401k Plan data: C. E. NIEHOFF & CO. FLEXIBLE BENEFITS PLAN plan

C. E. NIEHOFF & CO. FLEXIBLE BENEFITS PLAN 401k Plan overview

Plan Name	C. E. NIEHOFF & CO. FLEXIBLE BENEFITS PLAN
Plan identification number	511

C. E. NIEHOFF & CO. FLEXIBLE BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

C. E. NIEHOFF & CO. has sponsored the creation of one or more 401k plans.

Company Name: C. E. NIEHOFF & CO.

Employer identification number (EIN): 202346619

NAIC Classification: 336300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan C. E. NIEHOFF & CO. FLEXIBLE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
511 2023-01-01

Plan Statistics for C. E. NIEHOFF & CO. FLEXIBLE BENEFITS PLAN

401k plan membership statisitcs for C. E. NIEHOFF & CO. FLEXIBLE BENEFITS PLAN

Measure Date Value
2023: C. E. NIEHOFF & CO. FLEXIBLE BENEFITS PLAN 2023 401k membership
Total participants, beginning-of-year 2023-01-01 326
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 300
Number of retired or separated participants receiving benefits 2023-01-01 8
Number of other retired or separated participants entitled to future benefits 2023-01-01 0
Total of all active and inactive participants 2023-01-01 308

Measure	Date	Value
2023: C. E. NIEHOFF & CO. FLEXIBLE BENEFITS PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	326
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	300
Number of retired or separated participants receiving benefits	2023-01-01	8
Number of other retired or separated participants entitled to future benefits	2023-01-01	0
Total of all active and inactive participants	2023-01-01	308

Form 5500 Responses for C. E. NIEHOFF & CO. FLEXIBLE BENEFITS PLAN

2023: C. E. NIEHOFF & CO. FLEXIBLE BENEFITS PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Submission has been amended	No
2023-01-01	This submission is the final filing	No
2023-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2023-01-01	Plan is a collectively bargained plan	No
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement – General assets of the sponsor	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

00191240

Policy instance

Insurance contract or identification number	00191240
Number of Individuals Covered	293
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $84,550
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	No
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 $563,668
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 )

Policy contract number

146381

Policy instance

Insurance contract or identification number	146381
Number of Individuals Covered	357
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $50,636
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	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH & 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 $203,967
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	C. E. NIEHOFF & CO.
Employer identification number (EIN):	202346619
NAIC Classification:	336300