401k Plan data: EL MORRO CORRUGATED HEALTH PLAN INS. plan

EL MORRO CORRUGATED HEALTH PLAN INS. 401k Plan overview

Plan Name	EL MORRO CORRUGATED HEALTH PLAN INS.
Plan identification number	501

EL MORRO CORRUGATED HEALTH PLAN INS. Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Other welfare benefit cover

401k Sponsoring company profile

EL MORRO CORRUGATED BOX, CORP. has sponsored the creation of one or more 401k plans.

Company Name: EL MORRO CORRUGATED BOX, CORP.

Employer identification number (EIN): 660274059

NAIC Classification: 322100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EL MORRO CORRUGATED HEALTH PLAN INS.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2013-03-01 GONZALO CALLEJAS GONZALO CALLEJAS 2014-02-07
501 2012-03-01 SAMUELMARTINEZ
501 2011-03-01 SAMUEL MARTINEZ
501 2010-03-01 SAMUEL MARTINEZ
501 2009-03-01 SAMUEL MARTINEZ

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2013-03-01	GONZALO CALLEJAS	GONZALO CALLEJAS	2014-02-07
501	2012-03-01	SAMUELMARTINEZ
501	2011-03-01	SAMUEL MARTINEZ
501	2010-03-01	SAMUEL MARTINEZ
501	2009-03-01	SAMUEL MARTINEZ

Plan Statistics for EL MORRO CORRUGATED HEALTH PLAN INS.

401k plan membership statisitcs for EL MORRO CORRUGATED HEALTH PLAN INS.

Measure Date Value
2013: EL MORRO CORRUGATED HEALTH PLAN INS. 2013 401k membership
Total participants, beginning-of-year 2013-03-01 30
Total number of active participants reported on line 7a of the Form 5500 2013-03-01 0
Number of retired or separated participants receiving benefits 2013-03-01 0
Number of other retired or separated participants entitled to future benefits 2013-03-01 0
Total of all active and inactive participants 2013-03-01 0
2012: EL MORRO CORRUGATED HEALTH PLAN INS. 2012 401k membership
Total participants, beginning-of-year 2012-03-01 99
Total number of active participants reported on line 7a of the Form 5500 2012-03-01 31
Number of retired or separated participants receiving benefits 2012-03-01 0
Number of other retired or separated participants entitled to future benefits 2012-03-01 0
Total of all active and inactive participants 2012-03-01 31
2011: EL MORRO CORRUGATED HEALTH PLAN INS. 2011 401k membership
Total participants, beginning-of-year 2011-03-01 103
Total number of active participants reported on line 7a of the Form 5500 2011-03-01 99
Number of retired or separated participants receiving benefits 2011-03-01 0
Number of other retired or separated participants entitled to future benefits 2011-03-01 0
Total of all active and inactive participants 2011-03-01 99
2010: EL MORRO CORRUGATED HEALTH PLAN INS. 2010 401k membership
Total participants, beginning-of-year 2010-03-01 105
Total number of active participants reported on line 7a of the Form 5500 2010-03-01 105
Number of retired or separated participants receiving benefits 2010-03-01 0
Number of other retired or separated participants entitled to future benefits 2010-03-01 0
Total of all active and inactive participants 2010-03-01 105
2009: EL MORRO CORRUGATED HEALTH PLAN INS. 2009 401k membership
Total participants, beginning-of-year 2009-03-01 116
Total number of active participants reported on line 7a of the Form 5500 2009-03-01 116
Number of retired or separated participants receiving benefits 2009-03-01 0
Number of other retired or separated participants entitled to future benefits 2009-03-01 0
Total of all active and inactive participants 2009-03-01 116

Measure	Date	Value
2013: EL MORRO CORRUGATED HEALTH PLAN INS. 2013 401k membership
Total participants, beginning-of-year	2013-03-01	30
Total number of active participants reported on line 7a of the Form 5500	2013-03-01	0
Number of retired or separated participants receiving benefits	2013-03-01	0
Number of other retired or separated participants entitled to future benefits	2013-03-01	0
Total of all active and inactive participants	2013-03-01	0
2012: EL MORRO CORRUGATED HEALTH PLAN INS. 2012 401k membership
Total participants, beginning-of-year	2012-03-01	99
Total number of active participants reported on line 7a of the Form 5500	2012-03-01	31
Number of retired or separated participants receiving benefits	2012-03-01	0
Number of other retired or separated participants entitled to future benefits	2012-03-01	0
Total of all active and inactive participants	2012-03-01	31
2011: EL MORRO CORRUGATED HEALTH PLAN INS. 2011 401k membership
Total participants, beginning-of-year	2011-03-01	103
Total number of active participants reported on line 7a of the Form 5500	2011-03-01	99
Number of retired or separated participants receiving benefits	2011-03-01	0
Number of other retired or separated participants entitled to future benefits	2011-03-01	0
Total of all active and inactive participants	2011-03-01	99
2010: EL MORRO CORRUGATED HEALTH PLAN INS. 2010 401k membership
Total participants, beginning-of-year	2010-03-01	105
Total number of active participants reported on line 7a of the Form 5500	2010-03-01	105
Number of retired or separated participants receiving benefits	2010-03-01	0
Number of other retired or separated participants entitled to future benefits	2010-03-01	0
Total of all active and inactive participants	2010-03-01	105
2009: EL MORRO CORRUGATED HEALTH PLAN INS. 2009 401k membership
Total participants, beginning-of-year	2009-03-01	116
Total number of active participants reported on line 7a of the Form 5500	2009-03-01	116
Number of retired or separated participants receiving benefits	2009-03-01	0
Number of other retired or separated participants entitled to future benefits	2009-03-01	0
Total of all active and inactive participants	2009-03-01	116

Form 5500 Responses for EL MORRO CORRUGATED HEALTH PLAN INS.

2013: EL MORRO CORRUGATED HEALTH PLAN INS. 2013 form 5500 responses
2013-03-01	Type of plan entity	Single employer plan
2013-03-01	Submission has been amended	Yes
2013-03-01	This submission is the final filing	Yes
2013-03-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2013-03-01	Plan is a collectively bargained plan	No
2013-03-01	Plan funding arrangement – Insurance	Yes
2013-03-01	Plan benefit arrangement – Insurance	Yes
2012: EL MORRO CORRUGATED HEALTH PLAN INS. 2012 form 5500 responses
2012-03-01	Type of plan entity	Single employer plan
2012-03-01	Submission has been amended	No
2012-03-01	This submission is the final filing	No
2012-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-03-01	Plan is a collectively bargained plan	No
2012-03-01	Plan funding arrangement – Insurance	Yes
2012-03-01	Plan benefit arrangement – Insurance	Yes
2011: EL MORRO CORRUGATED HEALTH PLAN INS. 2011 form 5500 responses
2011-03-01	Type of plan entity	Single employer plan
2011-03-01	Submission has been amended	No
2011-03-01	This submission is the final filing	No
2011-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-03-01	Plan is a collectively bargained plan	No
2011-03-01	Plan funding arrangement – Insurance	Yes
2011-03-01	Plan benefit arrangement – Insurance	Yes
2010: EL MORRO CORRUGATED HEALTH PLAN INS. 2010 form 5500 responses
2010-03-01	Type of plan entity	Single employer plan
2010-03-01	Submission has been amended	No
2010-03-01	This submission is the final filing	No
2010-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-03-01	Plan is a collectively bargained plan	No
2010-03-01	Plan funding arrangement – Insurance	Yes
2010-03-01	Plan benefit arrangement – Insurance	Yes
2009: EL MORRO CORRUGATED HEALTH PLAN INS. 2009 form 5500 responses
2009-03-01	Type of plan entity	Single employer plan
2009-03-01	Submission has been amended	No
2009-03-01	This submission is the final filing	No
2009-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-03-01	Plan is a collectively bargained plan	No
2009-03-01	Plan funding arrangement – Insurance	Yes
2009-03-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

MCS LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60030 )

Policy contract number

79-790987

Policy instance

Insurance contract or identification number	79-790987
Number of Individuals Covered	28
Insurance policy start date	2013-03-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $1,858
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&D
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,858
Insurance broker organization code?	3
Insurance broker name	CARRION, LAFFITTE & CASELLAS, INC.

MCS LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60030 )

Policy contract number

79-790987

Policy instance

Insurance contract or identification number	79-790987
Number of Individuals Covered	99
Insurance policy start date	2012-03-01
Insurance policy end date	2013-02-28
Total amount of commissions paid to insurance broker	USD $16,315
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&D
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $16,315
Insurance broker organization code?	3
Insurance broker name	CARRION, LAFFITTE & CASELLAS, INC.

TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 )

Policy contract number

SP OOO3733

Policy instance

Insurance contract or identification number	SP OOO3733
Number of Individuals Covered	99
Insurance policy start date	2011-03-01
Insurance policy end date	2012-02-29
Total amount of commissions paid to insurance broker	USD $14,355
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	MAJOR MEDICAL
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

TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 )

Policy contract number

1-05917

Policy instance

Insurance contract or identification number	1-05917
Number of Individuals Covered	105
Insurance policy start date	2010-03-01
Insurance policy end date	2011-02-28
Total amount of commissions paid to insurance broker	USD $14,528
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	TELECONSULTA
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,528
Insurance broker organization code?	3
Insurance broker name	CARRION, LAFFITTE & CASELLAS, INC.

Potentially related plans

EL MORRO HOLDINGS INC. RETIREMENT PLAN [EIN = 831808283]

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Company Name:	EL MORRO CORRUGATED BOX, CORP.
Employer identification number (EIN):	660274059
NAIC Classification:	322100