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KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 401k Plan overview

Plan NameKELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN
Plan identification number 501

KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN Benefits

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

401k Sponsoring company profile

KELLEY AUTOMOTIVE GROUP LLC has sponsored the creation of one or more 401k plans.

Company Name:KELLEY AUTOMOTIVE GROUP LLC
Employer identification number (EIN):351707660
NAIC Classification:541990
NAIC Description:All Other Professional, Scientific, and Technical Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-06-01
5012021-06-01
5012020-06-01
5012019-06-01
5012018-06-01
5012017-06-01MARY LYNN HAMRICK MATT BENNETT2019-03-07
5012016-06-01MARY LYNN HAMRICK MATT BENNETT2017-12-21
5012015-06-01MARY LYNN HAMRICK MATT BENNETT2017-02-11
5012014-06-01MARY LYNN HAMRICK TOM KELLEY2016-01-20
5012013-06-01GARY THELEN GARY THELEN2015-03-03
5012012-06-01GARY THELEN GARY THELEN2014-02-28
5012011-06-01GARY THELEN GARY THELEN2013-01-23
5012010-06-01GARY THELEN GARY THELEN2012-03-05
5012009-06-01GARY THELEN GARY THELEN2011-02-12

Plan Statistics for KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN

401k plan membership statisitcs for KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN

Measure Date Value
2022: KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-06-01280
Total number of active participants reported on line 7a of the Form 55002022-06-01287
Number of retired or separated participants receiving benefits2022-06-010
Number of other retired or separated participants entitled to future benefits2022-06-010
Total of all active and inactive participants2022-06-01287
2021: KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-06-01305
Total number of active participants reported on line 7a of the Form 55002021-06-01280
Number of retired or separated participants receiving benefits2021-06-010
Number of other retired or separated participants entitled to future benefits2021-06-010
Total of all active and inactive participants2021-06-01280
2020: KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-06-01248
Total number of active participants reported on line 7a of the Form 55002020-06-01305
Number of retired or separated participants receiving benefits2020-06-010
Number of other retired or separated participants entitled to future benefits2020-06-010
Total of all active and inactive participants2020-06-01305
2019: KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-06-01215
Total number of active participants reported on line 7a of the Form 55002019-06-01248
Number of retired or separated participants receiving benefits2019-06-010
Number of other retired or separated participants entitled to future benefits2019-06-010
Total of all active and inactive participants2019-06-01248
2018: KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-06-01207
Total number of active participants reported on line 7a of the Form 55002018-06-01215
Number of retired or separated participants receiving benefits2018-06-010
Number of other retired or separated participants entitled to future benefits2018-06-010
Total of all active and inactive participants2018-06-01215
2017: KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-06-01191
Total number of active participants reported on line 7a of the Form 55002017-06-01207
Number of retired or separated participants receiving benefits2017-06-010
Number of other retired or separated participants entitled to future benefits2017-06-010
Total of all active and inactive participants2017-06-01207
2016: KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-06-01177
Total number of active participants reported on line 7a of the Form 55002016-06-01191
Number of retired or separated participants receiving benefits2016-06-010
Number of other retired or separated participants entitled to future benefits2016-06-010
Total of all active and inactive participants2016-06-01191
2015: KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-06-01157
Total number of active participants reported on line 7a of the Form 55002015-06-01177
Number of retired or separated participants receiving benefits2015-06-010
Number of other retired or separated participants entitled to future benefits2015-06-010
Total of all active and inactive participants2015-06-01177
2014: KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year2014-06-01157
Total number of active participants reported on line 7a of the Form 55002014-06-01157
Number of retired or separated participants receiving benefits2014-06-012
Number of other retired or separated participants entitled to future benefits2014-06-010
Total of all active and inactive participants2014-06-01159
2013: KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year2013-06-01148
Total number of active participants reported on line 7a of the Form 55002013-06-01157
Number of retired or separated participants receiving benefits2013-06-012
Total of all active and inactive participants2013-06-01159
2012: KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year2012-06-01155
Total number of active participants reported on line 7a of the Form 55002012-06-01148
Number of retired or separated participants receiving benefits2012-06-012
Total of all active and inactive participants2012-06-01150
2011: KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year2011-06-01179
Total number of active participants reported on line 7a of the Form 55002011-06-01155
Number of retired or separated participants receiving benefits2011-06-011
Total of all active and inactive participants2011-06-01156
2010: KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2010 401k membership
Total participants, beginning-of-year2010-06-01205
Total number of active participants reported on line 7a of the Form 55002010-06-01179
Number of retired or separated participants receiving benefits2010-06-014
Total of all active and inactive participants2010-06-01183
2009: KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year2009-06-01299
Total number of active participants reported on line 7a of the Form 55002009-06-01205
Number of retired or separated participants receiving benefits2009-06-0113
Total of all active and inactive participants2009-06-01218

Financial Data on KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN

Measure Date Value
2023 : KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2023 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-05-31$522,374
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-05-31$101,200
Total income from all sources (including contributions)2023-05-31$3,280,935
Total of all expenses incurred2023-05-31$4,666,209
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-05-31$4,560,503
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-05-31$3,241,976
Value of total assets at end of year2023-05-31$2,442,583
Value of total assets at beginning of year2023-05-31$3,406,683
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-05-31$105,706
Total interest from all sources2023-05-31$38,959
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-05-31No
Administrative expenses professional fees incurred2023-05-31$22,500
Was this plan covered by a fidelity bond2023-05-31Yes
Value of fidelity bond cover2023-05-31$500,000
If this is an individual account plan, was there a blackout period2023-05-31No
Were there any nonexempt tranactions with any party-in-interest2023-05-31No
Contributions received from participants2023-05-31$968,919
Income. Received or receivable in cash from other sources (including rollovers)2023-05-31$7,124
Total non interest bearing cash at beginning of year2023-05-31$3,329,399
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-05-31No
Value of net income/loss2023-05-31$-1,385,274
Value of net assets at end of year (total assets less liabilities)2023-05-31$1,920,209
Value of net assets at beginning of year (total assets less liabilities)2023-05-31$3,305,483
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-05-31No
Were any leases to which the plan was party in default or uncollectible2023-05-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2023-05-31$2,435,873
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2023-05-31$77,284
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2023-05-31$77,284
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2023-05-31$38,959
Expenses. Payments to insurance carriers foe the provision of benefits2023-05-31$612,659
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-05-31No
Was there a failure to transmit to the plan any participant contributions2023-05-31No
Has the plan failed to provide any benefit when due under the plan2023-05-31No
Contributions received in cash from employer2023-05-31$2,265,933
Employer contributions (assets) at end of year2023-05-31$6,710
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-05-31$3,947,844
Contract administrator fees2023-05-31$83,206
Liabilities. Value of benefit claims payable at end of year2023-05-31$522,374
Liabilities. Value of benefit claims payable at beginning of year2023-05-31$101,200
Did the plan have assets held for investment2023-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-05-31No
Opinion of an independent qualified public accountant for this plan2023-05-31Unqualified
Accountancy firm name2023-05-31ATM & COMPANY
Accountancy firm EIN2023-05-31050528051
2022 : KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2022 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-05-31$101,200
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-05-31$68,491
Total income from all sources (including contributions)2022-05-31$3,301,093
Total of all expenses incurred2022-05-31$3,444,950
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-05-31$3,340,833
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-05-31$3,295,249
Value of total assets at end of year2022-05-31$3,406,683
Value of total assets at beginning of year2022-05-31$3,517,831
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-05-31$104,117
Total interest from all sources2022-05-31$5,844
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-05-31No
Administrative expenses professional fees incurred2022-05-31$22,500
Was this plan covered by a fidelity bond2022-05-31Yes
Value of fidelity bond cover2022-05-31$500,000
If this is an individual account plan, was there a blackout period2022-05-31No
Were there any nonexempt tranactions with any party-in-interest2022-05-31No
Contributions received from participants2022-05-31$1,070,819
Total non interest bearing cash at end of year2022-05-31$3,329,399
Total non interest bearing cash at beginning of year2022-05-31$3,440,670
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-05-31No
Value of net income/loss2022-05-31$-143,857
Value of net assets at end of year (total assets less liabilities)2022-05-31$3,305,483
Value of net assets at beginning of year (total assets less liabilities)2022-05-31$3,449,340
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-05-31No
Were any leases to which the plan was party in default or uncollectible2022-05-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-05-31$77,284
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-05-31$77,161
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-05-31$77,161
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-05-31$5,844
Expenses. Payments to insurance carriers foe the provision of benefits2022-05-31$664,476
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-05-31No
Was there a failure to transmit to the plan any participant contributions2022-05-31No
Has the plan failed to provide any benefit when due under the plan2022-05-31No
Contributions received in cash from employer2022-05-31$2,224,430
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-05-31$2,676,357
Contract administrator fees2022-05-31$81,617
Liabilities. Value of benefit claims payable at end of year2022-05-31$101,200
Liabilities. Value of benefit claims payable at beginning of year2022-05-31$68,491
Did the plan have assets held for investment2022-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-05-31No
Opinion of an independent qualified public accountant for this plan2022-05-31Unqualified
Accountancy firm name2022-05-31ATM & COMPANY
Accountancy firm EIN2022-05-31050528051
2021 : KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2021 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-05-31$68,491
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-05-31$119,267
Total income from all sources (including contributions)2021-05-31$3,190,275
Total of all expenses incurred2021-05-31$2,548,541
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-05-31$2,452,870
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-05-31$3,185,178
Value of total assets at end of year2021-05-31$3,517,831
Value of total assets at beginning of year2021-05-31$2,926,873
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-05-31$95,671
Total interest from all sources2021-05-31$5,097
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-05-31No
Administrative expenses professional fees incurred2021-05-31$22,000
Was this plan covered by a fidelity bond2021-05-31Yes
Value of fidelity bond cover2021-05-31$500,000
If this is an individual account plan, was there a blackout period2021-05-31No
Were there any nonexempt tranactions with any party-in-interest2021-05-31No
Contributions received from participants2021-05-31$1,056,128
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-05-31$62,511
Total non interest bearing cash at end of year2021-05-31$3,440,670
Total non interest bearing cash at beginning of year2021-05-31$2,787,325
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-05-31No
Value of net income/loss2021-05-31$641,734
Value of net assets at end of year (total assets less liabilities)2021-05-31$3,449,340
Value of net assets at beginning of year (total assets less liabilities)2021-05-31$2,807,606
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-05-31No
Were any leases to which the plan was party in default or uncollectible2021-05-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-05-31$77,161
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-05-31$77,037
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-05-31$77,037
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-05-31$5,097
Expenses. Payments to insurance carriers foe the provision of benefits2021-05-31$696,260
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-05-31No
Was there a failure to transmit to the plan any participant contributions2021-05-31No
Has the plan failed to provide any benefit when due under the plan2021-05-31No
Contributions received in cash from employer2021-05-31$2,129,050
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-05-31$1,756,610
Contract administrator fees2021-05-31$73,671
Liabilities. Value of benefit claims payable at end of year2021-05-31$68,491
Liabilities. Value of benefit claims payable at beginning of year2021-05-31$119,267
Did the plan have assets held for investment2021-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-05-31No
Opinion of an independent qualified public accountant for this plan2021-05-31Unqualified
Accountancy firm name2021-05-31ATM & COMPANY
Accountancy firm EIN2021-05-31050528051
2020 : KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2020 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-05-31$119,267
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-05-31$58,301
Total income from all sources (including contributions)2020-05-31$3,813,999
Total of all expenses incurred2020-05-31$3,158,781
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-05-31$3,068,153
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-05-31$3,808,979
Value of total assets at end of year2020-05-31$2,926,873
Value of total assets at beginning of year2020-05-31$2,210,689
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-05-31$90,628
Total interest from all sources2020-05-31$5,020
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-05-31No
Administrative expenses professional fees incurred2020-05-31$21,000
Was this plan covered by a fidelity bond2020-05-31Yes
Value of fidelity bond cover2020-05-31$500,000
If this is an individual account plan, was there a blackout period2020-05-31No
Were there any nonexempt tranactions with any party-in-interest2020-05-31No
Contributions received from participants2020-05-31$2,530,322
Income. Received or receivable in cash from other sources (including rollovers)2020-05-31$43,097
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-05-31$62,511
Total non interest bearing cash at end of year2020-05-31$2,787,325
Total non interest bearing cash at beginning of year2020-05-31$2,133,818
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-05-31No
Value of net income/loss2020-05-31$655,218
Value of net assets at end of year (total assets less liabilities)2020-05-31$2,807,606
Value of net assets at beginning of year (total assets less liabilities)2020-05-31$2,152,388
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-05-31No
Were any leases to which the plan was party in default or uncollectible2020-05-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-05-31$77,037
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-05-31$76,871
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-05-31$76,871
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-05-31$5,020
Expenses. Payments to insurance carriers foe the provision of benefits2020-05-31$522,107
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-05-31No
Was there a failure to transmit to the plan any participant contributions2020-05-31No
Has the plan failed to provide any benefit when due under the plan2020-05-31No
Contributions received in cash from employer2020-05-31$1,235,560
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-05-31$2,546,046
Contract administrator fees2020-05-31$69,628
Liabilities. Value of benefit claims payable at end of year2020-05-31$119,267
Liabilities. Value of benefit claims payable at beginning of year2020-05-31$58,301
Did the plan have assets held for investment2020-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-05-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-05-31No
Opinion of an independent qualified public accountant for this plan2020-05-31Unqualified
Accountancy firm name2020-05-31ATM & COMPANY
Accountancy firm EIN2020-05-31050528051
2019 : KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2019 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-05-31$58,301
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-05-31$98,029
Total income from all sources (including contributions)2019-05-31$3,087,977
Total of all expenses incurred2019-05-31$3,155,922
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-05-31$3,068,232
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-05-31$3,083,348
Value of total assets at end of year2019-05-31$2,210,689
Value of total assets at beginning of year2019-05-31$2,318,362
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-05-31$87,690
Total interest from all sources2019-05-31$4,629
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-05-31No
Administrative expenses professional fees incurred2019-05-31$23,000
Was this plan covered by a fidelity bond2019-05-31Yes
Value of fidelity bond cover2019-05-31$500,000
If this is an individual account plan, was there a blackout period2019-05-31No
Were there any nonexempt tranactions with any party-in-interest2019-05-31No
Contributions received from participants2019-05-31$2,081,513
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-05-31$265,935
Total non interest bearing cash at end of year2019-05-31$2,133,818
Total non interest bearing cash at beginning of year2019-05-31$1,975,801
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-05-31No
Value of net income/loss2019-05-31$-67,945
Value of net assets at end of year (total assets less liabilities)2019-05-31$2,152,388
Value of net assets at beginning of year (total assets less liabilities)2019-05-31$2,220,333
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-05-31No
Were any leases to which the plan was party in default or uncollectible2019-05-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-05-31$76,871
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-05-31$76,626
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-05-31$76,626
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-05-31$4,629
Expenses. Payments to insurance carriers foe the provision of benefits2019-05-31$470,447
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-05-31No
Was there a failure to transmit to the plan any participant contributions2019-05-31No
Has the plan failed to provide any benefit when due under the plan2019-05-31No
Contributions received in cash from employer2019-05-31$1,001,835
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-05-31$2,597,785
Contract administrator fees2019-05-31$64,690
Liabilities. Value of benefit claims payable at end of year2019-05-31$58,301
Liabilities. Value of benefit claims payable at beginning of year2019-05-31$98,029
Did the plan have assets held for investment2019-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-05-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-05-31No
Opinion of an independent qualified public accountant for this plan2019-05-31Unqualified
Accountancy firm name2019-05-31ATM & COMPANY
Accountancy firm EIN2019-05-31050528051
2018 : KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2018 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-05-31$98,029
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-05-31$91,566
Total income from all sources (including contributions)2018-05-31$2,522,303
Total of all expenses incurred2018-05-31$2,139,700
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-05-31$2,061,770
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-05-31$2,519,139
Value of total assets at end of year2018-05-31$2,318,362
Value of total assets at beginning of year2018-05-31$1,929,296
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-05-31$77,930
Total interest from all sources2018-05-31$3,164
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-05-31No
Administrative expenses professional fees incurred2018-05-31$22,000
Was this plan covered by a fidelity bond2018-05-31Yes
Value of fidelity bond cover2018-05-31$500,000
If this is an individual account plan, was there a blackout period2018-05-31No
Were there any nonexempt tranactions with any party-in-interest2018-05-31No
Contributions received from participants2018-05-31$1,690,873
Income. Received or receivable in cash from other sources (including rollovers)2018-05-31$9,456
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-05-31$265,935
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-05-31$180,145
Total non interest bearing cash at end of year2018-05-31$1,975,801
Total non interest bearing cash at beginning of year2018-05-31$1,672,655
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-05-31No
Value of net income/loss2018-05-31$382,603
Value of net assets at end of year (total assets less liabilities)2018-05-31$2,220,333
Value of net assets at beginning of year (total assets less liabilities)2018-05-31$1,837,730
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-05-31No
Were any leases to which the plan was party in default or uncollectible2018-05-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-05-31$76,626
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-05-31$76,496
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-05-31$76,496
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-05-31$3,164
Expenses. Payments to insurance carriers foe the provision of benefits2018-05-31$363,387
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-05-31No
Was there a failure to transmit to the plan any participant contributions2018-05-31No
Has the plan failed to provide any benefit when due under the plan2018-05-31No
Contributions received in cash from employer2018-05-31$818,810
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-05-31$1,698,383
Contract administrator fees2018-05-31$55,930
Liabilities. Value of benefit claims payable at end of year2018-05-31$98,029
Liabilities. Value of benefit claims payable at beginning of year2018-05-31$91,566
Did the plan have assets held for investment2018-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-05-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-05-31No
Opinion of an independent qualified public accountant for this plan2018-05-31Unqualified
Accountancy firm name2018-05-31ATM & COMPANY
Accountancy firm EIN2018-05-31050528051
2017 : KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2017 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-05-31$91,566
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-05-31$80,500
Total income from all sources (including contributions)2017-05-31$2,587,695
Total of all expenses incurred2017-05-31$1,926,627
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-05-31$1,877,135
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-05-31$2,586,121
Value of total assets at end of year2017-05-31$1,929,296
Value of total assets at beginning of year2017-05-31$1,257,162
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-05-31$49,492
Total interest from all sources2017-05-31$1,574
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-05-31No
Was this plan covered by a fidelity bond2017-05-31Yes
Value of fidelity bond cover2017-05-31$500,000
If this is an individual account plan, was there a blackout period2017-05-31No
Were there any nonexempt tranactions with any party-in-interest2017-05-31No
Contributions received from participants2017-05-31$1,701,497
Income. Received or receivable in cash from other sources (including rollovers)2017-05-31$14,159
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-05-31$180,145
Total non interest bearing cash at end of year2017-05-31$1,672,655
Total non interest bearing cash at beginning of year2017-05-31$1,180,754
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-05-31No
Value of net income/loss2017-05-31$661,068
Value of net assets at end of year (total assets less liabilities)2017-05-31$1,837,730
Value of net assets at beginning of year (total assets less liabilities)2017-05-31$1,176,662
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-05-31No
Were any leases to which the plan was party in default or uncollectible2017-05-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-05-31$76,496
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-05-31$76,408
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-05-31$76,408
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-05-31$1,574
Expenses. Payments to insurance carriers foe the provision of benefits2017-05-31$367,224
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-05-31No
Was there a failure to transmit to the plan any participant contributions2017-05-31No
Has the plan failed to provide any benefit when due under the plan2017-05-31No
Contributions received in cash from employer2017-05-31$870,465
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-05-31$1,509,911
Contract administrator fees2017-05-31$49,492
Liabilities. Value of benefit claims payable at end of year2017-05-31$91,566
Liabilities. Value of benefit claims payable at beginning of year2017-05-31$80,500
Did the plan have assets held for investment2017-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-05-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-05-31No
Opinion of an independent qualified public accountant for this plan2017-05-31Unqualified
Accountancy firm name2017-05-31ATM & COMPANY
Accountancy firm EIN2017-05-31050528051
2016 : KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-05-31$80,500
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-05-31$112,144
Total income from all sources (including contributions)2016-05-31$2,598,158
Total of all expenses incurred2016-05-31$2,075,627
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-05-31$2,007,240
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-05-31$2,597,215
Value of total assets at end of year2016-05-31$1,257,162
Value of total assets at beginning of year2016-05-31$766,275
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-05-31$68,387
Total interest from all sources2016-05-31$943
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-05-31No
Was this plan covered by a fidelity bond2016-05-31Yes
Value of fidelity bond cover2016-05-31$500,000
If this is an individual account plan, was there a blackout period2016-05-31No
Were there any nonexempt tranactions with any party-in-interest2016-05-31No
Contributions received from participants2016-05-31$940,004
Income. Received or receivable in cash from other sources (including rollovers)2016-05-31$32,260
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-05-31$43,094
Administrative expenses (other) incurred2016-05-31$21,500
Total non interest bearing cash at end of year2016-05-31$1,180,754
Total non interest bearing cash at beginning of year2016-05-31$646,849
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-05-31No
Value of net income/loss2016-05-31$522,531
Value of net assets at end of year (total assets less liabilities)2016-05-31$1,176,662
Value of net assets at beginning of year (total assets less liabilities)2016-05-31$654,131
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-05-31No
Were any leases to which the plan was party in default or uncollectible2016-05-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-05-31$76,408
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-05-31$76,332
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-05-31$76,332
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-05-31$943
Expenses. Payments to insurance carriers foe the provision of benefits2016-05-31$359,485
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-05-31No
Was there a failure to transmit to the plan any participant contributions2016-05-31No
Has the plan failed to provide any benefit when due under the plan2016-05-31No
Contributions received in cash from employer2016-05-31$1,624,951
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-05-31$1,647,755
Contract administrator fees2016-05-31$46,887
Liabilities. Value of benefit claims payable at end of year2016-05-31$80,500
Liabilities. Value of benefit claims payable at beginning of year2016-05-31$112,144
Did the plan have assets held for investment2016-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-05-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-05-31No
Opinion of an independent qualified public accountant for this plan2016-05-31Unqualified
Accountancy firm name2016-05-31ATM & COMPANY
Accountancy firm EIN2016-05-31050528051
2015 : KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-05-31$112,144
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-05-31$157,724
Total income from all sources (including contributions)2015-05-31$2,175,879
Total of all expenses incurred2015-05-31$2,049,003
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-05-31$1,968,420
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-05-31$2,175,296
Value of total assets at end of year2015-05-31$766,275
Value of total assets at beginning of year2015-05-31$684,979
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-05-31$80,583
Total interest from all sources2015-05-31$583
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-05-31No
Was this plan covered by a fidelity bond2015-05-31Yes
Value of fidelity bond cover2015-05-31$500,000
If this is an individual account plan, was there a blackout period2015-05-31No
Were there any nonexempt tranactions with any party-in-interest2015-05-31No
Contributions received from participants2015-05-31$910,574
Income. Received or receivable in cash from other sources (including rollovers)2015-05-31$25,910
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-05-31$43,094
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-05-31$71,292
Administrative expenses (other) incurred2015-05-31$40,960
Total non interest bearing cash at end of year2015-05-31$646,849
Total non interest bearing cash at beginning of year2015-05-31$537,431
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-05-31No
Value of net income/loss2015-05-31$126,876
Value of net assets at end of year (total assets less liabilities)2015-05-31$654,131
Value of net assets at beginning of year (total assets less liabilities)2015-05-31$527,255
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-05-31No
Were any leases to which the plan was party in default or uncollectible2015-05-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-05-31$76,332
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-05-31$76,256
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-05-31$76,256
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-05-31$583
Expenses. Payments to insurance carriers foe the provision of benefits2015-05-31$322,634
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-05-31No
Was there a failure to transmit to the plan any participant contributions2015-05-31No
Has the plan failed to provide any benefit when due under the plan2015-05-31No
Contributions received in cash from employer2015-05-31$1,238,812
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-05-31$1,645,786
Contract administrator fees2015-05-31$39,623
Liabilities. Value of benefit claims payable at end of year2015-05-31$112,144
Liabilities. Value of benefit claims payable at beginning of year2015-05-31$157,724
Did the plan have assets held for investment2015-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-05-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-05-31No
Opinion of an independent qualified public accountant for this plan2015-05-31Unqualified
Accountancy firm name2015-05-31ATM & COMPANY
Accountancy firm EIN2015-05-31050528051
2014 : KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-05-31$157,724
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-05-31$134,086
Total income from all sources (including contributions)2014-05-31$1,967,327
Total of all expenses incurred2014-05-31$1,934,725
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-05-31$1,881,940
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-05-31$1,966,100
Value of total assets at end of year2014-05-31$684,979
Value of total assets at beginning of year2014-05-31$628,739
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-05-31$52,785
Total interest from all sources2014-05-31$1,227
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-05-31No
Was this plan covered by a fidelity bond2014-05-31Yes
Value of fidelity bond cover2014-05-31$500,000
If this is an individual account plan, was there a blackout period2014-05-31No
Were there any nonexempt tranactions with any party-in-interest2014-05-31No
Contributions received from participants2014-05-31$857,801
Income. Received or receivable in cash from other sources (including rollovers)2014-05-31$9,117
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-05-31$71,292
Administrative expenses (other) incurred2014-05-31$17,820
Total non interest bearing cash at end of year2014-05-31$537,431
Total non interest bearing cash at beginning of year2014-05-31$614,908
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-05-31No
Value of net income/loss2014-05-31$32,602
Value of net assets at end of year (total assets less liabilities)2014-05-31$527,255
Value of net assets at beginning of year (total assets less liabilities)2014-05-31$494,653
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-05-31No
Were any leases to which the plan was party in default or uncollectible2014-05-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-05-31$76,256
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-05-31$13,831
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-05-31$13,831
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-05-31$1,227
Expenses. Payments to insurance carriers foe the provision of benefits2014-05-31$324,254
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-05-31No
Was there a failure to transmit to the plan any participant contributions2014-05-31No
Has the plan failed to provide any benefit when due under the plan2014-05-31No
Contributions received in cash from employer2014-05-31$1,099,182
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-05-31$1,557,686
Contract administrator fees2014-05-31$34,965
Liabilities. Value of benefit claims payable at end of year2014-05-31$157,724
Liabilities. Value of benefit claims payable at beginning of year2014-05-31$134,086
Did the plan have assets held for investment2014-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-05-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-05-31No
Opinion of an independent qualified public accountant for this plan2014-05-31Unqualified
Accountancy firm name2014-05-31ATM & COMPANY
Accountancy firm EIN2014-05-31050528051
2013 : KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-05-31$134,086
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-05-31$163,101
Total income from all sources (including contributions)2013-05-31$1,919,506
Total of all expenses incurred2013-05-31$1,655,003
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-05-31$1,594,975
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-05-31$1,917,195
Value of total assets at end of year2013-05-31$628,739
Value of total assets at beginning of year2013-05-31$393,251
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-05-31$60,028
Total interest from all sources2013-05-31$2,311
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-05-31No
Was this plan covered by a fidelity bond2013-05-31Yes
Value of fidelity bond cover2013-05-31$500,000
If this is an individual account plan, was there a blackout period2013-05-31No
Were there any nonexempt tranactions with any party-in-interest2013-05-31No
Contributions received from participants2013-05-31$836,783
Income. Received or receivable in cash from other sources (including rollovers)2013-05-31$8,077
Administrative expenses (other) incurred2013-05-31$17,140
Total non interest bearing cash at end of year2013-05-31$614,908
Total non interest bearing cash at beginning of year2013-05-31$379,426
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-05-31No
Value of net income/loss2013-05-31$264,503
Value of net assets at end of year (total assets less liabilities)2013-05-31$494,653
Value of net assets at beginning of year (total assets less liabilities)2013-05-31$230,150
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-05-31No
Were any leases to which the plan was party in default or uncollectible2013-05-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-05-31$13,831
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-05-31$13,825
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-05-31$13,825
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-05-31$2,311
Expenses. Payments to insurance carriers foe the provision of benefits2013-05-31$281,552
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-05-31No
Was there a failure to transmit to the plan any participant contributions2013-05-31No
Has the plan failed to provide any benefit when due under the plan2013-05-31No
Contributions received in cash from employer2013-05-31$1,072,335
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-05-31$1,313,423
Contract administrator fees2013-05-31$42,888
Liabilities. Value of benefit claims payable at end of year2013-05-31$134,086
Liabilities. Value of benefit claims payable at beginning of year2013-05-31$163,101
Did the plan have assets held for investment2013-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-05-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-05-31No
Opinion of an independent qualified public accountant for this plan2013-05-31Unqualified
Accountancy firm name2013-05-31ATM & COMPANY
Accountancy firm EIN2013-05-31050528051
2012 : KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-05-31$163,101
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-05-31$157,399
Total income from all sources (including contributions)2012-05-31$1,866,615
Total of all expenses incurred2012-05-31$1,494,238
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-05-31$1,432,488
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-05-31$1,865,609
Value of total assets at end of year2012-05-31$393,251
Value of total assets at beginning of year2012-05-31$15,172
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-05-31$61,750
Total interest from all sources2012-05-31$1,006
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-05-31No
Was this plan covered by a fidelity bond2012-05-31Yes
Value of fidelity bond cover2012-05-31$500,000
If this is an individual account plan, was there a blackout period2012-05-31No
Were there any nonexempt tranactions with any party-in-interest2012-05-31No
Contributions received from participants2012-05-31$850,811
Income. Received or receivable in cash from other sources (including rollovers)2012-05-31$19,219
Administrative expenses (other) incurred2012-05-31$17,719
Total non interest bearing cash at end of year2012-05-31$379,426
Total non interest bearing cash at beginning of year2012-05-31$1,361
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-05-31No
Value of net income/loss2012-05-31$372,377
Value of net assets at end of year (total assets less liabilities)2012-05-31$230,150
Value of net assets at beginning of year (total assets less liabilities)2012-05-31$-142,227
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-05-31No
Were any leases to which the plan was party in default or uncollectible2012-05-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-05-31$13,825
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-05-31$13,811
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-05-31$13,811
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-05-31$1,006
Expenses. Payments to insurance carriers foe the provision of benefits2012-05-31$250,465
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-05-31No
Was there a failure to transmit to the plan any participant contributions2012-05-31No
Has the plan failed to provide any benefit when due under the plan2012-05-31No
Contributions received in cash from employer2012-05-31$995,579
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-05-31$1,182,023
Contract administrator fees2012-05-31$44,031
Liabilities. Value of benefit claims payable at end of year2012-05-31$163,101
Liabilities. Value of benefit claims payable at beginning of year2012-05-31$157,399
Did the plan have assets held for investment2012-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-05-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-05-31No
Opinion of an independent qualified public accountant for this plan2012-05-31Unqualified
Accountancy firm name2012-05-31ATM & COMPANY
Accountancy firm EIN2012-05-31050528051
2011 : KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-05-31$157,399
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-05-31$286,679
Total income from all sources (including contributions)2011-05-31$2,223,970
Total of all expenses incurred2011-05-31$2,336,957
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-05-31$2,271,059
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-05-31$2,222,587
Value of total assets at end of year2011-05-31$15,172
Value of total assets at beginning of year2011-05-31$257,439
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-05-31$65,898
Total interest from all sources2011-05-31$1,383
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-05-31No
Was this plan covered by a fidelity bond2011-05-31Yes
Value of fidelity bond cover2011-05-31$500,000
If this is an individual account plan, was there a blackout period2011-05-31No
Were there any nonexempt tranactions with any party-in-interest2011-05-31No
Contributions received from participants2011-05-31$831,282
Income. Received or receivable in cash from other sources (including rollovers)2011-05-31$110,327
Administrative expenses (other) incurred2011-05-31$15,571
Total non interest bearing cash at end of year2011-05-31$1,361
Total non interest bearing cash at beginning of year2011-05-31$256,817
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-05-31No
Value of net income/loss2011-05-31$-112,987
Value of net assets at end of year (total assets less liabilities)2011-05-31$-142,227
Value of net assets at beginning of year (total assets less liabilities)2011-05-31$-29,240
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-05-31No
Were any leases to which the plan was party in default or uncollectible2011-05-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-05-31$13,811
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-05-31$622
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-05-31$622
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-05-31$1,383
Expenses. Payments to insurance carriers foe the provision of benefits2011-05-31$215,558
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-05-31No
Was there a failure to transmit to the plan any participant contributions2011-05-31No
Has the plan failed to provide any benefit when due under the plan2011-05-31No
Contributions received in cash from employer2011-05-31$1,280,978
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-05-31$2,055,501
Contract administrator fees2011-05-31$50,327
Liabilities. Value of benefit claims payable at end of year2011-05-31$157,399
Liabilities. Value of benefit claims payable at beginning of year2011-05-31$286,679
Did the plan have assets held for investment2011-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-05-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-05-31No
Opinion of an independent qualified public accountant for this plan2011-05-31Unqualified
Accountancy firm name2011-05-31ATM & COMPANY
Accountancy firm EIN2011-05-31050528051

Form 5500 Responses for KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN

2022: KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2022 form 5500 responses
2022-06-01Type of plan entitySingle employer plan
2022-06-01Plan funding arrangement – InsuranceYes
2022-06-01Plan funding arrangement – TrustYes
2022-06-01Plan funding arrangement – General assets of the sponsorYes
2022-06-01Plan benefit arrangement – InsuranceYes
2022-06-01Plan benefit arrangement - TrustYes
2022-06-01Plan benefit arrangement – General assets of the sponsorYes
2021: KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2021 form 5500 responses
2021-06-01Type of plan entitySingle employer plan
2021-06-01Plan funding arrangement – InsuranceYes
2021-06-01Plan funding arrangement – TrustYes
2021-06-01Plan funding arrangement – General assets of the sponsorYes
2021-06-01Plan benefit arrangement – InsuranceYes
2021-06-01Plan benefit arrangement - TrustYes
2021-06-01Plan benefit arrangement – General assets of the sponsorYes
2020: KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2020 form 5500 responses
2020-06-01Type of plan entitySingle employer plan
2020-06-01Plan funding arrangement – InsuranceYes
2020-06-01Plan funding arrangement – TrustYes
2020-06-01Plan funding arrangement – General assets of the sponsorYes
2020-06-01Plan benefit arrangement – InsuranceYes
2020-06-01Plan benefit arrangement - TrustYes
2020-06-01Plan benefit arrangement – General assets of the sponsorYes
2019: KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2019 form 5500 responses
2019-06-01Type of plan entitySingle employer plan
2019-06-01Plan funding arrangement – InsuranceYes
2019-06-01Plan funding arrangement – TrustYes
2019-06-01Plan funding arrangement – General assets of the sponsorYes
2019-06-01Plan benefit arrangement – InsuranceYes
2019-06-01Plan benefit arrangement - TrustYes
2019-06-01Plan benefit arrangement – General assets of the sponsorYes
2018: KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2018 form 5500 responses
2018-06-01Type of plan entitySingle employer plan
2018-06-01Plan funding arrangement – InsuranceYes
2018-06-01Plan funding arrangement – TrustYes
2018-06-01Plan funding arrangement – General assets of the sponsorYes
2018-06-01Plan benefit arrangement – InsuranceYes
2018-06-01Plan benefit arrangement - TrustYes
2018-06-01Plan benefit arrangement – General assets of the sponsorYes
2017: KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2017 form 5500 responses
2017-06-01Type of plan entitySingle employer plan
2017-06-01Plan funding arrangement – InsuranceYes
2017-06-01Plan funding arrangement – TrustYes
2017-06-01Plan funding arrangement – General assets of the sponsorYes
2017-06-01Plan benefit arrangement – InsuranceYes
2017-06-01Plan benefit arrangement - TrustYes
2017-06-01Plan benefit arrangement – General assets of the sponsorYes
2016: KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2016 form 5500 responses
2016-06-01Type of plan entitySingle employer plan
2016-06-01Plan funding arrangement – InsuranceYes
2016-06-01Plan funding arrangement – TrustYes
2016-06-01Plan funding arrangement – General assets of the sponsorYes
2016-06-01Plan benefit arrangement – InsuranceYes
2016-06-01Plan benefit arrangement - TrustYes
2016-06-01Plan benefit arrangement – General assets of the sponsorYes
2015: KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2015 form 5500 responses
2015-06-01Type of plan entitySingle employer plan
2015-06-01Plan funding arrangement – InsuranceYes
2015-06-01Plan funding arrangement – TrustYes
2015-06-01Plan funding arrangement – General assets of the sponsorYes
2015-06-01Plan benefit arrangement – InsuranceYes
2015-06-01Plan benefit arrangement - TrustYes
2015-06-01Plan benefit arrangement – General assets of the sponsorYes
2014: KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2014 form 5500 responses
2014-06-01Type of plan entitySingle employer plan
2014-06-01Plan funding arrangement – InsuranceYes
2014-06-01Plan funding arrangement – TrustYes
2014-06-01Plan funding arrangement – General assets of the sponsorYes
2014-06-01Plan benefit arrangement – InsuranceYes
2014-06-01Plan benefit arrangement - TrustYes
2014-06-01Plan benefit arrangement – General assets of the sponsorYes
2013: KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2013 form 5500 responses
2013-06-01Type of plan entitySingle employer plan
2013-06-01Plan funding arrangement – InsuranceYes
2013-06-01Plan funding arrangement – TrustYes
2013-06-01Plan funding arrangement – General assets of the sponsorYes
2013-06-01Plan benefit arrangement – InsuranceYes
2013-06-01Plan benefit arrangement - TrustYes
2013-06-01Plan benefit arrangement – General assets of the sponsorYes
2012: KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2012 form 5500 responses
2012-06-01Type of plan entitySingle employer plan
2012-06-01Plan funding arrangement – InsuranceYes
2012-06-01Plan funding arrangement – TrustYes
2012-06-01Plan funding arrangement – General assets of the sponsorYes
2012-06-01Plan benefit arrangement – InsuranceYes
2012-06-01Plan benefit arrangement - TrustYes
2012-06-01Plan benefit arrangement – General assets of the sponsorYes
2011: KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2011 form 5500 responses
2011-06-01Type of plan entitySingle employer plan
2011-06-01Plan funding arrangement – InsuranceYes
2011-06-01Plan funding arrangement – TrustYes
2011-06-01Plan funding arrangement – General assets of the sponsorYes
2011-06-01Plan benefit arrangement – InsuranceYes
2011-06-01Plan benefit arrangement - TrustYes
2011-06-01Plan benefit arrangement – General assets of the sponsorYes
2010: KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2010 form 5500 responses
2010-06-01Type of plan entitySingle employer plan
2010-06-01Plan funding arrangement – InsuranceYes
2010-06-01Plan funding arrangement – TrustYes
2010-06-01Plan funding arrangement – General assets of the sponsorYes
2010-06-01Plan benefit arrangement – InsuranceYes
2010-06-01Plan benefit arrangement - TrustYes
2010-06-01Plan benefit arrangement – General assets of the sponsorYes
2009: KELLEY AUTOMOTIVE GROUP HEALTH & WELFARE PLAN 2009 form 5500 responses
2009-06-01Type of plan entitySingle employer plan
2009-06-01Plan funding arrangement – InsuranceYes
2009-06-01Plan funding arrangement – TrustYes
2009-06-01Plan funding arrangement – General assets of the sponsorYes
2009-06-01Plan benefit arrangement – InsuranceYes
2009-06-01Plan benefit arrangement - TrustYes
2009-06-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

ASSURITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71439 )
Policy contract number0800000344
Policy instance 2
Insurance contract or identification number0800000344
Number of Individuals Covered154
Insurance policy start date2022-06-01
Insurance policy end date2023-05-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $35,043
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number406536
Policy instance 1
Insurance contract or identification number406536
Number of Individuals Covered287
Insurance policy start date2022-06-01
Insurance policy end date2023-05-31
Welfare Benefit Premiums Paid to CarrierUSD $443,263
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance broker3
ASSURITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71439 )
Policy contract number0800000344
Policy instance 2
Insurance contract or identification number0800000344
Number of Individuals Covered180
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,621
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number406536
Policy instance 1
Insurance contract or identification number406536
Number of Individuals Covered270
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Welfare Benefit Premiums Paid to CarrierUSD $515,212
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance broker3
ASSURITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71439 )
Policy contract number0800000344
Policy instance 2
Insurance contract or identification number0800000344
Number of Individuals Covered156
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $4,245
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,558
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,245
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number406536
Policy instance 1
Insurance contract or identification number406536
Number of Individuals Covered287
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Welfare Benefit Premiums Paid to CarrierUSD $571,837
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance broker3
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number406536
Policy instance 1
Insurance contract or identification number406536
Number of Individuals Covered247
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Welfare Benefit Premiums Paid to CarrierUSD $406,685
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance broker3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUPR0AGM9
Policy instance 2
Insurance contract or identification numberGUPR0AGM9
Number of Individuals Covered87
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,312
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0AGM9
Policy instance 3
Insurance contract or identification numberGLUG0AGM9
Number of Individuals Covered244
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD & D
Welfare Benefit Premiums Paid to CarrierUSD $10,427
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUC0AGM9
Policy instance 4
Insurance contract or identification numberGUC0AGM9
Number of Individuals Covered136
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,733
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0AGM9
Policy instance 5
Insurance contract or identification numberGVTL0AGM9
Number of Individuals Covered113
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Life Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY AD & D
Welfare Benefit Premiums Paid to CarrierUSD $51,755
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerAGENT OR RECORD OF BROKER
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0AGM9
Policy instance 5
Insurance contract or identification numberGVTL0AGM9
Number of Individuals Covered122
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $8,596
Total amount of fees paid to insurance companyUSD $1,546
Life Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY AD & D
Welfare Benefit Premiums Paid to CarrierUSD $57,307
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,596
Amount paid for insurance broker fees1546
Additional information about fees paid to insurance brokerAGENT OR RECORD OF BROKER
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUC0AGM9
Policy instance 4
Insurance contract or identification numberGUC0AGM9
Number of Individuals Covered135
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $5,871
Total amount of fees paid to insurance companyUSD $991
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $39,142
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,871
Amount paid for insurance broker fees991
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0AGM9
Policy instance 3
Insurance contract or identification numberGLUG0AGM9
Number of Individuals Covered237
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $1,475
Total amount of fees paid to insurance companyUSD $311
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD & D
Welfare Benefit Premiums Paid to CarrierUSD $9,833
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,475
Amount paid for insurance broker fees311
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUPR0AGM9
Policy instance 2
Insurance contract or identification numberGUPR0AGM9
Number of Individuals Covered85
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $5,976
Total amount of fees paid to insurance companyUSD $1,077
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $39,837
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,976
Amount paid for insurance broker fees1077
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number406536
Policy instance 1
Insurance contract or identification number406536
Number of Individuals Covered228
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Welfare Benefit Premiums Paid to CarrierUSD $349,989
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance broker3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0AGM9
Policy instance 5
Insurance contract or identification numberGVTL0AGM9
Number of Individuals Covered85
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $5,180
Life Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY AD & D
Welfare Benefit Premiums Paid to CarrierUSD $34,534
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUC0AGM9
Policy instance 4
Insurance contract or identification numberGUC0AGM9
Number of Individuals Covered83
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $3,227
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,510
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0AGM9
Policy instance 3
Insurance contract or identification numberGLUG0AGM9
Number of Individuals Covered224
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $1,307
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD & D
Welfare Benefit Premiums Paid to CarrierUSD $8,715
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUPR0AGM9
Policy instance 2
Insurance contract or identification numberGUPR0AGM9
Number of Individuals Covered54
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $3,677
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,512
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number406536
Policy instance 1
Insurance contract or identification number406536
Number of Individuals Covered228
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Welfare Benefit Premiums Paid to CarrierUSD $293,228
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN NATIONAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60739 )
Policy contract number746908-15
Policy instance 1
Insurance contract or identification number746908-15
Number of Individuals Covered120
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Welfare Benefit Premiums Paid to CarrierUSD $272,371
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance broker3
Insurance broker nameAMERICAN NATIONAL INSURANCE COMPANY
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUPR0AGM9
Policy instance 2
Insurance contract or identification numberGUPR0AGM9
Number of Individuals Covered46
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Total amount of commissions paid to insurance brokerUSD $3,434
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,890
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,434
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
Insurance broker nameONB INSURANCE GROUP
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0AGM9
Policy instance 3
Insurance contract or identification numberGLUG0AGM9
Number of Individuals Covered185
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Total amount of commissions paid to insurance brokerUSD $1,232
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD & D
Welfare Benefit Premiums Paid to CarrierUSD $8,217
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,232
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
Insurance broker nameONB INSURANCE GROUP
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUC0AGM9
Policy instance 4
Insurance contract or identification numberGUC0AGM9
Number of Individuals Covered78
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Total amount of commissions paid to insurance brokerUSD $3,175
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,167
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,175
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
Insurance broker nameONB INSURANCE GROUP
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0AGM9
Policy instance 5
Insurance contract or identification numberGVTL0AGM9
Number of Individuals Covered76
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Total amount of commissions paid to insurance brokerUSD $4,983
Life Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY AD & D
Welfare Benefit Premiums Paid to CarrierUSD $33,220
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,983
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
Insurance broker nameONB INSURANCE GROUP
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberSLM540149
Policy instance 1
Insurance contract or identification numberSLM540149
Number of Individuals Covered157
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $45,902
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $306,014
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,902
Additional information about fees paid to insurance broker3
Insurance broker nameRELIANCE STANDARD LIFE INSURANCE
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUPR0AGM9
Policy instance 2
Insurance contract or identification numberGUPR0AGM9
Number of Individuals Covered41
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $3,010
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,066
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,010
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
Insurance broker nameONB INSURANCE GROUP
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0AGM9
Policy instance 3
Insurance contract or identification numberGLUG0AGM9
Number of Individuals Covered176
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $1,083
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD & D
Welfare Benefit Premiums Paid to CarrierUSD $7,221
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,083
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
Insurance broker nameONB INSURANCE GROUP
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUC0AGM9
Policy instance 4
Insurance contract or identification numberGUC0AGM9
Number of Individuals Covered79
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $3,165
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,102
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,165
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
Insurance broker nameONB INSURANCE GROUP
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0AGM9
Policy instance 5
Insurance contract or identification numberGVTL0AGM9
Number of Individuals Covered75
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $4,893
Life Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY AD & D
Welfare Benefit Premiums Paid to CarrierUSD $32,618
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,893
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
Insurance broker nameONB INSURANCE GROUP
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract numberELSL-1056
Policy instance 1
Insurance contract or identification numberELSL-1056
Number of Individuals Covered157
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $46,728
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $311,548
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $46,728
Additional information about fees paid to insurance broker3
Insurance broker nameELITE UNDERWRITING SERVICES INC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number218439
Policy instance 1
Insurance contract or identification number218439
Number of Individuals Covered148
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $41,787
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $278,581
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,787
Additional information about fees paid to insurance broker3
Insurance broker nameONB INSURANCE GROUP INC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number218439
Policy instance 1
Insurance contract or identification number218439
Number of Individuals Covered155
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $30,536
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $247,582
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MADISON NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65781 )
Policy contract numberAULM1035
Policy instance 1
Insurance contract or identification numberAULM1035
Number of Individuals Covered179
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Total amount of commissions paid to insurance brokerUSD $27,689
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $212,989
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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