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ROLLIE WILLIAMS PAINT SPOT INC GROUP BENEFITS PLAN 401k Plan overview

Plan NameROLLIE WILLIAMS PAINT SPOT INC GROUP BENEFITS PLAN
Plan identification number 501

ROLLIE WILLIAMS PAINT SPOT INC GROUP BENEFITS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Other welfare benefit cover

401k Sponsoring company profile

ROLLIE WILLIAMS PAINT SPOT, INC. has sponsored the creation of one or more 401k plans.

Company Name:ROLLIE WILLIAMS PAINT SPOT, INC.
Employer identification number (EIN):351162473
NAIC Classification:444120
NAIC Description:Paint and Wallpaper Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ROLLIE WILLIAMS PAINT SPOT INC GROUP BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012016-10-01 LILA LEONARD2019-03-22
5012015-10-01
5012014-10-01

Plan Statistics for ROLLIE WILLIAMS PAINT SPOT INC GROUP BENEFITS PLAN

401k plan membership statisitcs for ROLLIE WILLIAMS PAINT SPOT INC GROUP BENEFITS PLAN

Measure Date Value
2016: ROLLIE WILLIAMS PAINT SPOT INC GROUP BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-01148
Total number of active participants reported on line 7a of the Form 55002016-10-01151
Number of retired or separated participants receiving benefits2016-10-010
Number of other retired or separated participants entitled to future benefits2016-10-010
Total of all active and inactive participants2016-10-01151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-10-010
Total participants2016-10-01151
Number of participants with account balances2016-10-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-10-010
2015: ROLLIE WILLIAMS PAINT SPOT INC GROUP BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-0186
Total number of active participants reported on line 7a of the Form 55002015-10-010
Number of retired or separated participants receiving benefits2015-10-010
Number of other retired or separated participants entitled to future benefits2015-10-010
Total of all active and inactive participants2015-10-010
2014: ROLLIE WILLIAMS PAINT SPOT INC GROUP BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-10-0189
Total number of active participants reported on line 7a of the Form 55002014-10-0186
Number of retired or separated participants receiving benefits2014-10-010
Number of other retired or separated participants entitled to future benefits2014-10-010
Total of all active and inactive participants2014-10-0186

Financial Data on ROLLIE WILLIAMS PAINT SPOT INC GROUP BENEFITS PLAN

Measure Date Value
2015 : ROLLIE WILLIAMS PAINT SPOT INC GROUP BENEFITS PLAN 2015 401k financial data
Total income from all sources2015-12-31$133,798
Expenses. Total of all expenses incurred2015-12-31$133,798
Benefits paid (including direct rollovers)2015-12-31$133,798
Net income (gross income less expenses)2015-12-31$0
Net plan assets at end of year (total assets less liabilities)2015-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$0
Total contributions received or receivable from employer(s)2015-12-31$133,798
Total income from all sources2015-09-30$480,640
Expenses. Total of all expenses incurred2015-09-30$480,640
Benefits paid (including direct rollovers)2015-09-30$480,640
Net income (gross income less expenses)2015-09-30$0
Net plan assets at end of year (total assets less liabilities)2015-09-30$0
Net plan assets at beginning of year (total assets less liabilities)2015-09-30$0
Total contributions received or receivable from employer(s)2015-09-30$480,640

Form 5500 Responses for ROLLIE WILLIAMS PAINT SPOT INC GROUP BENEFITS PLAN

2016: ROLLIE WILLIAMS PAINT SPOT INC GROUP BENEFITS PLAN 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01First time form 5500 has been submittedYes
2016-10-01Submission has been amendedYes
2016-10-01This submission is the final filingNo
2016-10-01This return/report is a short plan year return/report (less than 12 months)No
2016-10-01Plan is a collectively bargained planNo
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan benefit arrangement – InsuranceYes
2015: ROLLIE WILLIAMS PAINT SPOT INC GROUP BENEFITS PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Submission has been amendedNo
2015-10-01This submission is the final filingYes
2015-10-01This return/report is a short plan year return/report (less than 12 months)Yes
2015-10-01Plan is a collectively bargained planNo
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan funding arrangement – General assets of the sponsorYes
2015-10-01Plan benefit arrangement – InsuranceYes
2015-10-01Plan benefit arrangement – General assets of the sponsorYes
2014: ROLLIE WILLIAMS PAINT SPOT INC GROUP BENEFITS PLAN 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01First time form 5500 has been submittedYes
2014-10-01Submission has been amendedNo
2014-10-01This submission is the final filingNo
2014-10-01This return/report is a short plan year return/report (less than 12 months)No
2014-10-01Plan is a collectively bargained planNo
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan funding arrangement – General assets of the sponsorYes
2014-10-01Plan benefit arrangement – InsuranceYes
2014-10-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

NATIONAL HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 82538 )
Policy contract number1963
Policy instance 1
Insurance contract or identification number1963
Number of Individuals Covered0
Insurance policy start date2015-10-01
Insurance policy end date2015-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $53,593
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 82538 )
Policy contract number1963
Policy instance 1
Insurance contract or identification number1963
Number of Individuals Covered86
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $148,390
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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