401k Plan data: GULF PACIFIC RICE CO., INC. HEALTH AND WELFARE BENEFIT PLAN plan

GULF PACIFIC RICE CO., INC. HEALTH AND WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	GULF PACIFIC RICE CO., INC. HEALTH AND WELFARE BENEFIT PLAN
Plan identification number	501

GULF PACIFIC RICE CO., INC. HEALTH AND WELFARE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

GULF PACIFIC RICE CO., INC. has sponsored the creation of one or more 401k plans.

Company Name: GULF PACIFIC RICE CO., INC.

Employer identification number (EIN): 760259520

NAIC Classification: 311200
NAIC Description: Grain and Oilseed Milling

Additional information about GULF PACIFIC RICE CO., INC.

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 1988-09-28

Company Identification Number: 0109021800

Legal Registered Office Address: 12010 TAYLOR RD

HOUSTON
United States of America (USA)
77041

More information about GULF PACIFIC RICE CO., INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GULF PACIFIC RICE CO., INC. HEALTH AND WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2017-04-01
501 2017-04-01 PATRICK J. CASSERLY 2019-01-15 PATRICK J. CASSERLY 2019-01-15
501 2016-04-01
501 2016-04-01 PATRICK J. CASSERLY 2019-01-15

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2017-04-01
501	2017-04-01	PATRICK J. CASSERLY	2019-01-15	PATRICK J. CASSERLY	2019-01-15
501	2016-04-01
501	2016-04-01	PATRICK J. CASSERLY	2019-01-15

Plan Statistics for GULF PACIFIC RICE CO., INC. HEALTH AND WELFARE BENEFIT PLAN

401k plan membership statisitcs for GULF PACIFIC RICE CO., INC. HEALTH AND WELFARE BENEFIT PLAN

Measure Date Value
2017: GULF PACIFIC RICE CO., INC. HEALTH AND WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-04-01 100
Total number of active participants reported on line 7a of the Form 5500 2017-04-01 99
Number of retired or separated participants receiving benefits 2017-04-01 1
Number of other retired or separated participants entitled to future benefits 2017-04-01 0
Total of all active and inactive participants 2017-04-01 100
Total participants 2017-04-01 100
2016: GULF PACIFIC RICE CO., INC. HEALTH AND WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-04-01 106
Total number of active participants reported on line 7a of the Form 5500 2016-04-01 120
Number of retired or separated participants receiving benefits 2016-04-01 1
Number of other retired or separated participants entitled to future benefits 2016-04-01 0
Total of all active and inactive participants 2016-04-01 121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-04-01 0
Total participants 2016-04-01 121

Measure	Date	Value
2017: GULF PACIFIC RICE CO., INC. HEALTH AND WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-04-01	100
Total number of active participants reported on line 7a of the Form 5500	2017-04-01	99
Number of retired or separated participants receiving benefits	2017-04-01	1
Number of other retired or separated participants entitled to future benefits	2017-04-01	0
Total of all active and inactive participants	2017-04-01	100
Total participants	2017-04-01	100
2016: GULF PACIFIC RICE CO., INC. HEALTH AND WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-04-01	106
Total number of active participants reported on line 7a of the Form 5500	2016-04-01	120
Number of retired or separated participants receiving benefits	2016-04-01	1
Number of other retired or separated participants entitled to future benefits	2016-04-01	0
Total of all active and inactive participants	2016-04-01	121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-04-01	0
Total participants	2016-04-01	121

Form 5500 Responses for GULF PACIFIC RICE CO., INC. HEALTH AND WELFARE BENEFIT PLAN

2017: GULF PACIFIC RICE CO., INC. HEALTH AND WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-04-01	Type of plan entity	Single employer plan
2017-04-01	Submission has been amended	No
2017-04-01	This submission is the final filing	No
2017-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-04-01	Plan is a collectively bargained plan	No
2017-04-01	Plan funding arrangement – Insurance	Yes
2017-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-04-01	Plan benefit arrangement – Insurance	Yes
2017-04-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: GULF PACIFIC RICE CO., INC. HEALTH AND WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-04-01	Type of plan entity	Single employer plan
2016-04-01	First time form 5500 has been submitted	Yes
2016-04-01	Submission has been amended	No
2016-04-01	This submission is the final filing	No
2016-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-04-01	Plan is a collectively bargained plan	No
2016-04-01	Plan funding arrangement – Insurance	Yes
2016-04-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

76651

Policy instance

Insurance contract or identification number	76651
Number of Individuals Covered	141
Insurance policy start date	2017-04-17
Insurance policy end date	2018-03-31
Total amount of commissions paid to insurance broker	USD $33,094
Total amount of fees paid to insurance company	USD $640
Are there contracts with allocated funds for individual policies?	0
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	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $624,381
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $33,094
Amount paid for insurance broker fees	640
Additional information about fees paid to insurance broker	SPECIAL PROGRAMS
Insurance broker organization code?	3
Insurance broker name	WELLS FARGO INS. SVC. USA INC.

Potentially related plans

GULF PACIFIC CO. 401(K) PROFIT SHARING PLAN [EIN = 931250186]

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Company Name:	GULF PACIFIC RICE CO., INC.
Employer identification number (EIN):	760259520
NAIC Classification:	311200
NAIC Description:	Grain and Oilseed Milling

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	1988-09-28
Company Identification Number:	0109021800
Legal Registered Office Address:	12010 TAYLOR RD HOUSTON United States of America (USA) 77041