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| Plan Name | MATESICH DISTRIBUTING CO. EMPLOYEE WELFARE PLAN |
| Plan identification number | 507 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | MATESICH DISTRIBUTION COMPANY |
| Employer identification number (EIN): | 310951279 |
| NAIC Classification: | 424800 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 507 | 2018-07-01 | ||||
| 507 | 2017-07-01 | DONNA STEVENS | DONNA STEVENS | 2019-01-23 |
| Measure | Date | Value |
|---|---|---|
| 2018: MATESICH DISTRIBUTING CO. EMPLOYEE WELFARE PLAN 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-07-01 | 104 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-07-01 | 100 |
| Total of all active and inactive participants | 2018-07-01 | 100 |
| Total participants | 2018-07-01 | 100 |
| 2017: MATESICH DISTRIBUTING CO. EMPLOYEE WELFARE PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-07-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 104 |
| Total of all active and inactive participants | 2017-07-01 | 104 |
| Total participants | 2017-07-01 | 104 |
| Measure | Date | Value |
|---|---|---|
| 2019 : MATESICH DISTRIBUTING CO. EMPLOYEE WELFARE PLAN 2019 401k financial data | ||
| Transfers to/from the plan | 2019-06-30 | $0 |
| Total plan liabilities at end of year | 2019-06-30 | $1,743 |
| Total plan liabilities at beginning of year | 2019-06-30 | $1,743 |
| Total income from all sources | 2019-06-30 | $82,690 |
| Expenses. Total of all expenses incurred | 2019-06-30 | $82,690 |
| Benefits paid (including direct rollovers) | 2019-06-30 | $82,690 |
| Total plan assets at end of year | 2019-06-30 | $1,743 |
| Total plan assets at beginning of year | 2019-06-30 | $1,743 |
| Value of fidelity bond covering the plan | 2019-06-30 | $1,500,000 |
| Net income (gross income less expenses) | 2019-06-30 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2019-06-30 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-06-30 | $0 |
| Total contributions received or receivable from employer(s) | 2019-06-30 | $82,690 |
| 2018 : MATESICH DISTRIBUTING CO. EMPLOYEE WELFARE PLAN 2018 401k financial data | ||
| Total income from all sources | 2018-06-30 | $73,200 |
| Expenses. Total of all expenses incurred | 2018-06-30 | $73,200 |
| Benefits paid (including direct rollovers) | 2018-06-30 | $73,200 |
| Total plan assets at end of year | 2018-06-30 | $1,743 |
| Total plan assets at beginning of year | 2018-06-30 | $1,743 |
| Value of fidelity bond covering the plan | 2018-06-30 | $1,500,000 |
| Net income (gross income less expenses) | 2018-06-30 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2018-06-30 | $1,743 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-06-30 | $1,743 |
| Total contributions received or receivable from employer(s) | 2018-06-30 | $73,200 |
| 2018: MATESICH DISTRIBUTING CO. EMPLOYEE WELFARE PLAN 2018 form 5500 responses | ||
|---|---|---|
| 2018-07-01 | Type of plan entity | Single employer plan |
| 2018-07-01 | First time form 5500 has been submitted | Yes |
| 2018-07-01 | Submission has been amended | No |
| 2018-07-01 | This submission is the final filing | No |
| 2018-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-07-01 | Plan is a collectively bargained plan | No |
| 2018-07-01 | Plan funding arrangement – Insurance | Yes |
| 2018-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: MATESICH DISTRIBUTING CO. EMPLOYEE WELFARE PLAN 2017 form 5500 responses | ||
| 2017-07-01 | Type of plan entity | Single employer plan |
| 2017-07-01 | First time form 5500 has been submitted | Yes |
| 2017-07-01 | Submission has been amended | No |
| 2017-07-01 | This submission is the final filing | No |
| 2017-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-07-01 | Plan is a collectively bargained plan | No |
| 2017-07-01 | Plan funding arrangement – Insurance | Yes |
| 2017-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | G 00617232 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 00172914 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 664682 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 855564G | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 00172914 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 664682 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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