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W. S. CUMBY, INC. EMPLOYEE BENEFITS HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameW. S. CUMBY, INC. EMPLOYEE BENEFITS HEALTH AND WELFARE PLAN
Plan identification number 501

W. S. CUMBY, INC. EMPLOYEE BENEFITS HEALTH AND WELFARE PLAN Benefits

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

401k Sponsoring company profile

W.S. CUMBY, INC. has sponsored the creation of one or more 401k plans.

Company Name:W.S. CUMBY, INC.
Employer identification number (EIN):232101220
NAIC Classification:236200

Form 5500 Filing Information

Submission information for form 5500 for 401k plan W. S. CUMBY, INC. EMPLOYEE BENEFITS HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01
5012022-12-01
5012021-12-01

Plan Statistics for W. S. CUMBY, INC. EMPLOYEE BENEFITS HEALTH AND WELFARE PLAN

401k plan membership statisitcs for W. S. CUMBY, INC. EMPLOYEE BENEFITS HEALTH AND WELFARE PLAN

Measure Date Value
2023: W. S. CUMBY, INC. EMPLOYEE BENEFITS HEALTH AND WELFARE PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-0162
Total number of active participants reported on line 7a of the Form 55002023-01-0152
Number of retired or separated participants receiving benefits2023-01-011
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-0153
2022: W. S. CUMBY, INC. EMPLOYEE BENEFITS HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-12-0149
Total number of active participants reported on line 7a of the Form 55002022-12-0162
Number of retired or separated participants receiving benefits2022-12-010
Number of other retired or separated participants entitled to future benefits2022-12-010
Total of all active and inactive participants2022-12-0162
2021: W. S. CUMBY, INC. EMPLOYEE BENEFITS HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-12-0140
Total number of active participants reported on line 7a of the Form 55002021-12-0149
Number of retired or separated participants receiving benefits2021-12-010
Number of other retired or separated participants entitled to future benefits2021-12-010
Total of all active and inactive participants2021-12-0149

Financial Data on W. S. CUMBY, INC. EMPLOYEE BENEFITS HEALTH AND WELFARE PLAN

Measure Date Value
2023 : W. S. CUMBY, INC. EMPLOYEE BENEFITS HEALTH AND WELFARE PLAN 2023 401k financial data
Total plan liabilities at end of year2023-12-31$68,173
Total plan liabilities at beginning of year2023-12-31$64,377
Total income from all sources2023-12-31$544,922
Expenses. Total of all expenses incurred2023-12-31$541,486
Benefits paid (including direct rollovers)2023-12-31$312,085
Total plan assets at end of year2023-12-31$13,159
Total plan assets at beginning of year2023-12-31$5,927
Value of fidelity bond covering the plan2023-12-31$1,000,000
Total contributions received or receivable from participants2023-12-31$211,633
Expenses. Other expenses not covered elsewhere2023-12-31$215,662
Contributions received from other sources (not participants or employers)2023-12-31$1,372
Other income received2023-12-31$1,827
Net income (gross income less expenses)2023-12-31$3,436
Net plan assets at end of year (total assets less liabilities)2023-12-31$-55,014
Net plan assets at beginning of year (total assets less liabilities)2023-12-31$-58,450
Total contributions received or receivable from employer(s)2023-12-31$330,090
Value of corrective distributions2023-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2023-12-31$13,739
2022 : W. S. CUMBY, INC. EMPLOYEE BENEFITS HEALTH AND WELFARE PLAN 2022 401k financial data
Total plan liabilities at end of year2022-12-31$64,377
Total plan liabilities at beginning of year2022-12-31$58,248
Total income from all sources2022-12-31$39,953
Expenses. Total of all expenses incurred2022-12-31$46,463
Benefits paid (including direct rollovers)2022-12-31$30,038
Total plan assets at end of year2022-12-31$5,927
Total plan assets at beginning of year2022-12-31$6,308
Value of fidelity bond covering the plan2022-12-31$1,000,000
Total contributions received or receivable from participants2022-12-31$16,884
Expenses. Other expenses not covered elsewhere2022-12-31$16,425
Contributions received from other sources (not participants or employers)2022-12-31$0
Other income received2022-12-31$4
Net income (gross income less expenses)2022-12-31$-6,510
Net plan assets at end of year (total assets less liabilities)2022-12-31$-58,450
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$-51,940
Total contributions received or receivable from employer(s)2022-12-31$23,065
Value of corrective distributions2022-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$0
Total plan liabilities at end of year2022-11-30$58,248
Total income from all sources2022-11-30$455,774
Expenses. Total of all expenses incurred2022-11-30$507,714
Benefits paid (including direct rollovers)2022-11-30$291,412
Total plan assets at end of year2022-11-30$6,308
Value of fidelity bond covering the plan2022-11-30$1,000,000
Total contributions received or receivable from participants2022-11-30$151,010
Expenses. Other expenses not covered elsewhere2022-11-30$188,186
Contributions received from other sources (not participants or employers)2022-11-30$0
Other income received2022-11-30$51
Net income (gross income less expenses)2022-11-30$-51,940
Net plan assets at end of year (total assets less liabilities)2022-11-30$-51,940
Net plan assets at beginning of year (total assets less liabilities)2022-11-30$0
Total contributions received or receivable from employer(s)2022-11-30$304,713
Value of corrective distributions2022-11-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2022-11-30$28,116

Form 5500 Responses for W. S. CUMBY, INC. EMPLOYEE BENEFITS HEALTH AND WELFARE PLAN

2023: W. S. CUMBY, INC. EMPLOYEE BENEFITS HEALTH AND WELFARE PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01First time form 5500 has been submittedYes
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement - TrustYes
2022: W. S. CUMBY, INC. EMPLOYEE BENEFITS HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-12-01Type of plan entitySingle employer plan
2022-12-01Submission has been amendedNo
2022-12-01This submission is the final filingNo
2022-12-01This return/report is a short plan year return/report (less than 12 months)Yes
2022-12-01Plan is a collectively bargained planNo
2022-12-01Plan funding arrangement – InsuranceYes
2022-12-01Plan funding arrangement – TrustYes
2022-12-01Plan benefit arrangement – InsuranceYes
2022-12-01Plan benefit arrangement - TrustYes
2021: W. S. CUMBY, INC. EMPLOYEE BENEFITS HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-12-01Type of plan entitySingle employer plan
2021-12-01First time form 5500 has been submittedYes
2021-12-01Submission has been amendedNo
2021-12-01This submission is the final filingNo
2021-12-01This return/report is a short plan year return/report (less than 12 months)No
2021-12-01Plan is a collectively bargained planNo
2021-12-01Plan funding arrangement – InsuranceYes
2021-12-01Plan funding arrangement – TrustYes
2021-12-01Plan benefit arrangement – InsuranceYes
2021-12-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract number30500817
Policy instance 1
Insurance contract or identification number30500817
Number of Individuals Covered52
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
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 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
Welfare Benefit Premiums Paid to CarrierUSD $175,276
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract number30500817
Policy instance 1
Insurance contract or identification number30500817
Number of Individuals Covered49
Insurance policy start date2022-12-01
Insurance policy end date2022-12-31
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 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
Welfare Benefit Premiums Paid to CarrierUSD $12,996
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract number30500817
Policy instance 1
Insurance contract or identification number30500817
Number of Individuals Covered49
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
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 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
Welfare Benefit Premiums Paid to CarrierUSD $147,607
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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