401k Plan data: HUSKY TIRE CORP. 401(K) PLAN plan

HUSKY TIRE CORP. 401(K) PLAN 401k Plan overview

Plan Name	HUSKY TIRE CORP. 401(K) PLAN
Plan identification number	001

HUSKY TIRE CORP. 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
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.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

HUSKY TIRE CORP. has sponsored the creation of one or more 401k plans.

Company Name: HUSKY TIRE CORP.

Employer identification number (EIN): 981046204

NAIC Classification: 423100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HUSKY TIRE CORP. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2017-01-01 TROY KLINE
001 2016-01-01 CATHERINE MCKEOWN
001 2015-01-01 FRANK NOAKES

Plan id#	Filing Submission Date	Name of Administrator
001	2017-01-01	TROY KLINE
001	2016-01-01	CATHERINE MCKEOWN
001	2015-01-01	FRANK NOAKES

Plan Statistics for HUSKY TIRE CORP. 401(K) PLAN

401k plan membership statisitcs for HUSKY TIRE CORP. 401(K) PLAN

Measure Date Value
2017: HUSKY TIRE CORP. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 63
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 32
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 24
Total of all active and inactive participants 2017-01-01 56
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 56
Number of participants with account balances 2017-01-01 47
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 1
2016: HUSKY TIRE CORP. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 61
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 43
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 18
Total of all active and inactive participants 2016-01-01 61
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 61
Number of participants with account balances 2016-01-01 52
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 8
2015: HUSKY TIRE CORP. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 41
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 50
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 8
Total of all active and inactive participants 2015-01-01 58
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 58
Number of participants with account balances 2015-01-01 58
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 7

Measure	Date	Value
2017: HUSKY TIRE CORP. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	63
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	32
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	24
Total of all active and inactive participants	2017-01-01	56
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	56
Number of participants with account balances	2017-01-01	47
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	1
2016: HUSKY TIRE CORP. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	61
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	43
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	18
Total of all active and inactive participants	2016-01-01	61
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	61
Number of participants with account balances	2016-01-01	52
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	8
2015: HUSKY TIRE CORP. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	41
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	50
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	8
Total of all active and inactive participants	2015-01-01	58
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	58
Number of participants with account balances	2015-01-01	58
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	7

Financial Data on HUSKY TIRE CORP. 401(K) PLAN

Measure	Date	Value
2017 : HUSKY TIRE CORP. 401(K) PLAN 2017 401k financial data
Total income from all sources	2017-12-31	$391,222
Expenses. Total of all expenses incurred	2017-12-31	$216,518
Benefits paid (including direct rollovers)	2017-12-31	$205,948
Total plan assets at end of year	2017-12-31	$962,204
Total plan assets at beginning of year	2017-12-31	$787,500
Total contributions received or receivable from participants	2017-12-31	$201,095
Other income received	2017-12-31	$114,536
Net income (gross income less expenses)	2017-12-31	$174,704
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$962,204
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$787,500
Total contributions received or receivable from employer(s)	2017-12-31	$75,591
Value of corrective distributions	2017-12-31	$6,919
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$3,651
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : HUSKY TIRE CORP. 401(K) PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$322,472
Expenses. Total of all expenses incurred	2016-12-31	$27,122
Benefits paid (including direct rollovers)	2016-12-31	$27,122
Total plan assets at end of year	2016-12-31	$787,500
Total plan assets at beginning of year	2016-12-31	$492,150
Total contributions received or receivable from participants	2016-12-31	$195,214
Other income received	2016-12-31	$47,132
Net income (gross income less expenses)	2016-12-31	$295,350
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$787,500
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$492,150
Total contributions received or receivable from employer(s)	2016-12-31	$80,126
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : HUSKY TIRE CORP. 401(K) PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$492,150
Expenses. Total of all expenses incurred	2015-12-31	$0
Total plan assets at end of year	2015-12-31	$492,150
Total plan assets at beginning of year	2015-12-31	$0
Total contributions received or receivable from participants	2015-12-31	$137,177
Contributions received from other sources (not participants or employers)	2015-12-31	$310,099
Other income received	2015-12-31	$-20,449
Net income (gross income less expenses)	2015-12-31	$492,150
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$492,150
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$0
Total contributions received or receivable from employer(s)	2015-12-31	$65,323

Form 5500 Responses for HUSKY TIRE CORP. 401(K) PLAN

2017: HUSKY TIRE CORP. 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: HUSKY TIRE CORP. 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: HUSKY TIRE CORP. 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	First time form 5500 has been submitted	Yes
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

916924-01

Policy instance

Insurance contract or identification number	916924-01
Number of Individuals Covered	46
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $4,369
Total amount of fees paid to insurance company	USD $0
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?	Yes
Health Insurance Welfare Benefit	No
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
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 $4,369
Insurance broker organization code?	3
Insurance broker name	NICHOLAS DELLA VEDOVA

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

916924-01

Policy instance

Insurance contract or identification number	916924-01
Number of Individuals Covered	59
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $1,166
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?	Yes
Health Insurance Welfare Benefit	No
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
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 $1,166
Insurance broker organization code?	3
Insurance broker name	NICHOLAS DELLA VEDOVA/NFP ADVISORS

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Company Name:	HUSKY TIRE CORP.
Employer identification number (EIN):	981046204
NAIC Classification:	423100