401k Plan data: LOW T CENTER SECTION 125 PLAN plan

LOW T CENTER SECTION 125 PLAN 401k Plan overview

Plan Name	LOW T CENTER SECTION 125 PLAN
Plan identification number	501

LOW T CENTER SECTION 125 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

LOW T CENTER, L.L.C. has sponsored the creation of one or more 401k plans.

Company Name: LOW T CENTER, L.L.C.

Employer identification number (EIN): 271496724

NAIC Classification: 561110
NAIC Description: Office Administrative Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LOW T CENTER SECTION 125 PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2017-10-01 DAVID MORAINE 2019-11-14 DAVID MORAINE 2019-11-14
501 2016-10-01 DAVID MORAINE 2019-11-14
501 2015-10-01 DAVID MORAINE DAVID MORAINE 2017-11-08
501 2014-10-01 DAVID MORAINE

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2017-10-01	DAVID MORAINE	2019-11-14	DAVID MORAINE	2019-11-14
501	2016-10-01	DAVID MORAINE	2019-11-14
501	2015-10-01	DAVID MORAINE		DAVID MORAINE	2017-11-08
501	2014-10-01	DAVID MORAINE

Plan Statistics for LOW T CENTER SECTION 125 PLAN

401k plan membership statisitcs for LOW T CENTER SECTION 125 PLAN

Measure Date Value
2017: LOW T CENTER SECTION 125 PLAN 2017 401k membership
Total participants, beginning-of-year 2017-10-01 342
Total number of active participants reported on line 7a of the Form 5500 2017-10-01 355
Number of retired or separated participants receiving benefits 2017-10-01 0
Number of other retired or separated participants entitled to future benefits 2017-10-01 0
Total of all active and inactive participants 2017-10-01 355
2016: LOW T CENTER SECTION 125 PLAN 2016 401k membership
Total participants, beginning-of-year 2016-10-01 241
Total number of active participants reported on line 7a of the Form 5500 2016-10-01 342
Number of retired or separated participants receiving benefits 2016-10-01 0
Number of other retired or separated participants entitled to future benefits 2016-10-01 0
Total of all active and inactive participants 2016-10-01 342
2015: LOW T CENTER SECTION 125 PLAN 2015 401k membership
Total participants, beginning-of-year 2015-10-01 119
Total number of active participants reported on line 7a of the Form 5500 2015-10-01 241
Number of retired or separated participants receiving benefits 2015-10-01 0
Number of other retired or separated participants entitled to future benefits 2015-10-01 0
Total of all active and inactive participants 2015-10-01 241
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-10-01 0
Total participants 2015-10-01 241
Number of participants with account balances 2015-10-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-10-01 0
Number of employers contributing to the scheme 2015-10-01 0
2014: LOW T CENTER SECTION 125 PLAN 2014 401k membership
Total participants, beginning-of-year 2014-10-01 130
Total number of active participants reported on line 7a of the Form 5500 2014-10-01 125
Number of retired or separated participants receiving benefits 2014-10-01 0
Number of other retired or separated participants entitled to future benefits 2014-10-01 0
Total of all active and inactive participants 2014-10-01 125

Measure	Date	Value
2017: LOW T CENTER SECTION 125 PLAN 2017 401k membership
Total participants, beginning-of-year	2017-10-01	342
Total number of active participants reported on line 7a of the Form 5500	2017-10-01	355
Number of retired or separated participants receiving benefits	2017-10-01	0
Number of other retired or separated participants entitled to future benefits	2017-10-01	0
Total of all active and inactive participants	2017-10-01	355
2016: LOW T CENTER SECTION 125 PLAN 2016 401k membership
Total participants, beginning-of-year	2016-10-01	241
Total number of active participants reported on line 7a of the Form 5500	2016-10-01	342
Number of retired or separated participants receiving benefits	2016-10-01	0
Number of other retired or separated participants entitled to future benefits	2016-10-01	0
Total of all active and inactive participants	2016-10-01	342
2015: LOW T CENTER SECTION 125 PLAN 2015 401k membership
Total participants, beginning-of-year	2015-10-01	119
Total number of active participants reported on line 7a of the Form 5500	2015-10-01	241
Number of retired or separated participants receiving benefits	2015-10-01	0
Number of other retired or separated participants entitled to future benefits	2015-10-01	0
Total of all active and inactive participants	2015-10-01	241
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-10-01	0
Total participants	2015-10-01	241
Number of participants with account balances	2015-10-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-10-01	0
Number of employers contributing to the scheme	2015-10-01	0
2014: LOW T CENTER SECTION 125 PLAN 2014 401k membership
Total participants, beginning-of-year	2014-10-01	130
Total number of active participants reported on line 7a of the Form 5500	2014-10-01	125
Number of retired or separated participants receiving benefits	2014-10-01	0
Number of other retired or separated participants entitled to future benefits	2014-10-01	0
Total of all active and inactive participants	2014-10-01	125

Form 5500 Responses for LOW T CENTER SECTION 125 PLAN

2017: LOW T CENTER SECTION 125 PLAN 2017 form 5500 responses
2017-10-01	Type of plan entity	Mulitple employer plan
2017-10-01	Submission has been amended	No
2017-10-01	This submission is the final filing	No
2017-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-10-01	Plan is a collectively bargained plan	No
2017-10-01	Plan funding arrangement – Insurance	Yes
2017-10-01	Plan benefit arrangement – Insurance	Yes
2016: LOW T CENTER SECTION 125 PLAN 2016 form 5500 responses
2016-10-01	Type of plan entity	Mulitple employer plan
2016-10-01	Submission has been amended	No
2016-10-01	This submission is the final filing	No
2016-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-10-01	Plan is a collectively bargained plan	No
2016-10-01	Plan funding arrangement – Insurance	Yes
2016-10-01	Plan benefit arrangement – Insurance	Yes
2015: LOW T CENTER SECTION 125 PLAN 2015 form 5500 responses
2015-10-01	Type of plan entity	Mulitple employer plan
2015-10-01	Submission has been amended	No
2015-10-01	This submission is the final filing	No
2015-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-10-01	Plan is a collectively bargained plan	No
2015-10-01	Plan funding arrangement – Insurance	Yes
2015-10-01	Plan benefit arrangement – Insurance	Yes
2014: LOW T CENTER SECTION 125 PLAN 2014 form 5500 responses
2014-10-01	Type of plan entity	Mulitple employer plan
2014-10-01	First time form 5500 has been submitted	Yes
2014-10-01	Submission has been amended	No
2014-10-01	This submission is the final filing	No
2014-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-10-01	Plan is a collectively bargained plan	No
2014-10-01	Plan funding arrangement – Insurance	Yes
2014-10-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

120743

Policy instance

Insurance contract or identification number	120743
Number of Individuals Covered	333
Insurance policy start date	2017-10-01
Insurance policy end date	2018-09-30
Total amount of commissions paid to insurance broker	USD $85,213
Total amount of fees paid to insurance company	USD $1,818
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	Yes
Dental Insurance Welfare Benefit	Yes
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 $2,065,905
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 )

Policy contract number

720977315

Policy instance

Insurance contract or identification number	720977315
Number of Individuals Covered	0
Insurance policy start date	2017-10-01
Insurance policy end date	2018-09-30
Total amount of commissions paid to insurance broker	USD $2,292
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	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 $19,098
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

30234

Policy instance

Insurance contract or identification number	30234
Number of Individuals Covered	135
Insurance policy start date	2017-10-01
Insurance policy end date	2018-09-30
Total amount of commissions paid to insurance broker	USD $5,686
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
Other welfare benefits provided	ACCIDENT ACCOUNTS
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 $19,236
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

30234

Policy instance

Insurance contract or identification number	30234
Number of Individuals Covered	48
Insurance policy start date	2017-10-01
Insurance policy end date	2018-09-30
Total amount of commissions paid to insurance broker	USD $2,492
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
Other welfare benefits provided	CRITICAL ILLNESS ACCOUNTS
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 $13,039
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )

Policy contract number

F019315

Policy instance

Insurance contract or identification number	F019315
Number of Individuals Covered	355
Insurance policy start date	2017-10-01
Insurance policy end date	2018-09-30
Total amount of commissions paid to insurance broker	USD $8,754
Total amount of fees paid to insurance company	USD $5,792
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	Yes
Long Term Disability Insurance Welfare Benefit	Yes
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 $90,656
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	LOW T CENTER, L.L.C.
Employer identification number (EIN):	271496724
NAIC Classification:	561110
NAIC Description:	Office Administrative Services