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TRAVEL ACCIDENT PROGRAM 401k Plan overview

Plan NameTRAVEL ACCIDENT PROGRAM
Plan identification number 518

TRAVEL ACCIDENT PROGRAM Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

INDIAN HEAD INDUSTRIES, INC. has sponsored the creation of one or more 401k plans.

Company Name:INDIAN HEAD INDUSTRIES, INC.
Employer identification number (EIN):382511555
NAIC Classification:336300

Additional information about INDIAN HEAD INDUSTRIES, INC.

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 2027130

More information about INDIAN HEAD INDUSTRIES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TRAVEL ACCIDENT PROGRAM

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5182013-04-01
5182013-04-01
5182012-04-01JEFFREY PARKER SUSAN PARKER2014-01-10
5182011-04-01JEFFREY PARKER SUSAN PARKER2013-01-08
5182010-04-01JEFFREY PARKER SUSAN PFEIFFER2012-01-13
5182009-04-01JEFFREY PARKER SUSAN PFEIFFER2011-01-14

Plan Statistics for TRAVEL ACCIDENT PROGRAM

401k plan membership statisitcs for TRAVEL ACCIDENT PROGRAM

Measure Date Value
2013: TRAVEL ACCIDENT PROGRAM 2013 401k membership
Total participants, beginning-of-year2013-04-01208
Total number of active participants reported on line 7a of the Form 55002013-04-010
Number of retired or separated participants receiving benefits2013-04-010
Number of other retired or separated participants entitled to future benefits2013-04-010
Total of all active and inactive participants2013-04-010
2012: TRAVEL ACCIDENT PROGRAM 2012 401k membership
Total participants, beginning-of-year2012-04-01234
Total number of active participants reported on line 7a of the Form 55002012-04-01208
Number of retired or separated participants receiving benefits2012-04-010
Number of other retired or separated participants entitled to future benefits2012-04-010
Total of all active and inactive participants2012-04-01208
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-04-010
Total participants2012-04-01208
2011: TRAVEL ACCIDENT PROGRAM 2011 401k membership
Total participants, beginning-of-year2011-04-01238
Total number of active participants reported on line 7a of the Form 55002011-04-01234
Number of retired or separated participants receiving benefits2011-04-010
Number of other retired or separated participants entitled to future benefits2011-04-010
Total of all active and inactive participants2011-04-01234
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-04-010
Total participants2011-04-01234
2010: TRAVEL ACCIDENT PROGRAM 2010 401k membership
Total participants, beginning-of-year2010-04-01244
Total number of active participants reported on line 7a of the Form 55002010-04-01238
Number of retired or separated participants receiving benefits2010-04-010
Number of other retired or separated participants entitled to future benefits2010-04-010
Total of all active and inactive participants2010-04-01238
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-04-010
Total participants2010-04-01238
2009: TRAVEL ACCIDENT PROGRAM 2009 401k membership
Total participants, beginning-of-year2009-04-01321
Total number of active participants reported on line 7a of the Form 55002009-04-01244
Number of retired or separated participants receiving benefits2009-04-010
Number of other retired or separated participants entitled to future benefits2009-04-010
Total of all active and inactive participants2009-04-01244
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-04-010
Total participants2009-04-01244

Form 5500 Responses for TRAVEL ACCIDENT PROGRAM

2013: TRAVEL ACCIDENT PROGRAM 2013 form 5500 responses
2013-04-01Type of plan entitySingle employer plan
2013-04-01Submission has been amendedYes
2013-04-01This submission is the final filingYes
2013-04-01This return/report is a short plan year return/report (less than 12 months)No
2013-04-01Plan is a collectively bargained planNo
2013-04-01Plan funding arrangement – InsuranceYes
2013-04-01Plan benefit arrangement – InsuranceYes
2012: TRAVEL ACCIDENT PROGRAM 2012 form 5500 responses
2012-04-01Type of plan entitySingle employer plan
2012-04-01Submission has been amendedNo
2012-04-01This submission is the final filingNo
2012-04-01This return/report is a short plan year return/report (less than 12 months)No
2012-04-01Plan is a collectively bargained planNo
2012-04-01Plan funding arrangement – InsuranceYes
2012-04-01Plan benefit arrangement – InsuranceYes
2011: TRAVEL ACCIDENT PROGRAM 2011 form 5500 responses
2011-04-01Type of plan entitySingle employer plan
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)No
2011-04-01Plan is a collectively bargained planNo
2011-04-01Plan funding arrangement – InsuranceYes
2011-04-01Plan benefit arrangement – InsuranceYes
2010: TRAVEL ACCIDENT PROGRAM 2010 form 5500 responses
2010-04-01Type of plan entitySingle employer plan
2010-04-01Submission has been amendedYes
2010-04-01This submission is the final filingNo
2010-04-01This return/report is a short plan year return/report (less than 12 months)No
2010-04-01Plan is a collectively bargained planNo
2010-04-01Plan funding arrangement – InsuranceYes
2010-04-01Plan benefit arrangement – InsuranceYes
2009: TRAVEL ACCIDENT PROGRAM 2009 form 5500 responses
2009-04-01Type of plan entitySingle employer plan
2009-04-01Submission has been amendedNo
2009-04-01This submission is the final filingNo
2009-04-01This return/report is a short plan year return/report (less than 12 months)No
2009-04-01Plan is a collectively bargained planNo
2009-04-01Plan funding arrangement – InsuranceYes
2009-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberETB126015
Policy instance 1
Insurance contract or identification numberETB126015
Number of Individuals Covered206
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $312
Total amount of fees paid to insurance companyUSD $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 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 providedTRAVEL ACCIDENT PROGRAM
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 $2,081
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $312
Insurance broker organization code?3
Insurance broker nameBENEFIT CONTROLS OF THE CAROLINAS

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