401k Plan data: J&M MANAGEMENT SERVICES EMPLOYEE BENEFITS PLAN plan

J&M MANAGEMENT SERVICES EMPLOYEE BENEFITS PLAN 401k Plan overview

Plan Name	J&M MANAGEMENT SERVICES EMPLOYEE BENEFITS PLAN
Plan identification number	501

J&M MANAGEMENT SERVICES EMPLOYEE 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 Other welfare benefit cover

401k Sponsoring company profile

J & M MANAGEMENT SERVICES has sponsored the creation of one or more 401k plans.

Company Name: J & M MANAGEMENT SERVICES

Employer identification number (EIN): 270765475

NAIC Classification: 561210
NAIC Description: Facilities Support Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan J&M MANAGEMENT SERVICES EMPLOYEE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2015-08-01 JAY CHESSER
501 2014-08-01 JAY CHESSER

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2015-08-01	JAY CHESSER
501	2014-08-01	JAY CHESSER

Plan Statistics for J&M MANAGEMENT SERVICES EMPLOYEE BENEFITS PLAN

401k plan membership statisitcs for J&M MANAGEMENT SERVICES EMPLOYEE BENEFITS PLAN

Measure Date Value
2015: J&M MANAGEMENT SERVICES EMPLOYEE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-08-01 102
Total number of active participants reported on line 7a of the Form 5500 2015-08-01 30
Number of retired or separated participants receiving benefits 2015-08-01 0
Number of other retired or separated participants entitled to future benefits 2015-08-01 0
Total of all active and inactive participants 2015-08-01 30
2014: J&M MANAGEMENT SERVICES EMPLOYEE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-08-01 135
Total number of active participants reported on line 7a of the Form 5500 2014-08-01 98
Number of retired or separated participants receiving benefits 2014-08-01 0
Number of other retired or separated participants entitled to future benefits 2014-08-01 0
Total of all active and inactive participants 2014-08-01 98

Measure	Date	Value
2015: J&M MANAGEMENT SERVICES EMPLOYEE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-08-01	102
Total number of active participants reported on line 7a of the Form 5500	2015-08-01	30
Number of retired or separated participants receiving benefits	2015-08-01	0
Number of other retired or separated participants entitled to future benefits	2015-08-01	0
Total of all active and inactive participants	2015-08-01	30
2014: J&M MANAGEMENT SERVICES EMPLOYEE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-08-01	135
Total number of active participants reported on line 7a of the Form 5500	2014-08-01	98
Number of retired or separated participants receiving benefits	2014-08-01	0
Number of other retired or separated participants entitled to future benefits	2014-08-01	0
Total of all active and inactive participants	2014-08-01	98

Form 5500 Responses for J&M MANAGEMENT SERVICES EMPLOYEE BENEFITS PLAN

2015: J&M MANAGEMENT SERVICES EMPLOYEE BENEFITS PLAN 2015 form 5500 responses
2015-08-01	Type of plan entity	Single employer plan
2015-08-01	Submission has been amended	No
2015-08-01	This submission is the final filing	No
2015-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-08-01	Plan is a collectively bargained plan	No
2015-08-01	Plan funding arrangement – Insurance	Yes
2015-08-01	Plan benefit arrangement – Insurance	Yes
2014: J&M MANAGEMENT SERVICES EMPLOYEE BENEFITS PLAN 2014 form 5500 responses
2014-08-01	Type of plan entity	Single employer plan
2014-08-01	First time form 5500 has been submitted	Yes
2014-08-01	Submission has been amended	No
2014-08-01	This submission is the final filing	No
2014-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-08-01	Plan is a collectively bargained plan	No
2014-08-01	Plan funding arrangement – Insurance	Yes
2014-08-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

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

Policy contract number

610432

Policy instance

Insurance contract or identification number	610432
Number of Individuals Covered	37
Insurance policy start date	2015-08-01
Insurance policy end date	2016-07-31
Total amount of commissions paid to insurance broker	USD $28,442
Total amount of fees paid to insurance company	USD $2,536
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	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 $414,711
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $16,826
Amount paid for insurance broker fees	2316
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3
Insurance broker name	LAKE NORMAN BENEFITS INC

UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )

Policy contract number

5477182

Policy instance

Insurance contract or identification number	5477182
Number of Individuals Covered	38
Insurance policy start date	2015-08-01
Insurance policy end date	2016-07-31
Total amount of commissions paid to insurance broker	USD $15,131
Total amount of fees paid to insurance company	USD $2,855
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	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	AD&D, SUPPLEMENTAL LIFE & DEP LIFE, SUPPLEMENTAL AD&D & DEP AD&D, ACCIDENT, 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 $79,205
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $15,131
Amount paid for insurance broker fees	2855
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3
Insurance broker name	HILB GROUP OF NORTH CAROLINA LLC

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

Policy contract number

610432

Policy instance

Insurance contract or identification number	610432
Number of Individuals Covered	169
Insurance policy start date	2014-08-01
Insurance policy end date	2015-07-31
Total amount of commissions paid to insurance broker	USD $38,317
Total amount of fees paid to insurance company	USD $5,663
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	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&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 Carrier	USD $621,193
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $24,775
Amount paid for insurance broker fees	4230
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3
Insurance broker name	THE HILB GROUP OF NORTH CAROLINA

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Company Name:	J & M MANAGEMENT SERVICES
Employer identification number (EIN):	270765475
NAIC Classification:	561210
NAIC Description:	Facilities Support Services