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DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 401k Plan overview

Plan NameDOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN
Plan identification number 010

DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN Benefits

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

DOE-ANDERSON, INC. has sponsored the creation of one or more 401k plans.

Company Name:DOE-ANDERSON, INC.
Employer identification number (EIN):610525990
NAIC Classification:541800

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0102022-01-01
0102021-01-01
0102020-01-01
0102019-01-01
0102018-01-01
0102017-01-01JULIE ICE2018-07-10
0102016-01-01JULIE ICE2017-07-06
0102015-01-01JULIE ICE
0102014-01-01THOMAS MUDD TODD SPENCER2015-07-01
0102013-01-01THOMAS MUDD TODD SPENCER2014-06-13
0102012-01-01THOMAS MUDD TODD SPENCER2013-07-03
0102011-01-01THOMAS MUDD TODD SPENCER2012-07-20
0102009-01-01THOMAS A. MUDD TODD SPENCER2010-07-15

Plan Statistics for DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN

401k plan membership statisitcs for DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN

Measure Date Value
2022: DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01145
Total number of active participants reported on line 7a of the Form 55002022-01-01108
Number of retired or separated participants receiving benefits2022-01-011
Number of other retired or separated participants entitled to future benefits2022-01-0129
Total of all active and inactive participants2022-01-01138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01138
Number of participants with account balances2022-01-01115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-0113
2021: DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01137
Total number of active participants reported on line 7a of the Form 55002021-01-01120
Number of retired or separated participants receiving benefits2021-01-012
Number of other retired or separated participants entitled to future benefits2021-01-0118
Total of all active and inactive participants2021-01-01140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01140
Number of participants with account balances2021-01-01114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-018
2020: DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01137
Total number of active participants reported on line 7a of the Form 55002020-01-01117
Number of retired or separated participants receiving benefits2020-01-011
Number of other retired or separated participants entitled to future benefits2020-01-0117
Total of all active and inactive participants2020-01-01135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01135
Number of participants with account balances2020-01-01111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-017
2019: DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01134
Total number of active participants reported on line 7a of the Form 55002019-01-01116
Number of retired or separated participants receiving benefits2019-01-012
Number of other retired or separated participants entitled to future benefits2019-01-0117
Total of all active and inactive participants2019-01-01135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-011
Total participants2019-01-01136
Number of participants with account balances2019-01-01113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-015
2018: DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01124
Total number of active participants reported on line 7a of the Form 55002018-01-01108
Number of retired or separated participants receiving benefits2018-01-012
Number of other retired or separated participants entitled to future benefits2018-01-0116
Total of all active and inactive participants2018-01-01126
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-011
Total participants2018-01-01127
Number of participants with account balances2018-01-01101
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-013
2015: DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0197
Total number of active participants reported on line 7a of the Form 55002015-01-0191
Number of retired or separated participants receiving benefits2015-01-012
Number of other retired or separated participants entitled to future benefits2015-01-0114
Total of all active and inactive participants2015-01-01107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01107
Number of participants with account balances2015-01-0186
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-016
2014: DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0185
Total number of active participants reported on line 7a of the Form 55002014-01-0186
Number of retired or separated participants receiving benefits2014-01-011
Number of other retired or separated participants entitled to future benefits2014-01-019
Total of all active and inactive participants2014-01-0196
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0196
Number of participants with account balances2014-01-0180
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-017
2013: DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0172
Total number of active participants reported on line 7a of the Form 55002013-01-0174
Number of retired or separated participants receiving benefits2013-01-011
Number of other retired or separated participants entitled to future benefits2013-01-0110
Total of all active and inactive participants2013-01-0185
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0185
Number of participants with account balances2013-01-0177
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-014
2012: DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0168
Total number of active participants reported on line 7a of the Form 55002012-01-0161
Number of retired or separated participants receiving benefits2012-01-011
Number of other retired or separated participants entitled to future benefits2012-01-0110
Total of all active and inactive participants2012-01-0172
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0172
Number of participants with account balances2012-01-0172
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-014
2011: DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0169
Total number of active participants reported on line 7a of the Form 55002011-01-0154
Number of retired or separated participants receiving benefits2011-01-012
Number of other retired or separated participants entitled to future benefits2011-01-0111
Total of all active and inactive participants2011-01-0167
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0167
Number of participants with account balances2011-01-0167
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-018
2009: DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0172
Total number of active participants reported on line 7a of the Form 55002009-01-0159
Number of retired or separated participants receiving benefits2009-01-012
Number of other retired or separated participants entitled to future benefits2009-01-0113
Total of all active and inactive participants2009-01-0174
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0174
Number of participants with account balances2009-01-0174
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-013

Financial Data on DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN

Measure Date Value
2022 : DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$510
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$299
Total income from all sources (including contributions)2022-12-31$-1,314,908
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$3,634,060
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$3,632,222
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$1,085,214
Value of total assets at end of year2022-12-31$10,917,355
Value of total assets at beginning of year2022-12-31$15,866,112
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$1,838
Total interest from all sources2022-12-31$626
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$811,464
Participant contributions at end of year2022-12-31$11,736
Participant contributions at beginning of year2022-12-31$18,380
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$26,276
Other income not declared elsewhere2022-12-31$3,470
Liabilities. Value of operating payables at end of year2022-12-31$510
Liabilities. Value of operating payables at beginning of year2022-12-31$299
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-4,948,968
Value of net assets at end of year (total assets less liabilities)2022-12-31$10,916,845
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$15,865,813
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Income. Interest from loans (other than to participants)2022-12-31$626
Assets. Value of investments in 103.12 investment entities at end of year2022-12-31$10,887,081
Assets. Value of investments in 103.12 investment entities at beginning of year2022-12-31$15,814,564
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$18,538
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$33,168
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$993
Net gain/loss from 103.12 investment entities2022-12-31$-2,404,218
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$247,474
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$3,631,229
Contract administrator fees2022-12-31$1,838
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31MCM CPA & ADVISORS LLP
Accountancy firm EIN2022-12-31271235638
2021 : DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$299
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$283
Total income from all sources (including contributions)2021-12-31$3,056,989
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$2,469,262
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$2,467,911
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$1,148,968
Value of total assets at end of year2021-12-31$15,866,112
Value of total assets at beginning of year2021-12-31$15,278,369
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$1,351
Total interest from all sources2021-12-31$998
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$875,776
Participant contributions at end of year2021-12-31$18,380
Participant contributions at beginning of year2021-12-31$26,282
Other income not declared elsewhere2021-12-31$-1,537
Liabilities. Value of operating payables at end of year2021-12-31$299
Liabilities. Value of operating payables at beginning of year2021-12-31$283
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$587,727
Value of net assets at end of year (total assets less liabilities)2021-12-31$15,865,813
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$15,278,086
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Interest on participant loans2021-12-31$998
Assets. Value of investments in 103.12 investment entities at end of year2021-12-31$15,814,564
Assets. Value of investments in 103.12 investment entities at beginning of year2021-12-31$15,217,382
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$33,168
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$34,705
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$1,605
Net gain/loss from 103.12 investment entities2021-12-31$1,908,560
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$273,192
Employer contributions (assets) at end of year2021-12-31$0
Employer contributions (assets) at beginning of year2021-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$2,466,306
Contract administrator fees2021-12-31$1,351
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31MCM CPA & ADVISORS LLP
Accountancy firm EIN2021-12-31271235638
2020 : DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$283
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$442
Total income from all sources (including contributions)2020-12-31$2,888,533
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$1,215,171
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$1,213,721
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$955,349
Value of total assets at end of year2020-12-31$15,278,369
Value of total assets at beginning of year2020-12-31$13,605,166
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$1,450
Total interest from all sources2020-12-31$1,063
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Administrative expenses professional fees incurred2020-12-31$1,450
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$710,508
Participant contributions at end of year2020-12-31$26,282
Participant contributions at beginning of year2020-12-31$23,945
Other income not declared elsewhere2020-12-31$-1,957
Liabilities. Value of operating payables at end of year2020-12-31$283
Liabilities. Value of operating payables at beginning of year2020-12-31$442
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$1,673,362
Value of net assets at end of year (total assets less liabilities)2020-12-31$15,278,086
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$13,604,724
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Interest on participant loans2020-12-31$1,063
Assets. Value of investments in 103.12 investment entities at end of year2020-12-31$15,217,382
Assets. Value of investments in 103.12 investment entities at beginning of year2020-12-31$13,544,006
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$34,705
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$36,662
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$1,605
Net gain/loss from 103.12 investment entities2020-12-31$1,934,078
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$244,841
Employer contributions (assets) at end of year2020-12-31$0
Employer contributions (assets) at beginning of year2020-12-31$553
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$1,212,116
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31MCM CPA & ADVISORS LLP
Accountancy firm EIN2020-12-31271235638
2019 : DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$442
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$426
Total income from all sources (including contributions)2019-12-31$3,398,803
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$1,247,882
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$1,246,100
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$919,151
Value of total assets at end of year2019-12-31$13,605,166
Value of total assets at beginning of year2019-12-31$11,454,229
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$1,782
Total interest from all sources2019-12-31$950
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$646,104
Participant contributions at end of year2019-12-31$23,945
Participant contributions at beginning of year2019-12-31$24,560
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$49,979
Other income not declared elsewhere2019-12-31$-1,390
Liabilities. Value of operating payables at end of year2019-12-31$442
Liabilities. Value of operating payables at beginning of year2019-12-31$426
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$2,150,921
Value of net assets at end of year (total assets less liabilities)2019-12-31$13,604,724
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$11,453,803
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Interest on participant loans2019-12-31$950
Assets. Value of investments in 103.12 investment entities at end of year2019-12-31$13,544,006
Assets. Value of investments in 103.12 investment entities at beginning of year2019-12-31$11,391,617
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$36,662
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$38,052
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$1,605
Net gain/loss from 103.12 investment entities2019-12-31$2,480,092
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$223,068
Employer contributions (assets) at end of year2019-12-31$553
Employer contributions (assets) at beginning of year2019-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$1,244,495
Contract administrator fees2019-12-31$1,782
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31MCM CPA & ADVISORS LLP
Accountancy firm EIN2019-12-31271235638
2018 : DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$426
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$380
Total income from all sources (including contributions)2018-12-31$266,711
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$481,821
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$460,729
Value of total corrective distributions2018-12-31$19,297
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$803,154
Value of total assets at end of year2018-12-31$11,454,229
Value of total assets at beginning of year2018-12-31$11,669,293
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$1,795
Total interest from all sources2018-12-31$987
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$585,945
Participant contributions at end of year2018-12-31$24,560
Participant contributions at beginning of year2018-12-31$28,562
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$15,639
Other income not declared elsewhere2018-12-31$-888
Liabilities. Value of operating payables at end of year2018-12-31$426
Liabilities. Value of operating payables at beginning of year2018-12-31$380
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-215,110
Value of net assets at end of year (total assets less liabilities)2018-12-31$11,453,803
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$11,668,913
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Interest on participant loans2018-12-31$987
Assets. Value of investments in 103.12 investment entities at end of year2018-12-31$11,391,617
Assets. Value of investments in 103.12 investment entities at beginning of year2018-12-31$11,601,791
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$38,052
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$38,940
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$1,605
Net gain/loss from 103.12 investment entities2018-12-31$-536,542
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$201,570
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$459,124
Contract administrator fees2018-12-31$1,795
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31MCM CPA & ADVISORS LLP
Accountancy firm EIN2018-12-31271235638
2015 : DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2015 401k financial data
Total plan liabilities at end of year2015-12-31$398
Total plan liabilities at beginning of year2015-12-31$214
Total income from all sources2015-12-31$703,935
Expenses. Total of all expenses incurred2015-12-31$43,243
Benefits paid (including direct rollovers)2015-12-31$34,701
Total plan assets at end of year2015-12-31$10,739,368
Total plan assets at beginning of year2015-12-31$10,078,492
Value of fidelity bond covering the plan2015-12-31$500,000
Total contributions received or receivable from participants2015-12-31$406,040
Contributions received from other sources (not participants or employers)2015-12-31$134,098
Other income received2015-12-31$4,898
Net income (gross income less expenses)2015-12-31$660,692
Net plan assets at end of year (total assets less liabilities)2015-12-31$10,738,970
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$10,078,278
Assets. Value of participant loans2015-12-31$30,045
Total contributions received or receivable from employer(s)2015-12-31$158,899
Value of corrective distributions2015-12-31$7,139
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$1,403
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2014 401k financial data
Total plan liabilities at end of year2014-12-31$214
Total plan liabilities at beginning of year2014-12-31$303
Total income from all sources2014-12-31$1,036,735
Expenses. Total of all expenses incurred2014-12-31$392,628
Benefits paid (including direct rollovers)2014-12-31$391,542
Total plan assets at end of year2014-12-31$10,078,492
Total plan assets at beginning of year2014-12-31$9,434,474
Value of fidelity bond covering the plan2014-12-31$500,000
Total contributions received or receivable from participants2014-12-31$316,192
Contributions received from other sources (not participants or employers)2014-12-31$8,860
Other income received2014-12-31$583,939
Net income (gross income less expenses)2014-12-31$644,107
Net plan assets at end of year (total assets less liabilities)2014-12-31$10,078,278
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$9,434,171
Assets. Value of participant loans2014-12-31$33,739
Total contributions received or receivable from employer(s)2014-12-31$127,744
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$1,086
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2013 401k financial data
Total plan liabilities at end of year2013-12-31$303
Total plan liabilities at beginning of year2013-12-31$268
Total income from all sources2013-12-31$1,931,226
Expenses. Total of all expenses incurred2013-12-31$111,883
Benefits paid (including direct rollovers)2013-12-31$109,092
Total plan assets at end of year2013-12-31$9,434,474
Total plan assets at beginning of year2013-12-31$7,615,096
Value of fidelity bond covering the plan2013-12-31$500,000
Total contributions received or receivable from participants2013-12-31$248,658
Expenses. Other expenses not covered elsewhere2013-12-31$1,605
Contributions received from other sources (not participants or employers)2013-12-31$13,370
Other income received2013-12-31$1,568,138
Net income (gross income less expenses)2013-12-31$1,819,343
Net plan assets at end of year (total assets less liabilities)2013-12-31$9,434,171
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$7,614,828
Assets. Value of participant loans2013-12-31$36,704
Total contributions received or receivable from employer(s)2013-12-31$101,060
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$1,186
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2012 401k financial data
Total plan liabilities at end of year2012-12-31$268
Total plan liabilities at beginning of year2012-12-31$319
Total income from all sources2012-12-31$1,197,607
Expenses. Total of all expenses incurred2012-12-31$200,906
Benefits paid (including direct rollovers)2012-12-31$198,564
Total plan assets at end of year2012-12-31$7,615,096
Total plan assets at beginning of year2012-12-31$6,618,446
Value of fidelity bond covering the plan2012-12-31$500,000
Total contributions received or receivable from participants2012-12-31$214,079
Expenses. Other expenses not covered elsewhere2012-12-31$1,605
Contributions received from other sources (not participants or employers)2012-12-31$91,827
Other income received2012-12-31$805,607
Net income (gross income less expenses)2012-12-31$996,701
Net plan assets at end of year (total assets less liabilities)2012-12-31$7,614,828
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$6,618,127
Assets. Value of participant loans2012-12-31$39,931
Total contributions received or receivable from employer(s)2012-12-31$86,094
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$737
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2011 401k financial data
Total plan liabilities at end of year2011-12-31$319
Total plan liabilities at beginning of year2011-12-31$480
Total income from all sources2011-12-31$173,251
Expenses. Total of all expenses incurred2011-12-31$563,906
Benefits paid (including direct rollovers)2011-12-31$562,619
Total plan assets at end of year2011-12-31$6,618,446
Total plan assets at beginning of year2011-12-31$7,009,262
Value of fidelity bond covering the plan2011-12-31$500,000
Total contributions received or receivable from participants2011-12-31$152,032
Other income received2011-12-31$9,124
Net income (gross income less expenses)2011-12-31$-390,655
Net plan assets at end of year (total assets less liabilities)2011-12-31$6,618,127
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$7,008,782
Assets. Value of participant loans2011-12-31$42,160
Total contributions received or receivable from employer(s)2011-12-31$12,095
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$1,287
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2010 401k financial data
Total plan liabilities at end of year2010-12-31$480
Total plan liabilities at beginning of year2010-12-31$491
Total income from all sources2010-12-31$892,906
Expenses. Total of all expenses incurred2010-12-31$90,243
Benefits paid (including direct rollovers)2010-12-31$88,337
Total plan assets at end of year2010-12-31$7,009,262
Total plan assets at beginning of year2010-12-31$6,206,610
Value of fidelity bond covering the plan2010-12-31$500,000
Total contributions received or receivable from participants2010-12-31$166,937
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$711,960
Net income (gross income less expenses)2010-12-31$802,663
Net plan assets at end of year (total assets less liabilities)2010-12-31$7,008,782
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$6,206,119
Assets. Value of participant loans2010-12-31$43,087
Total contributions received or receivable from employer(s)2010-12-31$14,009
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$1,906
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
2009 : DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN

2022: DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2015: DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: DOE-ANDERSON, INC. PROFIT SHARING 401(K) PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

C.M. LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93432 )
Policy contract number7080770, ETC
Policy instance 1
Insurance contract or identification number7080770, ETC
Number of Individuals Covered3
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?1
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?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
Welfare Benefit Premiums Paid to CarrierUSD $0
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 fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
C.M. LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93432 )
Policy contract number70807630, ETC
Policy instance 1
Insurance contract or identification number70807630, ETC
Number of Individuals Covered3
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 $0
Are there contracts with allocated funds for individual policies?1
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?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
Welfare Benefit Premiums Paid to CarrierUSD $0
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 fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
C.M. LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93432 )
Policy contract number70807630, ETC
Policy instance 1
Insurance contract or identification number70807630, ETC
Number of Individuals Covered3
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
Are there contracts with allocated funds for individual policies?1
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?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
Welfare Benefit Premiums Paid to CarrierUSD $0
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 fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
C.M. LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93432 )
Policy contract number70807630, ETC
Policy instance 1
Insurance contract or identification number70807630, ETC
Number of Individuals Covered3
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 $0
Are there contracts with allocated funds for individual policies?1
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?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
Welfare Benefit Premiums Paid to CarrierUSD $0
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 fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
C.M. LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93432 )
Policy contract number70807630
Policy instance 1
Insurance contract or identification number70807630
Number of Individuals Covered3
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameGREGORY A MCROBERTS
C.M. LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93432 )
Policy contract number70807630
Policy instance 1
Insurance contract or identification number70807630
Number of Individuals Covered3
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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?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
Insurance broker organization code?3
Insurance broker nameGREGORY A MCROBERTS
C.M. LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93432 )
Policy contract number70807630
Policy instance 1
Insurance contract or identification number70807630
Number of Individuals Covered3
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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?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
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameGREGORY A MCROBERTS
C.M. LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93432 )
Policy contract number70807630
Policy instance 1
Insurance contract or identification number70807630
Number of Individuals Covered3
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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?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
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameGREGORY A MCROBERTS
C.M. LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93432 )
Policy contract number70807630
Policy instance 1
Insurance contract or identification number70807630
Number of Individuals Covered3
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $51
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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?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
C.M. LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93432 )
Policy contract number70807630
Policy instance 1
Insurance contract or identification number70807630
Number of Individuals Covered3
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $90
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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?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
Commission paid to Insurance BrokerUSD $45
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameCHARLES J SCHULTZ

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