401k Plan data: GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN plan

GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN 401k Plan overview

Plan Name	GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN
Plan identification number	501

GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Dental Vision

401k Sponsoring company profile

GRABILL CABINET COMPANY, INC. has sponsored the creation of one or more 401k plans.

Company Name: GRABILL CABINET COMPANY, INC.

Employer identification number (EIN): 350979113

NAIC Classification: 337000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2017-04-01 MARTIN HEINY
501 2016-04-01 MARTIN HEINY
501 2015-10-01 MARTIN HEINY
501 2014-10-01 MARTIN HEINY
501 2013-10-01 JEFFREY FARBER
501 2012-10-01 JEFFREY FARBER
501 2011-10-01 JEFFREY FARBER
501 2009-10-01 DOUG HEINISCH

Plan id#	Filing Submission Date	Name of Administrator
501	2017-04-01	MARTIN HEINY
501	2016-04-01	MARTIN HEINY
501	2015-10-01	MARTIN HEINY
501	2014-10-01	MARTIN HEINY
501	2013-10-01	JEFFREY FARBER
501	2012-10-01	JEFFREY FARBER
501	2011-10-01	JEFFREY FARBER
501	2009-10-01	DOUG HEINISCH

Plan Statistics for GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN

401k plan membership statisitcs for GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN

Measure Date Value
2017: GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year 2017-04-01 122
Total number of active participants reported on line 7a of the Form 5500 2017-04-01 122
Number of retired or separated participants receiving benefits 2017-04-01 0
Number of other retired or separated participants entitled to future benefits 2017-04-01 0
Total of all active and inactive participants 2017-04-01 122
2016: GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year 2016-04-01 128
Total number of active participants reported on line 7a of the Form 5500 2016-04-01 122
Number of retired or separated participants receiving benefits 2016-04-01 0
Number of other retired or separated participants entitled to future benefits 2016-04-01 0
Total of all active and inactive participants 2016-04-01 122
2015: GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year 2015-10-01 142
Total number of active participants reported on line 7a of the Form 5500 2015-10-01 128
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 2015-10-01 128
2014: GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year 2014-10-01 106
Total number of active participants reported on line 7a of the Form 5500 2014-10-01 142
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 2014-10-01 142
2013: GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year 2013-10-01 98
Total number of active participants reported on line 7a of the Form 5500 2013-10-01 106
Total of all active and inactive participants 2013-10-01 106
2012: GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year 2012-10-01 99
Total number of active participants reported on line 7a of the Form 5500 2012-10-01 98
Total of all active and inactive participants 2012-10-01 98
2011: GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year 2011-10-01 109
Total number of active participants reported on line 7a of the Form 5500 2011-10-01 99
Total of all active and inactive participants 2011-10-01 99
Total participants 2011-10-01 99
2009: GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN 2009 401k membership
Total participants, beginning-of-year 2009-10-01 100
Total number of active participants reported on line 7a of the Form 5500 2009-10-01 113
Total of all active and inactive participants 2009-10-01 113
Total participants 2009-10-01 113

Measure	Date	Value
2017: GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year	2017-04-01	122
Total number of active participants reported on line 7a of the Form 5500	2017-04-01	122
Number of retired or separated participants receiving benefits	2017-04-01	0
Number of other retired or separated participants entitled to future benefits	2017-04-01	0
Total of all active and inactive participants	2017-04-01	122
2016: GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year	2016-04-01	128
Total number of active participants reported on line 7a of the Form 5500	2016-04-01	122
Number of retired or separated participants receiving benefits	2016-04-01	0
Number of other retired or separated participants entitled to future benefits	2016-04-01	0
Total of all active and inactive participants	2016-04-01	122
2015: GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year	2015-10-01	142
Total number of active participants reported on line 7a of the Form 5500	2015-10-01	128
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	128
2014: GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year	2014-10-01	106
Total number of active participants reported on line 7a of the Form 5500	2014-10-01	142
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	142
2013: GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year	2013-10-01	98
Total number of active participants reported on line 7a of the Form 5500	2013-10-01	106
Total of all active and inactive participants	2013-10-01	106
2012: GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year	2012-10-01	99
Total number of active participants reported on line 7a of the Form 5500	2012-10-01	98
Total of all active and inactive participants	2012-10-01	98
2011: GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year	2011-10-01	109
Total number of active participants reported on line 7a of the Form 5500	2011-10-01	99
Total of all active and inactive participants	2011-10-01	99
Total participants	2011-10-01	99
2009: GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN 2009 401k membership
Total participants, beginning-of-year	2009-10-01	100
Total number of active participants reported on line 7a of the Form 5500	2009-10-01	113
Total of all active and inactive participants	2009-10-01	113
Total participants	2009-10-01	113

Form 5500 Responses for GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN

2017: GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN 2017 form 5500 responses
2017-04-01	Type of plan entity	Single employer plan
2017-04-01	Plan funding arrangement – Insurance	Yes
2017-04-01	Plan benefit arrangement – Insurance	Yes
2016: GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN 2016 form 5500 responses
2016-04-01	Type of plan entity	Single employer plan
2016-04-01	Plan funding arrangement – Insurance	Yes
2016-04-01	Plan benefit arrangement – Insurance	Yes
2015: GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN 2015 form 5500 responses
2015-10-01	Type of plan entity	Single employer plan
2015-10-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2015-10-01	Plan funding arrangement – Insurance	Yes
2015-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-10-01	Plan benefit arrangement – Insurance	Yes
2015-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN 2014 form 5500 responses
2014-10-01	Type of plan entity	Single employer plan
2014-10-01	Plan funding arrangement – Insurance	Yes
2014-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-10-01	Plan benefit arrangement – Insurance	Yes
2014-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN 2013 form 5500 responses
2013-10-01	Type of plan entity	Single employer plan
2013-10-01	Plan funding arrangement – Insurance	Yes
2013-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-10-01	Plan benefit arrangement – Insurance	Yes
2013-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN 2012 form 5500 responses
2012-10-01	Type of plan entity	Single employer plan
2012-10-01	Plan funding arrangement – Insurance	Yes
2012-10-01	Plan benefit arrangement – Insurance	Yes
2011: GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN 2011 form 5500 responses
2011-10-01	Type of plan entity	Single employer plan
2011-10-01	Plan funding arrangement – Insurance	Yes
2011-10-01	Plan benefit arrangement – Insurance	Yes
2009: GRABILL CABINET COMPANY, INC. GROUP MEDICAL PLAN 2009 form 5500 responses
2009-10-01	Type of plan entity	Single employer plan
2009-10-01	Plan funding arrangement – Insurance	Yes
2009-10-01	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	1062739
Policy instance	3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number	1062739
Policy instance	2
PHYSICIANS HEALTH PLAN OF NORTHERN INDIANA (National Association of Insurance Commissioners NAIC id number: 95436 )
Policy contract number	H655/H850-16
Policy instance	1
UNITED STATES FIRE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	AH27244-008
Policy instance	2
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number	HCL30657
Policy instance	1
UNITED STATES FIRE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	AH27244-008
Policy instance	2
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number	HCL30657
Policy instance	1
UNITED STATES FIRE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	AH27244-008
Policy instance	2
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number	HCL30657
Policy instance	1
UNITED STATES FIRE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	AH27244-008
Policy instance	2
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract number	GL0068
Policy instance	1
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number	HCL11312
Policy instance	1
PERICO LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85561 )
Policy contract number	PX02117
Policy instance	1

Potentially related plans

GRABILL CABINETS ACQUISITION COMPANY, LLC 401(K) PLAN [EIN = 871583357]

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Company Name:	GRABILL CABINET COMPANY, INC.
Employer identification number (EIN):	350979113
NAIC Classification:	337000