beginning of year (total assets less liabilities)2021-09-30$12,744
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2021-09-30No
Were any leases to which the plan was party in default or uncollectible2021-09-30No
Expenses. Payments to insurance carriers foe the provision of benefits2021-09-30$961,844
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-09-30No
Was there a failure to transmit to the plan any participant contributions2021-09-30No
Has the plan failed to provide any benefit when due under the plan2021-09-30No
Contributions received in cash from employer2021-09-30$1,057,332
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-09-30$61,602
Contract administrator fees2021-09-30$109,088
Did the plan have assets held for investment2021-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-09-30No
Opinion of an independent qualified public accountant for this plan2021-09-30Unqualified
Accountancy firm name2021-09-30A.C. EVANS LLC
Accountancy firm EIN2021-09-30263421158
2020 : SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2020 401k financial data
Total income from all sources (including contributions)2020-09-30$1,344,424
Total of all expenses incurred2020-09-30$1,367,642
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-09-30$1,259,404
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-09-30$1,276,472
Value of total assets at end of year2020-09-30$12,744
Value of total assets at beginning of year2020-09-30$35,962
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-09-30$108,238
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-09-30No
Was this plan covered by a fidelity bond2020-09-30Yes
Value of fidelity bond cover2020-09-30$999,999
If this is an individual account plan, was there a blackout period2020-09-30No
Were there any nonexempt tranactions with any party-in-interest2020-09-30No
Contributions received from participants2020-09-30$359,781
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2020-09-30$371,680
Other income not declared elsewhere2020-09-30$67,952
Total non interest bearing cash at end of year2020-09-30$12,744
Total non interest bearing cash at beginning of year2020-09-30$35,962
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-09-30No
Value of net income/loss2020-09-30$-23,218
Value of net assets at end of year (total assets less liabilities)2020-09-30$12,744
Value of net assets at beginning of year (total assets less liabilities)2020-09-30$35,962
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2020-09-30No
Were any leases to which the plan was party in default or uncollectible2020-09-30No
Expenses. Payments to insurance carriers foe the provision of benefits2020-09-30$827,390
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-09-30No
Was there a failure to transmit to the plan any participant contributions2020-09-30No
Has the plan failed to provide any benefit when due under the plan2020-09-30No
Contributions received in cash from employer2020-09-30$916,691
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-09-30$60,334
Contract administrator fees2020-09-30$108,238
Did the plan have assets held for investment2020-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-09-30No
Opinion of an independent qualified public accountant for this plan2020-09-30Unqualified
Accountancy firm name2020-09-30A.C. EVANS LLC
Accountancy firm EIN2020-09-30263421158
2019 : SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2019 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2019-09-30$189
Total unrealized appreciation/depreciation of assets2019-09-30$189
Total income from all sources (including contributions)2019-09-30$1,021,257
Total of all expenses incurred2019-09-30$1,378,469
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-09-30$1,274,031
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-09-30$922,891
Value of total assets at end of year2019-09-30$35,962
Value of total assets at beginning of year2019-09-30$393,174
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-09-30$104,438
Total interest from all sources2019-09-30$2,369
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-09-30No
Was this plan covered by a fidelity bond2019-09-30Yes
Value of fidelity bond cover2019-09-30$999,999
If this is an individual account plan, was there a blackout period2019-09-30No
Were there any nonexempt tranactions with any party-in-interest2019-09-30No
Contributions received from participants2019-09-30$372,602
Assets. Other investments not covered elsewhere at end of year2019-09-30$0
Assets. Other investments not covered elsewhere at beginning of year2019-09-30$227,019
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-09-30$370,815
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-09-30$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-09-30$1,558
Other income not declared elsewhere2019-09-30$95,808
Total non interest bearing cash at end of year2019-09-30$35,962
Total non interest bearing cash at beginning of year2019-09-30$164,597
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-09-30No
Value of net income/loss2019-09-30$-357,212
Value of net assets at end of year (total assets less liabilities)2019-09-30$35,962
Value of net assets at beginning of year (total assets less liabilities)2019-09-30$393,174
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2019-09-30No
Were any leases to which the plan was party in default or uncollectible2019-09-30No
Interest earned on other investments2019-09-30$2,369
Expenses. Payments to insurance carriers foe the provision of benefits2019-09-30$843,988
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-09-30Yes
Was there a failure to transmit to the plan any participant contributions2019-09-30No
Has the plan failed to provide any benefit when due under the plan2019-09-30No
Contributions received in cash from employer2019-09-30$550,289
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-09-30$59,228
Contract administrator fees2019-09-30$104,438
Did the plan have assets held for investment2019-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-09-30No
Opinion of an independent qualified public accountant for this plan2019-09-30Unqualified
Accountancy firm name2019-09-30A.C. EVANS LLC
Accountancy firm EIN2019-09-30263421158
2018 : SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2018 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2018-09-30$-8,174
Total unrealized appreciation/depreciation of assets2018-09-30$-8,174
Total income from all sources (including contributions)2018-09-30$1,501,502
Total of all expenses incurred2018-09-30$1,776,392
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-09-30$1,325,148
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-09-30$1,377,911
Value of total assets at end of year2018-09-30$393,174
Value of total assets at beginning of year2018-09-30$668,064
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-09-30$451,244
Total interest from all sources2018-09-30$11,458
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-09-30No
Was this plan covered by a fidelity bond2018-09-30Yes
Value of fidelity bond cover2018-09-30$999,999
If this is an individual account plan, was there a blackout period2018-09-30No
Were there any nonexempt tranactions with any party-in-interest2018-09-30No
Contributions received from participants2018-09-30$345,812
Assets. Other investments not covered elsewhere at end of year2018-09-30$227,019
Assets. Other investments not covered elsewhere at beginning of year2018-09-30$640,560
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-09-30$1,558
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-09-30$5,933
Other income not declared elsewhere2018-09-30$120,307
Total non interest bearing cash at end of year2018-09-30$164,597
Total non interest bearing cash at beginning of year2018-09-30$21,571
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-09-30No
Value of net income/loss2018-09-30$-274,890
Value of net assets at end of year (total assets less liabilities)2018-09-30$393,174
Value of net assets at beginning of year (total assets less liabilities)2018-09-30$668,064
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2018-09-30No
Were any leases to which the plan was party in default or uncollectible2018-09-30No
Interest earned on other investments2018-09-30$11,458
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-09-30$0
Expenses. Payments to insurance carriers foe the provision of benefits2018-09-30$1,259,258
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-09-30Yes
Was there a failure to transmit to the plan any participant contributions2018-09-30No
Has the plan failed to provide any benefit when due under the plan2018-09-30No
Contributions received in cash from employer2018-09-30$1,032,099
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-09-30$65,890
Contract administrator fees2018-09-30$451,244
Did the plan have assets held for investment2018-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-09-30No
Opinion of an independent qualified public accountant for this plan2018-09-30Unqualified
Accountancy firm name2018-09-30KELLER AND OWENS, LLC
Accountancy firm EIN2018-09-30481195228
2017 : SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2017 401k financial data
Unrealized appreciation/depreciation of real estate assets2017-09-30$0
Unrealized appreciation/depreciation of other (non real estate) assets2017-09-30$-9,441
Total unrealized appreciation/depreciation of assets2017-09-30$-9,441
Total transfer of assets to this plan2017-09-30$0
Total transfer of assets from this plan2017-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-09-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-09-30$0
Expenses. Interest paid2017-09-30$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022017-09-30$0
Total income from all sources (including contributions)2017-09-30$2,243,055
Total loss/gain on sale of assets2017-09-30$0
Total of all expenses incurred2017-09-30$2,282,599
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-09-30$1,906,423
Expenses. Certain deemed distributions of participant loans2017-09-30$0
Value of total corrective distributions2017-09-30$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-09-30$1,137,450
Value of total assets at end of year2017-09-30$668,064
Value of total assets at beginning of year2017-09-30$707,608
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-09-30$376,176
Total income from rents2017-09-30$0
Total interest from all sources2017-09-30$14,355
Total dividends received (eg from common stock, registered investment company shares)2017-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-09-30No
Total dividends received from registered investment company shares (eg mutual funds)2017-09-30$0
Assets. Real estate other than employer real property at end of year2017-09-30$0
Assets. Real estate other than employer real property at beginning of year2017-09-30$0
Administrative expenses professional fees incurred2017-09-30$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2017-09-30$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2017-09-30$0
Was this plan covered by a fidelity bond2017-09-30Yes
Value of fidelity bond cover2017-09-30$1,000,000
If this is an individual account plan, was there a blackout period2017-09-30No
Were there any nonexempt tranactions with any party-in-interest2017-09-30No
Contributions received from participants2017-09-30$341,890
Participant contributions at end of year2017-09-30$0
Participant contributions at beginning of year2017-09-30$0
Participant contributions at end of year2017-09-30$0
Participant contributions at beginning of year2017-09-30$0
Assets. Other investments not covered elsewhere at end of year2017-09-30$640,560
Assets. Other investments not covered elsewhere at beginning of year2017-09-30$659,198
Income. Received or receivable in cash from other sources (including rollovers)2017-09-30$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2017-09-30$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-09-30$5,933
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-09-30$5,933
Assets. Loans (other than to participants) at end of year2017-09-30$0
Assets. Loans (other than to participants) at beginning of year2017-09-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-09-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-09-30$0
Other income not declared elsewhere2017-09-30$1,100,691
Administrative expenses (other) incurred2017-09-30$0
Liabilities. Value of operating payables at end of year2017-09-30$0
Liabilities. Value of operating payables at beginning of year2017-09-30$0
Total non interest bearing cash at end of year2017-09-30$21,571
Total non interest bearing cash at beginning of year2017-09-30$41,477
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-09-30No
Income. Non cash contributions2017-09-30$0
Value of net income/loss2017-09-30$-39,544
Value of net assets at end of year (total assets less liabilities)2017-09-30$668,064
Value of net assets at beginning of year (total assets less liabilities)2017-09-30$707,608
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2017-09-30No
Were any leases to which the plan was party in default or uncollectible2017-09-30No
Assets. partnership/joint venture interests at end of year2017-09-30$0
Assets. partnership/joint venture interests at beginning of year2017-09-30$0
Investment advisory and management fees2017-09-30$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-09-30$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-09-30$0
Value of interest in pooled separate accounts at end of year2017-09-30$0
Value of interest in pooled separate accounts at beginning of year2017-09-30$0
Interest on participant loans2017-09-30$0
Income. Interest from loans (other than to participants)2017-09-30$0
Interest earned on other investments2017-09-30$14,354
Income. Interest from US Government securities2017-09-30$0
Income. Interest from corporate debt instruments2017-09-30$0
Value of interest in master investment trust accounts at end of year2017-09-30$0
Value of interest in master investment trust accounts at beginning of year2017-09-30$0
Value of interest in common/collective trusts at end of year2017-09-30$0
Value of interest in common/collective trusts at beginning of year2017-09-30$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-09-30$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-09-30$1,000
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-09-30$1,000
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-09-30$1
Assets. Value of investments in 103.12 investment entities at end of year2017-09-30$0
Assets. Value of investments in 103.12 investment entities at beginning of year2017-09-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-09-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-09-30$0
Expenses. Payments to insurance carriers foe the provision of benefits2017-09-30$1,838,912
Asset value of US Government securities at end of year2017-09-30$0
Asset value of US Government securities at beginning of year2017-09-30$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-09-30$0
Net investment gain/loss from pooled separate accounts2017-09-30$0
Net investment gain or loss from common/collective trusts2017-09-30$1,100,691
Net gain/loss from 103.12 investment entities2017-09-30$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-09-30Yes
Was there a failure to transmit to the plan any participant contributions2017-09-30No
Has the plan failed to provide any benefit when due under the plan2017-09-30No
Assets. Invements in employer securities at end of year2017-09-30$0
Assets. Invements in employer securities at beginning of year2017-09-30$0
Assets. Value of employer real property at end of year2017-09-30$0
Assets. Value of employer real property at beginning of year2017-09-30$0
Contributions received in cash from employer2017-09-30$795,560
Employer contributions (assets) at end of year2017-09-30$0
Employer contributions (assets) at beginning of year2017-09-30$0
Income. Dividends from preferred stock2017-09-30$0
Income. Dividends from common stock2017-09-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-09-30$67,511
Asset. Corporate debt instrument preferred debt at end of year2017-09-30$0
Asset. Corporate debt instrument preferred debt at beginning of year2017-09-30$0
Asset. Corporate debt instrument debt (other) at end of year2017-09-30$0
Asset. Corporate debt instrument debt (other) at beginning of year2017-09-30$0
Contract administrator fees2017-09-30$376,176
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-09-30No
Assets. Corporate common stocks other than exployer securities at end of year2017-09-30$0
Assets. Corporate common stocks other than exployer securities at beginning of year2017-09-30$0
Liabilities. Value of benefit claims payable at end of year2017-09-30$0
Liabilities. Value of benefit claims payable at beginning of year2017-09-30$0
Assets. Value of buildings and other operty used in plan operation at end of year2017-09-30$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2017-09-30$0
Did the plan have assets held for investment2017-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-09-30No
Aggregate proceeds on sale of assets2017-09-30$0
Aggregate carrying amount (costs) on sale of assets2017-09-30$0
Liabilities. Value of acquisition indebtedness at end of year2017-09-30$0
Liabilities. Value of acquisition indebtedness at beginning of year2017-09-30$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-09-30No
Opinion of an independent qualified public accountant for this plan2017-09-30Unqualified
Accountancy firm name2017-09-30KELLER AND OWENS, LLC
Accountancy firm EIN2017-09-30481195228
2016 : SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2016 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2016-09-30$10,871
Total unrealized appreciation/depreciation of assets2016-09-30$10,871
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-09-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-09-30$0
Total income from all sources (including contributions)2016-09-30$1,950,900
Total loss/gain on sale of assets2016-09-30$0
Total of all expenses incurred2016-09-30$1,922,050
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-09-30$1,577,566
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-09-30$1,899,340
Value of total assets at end of year2016-09-30$707,608
Value of total assets at beginning of year2016-09-30$678,758
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-09-30$344,484
Total interest from all sources2016-09-30$40,689
Total dividends received (eg from common stock, registered investment company shares)2016-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-09-30No
Was this plan covered by a fidelity bond2016-09-30Yes
Value of fidelity bond cover2016-09-30$1,000,000
If this is an individual account plan, was there a blackout period2016-09-30No
Were there any nonexempt tranactions with any party-in-interest2016-09-30No
Contributions received from participants2016-09-30$339,358
Assets. Other investments not covered elsewhere at end of year2016-09-30$659,198
Assets. Other investments not covered elsewhere at beginning of year2016-09-30$663,491
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2016-09-30$383,780
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-09-30$5,933
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-09-30$5,933
Total non interest bearing cash at end of year2016-09-30$41,477
Total non interest bearing cash at beginning of year2016-09-30$6,949
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-09-30No
Value of net income/loss2016-09-30$28,850
Value of net assets at end of year (total assets less liabilities)2016-09-30$707,608
Value of net assets at beginning of year (total assets less liabilities)2016-09-30$678,758
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2016-09-30No
Were any leases to which the plan was party in default or uncollectible2016-09-30No
Interest earned on other investments2016-09-30$40,681
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-09-30$1,000
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-09-30$2,385
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-09-30$2,385
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-09-30$8
Expenses. Payments to insurance carriers foe the provision of benefits2016-09-30$1,134,797
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-09-30Yes
Was there a failure to transmit to the plan any participant contributions2016-09-30No
Has the plan failed to provide any benefit when due under the plan2016-09-30No
Contributions received in cash from employer2016-09-30$1,559,982
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-09-30$58,989
Contract administrator fees2016-09-30$344,484
Did the plan have assets held for investment2016-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-09-30No
Opinion of an independent qualified public accountant for this plan2016-09-30Unqualified
Accountancy firm name2016-09-30KELLER AND OWENS, LLC
Accountancy firm EIN2016-09-30481195228
2015 : SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2015 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2015-09-30$10,045
Total unrealized appreciation/depreciation of assets2015-09-30$10,045
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-09-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-09-30$0
Total income from all sources (including contributions)2015-09-30$1,343,266
Total loss/gain on sale of assets2015-09-30$0
Total of all expenses incurred2015-09-30$2,366,453
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-09-30$1,580,614
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-09-30$1,318,450
Value of total assets at end of year2015-09-30$678,758
Value of total assets at beginning of year2015-09-30$1,701,945
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-09-30$785,839
Total interest from all sources2015-09-30$14,771
Total dividends received (eg from common stock, registered investment company shares)2015-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-09-30No
Was this plan covered by a fidelity bond2015-09-30Yes
Value of fidelity bond cover2015-09-30$1,000,000
If this is an individual account plan, was there a blackout period2015-09-30No
Were there any nonexempt tranactions with any party-in-interest2015-09-30No
Contributions received from participants2015-09-30$337,775
Assets. Other investments not covered elsewhere at end of year2015-09-30$663,491
Assets. Other investments not covered elsewhere at beginning of year2015-09-30$1,409,925
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-09-30$5,933
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-09-30$12,929
Administrative expenses (other) incurred2015-09-30$754,278
Total non interest bearing cash at end of year2015-09-30$6,949
Total non interest bearing cash at beginning of year2015-09-30$7,609
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-09-30No
Value of net income/loss2015-09-30$-1,023,187
Value of net assets at end of year (total assets less liabilities)2015-09-30$678,758
Value of net assets at beginning of year (total assets less liabilities)2015-09-30$1,701,945
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2015-09-30No
Were any leases to which the plan was party in default or uncollectible2015-09-30No
Interest earned on other investments2015-09-30$14,354
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-09-30$2,385
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-09-30$271,482
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-09-30$271,482
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-09-30$417
Expenses. Payments to insurance carriers foe the provision of benefits2015-09-30$1,514,791
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-09-30Yes
Was there a failure to transmit to the plan any participant contributions2015-09-30No
Has the plan failed to provide any benefit when due under the plan2015-09-30No
Contributions received in cash from employer2015-09-30$980,675
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-09-30$65,823
Contract administrator fees2015-09-30$31,561
Did the plan have assets held for investment2015-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-09-30No
Opinion of an independent qualified public accountant for this plan2015-09-30Unqualified
Accountancy firm name2015-09-30KELLER AND OWENS, LLC
Accountancy firm EIN2015-09-30481195228
2014 : SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2014-09-30$64,218
Total unrealized appreciation/depreciation of assets2014-09-30$64,218
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-09-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-09-30$0
Total income from all sources (including contributions)2014-09-30$1,514,396
Total loss/gain on sale of assets2014-09-30$0
Total of all expenses incurred2014-09-30$1,571,602
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-09-30$1,543,938
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-09-30$1,417,688
Value of total assets at end of year2014-09-30$1,701,945
Value of total assets at beginning of year2014-09-30$1,759,151
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-09-30$27,664
Total interest from all sources2014-09-30$32,490
Total dividends received (eg from common stock, registered investment company shares)2014-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-09-30No
Was this plan covered by a fidelity bond2014-09-30Yes
Value of fidelity bond cover2014-09-30$1,500,000
If this is an individual account plan, was there a blackout period2014-09-30No
Were there any nonexempt tranactions with any party-in-interest2014-09-30No
Contributions received from participants2014-09-30$292,509
Assets. Other investments not covered elsewhere at end of year2014-09-30$1,409,925
Assets. Other investments not covered elsewhere at beginning of year2014-09-30$1,365,288
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-09-30$12,929
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-09-30$12,929
Total non interest bearing cash at end of year2014-09-30$7,609
Total non interest bearing cash at beginning of year2014-09-30$8,212
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-09-30No
Value of net income/loss2014-09-30$-57,206
Value of net assets at end of year (total assets less liabilities)2014-09-30$1,701,945
Value of net assets at beginning of year (total assets less liabilities)2014-09-30$1,759,151
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2014-09-30No
Were any leases to which the plan was party in default or uncollectible2014-09-30No
Interest earned on other investments2014-09-30$32,131
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-09-30$271,482
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-09-30$372,722
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-09-30$372,722
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-09-30$359
Expenses. Payments to insurance carriers foe the provision of benefits2014-09-30$1,477,222
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-09-30No
Was there a failure to transmit to the plan any participant contributions2014-09-30No
Has the plan failed to provide any benefit when due under the plan2014-09-30No
Contributions received in cash from employer2014-09-30$1,125,179
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-09-30$66,716
Contract administrator fees2014-09-30$27,664
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-09-30No
Did the plan have assets held for investment2014-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-09-30No
Opinion of an independent qualified public accountant for this plan2014-09-30Unqualified
Accountancy firm name2014-09-30KELLER AND OWENS, LLC
Accountancy firm EIN2014-09-30481195228
2013 : SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2013-09-30$-53,791
Total unrealized appreciation/depreciation of assets2013-09-30$-53,791
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-09-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-09-30$0
Total income from all sources (including contributions)2013-09-30$1,479,731
Total loss/gain on sale of assets2013-09-30$0
Total of all expenses incurred2013-09-30$1,533,519
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-09-30$1,527,128
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-09-30$1,500,823
Value of total assets at end of year2013-09-30$1,759,151
Value of total assets at beginning of year2013-09-30$1,812,939
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-09-30$6,391
Total interest from all sources2013-09-30$32,699
Total dividends received (eg from common stock, registered investment company shares)2013-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-09-30No
Was this plan covered by a fidelity bond2013-09-30Yes
Value of fidelity bond cover2013-09-30$1,500,000
If this is an individual account plan, was there a blackout period2013-09-30No
Were there any nonexempt tranactions with any party-in-interest2013-09-30No
Contributions received from participants2013-09-30$264,144
Assets. Other investments not covered elsewhere at end of year2013-09-30$1,365,288
Assets. Other investments not covered elsewhere at beginning of year2013-09-30$1,438,661
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-09-30$12,929
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-09-30$12,983
Total non interest bearing cash at end of year2013-09-30$8,212
Total non interest bearing cash at beginning of year2013-09-30$3,731
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-09-30No
Value of net income/loss2013-09-30$-53,788
Value of net assets at end of year (total assets less liabilities)2013-09-30$1,759,151
Value of net assets at beginning of year (total assets less liabilities)2013-09-30$1,812,939
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2013-09-30No
Were any leases to which the plan was party in default or uncollectible2013-09-30No
Interest earned on other investments2013-09-30$32,131
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-09-30$372,722
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-09-30$357,564
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-09-30$357,564
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-09-30$568
Expenses. Payments to insurance carriers foe the provision of benefits2013-09-30$1,451,800
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-09-30No
Was there a failure to transmit to the plan any participant contributions2013-09-30No
Has the plan failed to provide any benefit when due under the plan2013-09-30No
Contributions received in cash from employer2013-09-30$1,236,679
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-09-30$75,328
Contract administrator fees2013-09-30$6,391
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-09-30No
Did the plan have assets held for investment2013-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-09-30No
Opinion of an independent qualified public accountant for this plan2013-09-30Unqualified
Accountancy firm name2013-09-30STEPHEN T. OSBORNE, C.P.A.
Accountancy firm EIN2013-09-30431395134
2012 : SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2012-09-30$-11,609
Total unrealized appreciation/depreciation of assets2012-09-30$-11,609
Total income from all sources (including contributions)2012-09-30$1,457,467
Total of all expenses incurred2012-09-30$1,469,733
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-09-30$1,456,154
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-09-30$1,446,086
Value of total assets at end of year2012-09-30$1,812,939
Value of total assets at beginning of year2012-09-30$1,825,205
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-09-30$13,579
Total interest from all sources2012-09-30$22,990
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-09-30No
Was this plan covered by a fidelity bond2012-09-30Yes
Value of fidelity bond cover2012-09-30$1,500,000
If this is an individual account plan, was there a blackout period2012-09-30No
Were there any nonexempt tranactions with any party-in-interest2012-09-30No
Contributions received from participants2012-09-30$256,548
Assets. Other investments not covered elsewhere at end of year2012-09-30$1,438,661
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-09-30$12,983
Total non interest bearing cash at end of year2012-09-30$3,731
Total non interest bearing cash at beginning of year2012-09-30$10,463
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-09-30No
Value of net income/loss2012-09-30$-12,266
Value of net assets at end of year (total assets less liabilities)2012-09-30$1,812,939
Value of net assets at beginning of year (total assets less liabilities)2012-09-30$1,825,205
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2012-09-30No
Were any leases to which the plan was party in default or uncollectible2012-09-30No
Interest earned on other investments2012-09-30$15,168
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-09-30$357,564
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-09-30$1,814,742
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-09-30$1,814,742
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-09-30$7,822
Expenses. Payments to insurance carriers foe the provision of benefits2012-09-30$1,370,402
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-09-30Yes
Was there a failure to transmit to the plan any participant contributions2012-09-30No
Has the plan failed to provide any benefit when due under the plan2012-09-30No
Contributions received in cash from employer2012-09-30$1,189,538
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-09-30$85,752
Contract administrator fees2012-09-30$13,579
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-09-30No
Did the plan have assets held for investment2012-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-09-30No
Opinion of an independent qualified public accountant for this plan2012-09-30Unqualified
Accountancy firm name2012-09-30STEVEN T. OSBORNE, C.P.A.
Accountancy firm EIN2012-09-30431395134
2011 : SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2011 401k financial data
Total income from all sources (including contributions)2011-09-30$1,511,800
Total of all expenses incurred2011-09-30$1,511,806
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-09-30$1,452,690
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-09-30$1,490,000
Value of total assets at end of year2011-09-30$1,825,205
Value of total assets at beginning of year2011-09-30$1,825,211
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-09-30$59,116
Total interest from all sources2011-09-30$21,800
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-09-30No
Was this plan covered by a fidelity bond2011-09-30Yes
Value of fidelity bond cover2011-09-30$1,500,000
If this is an individual account plan, was there a blackout period2011-09-30No
Were there any nonexempt tranactions with any party-in-interest2011-09-30No
Contributions received from participants2011-09-30$283,473
Total non interest bearing cash at end of year2011-09-30$10,463
Total non interest bearing cash at beginning of year2011-09-30$38,269
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-09-30No
Value of net income/loss2011-09-30$-6
Value of net assets at end of year (total assets less liabilities)2011-09-30$1,825,205
Value of net assets at beginning of year (total assets less liabilities)2011-09-30$1,825,211
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2011-09-30No
Were any leases to which the plan was party in default or uncollectible2011-09-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-09-30$1,814,742
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-09-30$1,786,942
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-09-30$1,786,942
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-09-30$21,800
Expenses. Payments to insurance carriers foe the provision of benefits2011-09-30$1,344,550
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-09-30Yes
Was there a failure to transmit to the plan any participant contributions2011-09-30No
Has the plan failed to provide any benefit when due under the plan2011-09-30No
Contributions received in cash from employer2011-09-30$1,206,527
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-09-30$108,140
Contract administrator fees2011-09-30$59,116
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-09-30No
Did the plan have assets held for investment2011-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-09-30No
Opinion of an independent qualified public accountant for this plan2011-09-30Unqualified
Accountancy firm name2011-09-30COCHRAN, HEAD, VICK AND CO. P.C.
Accountancy firm EIN2011-09-30481028532

Form 5500 Responses for SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN

2021: SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2021 form 5500 responses
2021-10-01Type of plan entitySingle employer plan
2021-10-01Plan funding arrangement – InsuranceYes
2021-10-01Plan funding arrangement – TrustYes
2021-10-01Plan funding arrangement – General assets of the sponsorYes
2021-10-01Plan benefit arrangement – InsuranceYes
2021-10-01Plan benefit arrangement - TrustYes
2021-10-01Plan benefit arrangement – General assets of the sponsorYes
2020: SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2020 form 5500 responses
2020-10-01Type of plan entitySingle employer plan
2020-10-01Plan funding arrangement – InsuranceYes
2020-10-01Plan funding arrangement – TrustYes
2020-10-01Plan funding arrangement – General assets of the sponsorYes
2020-10-01Plan benefit arrangement – InsuranceYes
2020-10-01Plan benefit arrangement - TrustYes
2020-10-01Plan benefit arrangement – General assets of the sponsorYes
2019: SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01Plan funding arrangement – InsuranceYes
2019-10-01Plan funding arrangement – TrustYes
2019-10-01Plan funding arrangement – General assets of the sponsorYes
2019-10-01Plan benefit arrangement – InsuranceYes
2019-10-01Plan benefit arrangement - TrustYes
2019-10-01Plan benefit arrangement – General assets of the sponsorYes
2018: SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2018 form 5500 responses
2018-10-01Type of plan entitySingle employer plan
2018-10-01Plan funding arrangement – InsuranceYes
2018-10-01Plan funding arrangement – TrustYes
2018-10-01Plan funding arrangement – General assets of the sponsorYes
2018-10-01Plan benefit arrangement – InsuranceYes
2018-10-01Plan benefit arrangement - TrustYes
2018-10-01Plan benefit arrangement – General assets of the sponsorYes
2017: SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan funding arrangement – TrustYes
2017-10-01Plan funding arrangement – General assets of the sponsorYes
2017-10-01Plan benefit arrangement – InsuranceYes
2017-10-01Plan benefit arrangement - TrustYes
2017-10-01Plan benefit arrangement – General assets of the sponsorYes
2016: SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Submission has been amendedYes
2016-10-01This submission is the final filingNo
2016-10-01This return/report is a short plan year return/report (less than 12 months)No
2016-10-01Plan is a collectively bargained planNo
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan funding arrangement – TrustYes
2016-10-01Plan funding arrangement – General assets of the sponsorYes
2016-10-01Plan benefit arrangement – InsuranceYes
2016-10-01Plan benefit arrangement - TrustYes
2016-10-01Plan benefit arrangement – General assets of the sponsorYes
2015: SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Submission has been amendedNo
2015-10-01This submission is the final filingNo
2015-10-01This return/report is a short plan year return/report (less than 12 months)No
2015-10-01Plan is a collectively bargained planNo
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan funding arrangement – TrustYes
2015-10-01Plan funding arrangement – General assets of the sponsorYes
2015-10-01Plan benefit arrangement – InsuranceYes
2015-10-01Plan benefit arrangement - TrustYes
2015-10-01Plan benefit arrangement – General assets of the sponsorYes
2014: SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Submission has been amendedNo
2014-10-01This submission is the final filingNo
2014-10-01This return/report is a short plan year return/report (less than 12 months)No
2014-10-01Plan is a collectively bargained planNo
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan funding arrangement – TrustYes
2014-10-01Plan funding arrangement – General assets of the sponsorYes
2014-10-01Plan benefit arrangement – InsuranceYes
2014-10-01Plan benefit arrangement - TrustYes
2014-10-01Plan benefit arrangement – General assets of the sponsorYes
2013: SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Submission has been amendedNo
2013-10-01This submission is the final filingNo
2013-10-01This return/report is a short plan year return/report (less than 12 months)No
2013-10-01Plan is a collectively bargained planNo
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan funding arrangement – TrustYes
2013-10-01Plan funding arrangement – General assets of the sponsorYes
2013-10-01Plan benefit arrangement – InsuranceYes
2013-10-01Plan benefit arrangement - TrustYes
2013-10-01Plan benefit arrangement – General assets of the sponsorYes
2012: SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Submission has been amendedNo
2012-10-01This submission is the final filingNo
2012-10-01This return/report is a short plan year return/report (less than 12 months)No
2012-10-01Plan is a collectively bargained planNo
2012-10-01Plan funding arrangement – InsuranceYes
2012-10-01Plan funding arrangement – TrustYes
2012-10-01Plan funding arrangement – General assets of the sponsorYes
2012-10-01Plan benefit arrangement – InsuranceYes
2012-10-01Plan benefit arrangement - TrustYes
2012-10-01Plan benefit arrangement – General assets of the sponsorYes
2011: SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2011 form 5500 responses
2011-10-01Type of plan entitySingle employer plan
2011-10-01Submission has been amendedNo
2011-10-01This submission is the final filingNo
2011-10-01This return/report is a short plan year return/report (less than 12 months)No
2011-10-01Plan is a collectively bargained planNo
2011-10-01Plan funding arrangement – InsuranceYes
2011-10-01Plan funding arrangement – TrustYes
2011-10-01Plan funding arrangement – General assets of the sponsorYes
2011-10-01Plan benefit arrangement – InsuranceYes
2011-10-01Plan benefit arrangement - TrustYes
2011-10-01Plan benefit arrangement – General assets of the sponsorYes
2009: SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2009 form 5500 responses
2009-10-01Type of plan entitySingle employer plan
2009-10-01Submission has been amendedNo
2009-10-01This submission is the final filingNo
2009-10-01This return/report is a short plan year return/report (less than 12 months)No
2009-10-01Plan is a collectively bargained planNo
2009-10-01Plan funding arrangement – InsuranceYes
2009-10-01Plan funding arrangement – TrustYes
2009-10-01Plan benefit arrangement – InsuranceYes
2009-10-01Plan benefit arrangement - TrustYes
2008: SMITH & LOVELESS, INC. EMPLOYEE HEALTH CARE PLAN 2008 form 5500 responses
2008-10-01Type of plan entitySingle employer plan
2008-10-01Submission has been amendedNo
2008-10-01This submission is the final filingNo
2008-10-01This return/report is a short plan year return/report (less than 12 months)No
2008-10-01Plan is a collectively bargained planNo

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0B76H
Policy instance 3
Insurance contract or identification numberGLUG0B76H
Number of Individuals Covered171
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $4,934
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $71,725
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees4934
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberGMDC0B76H
Policy instance 2
Insurance contract or identification numberGMDC0B76H
Number of Individuals Covered15
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $182
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $3,025
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees182
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL32913
Policy instance 1
Insurance contract or identification numberHCL32913
Number of Individuals Covered118
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $4,135
Welfare Benefit Premiums Paid to CarrierUSD $356,626
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees4135
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0B76H
Policy instance 3
Insurance contract or identification numberGLUG0B76H
Number of Individuals Covered193
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $4,358
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $78,084
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees4358
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberGMDC0B76H
Policy instance 2
Insurance contract or identification numberGMDC0B76H
Number of Individuals Covered33
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $175
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $3,065
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees175
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL32913
Policy instance 1
Insurance contract or identification numberHCL32913
Number of Individuals Covered120
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $376,413
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0B76H
Policy instance 3
Insurance contract or identification numberGLUG0B76H
Number of Individuals Covered201
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $5,050
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $78,900
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees5050
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberGMDC0B76H
Policy instance 2
Insurance contract or identification numberGMDC0B76H
Number of Individuals Covered36
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $199
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $3,181
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees199
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL32913
Policy instance 1
Insurance contract or identification numberHCL32913
Number of Individuals Covered129
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $19,254
Welfare Benefit Premiums Paid to CarrierUSD $399,609
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees19254
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0B76H
Policy instance 3
Insurance contract or identification numberGLUG0B76H
Number of Individuals Covered209
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $2,087
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $73,466
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees1193
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberGMDC0B76H
Policy instance 2
Insurance contract or identification numberGMDC0B76H
Number of Individuals Covered34
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $77
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $2,238
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees42
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL32913
Policy instance 1
Insurance contract or identification numberHCL32913
Number of Individuals Covered136
Insurance policy start date2018-10-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $4,260
Welfare Benefit Premiums Paid to CarrierUSD $88,503
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees4260
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0B76H
Policy instance 3
Insurance contract or identification numberGLUG0B76H
Number of Individuals Covered191
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,885
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $66,366
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL32913
Policy instance 1
Insurance contract or identification numberHCL32913
Number of Individuals Covered140
Insurance policy start date2017-10-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $1,537
Welfare Benefit Premiums Paid to CarrierUSD $76,844
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL32913
Policy instance 2
Insurance contract or identification numberHCL32913
Number of Individuals Covered137
Insurance policy start date2018-01-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $12,382
Welfare Benefit Premiums Paid to CarrierUSD $257,560
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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