401k Plan data: AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN plan

AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN 401k Plan overview

Plan Name	AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN
Plan identification number	001

AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN Benefits

401k Plan Type

Defined 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.
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

AFFIRMATIVE INSURANCE HOLDINGS, INC has sponsored the creation of one or more 401k plans.

Company Name: AFFIRMATIVE INSURANCE HOLDINGS, INC

Employer identification number (EIN): 752957865

NAIC Classification: 524290

Additional information about AFFIRMATIVE INSURANCE HOLDINGS, INC

Jurisdiction of Incorporation: State of Delaware Division of Corporations

Incorporation Date:

Company Identification Number: 2913512

More information about AFFIRMATIVE INSURANCE HOLDINGS, INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2014-01-01 KIMBERLY DOMINGUEZ KIMBERLY DOMINGUEZ 2015-07-17
001 2013-01-01 KIMBERLY DOMINGUEZ
001 2012-01-01 KIMBERLY DOMINGUEZ
001 2011-01-01 DEBBIE MCKINNEY
001 2010-01-01 RANDY SMITH
001 2009-01-01 RANDY SMITH
001 2009-01-01 JACQUELINE DEBOWSKI

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2014-01-01	KIMBERLY DOMINGUEZ	KIMBERLY DOMINGUEZ	2015-07-17
001	2013-01-01	KIMBERLY DOMINGUEZ
001	2012-01-01	KIMBERLY DOMINGUEZ
001	2011-01-01	DEBBIE MCKINNEY
001	2010-01-01	RANDY SMITH
001	2009-01-01	RANDY SMITH
001	2009-01-01	JACQUELINE DEBOWSKI

Plan Statistics for AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN

401k plan membership statisitcs for AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN

Measure Date Value
2014: AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 817
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 486
Number of retired or separated participants receiving benefits 2014-01-01 1
Number of other retired or separated participants entitled to future benefits 2014-01-01 263
Total of all active and inactive participants 2014-01-01 750
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 1
Total participants 2014-01-01 751
Number of participants with account balances 2014-01-01 515
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1,149
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 523
Number of retired or separated participants receiving benefits 2013-01-01 1
Number of other retired or separated participants entitled to future benefits 2013-01-01 292
Total of all active and inactive participants 2013-01-01 816
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 1
Total participants 2013-01-01 817
Number of participants with account balances 2013-01-01 453
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1,456
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 884
Number of retired or separated participants receiving benefits 2012-01-01 1
Number of other retired or separated participants entitled to future benefits 2012-01-01 263
Total of all active and inactive participants 2012-01-01 1,148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 1
Total participants 2012-01-01 1,149
Number of participants with account balances 2012-01-01 531
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 1
2011: AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,697
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 1,053
Number of retired or separated participants receiving benefits 2011-01-01 2
Number of other retired or separated participants entitled to future benefits 2011-01-01 378
Total of all active and inactive participants 2011-01-01 1,433
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 2
Total participants 2011-01-01 1,435
Number of participants with account balances 2011-01-01 729
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 1,693
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 1,219
Number of retired or separated participants receiving benefits 2010-01-01 2
Number of other retired or separated participants entitled to future benefits 2010-01-01 441
Total of all active and inactive participants 2010-01-01 1,662
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 1,662
Number of participants with account balances 2010-01-01 942
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 12
2009: AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 1,840
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 1,116
Number of retired or separated participants receiving benefits 2009-01-01 2
Number of other retired or separated participants entitled to future benefits 2009-01-01 538
Total of all active and inactive participants 2009-01-01 1,656
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 1,656
Number of participants with account balances 2009-01-01 1,040
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 24

Measure	Date	Value
2014: AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	817
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	486
Number of retired or separated participants receiving benefits	2014-01-01	1
Number of other retired or separated participants entitled to future benefits	2014-01-01	263
Total of all active and inactive participants	2014-01-01	750
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	1
Total participants	2014-01-01	751
Number of participants with account balances	2014-01-01	515
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,149
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	523
Number of retired or separated participants receiving benefits	2013-01-01	1
Number of other retired or separated participants entitled to future benefits	2013-01-01	292
Total of all active and inactive participants	2013-01-01	816
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	1
Total participants	2013-01-01	817
Number of participants with account balances	2013-01-01	453
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,456
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	884
Number of retired or separated participants receiving benefits	2012-01-01	1
Number of other retired or separated participants entitled to future benefits	2012-01-01	263
Total of all active and inactive participants	2012-01-01	1,148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	1
Total participants	2012-01-01	1,149
Number of participants with account balances	2012-01-01	531
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	1
2011: AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,697
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1,053
Number of retired or separated participants receiving benefits	2011-01-01	2
Number of other retired or separated participants entitled to future benefits	2011-01-01	378
Total of all active and inactive participants	2011-01-01	1,433
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	2
Total participants	2011-01-01	1,435
Number of participants with account balances	2011-01-01	729
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	1,693
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	1,219
Number of retired or separated participants receiving benefits	2010-01-01	2
Number of other retired or separated participants entitled to future benefits	2010-01-01	441
Total of all active and inactive participants	2010-01-01	1,662
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	1,662
Number of participants with account balances	2010-01-01	942
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	12
2009: AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,840
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1,116
Number of retired or separated participants receiving benefits	2009-01-01	2
Number of other retired or separated participants entitled to future benefits	2009-01-01	538
Total of all active and inactive participants	2009-01-01	1,656
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	1,656
Number of participants with account balances	2009-01-01	1,040
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	24

Financial Data on AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN

Measure	Date	Value
2014 : AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$3,160,033
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$2,853,757
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$2,769,951
Value of total corrective distributions	2014-12-31	$58,694
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$2,040,708
Value of total assets at end of year	2014-12-31	$18,807,915
Value of total assets at beginning of year	2014-12-31	$18,501,639
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$25,112
Total interest from all sources	2014-12-31	$202,053
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$1,125,644
Participant contributions at end of year	2014-12-31	$387,592
Participant contributions at beginning of year	2014-12-31	$546,682
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$295,170
Other income not declared elsewhere	2014-12-31	$2,017
Administrative expenses (other) incurred	2014-12-31	$25,112
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$306,276
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$18,807,915
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$18,501,639
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$12,548,436
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$11,257,038
Interest on participant loans	2014-12-31	$17,403
Interest earned on other investments	2014-12-31	$184,650
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$5,871,887
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$6,697,919
Net investment gain/loss from pooled separate accounts	2014-12-31	$915,255
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$619,894
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$2,769,951
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	CPWR, LLP
Accountancy firm EIN	2014-12-31	203676004
2013 : AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$3,486,406
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$3,183,974
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$3,092,801
Value of total corrective distributions	2013-12-31	$66,888
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$844,573
Value of total assets at end of year	2013-12-31	$18,501,639
Value of total assets at beginning of year	2013-12-31	$18,199,207
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$24,285
Total interest from all sources	2013-12-31	$227,252
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$834,484
Participant contributions at end of year	2013-12-31	$546,682
Participant contributions at beginning of year	2013-12-31	$746,087
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$10,089
Other income not declared elsewhere	2013-12-31	$6,304
Administrative expenses (other) incurred	2013-12-31	$24,285
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$302,432
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$18,501,639
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$18,199,207
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$11,257,038
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$10,347,431
Interest on participant loans	2013-12-31	$23,790
Interest earned on other investments	2013-12-31	$203,462
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$6,697,919
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$7,105,689
Net investment gain/loss from pooled separate accounts	2013-12-31	$2,408,277
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$3,092,801
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	CPWR, LLP
Accountancy firm EIN	2013-12-31	203676004
2012 : AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$2,670,722
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$3,541,277
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$3,475,689
Value of total corrective distributions	2012-12-31	$47,177
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$975,505
Value of total assets at end of year	2012-12-31	$18,199,207
Value of total assets at beginning of year	2012-12-31	$19,069,762
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$18,411
Total interest from all sources	2012-12-31	$256,837
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$974,250
Participant contributions at end of year	2012-12-31	$746,087
Participant contributions at beginning of year	2012-12-31	$938,825
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$1,255
Other income not declared elsewhere	2012-12-31	$2,191
Administrative expenses (other) incurred	2012-12-31	$18,411
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$-870,555
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$18,199,207
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$19,069,762
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$10,347,431
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$10,422,242
Interest on participant loans	2012-12-31	$36,349
Interest earned on other investments	2012-12-31	$220,488
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$7,105,689
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$7,708,695
Net investment gain/loss from pooled separate accounts	2012-12-31	$1,436,189
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$3,475,689
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	CPWR, LLP
Accountancy firm EIN	2012-12-31	203676004
2011 : AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$1,163,070
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$3,644,232
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$3,570,300
Expenses. Certain deemed distributions of participant loans	2011-12-31	$617
Value of total corrective distributions	2011-12-31	$56,199
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$1,297,535
Value of total assets at end of year	2011-12-31	$19,069,762
Value of total assets at beginning of year	2011-12-31	$21,550,924
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$17,116
Total interest from all sources	2011-12-31	$277,128
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$1,223,970
Participant contributions at end of year	2011-12-31	$938,825
Participant contributions at beginning of year	2011-12-31	$1,014,788
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$73,565
Other income not declared elsewhere	2011-12-31	$1,915
Administrative expenses (other) incurred	2011-12-31	$17,116
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$-2,481,162
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$19,069,762
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$21,550,924
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$10,422,242
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$12,716,315
Interest on participant loans	2011-12-31	$41,533
Interest earned on other investments	2011-12-31	$235,595
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$7,708,695
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$7,819,821
Net investment gain/loss from pooled separate accounts	2011-12-31	$-413,508
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$3,570,300
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	CPWR, LLP
Accountancy firm EIN	2011-12-31	203676004
2010 : AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$3,789,761
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$4,156,971
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$4,090,915
Expenses. Certain deemed distributions of participant loans	2010-12-31	$34,368
Value of total corrective distributions	2010-12-31	$18,188
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$1,705,626
Value of total assets at end of year	2010-12-31	$21,550,924
Value of total assets at beginning of year	2010-12-31	$21,918,134
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$13,500
Total interest from all sources	2010-12-31	$324,969
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$1,359,445
Participant contributions at end of year	2010-12-31	$1,014,788
Participant contributions at beginning of year	2010-12-31	$1,127,900
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$346,181
Other income not declared elsewhere	2010-12-31	$6,438
Administrative expenses (other) incurred	2010-12-31	$13,500
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$-367,210
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$21,550,924
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$21,918,134
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$12,716,315
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$11,913,049
Interest on participant loans	2010-12-31	$50,606
Interest earned on other investments	2010-12-31	$274,363
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$7,819,821
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$8,877,185
Net investment gain/loss from pooled separate accounts	2010-12-31	$1,752,728
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$4,090,915
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	WHITLEY PENN
Accountancy firm EIN	2010-12-31	752393478
2009 : AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN

2014: AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	Yes
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	Yes
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: AFFIRMATIVE INSURANCE HOLDINGS, INC 401K PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	AFFIRMATIVE INSURANCE HOLDINGS, INC
Employer identification number (EIN):	752957865
NAIC Classification:	524290

Jurisdiction of Incorporation:	State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number:	2913512