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E. R. STUEBNER, INC. EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan NameE. R. STUEBNER, INC. EMPLOYEE BENEFIT PLAN
Plan identification number 502

E. R. STUEBNER, INC. EMPLOYEE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

E. R. STUEBNER, INC. has sponsored the creation of one or more 401k plans.

Company Name:E. R. STUEBNER, INC.
Employer identification number (EIN):234232683
NAIC Classification:236200

Form 5500 Filing Information

Submission information for form 5500 for 401k plan E. R. STUEBNER, INC. EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-03-01
5022022-03-01MICHAEL CLEAVELAND
5022021-03-01
5022021-03-01MICHAEL CLEAVELAND

Financial Data on E. R. STUEBNER, INC. EMPLOYEE BENEFIT PLAN

Measure Date Value
2023 : E. R. STUEBNER, INC. EMPLOYEE BENEFIT PLAN 2023 401k financial data
Total plan liabilities at end of year2023-02-28$29,751
Total plan liabilities at beginning of year2023-02-28$42,829
Total income from all sources2023-02-28$344,459
Expenses. Total of all expenses incurred2023-02-28$281,788
Benefits paid (including direct rollovers)2023-02-28$158,319
Total plan assets at end of year2023-02-28$51,125
Total plan assets at beginning of year2023-02-28$1,532
Value of fidelity bond covering the plan2023-02-28$500,000
Total contributions received or receivable from participants2023-02-28$50,908
Expenses. Other expenses not covered elsewhere2023-02-28$114,692
Contributions received from other sources (not participants or employers)2023-02-28$6,882
Other income received2023-02-28$151
Net income (gross income less expenses)2023-02-28$62,671
Net plan assets at end of year (total assets less liabilities)2023-02-28$21,374
Net plan assets at beginning of year (total assets less liabilities)2023-02-28$-41,297
Total contributions received or receivable from employer(s)2023-02-28$286,518
Value of corrective distributions2023-02-28$0
Expenses. Administrative service providers (salaries,fees and commissions)2023-02-28$8,777
2022 : E. R. STUEBNER, INC. EMPLOYEE BENEFIT PLAN 2022 401k financial data
Total plan liabilities at end of year2022-02-28$42,829
Total income from all sources2022-02-28$297,526
Expenses. Total of all expenses incurred2022-02-28$338,823
Benefits paid (including direct rollovers)2022-02-28$233,105
Total plan assets at end of year2022-02-28$1,532
Value of fidelity bond covering the plan2022-02-28$520,000
Total contributions received or receivable from participants2022-02-28$38,829
Expenses. Other expenses not covered elsewhere2022-02-28$93,787
Contributions received from other sources (not participants or employers)2022-02-28$3,386
Other income received2022-02-28$89
Net income (gross income less expenses)2022-02-28$-41,297
Net plan assets at end of year (total assets less liabilities)2022-02-28$-41,297
Net plan assets at beginning of year (total assets less liabilities)2022-02-28$0
Total contributions received or receivable from employer(s)2022-02-28$255,222
Expenses. Administrative service providers (salaries,fees and commissions)2022-02-28$11,931

Form 5500 Responses for E. R. STUEBNER, INC. EMPLOYEE BENEFIT PLAN

2022: E. R. STUEBNER, INC. EMPLOYEE BENEFIT PLAN 2022 form 5500 responses
2022-03-01Type of plan entitySingle employer plan
2022-03-01Submission has been amendedNo
2022-03-01This submission is the final filingNo
2022-03-01This return/report is a short plan year return/report (less than 12 months)No
2022-03-01Plan is a collectively bargained planNo
2022-03-01Plan funding arrangement – InsuranceYes
2022-03-01Plan funding arrangement – TrustYes
2022-03-01Plan benefit arrangement – InsuranceYes
2021: E. R. STUEBNER, INC. EMPLOYEE BENEFIT PLAN 2021 form 5500 responses
2021-03-01Type of plan entitySingle employer plan
2021-03-01First time form 5500 has been submittedYes
2021-03-01Submission has been amendedNo
2021-03-01This submission is the final filingNo
2021-03-01This return/report is a short plan year return/report (less than 12 months)No
2021-03-01Plan is a collectively bargained planNo
2021-03-01Plan funding arrangement – InsuranceYes
2021-03-01Plan funding arrangement – TrustYes
2021-03-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract number30500761
Policy instance 1
Insurance contract or identification number30500761
Number of Individuals Covered30
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
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 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 $73,985
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 )
Policy contract number00531859
Policy instance 2
Insurance contract or identification number00531859
Number of Individuals Covered40
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $678
Total amount of fees paid to insurance companyUSD $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 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 BenefitYes
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 $6,781
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number0
Policy instance 3
Insurance contract or identification number0
Number of Individuals Covered0
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
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 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 BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 )
Policy contract number00531859
Policy instance 4
Insurance contract or identification number00531859
Number of Individuals Covered30
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
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 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 $9,665
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract number30500761
Policy instance 1
CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 )
Policy contract number00531859
Policy instance 2
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number0
Policy instance 3

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