401k Plan data: PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC plan

PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC 401k Plan overview

Plan Name	PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC
Plan identification number	504

PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Temporary disability (accident and sickness) Other welfare benefit cover

401k Sponsoring company profile

HARLEY-DAVIDSON MOTOR COMPANY GROUP, LLC has sponsored the creation of one or more 401k plans.

Company Name: HARLEY-DAVIDSON MOTOR COMPANY GROUP, LLC

Employer identification number (EIN): 391805420

NAIC Classification: 336100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
504 2016-01-01 AMY OSTOP
504 2015-01-01 AMY OSTOP
504 2014-01-01 AMY OSTOP
504 2013-01-01 AMY OSTOP
504 2012-01-01 AMY OSTOP
504 2011-01-01 AMY OSTOP
504 2010-01-01 AMY OSTOP AMY OSTOP 2011-09-06
504 2009-01-01 NANCY THONE

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
504	2016-01-01	AMY OSTOP
504	2015-01-01	AMY OSTOP
504	2014-01-01	AMY OSTOP
504	2013-01-01	AMY OSTOP
504	2012-01-01	AMY OSTOP
504	2011-01-01	AMY OSTOP
504	2010-01-01	AMY OSTOP	AMY OSTOP	2011-09-06
504	2009-01-01	NANCY THONE

Plan Statistics for PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC

401k plan membership statisitcs for PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC

Measure Date Value
2016: PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC 2016 401k membership
Total participants, beginning-of-year 2016-01-01 1,286
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 1,251
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 1,251
2015: PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC 2015 401k membership
Total participants, beginning-of-year 2015-01-01 1,272
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 1,286
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 1,286
2014: PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC 2014 401k membership
Total participants, beginning-of-year 2014-01-01 1,323
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 1,272
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 1,272
2013: PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1,255
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 1,323
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 1,323
2012: PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1,380
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 1,255
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 1,255
2011: PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,214
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 1,380
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 1,380
2010: PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC 2010 401k membership
Total participants, beginning-of-year 2010-01-01 1,352
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 1,214
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 1,214
Total participants 2010-01-01 1,214
2009: PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC 2009 401k membership
Total participants, beginning-of-year 2009-01-01 1,541
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 1,352
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 1,352

Measure	Date	Value
2016: PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC 2016 401k membership
Total participants, beginning-of-year	2016-01-01	1,286
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	1,251
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	1,251
2015: PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC 2015 401k membership
Total participants, beginning-of-year	2015-01-01	1,272
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	1,286
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	1,286
2014: PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC 2014 401k membership
Total participants, beginning-of-year	2014-01-01	1,323
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	1,272
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	1,272
2013: PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,255
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	1,323
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	1,323
2012: PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,380
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	1,255
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	1,255
2011: PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,214
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1,380
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	1,380
2010: PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC 2010 401k membership
Total participants, beginning-of-year	2010-01-01	1,352
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	1,214
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	1,214
Total participants	2010-01-01	1,214
2009: PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,541
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1,352
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	1,352

Form 5500 Responses for PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC

2016: PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC 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 benefit arrangement – Insurance	Yes
2015: PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
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 benefit arrangement – Insurance	Yes
2014: PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: PERSONAL ACCIDENT INSURANCE PLAN FOR EMPLOYEES OF HARLEY-DAVIDSON MOTOR COMPANY GROUP LLC 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

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Company Name:	HARLEY-DAVIDSON MOTOR COMPANY GROUP, LLC
Employer identification number (EIN):	391805420
NAIC Classification:	336100