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ROYAL FINANCIAL SERVICES SELF INSURED HEALTH PLAN 401k Plan overview

Plan NameROYAL FINANCIAL SERVICES SELF INSURED HEALTH PLAN
Plan identification number 501

ROYAL FINANCIAL SERVICES SELF INSURED HEALTH PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental

401k Sponsoring company profile

ROYAL FINANCIAL SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name:ROYAL FINANCIAL SERVICES, INC.
Employer identification number (EIN):710656664
NAIC Classification:541214
NAIC Description:Payroll Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ROYAL FINANCIAL SERVICES SELF INSURED HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012014-01-01
5012013-01-01DAN MESSERSMITH, CFO

Plan Statistics for ROYAL FINANCIAL SERVICES SELF INSURED HEALTH PLAN

401k plan membership statisitcs for ROYAL FINANCIAL SERVICES SELF INSURED HEALTH PLAN

Measure Date Value
2014: ROYAL FINANCIAL SERVICES SELF INSURED HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01305
Total number of active participants reported on line 7a of the Form 55002014-01-01194
Total of all active and inactive participants2014-01-01194
Total participants2014-01-01194
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: ROYAL FINANCIAL SERVICES SELF INSURED HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-010
Total number of active participants reported on line 7a of the Form 55002013-01-01305
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01305

Financial Data on ROYAL FINANCIAL SERVICES SELF INSURED HEALTH PLAN

Measure Date Value
2013 : ROYAL FINANCIAL SERVICES SELF INSURED HEALTH PLAN 2013 401k financial data
Total income from all sources (including contributions)2013-12-31$625,000
Total of all expenses incurred2013-12-31$603,925
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$515,806
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$625,000
Value of total assets at end of year2013-12-31$21,075
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$88,119
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31No
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-12-31$515,806
Administrative expenses (other) incurred2013-12-31$37,774
Total non interest bearing cash at end of year2013-12-31$21,075
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$21,075
Value of net assets at end of year (total assets less liabilities)2013-12-31$21,075
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$625,000
Contract administrator fees2013-12-31$50,345
Did the plan have assets held for investment2013-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No

Form 5500 Responses for ROYAL FINANCIAL SERVICES SELF INSURED HEALTH PLAN

2014: ROYAL FINANCIAL SERVICES SELF INSURED HEALTH 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 – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: ROYAL FINANCIAL SERVICES SELF INSURED HEALTH PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01First time form 5500 has been submittedYes
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

QCA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95448 )
Policy contract number90003
Policy instance 1
Insurance contract or identification number90003
Number of Individuals Covered335
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $23,644
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,644
Insurance broker organization code?3
Insurance broker nameCRAIG WURTZ
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 )
Policy contract number000003523
Policy instance 2
Insurance contract or identification number000003523
Number of Individuals Covered307
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $6,251
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,251
Insurance broker organization code?3
Insurance broker nameWURTZ AGENCY DBA MWA
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL19971
Policy instance 3
Insurance contract or identification numberHCL19971
Number of Individuals Covered194
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?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?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
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number11515000
Policy instance 4
Insurance contract or identification number11515000
Number of Individuals Covered221
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $8,739
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?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
Other welfare benefits providedFIXED PAYMENT INDEMNITY
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,739
Insurance broker organization code?3
Insurance broker nameWURTZ AGENCY INC.
QCA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95448 )
Policy contract number90003
Policy instance 1
Insurance contract or identification number90003
Number of Individuals Covered305
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $22,839
Total amount of fees paid to insurance companyUSD $50,345
Are there contracts with allocated funds for types other than group deferred annuity or individual?Yes
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractEMPLOYEE WELFARE PLAN
Commission paid to Insurance BrokerUSD $22,839
Amount paid for insurance broker fees50345
Additional information about fees paid to insurance brokerCONSULTING
Insurance broker organization code?3
Insurance broker nameWURTZ AGENCY, INC.
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number
Policy instance 2
Number of Individuals Covered166
Insurance policy end date2013-12-31
Are there contracts with allocated funds for individual policies?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerCONSULTING
Insurance broker organization code?3
Insurance broker nameWURTZ AGENCY, INC.
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number11515000
Policy instance 3
Insurance contract or identification number11515000
Number of Individuals Covered210
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $9,163
Are there contracts with allocated funds for individual policies?Yes
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,163
Additional information about fees paid to insurance brokerCONSULTING
Insurance broker organization code?3
Insurance broker nameWURTZ AGENCY, INC.
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 )
Policy contract number000003523
Policy instance 4
Insurance contract or identification number000003523
Number of Individuals Covered254
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $5,772
Are there contracts with allocated funds for individual policies?Yes
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,772
Additional information about fees paid to insurance brokerCONSULTING
Insurance broker organization code?3
Insurance broker nameWURTZ AGENCY, INC.

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