401k Plan data: SEASHORE HOLDINGS, INC. WELFARE PLAN plan

SEASHORE HOLDINGS, INC. WELFARE PLAN 401k Plan overview

Plan Name	SEASHORE HOLDINGS, INC. WELFARE PLAN
Plan identification number	502

SEASHORE HOLDINGS, INC. WELFARE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Dental Death benefits (include travel accident but not life insurance) 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. Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

SEASHORE HOLDINGS, INC. has sponsored the creation of one or more 401k plans.

Company Name: SEASHORE HOLDINGS, INC.

Employer identification number (EIN): 200972308

NAIC Classification: 551112
NAIC Description: Offices of Other Holding Companies

Additional information about SEASHORE HOLDINGS, INC.

Jurisdiction of Incorporation: Nevada Department of State

Incorporation Date: 2004-03-25

Company Identification Number: 20041422695

Legal Registered Office Address: 1220 S COMMERCE ST STE 120

LAS VEGAS
United States of America (USA)
89102

More information about SEASHORE HOLDINGS, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SEASHORE HOLDINGS, INC. WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2012-01-01 ANDREA GOULD
502 2010-01-01 ANDREA GOULD

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
502	2012-01-01	ANDREA GOULD
502	2010-01-01	ANDREA GOULD

Plan Statistics for SEASHORE HOLDINGS, INC. WELFARE PLAN

401k plan membership statisitcs for SEASHORE HOLDINGS, INC. WELFARE PLAN

Measure Date Value
2012: SEASHORE HOLDINGS, INC. WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 102
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 0
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 0
2010: SEASHORE HOLDINGS, INC. WELFARE PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 109
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 99
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 99

Measure	Date	Value
2012: SEASHORE HOLDINGS, INC. WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	102
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	0
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	0
2010: SEASHORE HOLDINGS, INC. WELFARE PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	109
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	99
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	99

Form 5500 Responses for SEASHORE HOLDINGS, INC. WELFARE PLAN

2012: SEASHORE HOLDINGS, INC. WELFARE PLAN 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	Yes
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
2010: SEASHORE HOLDINGS, INC. WELFARE PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	First time form 5500 has been submitted	Yes
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

Insurance Providers Used on plan

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

Policy contract number

433169

Policy instance

Insurance contract or identification number	433169
Number of Individuals Covered	102
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $3,802
Total amount of fees paid to insurance company	USD $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 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	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
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 $63,243
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,802
Insurance broker organization code?	3
Insurance broker name	RICHARD DOUGALL

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

Policy contract number

433169

Policy instance

Insurance contract or identification number	433169
Number of Individuals Covered	99
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $3,810
Total amount of fees paid to insurance company	USD $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 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	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
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 $62,519
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,401
Insurance broker organization code?	3
Insurance broker name	V.W. ALLABASHI AND ASSOC., LLC

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Company Name:	SEASHORE HOLDINGS, INC.
Employer identification number (EIN):	200972308
NAIC Classification:	551112
NAIC Description:	Offices of Other Holding Companies

Jurisdiction of Incorporation:	Nevada Department of State
Incorporation Date:	2004-03-25
Company Identification Number:	20041422695
Legal Registered Office Address:	1220 S COMMERCE ST STE 120 LAS VEGAS United States of America (USA) 89102