401k Plan data: K P KAUFFMAN COMPANY, INC. plan

K P KAUFFMAN COMPANY, INC. 401k Plan overview

Plan Name	K P KAUFFMAN COMPANY, INC.
Plan identification number	503

K P KAUFFMAN COMPANY, INC. Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Dental Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

K P KAUFFMAN COMPANY, INC. has sponsored the creation of one or more 401k plans.

Company Name: K P KAUFFMAN COMPANY, INC.

Employer identification number (EIN): 953924854

NAIC Classification: 424700

Form 5500 Filing Information

Submission information for form 5500 for 401k plan K P KAUFFMAN COMPANY, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2019-01-01
503 2019-01-01 CHRISTINA LING 2021-07-26

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
503	2019-01-01
503	2019-01-01	CHRISTINA LING	2021-07-26

Plan Statistics for K P KAUFFMAN COMPANY, INC.

401k plan membership statisitcs for K P KAUFFMAN COMPANY, INC.

Measure Date Value
2019: K P KAUFFMAN COMPANY, INC. 2019 401k membership
Total participants, beginning-of-year 2019-01-01 100
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 94
Total of all active and inactive participants 2019-01-01 94
Total participants 2019-01-01 94
Number of employers contributing to the scheme 2019-01-01 0
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 0

Measure	Date	Value
2019: K P KAUFFMAN COMPANY, INC. 2019 401k membership
Total participants, beginning-of-year	2019-01-01	100
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	94
Total of all active and inactive participants	2019-01-01	94
Total participants	2019-01-01	94
Number of employers contributing to the scheme	2019-01-01	0
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	0

Form 5500 Responses for K P KAUFFMAN COMPANY, INC.

2019: K P KAUFFMAN COMPANY, INC. 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	First time form 5500 has been submitted	Yes
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

00617747

Policy instance

Insurance contract or identification number	00617747
Number of Individuals Covered	94
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $6,210
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $62,101
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,210
Amount paid for insurance broker fees	1744
Additional information about fees paid to insurance broker	INCENTIVE COMPENSATION
Insurance broker organization code?	3

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Company Name:	K P KAUFFMAN COMPANY, INC.
Employer identification number (EIN):	953924854
NAIC Classification:	424700