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HEISTER HOUSE MILLWORKS, INC. GROUP MEDICAL PLAN 401k Plan overview

Plan NameHEISTER HOUSE MILLWORKS, INC. GROUP MEDICAL PLAN
Plan identification number 501

HEISTER HOUSE MILLWORKS, INC. GROUP MEDICAL PLAN Benefits

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

401k Sponsoring company profile

HEISTER HOUSE MILLWORKS, INC. has sponsored the creation of one or more 401k plans.

Company Name:HEISTER HOUSE MILLWORKS, INC.
Employer identification number (EIN):232517398
NAIC Classification:321900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEISTER HOUSE MILLWORKS, INC. GROUP MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012016-01-01SUSAN WOMER
5012015-01-01SUSAN WOMER
5012014-01-01LORNE NIPPLE

Plan Statistics for HEISTER HOUSE MILLWORKS, INC. GROUP MEDICAL PLAN

401k plan membership statisitcs for HEISTER HOUSE MILLWORKS, INC. GROUP MEDICAL PLAN

Measure Date Value
2016: HEISTER HOUSE MILLWORKS, INC. GROUP MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0155
Total number of active participants reported on line 7a of the Form 55002016-01-0163
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-0163
2015: HEISTER HOUSE MILLWORKS, INC. GROUP MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0158
Total number of active participants reported on line 7a of the Form 55002015-01-0154
Number of retired or separated participants receiving benefits2015-01-011
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-0155
2014: HEISTER HOUSE MILLWORKS, INC. GROUP MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0155
Total number of active participants reported on line 7a of the Form 55002014-01-0158
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-0158

Financial Data on HEISTER HOUSE MILLWORKS, INC. GROUP MEDICAL PLAN

Measure Date Value
2016 : HEISTER HOUSE MILLWORKS, INC. GROUP MEDICAL PLAN 2016 401k financial data
Total plan liabilities at end of year2016-12-31$421,350
Total plan liabilities at beginning of year2016-12-31$120,434
Total income from all sources2016-12-31$875,700
Expenses. Total of all expenses incurred2016-12-31$1,162,084
Benefits paid (including direct rollovers)2016-12-31$909,143
Total plan assets at end of year2016-12-31$21,034
Total plan assets at beginning of year2016-12-31$6,502
Value of fidelity bond covering the plan2016-12-31$100,000
Total contributions received or receivable from participants2016-12-31$176,003
Expenses. Other expenses not covered elsewhere2016-12-31$214,848
Contributions received from other sources (not participants or employers)2016-12-31$0
Other income received2016-12-31$44
Net income (gross income less expenses)2016-12-31$-286,384
Net plan assets at end of year (total assets less liabilities)2016-12-31$-400,316
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$-113,932
Total contributions received or receivable from employer(s)2016-12-31$699,653
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$38,093
2015 : HEISTER HOUSE MILLWORKS, INC. GROUP MEDICAL PLAN 2015 401k financial data
Total plan liabilities at end of year2015-12-31$120,434
Total plan liabilities at beginning of year2015-12-31$74,184
Total income from all sources2015-12-31$624,558
Expenses. Total of all expenses incurred2015-12-31$684,187
Benefits paid (including direct rollovers)2015-12-31$470,796
Total plan assets at end of year2015-12-31$6,502
Total plan assets at beginning of year2015-12-31$19,881
Value of fidelity bond covering the plan2015-12-31$100,000
Total contributions received or receivable from participants2015-12-31$99,898
Expenses. Other expenses not covered elsewhere2015-12-31$179,948
Contributions received from other sources (not participants or employers)2015-12-31$0
Other income received2015-12-31$41
Net income (gross income less expenses)2015-12-31$-59,629
Net plan assets at end of year (total assets less liabilities)2015-12-31$-113,932
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$-54,303
Total contributions received or receivable from employer(s)2015-12-31$524,619
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$33,443
2014 : HEISTER HOUSE MILLWORKS, INC. GROUP MEDICAL PLAN 2014 401k financial data
Total plan liabilities at end of year2014-12-31$74,184
Total plan liabilities at beginning of year2014-12-31$0
Total income from all sources2014-12-31$621,499
Expenses. Total of all expenses incurred2014-12-31$643,493
Benefits paid (including direct rollovers)2014-12-31$439,217
Total plan assets at end of year2014-12-31$52,190
Total plan assets at beginning of year2014-12-31$0
Value of fidelity bond covering the plan2014-12-31$25,000
Total contributions received or receivable from participants2014-12-31$65,780
Expenses. Other expenses not covered elsewhere2014-12-31$20
Other income received2014-12-31$61
Net income (gross income less expenses)2014-12-31$-21,994
Net plan assets at end of year (total assets less liabilities)2014-12-31$-21,994
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$0
Total contributions received or receivable from employer(s)2014-12-31$555,658
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$204,256

Form 5500 Responses for HEISTER HOUSE MILLWORKS, INC. GROUP MEDICAL PLAN

2016: HEISTER HOUSE MILLWORKS, INC. GROUP MEDICAL PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
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: HEISTER HOUSE MILLWORKS, INC. GROUP MEDICAL PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
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: HEISTER HOUSE MILLWORKS, INC. GROUP MEDICAL PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01First time form 5500 has been submittedYes
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered55
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $156,894
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EXCESS REINSURANCE UNDERWRITERS (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered58
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $146,689
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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