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GRACE MANAGEMENT HEALTH & WELFARE PLAN 401k Plan overview

Plan NameGRACE MANAGEMENT HEALTH & WELFARE PLAN
Plan identification number 501

GRACE MANAGEMENT HEALTH & WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

GRACE MANAGEMENT, INC has sponsored the creation of one or more 401k plans.

Company Name:GRACE MANAGEMENT, INC
Employer identification number (EIN):262537582
NAIC Classification:238900

Additional information about GRACE MANAGEMENT, INC

Jurisdiction of Incorporation: Wyoming Corporations Division
Incorporation Date: 2012-08-17
Company Identification Number: 000627692
Legal Registered Office Address: 121 Grand Ave Ste 210

Laramie
United States of America (USA)
82070

More information about GRACE MANAGEMENT, INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GRACE MANAGEMENT HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012014-01-01ELISE EMMONS2015-10-14 ELISE EMMONS2015-10-14
5012013-01-01DERRICK QUAN2014-10-15
5012012-01-01DENNIS CHAMBERS DENNIS CHAMBERS2013-08-19
5012011-04-01DENNIS CHAMBERS DENNIS CHAMBERS2012-10-12

Plan Statistics for GRACE MANAGEMENT HEALTH & WELFARE PLAN

401k plan membership statisitcs for GRACE MANAGEMENT HEALTH & WELFARE PLAN

Measure Date Value
2012: GRACE MANAGEMENT HEALTH & WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01236
Total number of active participants reported on line 7a of the Form 55002012-01-01265
Total of all active and inactive participants2012-01-01265
2011: GRACE MANAGEMENT HEALTH & WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year2011-04-010
Total number of active participants reported on line 7a of the Form 55002011-04-01236
Total of all active and inactive participants2011-04-01236

Financial Data on GRACE MANAGEMENT HEALTH & WELFARE PLAN

Measure Date Value
2012 : GRACE MANAGEMENT HEALTH & WELFARE PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$157,709
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$170,808
Total income from all sources (including contributions)2012-12-31$637,670
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$643,408
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$438,291
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$637,670
Value of total assets at end of year2012-12-31$157,804
Value of total assets at beginning of year2012-12-31$176,641
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$205,117
Total interest from all sources2012-12-31$0
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 year2012-12-31No
Administrative expenses professional fees incurred2012-12-31$7,620
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$55,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Administrative expenses (other) incurred2012-12-31$52,191
Liabilities. Value of operating payables at end of year2012-12-31$78,037
Liabilities. Value of operating payables at beginning of year2012-12-31$58,308
Total non interest bearing cash at end of year2012-12-31$157,804
Total non interest bearing cash at beginning of year2012-12-31$77,694
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$-5,738
Value of net assets at end of year (total assets less liabilities)2012-12-31$95
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$5,833
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$382,708
Asset value of US Government securities at beginning of year2012-12-31$28,128
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$637,670
Employer contributions (assets) at beginning of year2012-12-31$70,819
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$55,583
Contract administrator fees2012-12-31$145,306
Liabilities. Value of benefit claims payable at end of year2012-12-31$79,672
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$112,500
Did the plan have assets held for investment2012-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31INEICH & COMPANY, LLP
Accountancy firm EIN2012-12-31562552172
2011 : GRACE MANAGEMENT HEALTH & WELFARE PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$170,808
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$552,960
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$547,127
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$400,432
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$552,903
Value of total assets at end of year2011-12-31$176,641
Value of total assets at beginning of year2011-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$146,695
Total interest from all sources2011-12-31$57
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 year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$55,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Administrative expenses (other) incurred2011-12-31$36,115
Liabilities. Value of operating payables at end of year2011-12-31$58,308
Total non interest bearing cash at end of year2011-12-31$77,694
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$5,833
Value of net assets at end of year (total assets less liabilities)2011-12-31$5,833
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$57
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$337,265
Asset value of US Government securities at end of year2011-12-31$28,128
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$552,903
Employer contributions (assets) at end of year2011-12-31$70,819
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$63,167
Contract administrator fees2011-12-31$110,580
Liabilities. Value of benefit claims payable at end of year2011-12-31$112,500
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31INEICH & COMPANY, LLP
Accountancy firm EIN2011-12-31562552172

Form 5500 Responses for GRACE MANAGEMENT HEALTH & WELFARE PLAN

2012: GRACE MANAGEMENT HEALTH & WELFARE PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: GRACE MANAGEMENT HEALTH & WELFARE PLAN 2011 form 5500 responses
2011-04-01Type of plan entitySingle employer plan
2011-04-01First time form 5500 has been submittedYes
2011-04-01Submission has been amendedNo
2011-04-01This submission is the final filingNo
2011-04-01This return/report is a short plan year return/report (less than 12 months)Yes
2011-04-01Plan is a collectively bargained planNo
2011-04-01Plan funding arrangement – TrustYes
2011-04-01Plan benefit arrangement – InsuranceYes
2011-04-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL645665
Policy instance 1
Insurance contract or identification numberGL645665
Number of Individuals Covered277
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $85
Total amount of fees paid to insurance companyUSD $2,272
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 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 BenefitYes
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 $14,627
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees2272
Additional information about fees paid to insurance brokerADMINISTRATIVE & OTHER
Insurance broker organization code?5
Commission paid to Insurance BrokerUSD $85
Insurance broker nameFCE BENEFIT ADMINISTRATORS, INC.
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVAR645863
Policy instance 2
Insurance contract or identification numberVAR645863
Number of Individuals Covered277
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $18
Total amount of fees paid to insurance companyUSD $488
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 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
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 $3,142
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees488
Additional information about fees paid to insurance brokerADMINISTRATIVE & OTHER
Insurance broker organization code?5
Commission paid to Insurance BrokerUSD $18
Insurance broker nameFCE BENEFIT ADMINISTRATORS, INC.
STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 )
Policy contract numberSSLLMBGMI1
Policy instance 3
Insurance contract or identification numberSSLLMBGMI1
Number of Individuals Covered236
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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 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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
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 $405,268
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL645665
Policy instance 1
Insurance contract or identification numberGL645665
Number of Individuals Covered253
Insurance policy start date2011-05-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $2,648
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 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 BenefitYes
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 $12,317
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVAR645863
Policy instance 2
Insurance contract or identification numberVAR645863
Number of Individuals Covered253
Insurance policy start date2011-05-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $568
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 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
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 $2,645
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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