401k Plan data: NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN plan

NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN 401k Plan overview

Plan Name	NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN
Plan identification number	501

NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

NELSON LABORATORIES, INC. has sponsored the creation of one or more 401k plans.

Company Name: NELSON LABORATORIES, INC.

Employer identification number (EIN): 870425936

NAIC Classification: 541380
NAIC Description: Testing Laboratories

Additional information about NELSON LABORATORIES, INC.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations

Incorporation Date: 1971-07-26

Company Identification Number: 385827

More information about NELSON LABORATORIES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2017-01-01
501 2016-01-01 JODY DORIUS JODY DORIUS 2017-10-06
501 2015-01-01 JODY DORIUS JODY DORIUS 2016-10-17
501 2014-01-01 JIM CARTER JIM CARTER 2015-10-15
501 2013-01-01 MICHAEL BENNETT MICHAEL BENNETT 2014-10-13
501 2012-01-01 MICHAEL BENNETT MICHAEL BENNETT 2013-10-14
501 2010-01-01 S DAVID JACKSON
501 2009-01-01 S DAVID JACKSON

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2017-01-01
501	2016-01-01	JODY DORIUS	JODY DORIUS	2017-10-06
501	2015-01-01	JODY DORIUS	JODY DORIUS	2016-10-17
501	2014-01-01	JIM CARTER	JIM CARTER	2015-10-15
501	2013-01-01	MICHAEL BENNETT	MICHAEL BENNETT	2014-10-13
501	2012-01-01	MICHAEL BENNETT	MICHAEL BENNETT	2013-10-14
501	2010-01-01	S DAVID JACKSON
501	2009-01-01	S DAVID JACKSON

Plan Statistics for NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN

401k plan membership statisitcs for NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN

Measure Date Value
2017: NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 551
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 0
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 0
2016: NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 521
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 551
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 551
2015: NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 476
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 521
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 521
2014: NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 440
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 476
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 476
2013: NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 430
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 440
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 440
Total participants 2013-01-01 440
2012: NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 369
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 430
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 430
Total participants 2012-01-01 430
2010: NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 274
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 369
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 369
Total participants 2010-01-01 369
2009: NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 255
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 274
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 274
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2017: NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	551
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	0
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	0
2016: NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	521
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	551
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	551
2015: NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	476
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	521
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	521
2014: NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	440
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	476
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	476
2013: NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	430
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	440
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	440
Total participants	2013-01-01	440
2012: NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	369
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	430
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	430
Total participants	2012-01-01	430
2010: NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	274
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	369
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	369
Total participants	2010-01-01	369
2009: NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	255
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	274
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	274
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Form 5500 Responses for NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN

2017: NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	This submission is the final filing	Yes
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS 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	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: NELSON LABORATORIES, INC. EMPLOYEE MEDICAL BENEFITS PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 )

Policy contract number

12156339

Policy instance

Insurance contract or identification number	12156339
Number of Individuals Covered	797
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

52074

Policy instance

Insurance contract or identification number	52074
Number of Individuals Covered	1317
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $9,858
Total amount of fees paid to insurance company	USD $440
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $460,774
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,858
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	THIRD PARTY ADMINISTRATION FEES
Insurance broker name	AXA ASSISTANCE, USA

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Company Name:	NELSON LABORATORIES, INC.
Employer identification number (EIN):	870425936
NAIC Classification:	541380
NAIC Description:	Testing Laboratories

Jurisdiction of Incorporation:	Florida Department of State Division of Corporations
Incorporation Date:	1971-07-26
Company Identification Number:	385827