401k Plan data: ROBBINS PROPERTY ASSOCIATES, LLC HEALTH AND WELFARE PLAN plan

ROBBINS PROPERTY ASSOCIATES, LLC HEALTH AND WELFARE PLAN 401k Plan overview

Plan Name	ROBBINS PROPERTY ASSOCIATES, LLC HEALTH AND WELFARE PLAN
Plan identification number	501

ROBBINS PROPERTY ASSOCIATES, LLC HEALTH AND WELFARE 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)

401k Sponsoring company profile

ROBBINS PROPERTY ASSOCIATES, LLC has sponsored the creation of one or more 401k plans.

Company Name: ROBBINS PROPERTY ASSOCIATES, LLC

Employer identification number (EIN): 270595061

NAIC Classification: 713900

Additional information about ROBBINS PROPERTY ASSOCIATES, LLC

Jurisdiction of Incorporation: Florida Department of State Division of Corporations

Incorporation Date: 2009-07-22

Company Identification Number: L09000070780

Legal Registered Office Address: 1200 South Pine Island Road

Plantation

33324

More information about ROBBINS PROPERTY ASSOCIATES, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ROBBINS PROPERTY ASSOCIATES, LLC HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2015-07-01 CAROLE THOMPSON
501 2015-07-01 CAROLE THOMPSON
501 2015-07-01 CAROLE THOMPSON
501 2014-07-01 CAROLE THOMPSON

Plan id#	Filing Submission Date	Name of Administrator
501	2015-07-01	CAROLE THOMPSON
501	2015-07-01	CAROLE THOMPSON
501	2015-07-01	CAROLE THOMPSON
501	2014-07-01	CAROLE THOMPSON

Plan Statistics for ROBBINS PROPERTY ASSOCIATES, LLC HEALTH AND WELFARE PLAN

401k plan membership statisitcs for ROBBINS PROPERTY ASSOCIATES, LLC HEALTH AND WELFARE PLAN

Measure Date Value
2015: ROBBINS PROPERTY ASSOCIATES, LLC HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 165
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 157
Number of retired or separated participants receiving benefits 2015-07-01 0
Number of other retired or separated participants entitled to future benefits 2015-07-01 0
Total of all active and inactive participants 2015-07-01 157
2014: ROBBINS PROPERTY ASSOCIATES, LLC HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 157
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 157
Number of retired or separated participants receiving benefits 2014-07-01 0
Number of other retired or separated participants entitled to future benefits 2014-07-01 0
Total of all active and inactive participants 2014-07-01 157

Measure	Date	Value
2015: ROBBINS PROPERTY ASSOCIATES, LLC HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	165
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	157
Number of retired or separated participants receiving benefits	2015-07-01	0
Number of other retired or separated participants entitled to future benefits	2015-07-01	0
Total of all active and inactive participants	2015-07-01	157
2014: ROBBINS PROPERTY ASSOCIATES, LLC HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	157
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	157
Number of retired or separated participants receiving benefits	2014-07-01	0
Number of other retired or separated participants entitled to future benefits	2014-07-01	0
Total of all active and inactive participants	2014-07-01	157

Form 5500 Responses for ROBBINS PROPERTY ASSOCIATES, LLC HEALTH AND WELFARE PLAN

2015: ROBBINS PROPERTY ASSOCIATES, LLC HEALTH AND WELFARE PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	Submission has been amended	No
2015-07-01	This submission is the final filing	No
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2015-07-01	Plan is a collectively bargained plan	No
2015-07-01	Plan funding arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes
2014: ROBBINS PROPERTY ASSOCIATES, LLC HEALTH AND WELFARE PLAN 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	First time form 5500 has been submitted	Yes
2014-07-01	Submission has been amended	No
2014-07-01	This submission is the final filing	No
2014-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-07-01	Plan is a collectively bargained plan	No
2014-07-01	Plan funding arrangement – Insurance	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10205273

Policy instance

Insurance contract or identification number	10205273
Number of Individuals Covered	238
Insurance policy start date	2015-07-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $4,533
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	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
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 $45,324
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,777
Insurance broker organization code?	3
Insurance broker name	WELLS FARGO INSURANCE SERVICES

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

535528

Policy instance

Insurance contract or identification number	535528
Number of Individuals Covered	320
Insurance policy start date	2015-07-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $42,780
Total amount of fees paid to insurance company	USD $468
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	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
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 $702,488
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $42,780
Amount paid for insurance broker fees	468
Additional information about fees paid to insurance broker	BONUS
Insurance broker organization code?	3
Insurance broker name	WELLS FARGO INSURANCE SERVICES

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

535528

Policy instance

Insurance contract or identification number	535528
Number of Individuals Covered	206
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $44,211
Total amount of fees paid to insurance company	USD $1,167
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	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
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 $818,195
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $44,293
Amount paid for insurance broker fees	1167
Additional information about fees paid to insurance broker	BONUS
Insurance broker organization code?	3
Insurance broker name	FRANKLIN STREET INS. SERVICES, LLC

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

EUD89

Policy instance

Insurance contract or identification number	EUD89
Number of Individuals Covered	156
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $17,635
Total amount of fees paid to insurance company	USD $1,435
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	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
Other welfare benefits provided	CANCER, CRITICAL ILLNESS
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 $80,202
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,475
Amount paid for insurance broker fees	677
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3
Insurance broker name	SUSAN C. BRIMHALL

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Company Name:	ROBBINS PROPERTY ASSOCIATES, LLC
Employer identification number (EIN):	270595061
NAIC Classification:	713900

Jurisdiction of Incorporation:	Florida Department of State Division of Corporations
Incorporation Date:	2009-07-22
Company Identification Number:	L09000070780
Legal Registered Office Address:	1200 South Pine Island Road Plantation 33324