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OAK GROVE CONSTRUCTION CO. PROFIT SHARING 401(K) PLAN & TRUST 401k Plan overview

Plan NameOAK GROVE CONSTRUCTION CO. PROFIT SHARING 401(K) PLAN & TRUST
Plan identification number 001

OAK GROVE CONSTRUCTION CO. PROFIT SHARING 401(K) PLAN & TRUST Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • 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.
  • Plan covering Self-Employed individuals.
  • 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.

401k Sponsoring company profile

OAK GROVE CONSTRUCTION CO. has sponsored the creation of one or more 401k plans.

Company Name:OAK GROVE CONSTRUCTION CO.
Employer identification number (EIN):942728317
NAIC Classification:238900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan OAK GROVE CONSTRUCTION CO. PROFIT SHARING 401(K) PLAN & TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012023-01-01JOHN D HAMILTON2024-08-26
0012022-01-01JOHN D HAMILTON2023-08-28
0012021-01-01JOHN D HAMILTON2022-06-29 JOHN D HAMILTON2022-06-29
0012020-01-01JOHN D HAMILTON2021-07-14 JOHN D HAMILTON2021-07-14
0012019-01-01DOUG HAMILTON2020-06-17 DOUG HAMILTON2020-06-17
0012018-01-01DOUG HAMILTON2019-10-02 DOUG HAMILTON2019-10-02
0012017-01-01JOHN DOUGLAS HAMILTON2018-06-19
0012016-01-01JOHN DOUGLAS HAMILTON2017-06-16
0012015-01-01J. DOUGLAS HAMILTON2016-06-10
0012015-01-01J. DOUGLAS HAMILTON2016-06-08
0012014-01-01JOHN DOUGLAS HAMILTON JOHN DOUGLAS HAMILTON2015-06-01
0012013-01-01DOUG HAMILTON DOUG HAMILTON2014-05-29
0012012-01-01DOUG HAMILTON
0012011-01-01DOUG HAMILTON
0012009-01-01DOUG HAMILTON DOUG HAMILTON2010-10-13

Plan Statistics for OAK GROVE CONSTRUCTION CO. PROFIT SHARING 401(K) PLAN & TRUST

401k plan membership statisitcs for OAK GROVE CONSTRUCTION CO. PROFIT SHARING 401(K) PLAN & TRUST

Measure Date Value
2014: OAK GROVE CONSTRUCTION CO. PROFIT SHARING 401(K) PLAN & TRUST 2014 401k membership
Total participants, beginning-of-year2014-01-015
Total number of active participants reported on line 7a of the Form 55002014-01-013
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-014
Total of all active and inactive participants2014-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-017
Number of participants with account balances2014-01-016
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-011
2013: OAK GROVE CONSTRUCTION CO. PROFIT SHARING 401(K) PLAN & TRUST 2013 401k membership
Total participants, beginning-of-year2013-01-015
Total number of active participants reported on line 7a of the Form 55002013-01-012
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-013
Total of all active and inactive participants2013-01-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-015
Number of participants with account balances2013-01-014
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-011
2012: OAK GROVE CONSTRUCTION CO. PROFIT SHARING 401(K) PLAN & TRUST 2012 401k membership
Total participants, beginning-of-year2012-01-015
Total number of active participants reported on line 7a of the Form 55002012-01-013
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-012
Total of all active and inactive participants2012-01-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-015
Number of participants with account balances2012-01-013
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-012
2011: OAK GROVE CONSTRUCTION CO. PROFIT SHARING 401(K) PLAN & TRUST 2011 401k membership
Total participants, beginning-of-year2011-01-017
Total number of active participants reported on line 7a of the Form 55002011-01-013
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-013
Total of all active and inactive participants2011-01-016
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-016
Number of participants with account balances2011-01-016
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: OAK GROVE CONSTRUCTION CO. PROFIT SHARING 401(K) PLAN & TRUST 2009 401k membership
Total participants, beginning-of-year2009-01-018
Total number of active participants reported on line 7a of the Form 55002009-01-014
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-014
Total of all active and inactive participants2009-01-018
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-018
Number of participants with account balances2009-01-018
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on OAK GROVE CONSTRUCTION CO. PROFIT SHARING 401(K) PLAN & TRUST

Measure Date Value
2014 : OAK GROVE CONSTRUCTION CO. PROFIT SHARING 401(K) PLAN & TRUST 2014 401k financial data
Total income from all sources2014-12-31$16,016
Expenses. Total of all expenses incurred2014-12-31$2,467
Benefits paid (including direct rollovers)2014-12-31$2,467
Total plan assets at end of year2014-12-31$154,963
Total plan assets at beginning of year2014-12-31$141,414
Value of fidelity bond covering the plan2014-12-31$25,000
Total contributions received or receivable from participants2014-12-31$0
Expenses. Other expenses not covered elsewhere2014-12-31$0
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$5,332
Net income (gross income less expenses)2014-12-31$13,549
Net plan assets at end of year (total assets less liabilities)2014-12-31$154,963
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$141,414
Assets. Value of participant loans2014-12-31$0
Total contributions received or receivable from employer(s)2014-12-31$10,684
Value of certain deemed distributions of participant loans2014-12-31$0
Value of corrective distributions2014-12-31$0
Funding deficiency by the employer to the plan for this plan year2014-12-31$0
Minimum employer required contribution for this plan year2014-12-31$0
Amount contributed by the employer to the plan for this plan year2014-12-31$0
2013 : OAK GROVE CONSTRUCTION CO. PROFIT SHARING 401(K) PLAN & TRUST 2013 401k financial data
Transfers to/from the plan2013-12-31$0
Total income from all sources2013-12-31$29,096
Expenses. Total of all expenses incurred2013-12-31$71,185
Benefits paid (including direct rollovers)2013-12-31$71,185
Total plan assets at end of year2013-12-31$141,414
Total plan assets at beginning of year2013-12-31$183,503
Value of fidelity bond covering the plan2013-12-31$25,000
Total contributions received or receivable from participants2013-12-31$2,857
Expenses. Other expenses not covered elsewhere2013-12-31$0
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$26,239
Net income (gross income less expenses)2013-12-31$-42,089
Net plan assets at end of year (total assets less liabilities)2013-12-31$141,414
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$183,503
Assets. Value of participant loans2013-12-31$0
Total contributions received or receivable from employer(s)2013-12-31$0
Value of certain deemed distributions of participant loans2013-12-31$0
Value of corrective distributions2013-12-31$0
Funding deficiency by the employer to the plan for this plan year2013-12-31$0
Minimum employer required contribution for this plan year2013-12-31$0
Amount contributed by the employer to the plan for this plan year2013-12-31$0
2012 : OAK GROVE CONSTRUCTION CO. PROFIT SHARING 401(K) PLAN & TRUST 2012 401k financial data
Transfers to/from the plan2012-12-31$0
Total income from all sources2012-12-31$69,627
Expenses. Total of all expenses incurred2012-12-31$61
Benefits paid (including direct rollovers)2012-12-31$61
Total plan assets at end of year2012-12-31$183,503
Total plan assets at beginning of year2012-12-31$113,937
Value of fidelity bond covering the plan2012-12-31$25,000
Total contributions received or receivable from participants2012-12-31$5,607
Expenses. Other expenses not covered elsewhere2012-12-31$0
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$16,268
Net income (gross income less expenses)2012-12-31$69,566
Net plan assets at end of year (total assets less liabilities)2012-12-31$183,503
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$113,937
Assets. Value of participant loans2012-12-31$0
Total contributions received or receivable from employer(s)2012-12-31$47,752
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$0
Funding deficiency by the employer to the plan for this plan year2012-12-31$0
Minimum employer required contribution for this plan year2012-12-31$0
Amount contributed by the employer to the plan for this plan year2012-12-31$0
2011 : OAK GROVE CONSTRUCTION CO. PROFIT SHARING 401(K) PLAN & TRUST 2011 401k financial data
Transfers to/from the plan2011-12-31$0
Total income from all sources2011-12-31$2,986
Expenses. Total of all expenses incurred2011-12-31$101,647
Benefits paid (including direct rollovers)2011-12-31$101,647
Total plan assets at end of year2011-12-31$113,937
Total plan assets at beginning of year2011-12-31$212,598
Value of fidelity bond covering the plan2011-12-31$25,000
Total contributions received or receivable from participants2011-12-31$5,502
Expenses. Other expenses not covered elsewhere2011-12-31$0
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-2,516
Net income (gross income less expenses)2011-12-31$-98,661
Net plan assets at end of year (total assets less liabilities)2011-12-31$113,937
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$212,598
Assets. Value of participant loans2011-12-31$0
Total contributions received or receivable from employer(s)2011-12-31$0
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$0
Funding deficiency by the employer to the plan for this plan year2011-12-31$0
Minimum employer required contribution for this plan year2011-12-31$0
Amount contributed by the employer to the plan for this plan year2011-12-31$0
2010 : OAK GROVE CONSTRUCTION CO. PROFIT SHARING 401(K) PLAN & TRUST 2010 401k financial data
Transfers to/from the plan2010-12-31$0
Total income from all sources2010-12-31$19,941
Expenses. Total of all expenses incurred2010-12-31$45,599
Benefits paid (including direct rollovers)2010-12-31$45,599
Total plan assets at end of year2010-12-31$212,598
Total plan assets at beginning of year2010-12-31$238,256
Value of fidelity bond covering the plan2010-12-31$25,000
Total contributions received or receivable from participants2010-12-31$4,192
Expenses. Other expenses not covered elsewhere2010-12-31$0
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$15,749
Net income (gross income less expenses)2010-12-31$-25,658
Net plan assets at end of year (total assets less liabilities)2010-12-31$212,598
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$238,256
Assets. Value of participant loans2010-12-31$0
Total contributions received or receivable from employer(s)2010-12-31$0
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$0
Funding deficiency by the employer to the plan for this plan year2010-12-31$0
Minimum employer required contribution for this plan year2010-12-31$0
Amount contributed by the employer to the plan for this plan year2010-12-31$0
2009 : OAK GROVE CONSTRUCTION CO. PROFIT SHARING 401(K) PLAN & TRUST 2009 401k financial data
Funding deficiency by the employer to the plan for this plan year2009-12-31$0
Minimum employer required contribution for this plan year2009-12-31$0
Amount contributed by the employer to the plan for this plan year2009-12-31$0

Form 5500 Responses for OAK GROVE CONSTRUCTION CO. PROFIT SHARING 401(K) PLAN & TRUST

2014: OAK GROVE CONSTRUCTION CO. PROFIT SHARING 401(K) PLAN & TRUST 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: OAK GROVE CONSTRUCTION CO. PROFIT SHARING 401(K) PLAN & TRUST 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: OAK GROVE CONSTRUCTION CO. PROFIT SHARING 401(K) PLAN & TRUST 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 – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: OAK GROVE CONSTRUCTION CO. PROFIT SHARING 401(K) PLAN & TRUST 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: OAK GROVE CONSTRUCTION CO. PROFIT SHARING 401(K) PLAN & TRUST 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-802931
Policy instance 1
Insurance contract or identification numberGA-802931
Number of Individuals Covered6
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $548
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $548
Insurance broker organization code?3
Insurance broker nameLINCOLN FINANCIAL ADVISORS CORPORAT
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-802931
Policy instance 1
Insurance contract or identification numberGA-802931
Number of Individuals Covered4
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $712
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $712
Insurance broker organization code?3
Insurance broker nameLINCOLN FINCL ADVISORS CORP
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-802931
Policy instance 1
Insurance contract or identification numberGA-802931
Number of Individuals Covered3
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $586
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $474
Insurance broker organization code?3
Insurance broker nameWELLS FARGO ADVRS INS AGCY
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-802931
Policy instance 1
Insurance contract or identification numberGA-802931
Number of Individuals Covered6
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $722
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-802931
Policy instance 1
Insurance contract or identification numberGA-802931
Number of Individuals Covered7
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $845
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $845
Insurance broker organization code?3
Insurance broker nameWS CA INSURANCE SERVICES LLC

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