401k Plan data: ENERVISE, INC. LONG TERM DISABILITY PLAN plan

ENERVISE, INC. LONG TERM DISABILITY PLAN 401k Plan overview

Plan Name	ENERVISE, INC. LONG TERM DISABILITY PLAN
Plan identification number	502

ENERVISE, INC. LONG TERM DISABILITY PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Temporary disability (accident and sickness) Long-term disability cover

401k Sponsoring company profile

ENERVISE, INC. has sponsored the creation of one or more 401k plans.

Company Name: ENERVISE, INC.

Employer identification number (EIN): 311144000

NAIC Classification: 541330
NAIC Description: Engineering Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ENERVISE, INC. LONG TERM DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2014-04-01 MARY W SEAMAN MARY W SEAMAN 2015-10-01
502 2013-04-01 MARY W SEAMAN MARY W SEAMAN 2014-10-02
502 2012-04-01 MARY WINSTEL SEAMAN MARY WINSTEL SEAMAN 2013-09-30
502 2011-04-01 MARY W SEAMAN MARY W SEAMAN 2012-10-18
502 2009-04-01 THOMAS WINSTEL THOMAS WINSTEL 2010-09-07

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
502	2014-04-01	MARY W SEAMAN	MARY W SEAMAN	2015-10-01
502	2013-04-01	MARY W SEAMAN	MARY W SEAMAN	2014-10-02
502	2012-04-01	MARY WINSTEL SEAMAN	MARY WINSTEL SEAMAN	2013-09-30
502	2011-04-01	MARY W SEAMAN	MARY W SEAMAN	2012-10-18
502	2009-04-01	THOMAS WINSTEL	THOMAS WINSTEL	2010-09-07

Plan Statistics for ENERVISE, INC. LONG TERM DISABILITY PLAN

401k plan membership statisitcs for ENERVISE, INC. LONG TERM DISABILITY PLAN

Measure Date Value
2014: ENERVISE, INC. LONG TERM DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year 2014-04-01 190
Total number of active participants reported on line 7a of the Form 5500 2014-04-01 83
Total of all active and inactive participants 2014-04-01 83
2013: ENERVISE, INC. LONG TERM DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year 2013-04-01 119
Total number of active participants reported on line 7a of the Form 5500 2013-04-01 190
Total of all active and inactive participants 2013-04-01 190
2012: ENERVISE, INC. LONG TERM DISABILITY PLAN 2012 401k membership
Total participants, beginning-of-year 2012-04-01 119
Total number of active participants reported on line 7a of the Form 5500 2012-04-01 119
Total of all active and inactive participants 2012-04-01 119
2011: ENERVISE, INC. LONG TERM DISABILITY PLAN 2011 401k membership
Total participants, beginning-of-year 2011-04-01 113
Total number of active participants reported on line 7a of the Form 5500 2011-04-01 119
Total of all active and inactive participants 2011-04-01 119
2009: ENERVISE, INC. LONG TERM DISABILITY PLAN 2009 401k membership
Total participants, beginning-of-year 2009-04-01 122
Total number of active participants reported on line 7a of the Form 5500 2009-04-01 99
Total of all active and inactive participants 2009-04-01 99

Measure	Date	Value
2014: ENERVISE, INC. LONG TERM DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year	2014-04-01	190
Total number of active participants reported on line 7a of the Form 5500	2014-04-01	83
Total of all active and inactive participants	2014-04-01	83
2013: ENERVISE, INC. LONG TERM DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year	2013-04-01	119
Total number of active participants reported on line 7a of the Form 5500	2013-04-01	190
Total of all active and inactive participants	2013-04-01	190
2012: ENERVISE, INC. LONG TERM DISABILITY PLAN 2012 401k membership
Total participants, beginning-of-year	2012-04-01	119
Total number of active participants reported on line 7a of the Form 5500	2012-04-01	119
Total of all active and inactive participants	2012-04-01	119
2011: ENERVISE, INC. LONG TERM DISABILITY PLAN 2011 401k membership
Total participants, beginning-of-year	2011-04-01	113
Total number of active participants reported on line 7a of the Form 5500	2011-04-01	119
Total of all active and inactive participants	2011-04-01	119
2009: ENERVISE, INC. LONG TERM DISABILITY PLAN 2009 401k membership
Total participants, beginning-of-year	2009-04-01	122
Total number of active participants reported on line 7a of the Form 5500	2009-04-01	99
Total of all active and inactive participants	2009-04-01	99

Form 5500 Responses for ENERVISE, INC. LONG TERM DISABILITY PLAN

2014: ENERVISE, INC. LONG TERM DISABILITY PLAN 2014 form 5500 responses
2014-04-01	Type of plan entity	Single employer plan
2014-04-01	Submission has been amended	No
2014-04-01	This submission is the final filing	No
2014-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-04-01	Plan is a collectively bargained plan	No
2014-04-01	Plan funding arrangement – Insurance	Yes
2014-04-01	Plan benefit arrangement – Insurance	Yes
2013: ENERVISE, INC. LONG TERM DISABILITY PLAN 2013 form 5500 responses
2013-04-01	Type of plan entity	Single employer plan
2013-04-01	Submission has been amended	No
2013-04-01	This submission is the final filing	No
2013-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-04-01	Plan is a collectively bargained plan	No
2013-04-01	Plan funding arrangement – Insurance	Yes
2013-04-01	Plan benefit arrangement – Insurance	Yes
2012: ENERVISE, INC. LONG TERM DISABILITY PLAN 2012 form 5500 responses
2012-04-01	Type of plan entity	Single employer plan
2012-04-01	Submission has been amended	No
2012-04-01	This submission is the final filing	No
2012-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-04-01	Plan is a collectively bargained plan	No
2012-04-01	Plan funding arrangement – Insurance	Yes
2012-04-01	Plan benefit arrangement – Insurance	Yes
2011: ENERVISE, INC. LONG TERM DISABILITY PLAN 2011 form 5500 responses
2011-04-01	Type of plan entity	Single employer plan
2011-04-01	Submission has been amended	No
2011-04-01	This submission is the final filing	No
2011-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-04-01	Plan is a collectively bargained plan	No
2011-04-01	Plan funding arrangement – Insurance	Yes
2011-04-01	Plan benefit arrangement – Insurance	Yes
2009: ENERVISE, INC. LONG TERM DISABILITY PLAN 2009 form 5500 responses
2009-04-01	Type of plan entity	Single employer plan
2009-04-01	Submission has been amended	No
2009-04-01	This submission is the final filing	No
2009-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-04-01	Plan is a collectively bargained plan	No
2009-04-01	Plan funding arrangement – Insurance	Yes
2009-04-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

1034269

Policy instance

Insurance contract or identification number	1034269
Number of Individuals Covered	83
Insurance policy start date	2014-03-01
Insurance policy end date	2015-02-28
Total amount of commissions paid to insurance broker	USD $1,268
Total amount of fees paid to insurance company	USD $820
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	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 $12,746
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,268
Amount paid for insurance broker fees	820
Additional information about fees paid to insurance broker	BONUS
Insurance broker organization code?	3
Insurance broker name	HORAN ASSOCIATES INC

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

1034269

Policy instance

Insurance contract or identification number	1034269
Number of Individuals Covered	190
Insurance policy start date	2013-03-01
Insurance policy end date	2014-02-28
Total amount of commissions paid to insurance broker	USD $6,210
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
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 $54,932
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,210
Insurance broker organization code?	3
Insurance broker name	HORAN ASSOCIATES INC

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

Policy contract number

5267144

Policy instance

Insurance contract or identification number	5267144
Number of Individuals Covered	119
Insurance policy start date	2012-03-01
Insurance policy end date	2013-02-28
Total amount of commissions paid to insurance broker	USD $2,371
Total amount of fees paid to insurance company	USD $307
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	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 $16,031
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,371
Amount paid for insurance broker fees	307
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3
Insurance broker name	HORAN ASSOCIATES, INC.

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

Policy contract number

5267144

Policy instance

Insurance contract or identification number	5267144
Number of Individuals Covered	119
Insurance policy start date	2011-03-01
Insurance policy end date	2012-02-29
Total amount of commissions paid to insurance broker	USD $2,280
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	No
Temporary Disability Insurance Welfare Benefit	No
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 $15,299
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

5267144

Policy instance

Insurance contract or identification number	5267144
Number of Individuals Covered	113
Insurance policy start date	2010-04-01
Insurance policy end date	2011-03-31
Total amount of commissions paid to insurance broker	USD $2,051
Total amount of fees paid to insurance company	USD $144
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	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 $14,134
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	ENERVISE, INC.
Employer identification number (EIN):	311144000
NAIC Classification:	541330
NAIC Description:	Engineering Services