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CHECKERBOARD, LTD. EMPLOYEE BENEFITS TRUST 401k Plan overview

Plan NameCHECKERBOARD, LTD. EMPLOYEE BENEFITS TRUST
Plan identification number 501

CHECKERBOARD, LTD. EMPLOYEE BENEFITS TRUST Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

CHECKERBOARD, LTD. has sponsored the creation of one or more 401k plans.

Company Name:CHECKERBOARD, LTD.
Employer identification number (EIN):043050276
NAIC Classification:323100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CHECKERBOARD, LTD. EMPLOYEE BENEFITS TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012017-01-01
5012016-01-01
5012015-01-01
5012014-01-01
5012013-01-01
5012012-01-01MICHAEL MUIR
5012011-01-01MICHAEL MUIR
5012009-01-01MICAH CHASE

Financial Data on CHECKERBOARD, LTD. EMPLOYEE BENEFITS TRUST

Measure Date Value
2017 : CHECKERBOARD, LTD. EMPLOYEE BENEFITS TRUST 2017 401k financial data
Value of fidelity bond covering the plan2017-10-31$265,000
2016 : CHECKERBOARD, LTD. EMPLOYEE BENEFITS TRUST 2016 401k financial data
Total income from all sources2016-12-31$7
Expenses. Total of all expenses incurred2016-12-31$214,115
Benefits paid (including direct rollovers)2016-12-31$214,057
Total plan assets at end of year2016-12-31$0
Total plan assets at beginning of year2016-12-31$214,108
Value of fidelity bond covering the plan2016-12-31$265,000
Other income received2016-12-31$7
Net income (gross income less expenses)2016-12-31$-214,108
Net plan assets at end of year (total assets less liabilities)2016-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$214,108
Total contributions received or receivable from employer(s)2016-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$58
2015 : CHECKERBOARD, LTD. EMPLOYEE BENEFITS TRUST 2015 401k financial data
Total income from all sources2015-12-31$203,304
Expenses. Total of all expenses incurred2015-12-31$443,190
Benefits paid (including direct rollovers)2015-12-31$440,996
Total plan assets at end of year2015-12-31$214,108
Total plan assets at beginning of year2015-12-31$453,994
Value of fidelity bond covering the plan2015-12-31$265,000
Other income received2015-12-31$2,176
Net income (gross income less expenses)2015-12-31$-239,886
Net plan assets at end of year (total assets less liabilities)2015-12-31$214,108
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$453,994
Total contributions received or receivable from employer(s)2015-12-31$201,128
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$2,194
2014 : CHECKERBOARD, LTD. EMPLOYEE BENEFITS TRUST 2014 401k financial data
Total income from all sources2014-12-31$247,641
Expenses. Total of all expenses incurred2014-12-31$429,326
Benefits paid (including direct rollovers)2014-12-31$425,827
Total plan assets at end of year2014-12-31$453,994
Total plan assets at beginning of year2014-12-31$635,679
Value of fidelity bond covering the plan2014-12-31$265,000
Other income received2014-12-31$4,386
Net income (gross income less expenses)2014-12-31$-181,685
Net plan assets at end of year (total assets less liabilities)2014-12-31$453,994
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$635,679
Total contributions received or receivable from employer(s)2014-12-31$243,255
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$3,499
2013 : CHECKERBOARD, LTD. EMPLOYEE BENEFITS TRUST 2013 401k financial data
Total income from all sources2013-12-31$566,657
Expenses. Total of all expenses incurred2013-12-31$525,153
Benefits paid (including direct rollovers)2013-12-31$519,867
Total plan assets at end of year2013-12-31$635,679
Total plan assets at beginning of year2013-12-31$594,175
Other income received2013-12-31$46,790
Net income (gross income less expenses)2013-12-31$41,504
Net plan assets at end of year (total assets less liabilities)2013-12-31$635,679
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$594,175
Total contributions received or receivable from employer(s)2013-12-31$519,867
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$5,286
2012 : CHECKERBOARD, LTD. EMPLOYEE BENEFITS TRUST 2012 401k financial data
Total income from all sources2012-12-31$619,668
Expenses. Total of all expenses incurred2012-12-31$575,078
Benefits paid (including direct rollovers)2012-12-31$569,349
Total plan assets at end of year2012-12-31$594,175
Total plan assets at beginning of year2012-12-31$549,585
Other income received2012-12-31$50,319
Net income (gross income less expenses)2012-12-31$44,590
Net plan assets at end of year (total assets less liabilities)2012-12-31$594,175
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$549,585
Total contributions received or receivable from employer(s)2012-12-31$569,349
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$5,729
2011 : CHECKERBOARD, LTD. EMPLOYEE BENEFITS TRUST 2011 401k financial data
Total income from all sources2011-12-31$563,772
Expenses. Total of all expenses incurred2011-12-31$575,782
Benefits paid (including direct rollovers)2011-12-31$570,168
Total plan assets at end of year2011-12-31$549,585
Total plan assets at beginning of year2011-12-31$561,595
Other income received2011-12-31$-6,396
Net income (gross income less expenses)2011-12-31$-12,010
Net plan assets at end of year (total assets less liabilities)2011-12-31$549,585
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$561,595
Total contributions received or receivable from employer(s)2011-12-31$570,168
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$5,614
2010 : CHECKERBOARD, LTD. EMPLOYEE BENEFITS TRUST 2010 401k financial data
Total income from all sources2010-12-31$584,457
Expenses. Total of all expenses incurred2010-12-31$552,321
Benefits paid (including direct rollovers)2010-12-31$552,221
Total plan assets at end of year2010-12-31$561,595
Total plan assets at beginning of year2010-12-31$529,459
Other income received2010-12-31$32,236
Net income (gross income less expenses)2010-12-31$32,136
Net plan assets at end of year (total assets less liabilities)2010-12-31$561,595
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$529,459
Total contributions received or receivable from employer(s)2010-12-31$552,221
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$100

Form 5500 Responses for CHECKERBOARD, LTD. EMPLOYEE BENEFITS TRUST

2017: CHECKERBOARD, LTD. EMPLOYEE BENEFITS TRUST 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01This submission is the final filingYes
2017-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: CHECKERBOARD, LTD. EMPLOYEE BENEFITS TRUST 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: CHECKERBOARD, LTD. EMPLOYEE BENEFITS TRUST 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: CHECKERBOARD, LTD. EMPLOYEE BENEFITS TRUST 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: CHECKERBOARD, LTD. EMPLOYEE BENEFITS TRUST 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: CHECKERBOARD, LTD. EMPLOYEE BENEFITS TRUST 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: CHECKERBOARD, LTD. EMPLOYEE BENEFITS TRUST 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: CHECKERBOARD, LTD. EMPLOYEE BENEFITS TRUST 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

FALLON HEALTH AND LIFE INSURANCE COMPANY - FHLAC (National Association of Insurance Commissioners NAIC id number: 66828 )
Policy contract numberC002252346C01
Policy instance 2
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract numberC002252346C01
Policy instance 1
FALLON HEALTH AND LIFE INSURANCE COMPANY - FHLAC (National Association of Insurance Commissioners NAIC id number: 66828 )
Policy contract numberC002252346C01
Policy instance 2
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract numberC002252346C01
Policy instance 1
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract numberC002252346C01
Policy instance 1
FALLON HEALTH AND LIFE INSURANCE COMPANY - FHLAC (National Association of Insurance Commissioners NAIC id number: 66828 )
Policy contract numberC002252346C01
Policy instance 2
FALLON HEALTH AND LIFE INSURANCE COMPANY - FHLAC (National Association of Insurance Commissioners NAIC id number: 66828 )
Policy contract numberC002252346C01
Policy instance 2
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract numberC002252346C01
Policy instance 1
FALLON HEALTH AND LIFE INSURANCE COMPANY - FHLAC (National Association of Insurance Commissioners NAIC id number: 66828 )
Policy contract numberC002252346C01
Policy instance 2
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract numberC002252346C01
Policy instance 1
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract numberC002252346C01
Policy instance 1
FALLON HEALTH AND LIFE INSURANCE COMPANY - FHLAC (National Association of Insurance Commissioners NAIC id number: 66828 )
Policy contract numberC002252346C01
Policy instance 2
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract numberC002252346C01
Policy instance 1
FALLON HEALTH AND LIFE INSURANCE COMPANY - FHLAC (National Association of Insurance Commissioners NAIC id number: 66828 )
Policy contract numberC002252346C01
Policy instance 2

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