401k Plan data: GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN plan

GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN
Plan identification number	506

GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Long-term disability cover

401k Sponsoring company profile

GAULT CHEVROLET COMPANY, INC. has sponsored the creation of one or more 401k plans.

Company Name: GAULT CHEVROLET COMPANY, INC.

Employer identification number (EIN): 150579146

NAIC Classification: 441110
NAIC Description: New Car Dealers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
506 2019-08-01 ROBERT J GAULT 2020-08-24 ROBERT J GAULT 2020-08-24
506 2018-08-01 ROBERT J GAULT 2020-03-07 ROBERT J GAULT 2020-03-07
506 2017-08-01 ROBERT J GAULT 2019-04-30 ROBERT J GAULT 2019-04-30
506 2016-08-01 ROBERT GAULT ROBERT GAULT 2018-05-07
506 2015-08-01 ROBERT GAULT
506 2014-08-01 ROBERT GAULT
506 2013-08-01 ROBERT GAULT
506 2012-08-01 ROBERT GAULT
506 2011-08-01 ROBERT GAULT

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
506	2019-08-01	ROBERT J GAULT	2020-08-24	ROBERT J GAULT	2020-08-24
506	2018-08-01	ROBERT J GAULT	2020-03-07	ROBERT J GAULT	2020-03-07
506	2017-08-01	ROBERT J GAULT	2019-04-30	ROBERT J GAULT	2019-04-30
506	2016-08-01	ROBERT GAULT		ROBERT GAULT	2018-05-07
506	2015-08-01	ROBERT GAULT
506	2014-08-01	ROBERT GAULT
506	2013-08-01	ROBERT GAULT
506	2012-08-01	ROBERT GAULT
506	2011-08-01	ROBERT GAULT

Plan Statistics for GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN

401k plan membership statisitcs for GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN

Measure Date Value
2019: GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-08-01 73
Total number of active participants reported on line 7a of the Form 5500 2019-08-01 69
Total of all active and inactive participants 2019-08-01 69
2018: GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-08-01 88
Total number of active participants reported on line 7a of the Form 5500 2018-08-01 73
Total of all active and inactive participants 2018-08-01 73
2017: GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-08-01 94
Total number of active participants reported on line 7a of the Form 5500 2017-08-01 88
Total of all active and inactive participants 2017-08-01 88
2016: GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-08-01 107
Total number of active participants reported on line 7a of the Form 5500 2016-08-01 94
Total of all active and inactive participants 2016-08-01 94
Total participants 2016-08-01 94
2015: GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-08-01 162
Total number of active participants reported on line 7a of the Form 5500 2015-08-01 107
Total of all active and inactive participants 2015-08-01 107
Total participants 2015-08-01 107
Number of employers contributing to the scheme 2015-08-01 0
2014: GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-08-01 166
Total number of active participants reported on line 7a of the Form 5500 2014-08-01 162
Total of all active and inactive participants 2014-08-01 162
Total participants 2014-08-01 162
Number of employers contributing to the scheme 2014-08-01 0
2013: GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-08-01 174
Total number of active participants reported on line 7a of the Form 5500 2013-08-01 166
Total of all active and inactive participants 2013-08-01 166
Total participants 2013-08-01 166
Number of employers contributing to the scheme 2013-08-01 0
2012: GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-08-01 168
Total number of active participants reported on line 7a of the Form 5500 2012-08-01 174
Number of retired or separated participants receiving benefits 2012-08-01 0
Number of other retired or separated participants entitled to future benefits 2012-08-01 0
Total of all active and inactive participants 2012-08-01 174
2011: GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-08-01 168
Total number of active participants reported on line 7a of the Form 5500 2011-08-01 168
Number of retired or separated participants receiving benefits 2011-08-01 0
Number of other retired or separated participants entitled to future benefits 2011-08-01 0
Total of all active and inactive participants 2011-08-01 168

Measure	Date	Value
2019: GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-08-01	73
Total number of active participants reported on line 7a of the Form 5500	2019-08-01	69
Total of all active and inactive participants	2019-08-01	69
2018: GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-08-01	88
Total number of active participants reported on line 7a of the Form 5500	2018-08-01	73
Total of all active and inactive participants	2018-08-01	73
2017: GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-08-01	94
Total number of active participants reported on line 7a of the Form 5500	2017-08-01	88
Total of all active and inactive participants	2017-08-01	88
2016: GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-08-01	107
Total number of active participants reported on line 7a of the Form 5500	2016-08-01	94
Total of all active and inactive participants	2016-08-01	94
Total participants	2016-08-01	94
2015: GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-08-01	162
Total number of active participants reported on line 7a of the Form 5500	2015-08-01	107
Total of all active and inactive participants	2015-08-01	107
Total participants	2015-08-01	107
Number of employers contributing to the scheme	2015-08-01	0
2014: GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-08-01	166
Total number of active participants reported on line 7a of the Form 5500	2014-08-01	162
Total of all active and inactive participants	2014-08-01	162
Total participants	2014-08-01	162
Number of employers contributing to the scheme	2014-08-01	0
2013: GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-08-01	174
Total number of active participants reported on line 7a of the Form 5500	2013-08-01	166
Total of all active and inactive participants	2013-08-01	166
Total participants	2013-08-01	166
Number of employers contributing to the scheme	2013-08-01	0
2012: GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-08-01	168
Total number of active participants reported on line 7a of the Form 5500	2012-08-01	174
Number of retired or separated participants receiving benefits	2012-08-01	0
Number of other retired or separated participants entitled to future benefits	2012-08-01	0
Total of all active and inactive participants	2012-08-01	174
2011: GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-08-01	168
Total number of active participants reported on line 7a of the Form 5500	2011-08-01	168
Number of retired or separated participants receiving benefits	2011-08-01	0
Number of other retired or separated participants entitled to future benefits	2011-08-01	0
Total of all active and inactive participants	2011-08-01	168

Form 5500 Responses for GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN

2019: GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-08-01	Type of plan entity	Single employer plan
2019-08-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2019-08-01	Plan funding arrangement – Insurance	Yes
2019-08-01	Plan benefit arrangement – Insurance	Yes
2018: GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-08-01	Type of plan entity	Single employer plan
2018-08-01	Plan funding arrangement – Insurance	Yes
2018-08-01	Plan benefit arrangement – Insurance	Yes
2017: GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-08-01	Type of plan entity	Single employer plan
2017-08-01	Plan funding arrangement – Insurance	Yes
2017-08-01	Plan benefit arrangement – Insurance	Yes
2016: GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-08-01	Type of plan entity	Single employer plan
2016-08-01	Submission has been amended	No
2016-08-01	This submission is the final filing	No
2016-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-08-01	Plan is a collectively bargained plan	No
2016-08-01	Plan funding arrangement – Insurance	Yes
2016-08-01	Plan benefit arrangement – Insurance	Yes
2015: GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-08-01	Type of plan entity	Single employer plan
2015-08-01	Submission has been amended	No
2015-08-01	This submission is the final filing	No
2015-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-08-01	Plan is a collectively bargained plan	No
2015-08-01	Plan funding arrangement – Insurance	Yes
2015-08-01	Plan benefit arrangement – Insurance	Yes
2014: GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-08-01	Type of plan entity	Single employer plan
2014-08-01	Submission has been amended	No
2014-08-01	This submission is the final filing	No
2014-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-08-01	Plan is a collectively bargained plan	No
2014-08-01	Plan funding arrangement – Insurance	Yes
2014-08-01	Plan benefit arrangement – Insurance	Yes
2013: GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-08-01	Type of plan entity	Single employer plan
2013-08-01	Submission has been amended	No
2013-08-01	This submission is the final filing	No
2013-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-08-01	Plan is a collectively bargained plan	No
2013-08-01	Plan funding arrangement – Insurance	Yes
2013-08-01	Plan benefit arrangement – Insurance	Yes
2012: GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-08-01	Type of plan entity	Single employer plan
2012-08-01	First time form 5500 has been submitted	Yes
2012-08-01	Submission has been amended	No
2012-08-01	This submission is the final filing	No
2012-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-08-01	Plan is a collectively bargained plan	No
2012-08-01	Plan funding arrangement – Insurance	Yes
2012-08-01	Plan benefit arrangement – Insurance	Yes
2011: GAULT CHEVROLET CO., INC. WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-08-01	Type of plan entity	Single employer plan
2011-08-01	First time form 5500 has been submitted	Yes
2011-08-01	Submission has been amended	No
2011-08-01	This submission is the final filing	No
2011-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-08-01	Plan is a collectively bargained plan	No
2011-08-01	Plan funding arrangement – Insurance	Yes
2011-08-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

1106093

Policy instance

Insurance contract or identification number	1106093
Insurance policy start date	2019-08-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $2,046
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,046
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )

Policy contract number

04-8034

Policy instance

Insurance contract or identification number	04-8034
Number of Individuals Covered	73
Insurance policy start date	2018-08-01
Insurance policy end date	2019-07-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $11,905
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	11905
Insurance broker organization code?	3

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

1106093

Policy instance

Insurance contract or identification number	1106093
Number of Individuals Covered	69
Insurance policy start date	2018-08-01
Insurance policy end date	2019-07-31
Total amount of commissions paid to insurance broker	USD $1,462
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,462
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00030021

Policy instance

Insurance contract or identification number	00030021
Number of Individuals Covered	88
Insurance policy start date	2017-08-01
Insurance policy end date	2018-07-31
Total amount of commissions paid to insurance broker	USD $3,806
Total amount of fees paid to insurance company	USD $4,168
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )

Policy contract number

04-8034

Policy instance

Insurance contract or identification number	04-8034
Number of Individuals Covered	73
Insurance policy start date	2017-08-01
Insurance policy end date	2018-08-31
Total amount of commissions paid to insurance broker	USD $11,905
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

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Company Name:	GAULT CHEVROLET COMPANY, INC.
Employer identification number (EIN):	150579146
NAIC Classification:	441110
NAIC Description:	New Car Dealers