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K & G PETROLEUM, LLC 401(K) PLAN 401k Plan overview

Plan NameK & G PETROLEUM, LLC 401(K) PLAN
Plan identification number 002

K & G PETROLEUM, LLC 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

K & G PETROLEUM, LLC has sponsored the creation of one or more 401k plans.

Company Name:K & G PETROLEUM, LLC
Employer identification number (EIN):364513700
NAIC Classification:447100
NAIC Description: Gasoline Stations, Gas

Additional information about K & G PETROLEUM, LLC

Jurisdiction of Incorporation: Colorado Department of State
Incorporation Date: 2002-12-02
Company Identification Number: 20021330522
Legal Registered Office Address: 7671 Shaffer Parkway
Building H
Littleton
United States of America (USA)
80127

More information about K & G PETROLEUM, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan K & G PETROLEUM, LLC 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022023-01-01SATISH CHANDER2024-10-15
0022022-01-01SATISH CHANDER2023-10-12
0022021-01-01SATISH CHANDER2022-10-11
0022020-01-01SATISH CHANDER2021-10-15
0022019-01-01SATISH CHANDER2020-10-06
0022018-01-01SATISH CHANDER2019-10-09
0022017-01-01SATISH CHANDER
0022017-01-01SATISH CHANDER2019-09-12

Plan Statistics for K & G PETROLEUM, LLC 401(K) PLAN

401k plan membership statisitcs for K & G PETROLEUM, LLC 401(K) PLAN

Measure Date Value
2023: K & G PETROLEUM, LLC 401(K) PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01735
Total number of active participants reported on line 7a of the Form 55002023-01-01645
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-0162
Total of all active and inactive participants2023-01-01707
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2023-01-010
Total participants2023-01-01707
Number of participants with account balances2023-01-01186
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2023-01-010
2022: K & G PETROLEUM, LLC 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01716
Total number of active participants reported on line 7a of the Form 55002022-01-01629
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0165
Total of all active and inactive participants2022-01-01694
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01694
Number of participants with account balances2022-01-01186
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: K & G PETROLEUM, LLC 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01600
Total number of active participants reported on line 7a of the Form 55002021-01-01602
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0144
Total of all active and inactive participants2021-01-01646
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01646
Number of participants with account balances2021-01-01177
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: K & G PETROLEUM, LLC 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01538
Total number of active participants reported on line 7a of the Form 55002020-01-01498
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0138
Total of all active and inactive participants2020-01-01536
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01536
Number of participants with account balances2020-01-01115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-013
2019: K & G PETROLEUM, LLC 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01421
Total number of active participants reported on line 7a of the Form 55002019-01-01477
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0114
Total of all active and inactive participants2019-01-01491
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01491
Number of participants with account balances2019-01-0164
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-0111
2018: K & G PETROLEUM, LLC 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01146
Total number of active participants reported on line 7a of the Form 55002018-01-01145
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-014
Total of all active and inactive participants2018-01-01149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01149
Number of participants with account balances2018-01-0122
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-011
2017: K & G PETROLEUM, LLC 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01194
Total number of active participants reported on line 7a of the Form 55002017-01-01132
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-014
Total of all active and inactive participants2017-01-01136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01136
Number of participants with account balances2017-01-0124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-014

Financial Data on K & G PETROLEUM, LLC 401(K) PLAN

Measure Date Value
2023 : K & G PETROLEUM, LLC 401(K) PLAN 2023 401k financial data
Total unrealized appreciation/depreciation of assets2023-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$0
Total income from all sources (including contributions)2023-12-31$899,080
Total loss/gain on sale of assets2023-12-31$0
Total of all expenses incurred2023-12-31$157,353
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-12-31$139,150
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-12-31$697,912
Value of total assets at end of year2023-12-31$1,749,902
Value of total assets at beginning of year2023-12-31$1,008,175
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-12-31$18,203
Total interest from all sources2023-12-31$68
Total dividends received (eg from common stock, registered investment company shares)2023-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-12-31No
Was this plan covered by a fidelity bond2023-12-31Yes
Value of fidelity bond cover2023-12-31$25,000
If this is an individual account plan, was there a blackout period2023-12-31Yes
Were there any nonexempt tranactions with any party-in-interest2023-12-31No
Contributions received from participants2023-12-31$265,031
Income. Received or receivable in cash from other sources (including rollovers)2023-12-31$278,481
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Value of net income/loss2023-12-31$741,727
Value of net assets at end of year (total assets less liabilities)2023-12-31$1,749,902
Value of net assets at beginning of year (total assets less liabilities)2023-12-31$1,008,175
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-12-31No
Were any leases to which the plan was party in default or uncollectible2023-12-31No
Value of interest in pooled separate accounts at end of year2023-12-31$1,742,807
Value of interest in pooled separate accounts at beginning of year2023-12-31$1,000,346
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2023-12-31$68
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2023-12-31$7,095
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2023-12-31$7,829
Net investment gain/loss from pooled separate accounts2023-12-31$201,100
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-12-31No
Was there a failure to transmit to the plan any participant contributions2023-12-31Yes
Has the plan failed to provide any benefit when due under the plan2023-12-31No
Contributions received in cash from employer2023-12-31$154,400
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-12-31$139,150
Contract administrator fees2023-12-31$18,203
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32023-12-31Yes
Did the plan have assets held for investment2023-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-12-31No
Opinion of an independent qualified public accountant for this plan2023-12-31Unqualified
Accountancy firm name2023-12-31PLANTE & MORAN, PLLC
Accountancy firm EIN2023-12-31381357951
2022 : K & G PETROLEUM, LLC 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$223,734
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$106,018
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$93,491
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$374,859
Value of total assets at end of year2022-12-31$1,008,175
Value of total assets at beginning of year2022-12-31$890,459
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$12,527
Total interest from all sources2022-12-31$56
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$25,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$241,087
Participant contributions at end of year2022-12-31$0
Participant contributions at beginning of year2022-12-31$1,146
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$117,716
Value of net assets at end of year (total assets less liabilities)2022-12-31$1,008,175
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$890,459
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in pooled separate accounts at end of year2022-12-31$1,000,346
Value of interest in pooled separate accounts at beginning of year2022-12-31$881,381
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$56
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$7,829
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$7,379
Net investment gain/loss from pooled separate accounts2022-12-31$-151,181
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$133,772
Employer contributions (assets) at end of year2022-12-31$0
Employer contributions (assets) at beginning of year2022-12-31$553
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$93,491
Contract administrator fees2022-12-31$12,527
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31PLANTE & MORAN, PLLC
Accountancy firm EIN2022-12-31381357951
2021 : K & G PETROLEUM, LLC 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$8,182
Total income from all sources (including contributions)2021-12-31$390,453
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$72,708
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$66,561
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$304,185
Value of total assets at end of year2021-12-31$890,459
Value of total assets at beginning of year2021-12-31$580,896
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$6,147
Total interest from all sources2021-12-31$37
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$25,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$190,524
Participant contributions at end of year2021-12-31$1,146
Participant contributions at beginning of year2021-12-31$6,559
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$4,821
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$8,182
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$317,745
Value of net assets at end of year (total assets less liabilities)2021-12-31$890,459
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$572,714
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in pooled separate accounts at end of year2021-12-31$881,381
Value of interest in pooled separate accounts at beginning of year2021-12-31$565,955
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$37
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$7,379
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$4,382
Net investment gain/loss from pooled separate accounts2021-12-31$86,231
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31Yes
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$108,840
Employer contributions (assets) at end of year2021-12-31$553
Employer contributions (assets) at beginning of year2021-12-31$4,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$66,561
Contract administrator fees2021-12-31$6,147
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31PLANTE & MORAN, PLLC
Accountancy firm EIN2021-12-31381357951
2020 : K & G PETROLEUM, LLC 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$8,182
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$311,189
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$17,632
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$11,698
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$245,116
Value of total assets at end of year2020-12-31$580,896
Value of total assets at beginning of year2020-12-31$279,157
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$5,934
Total interest from all sources2020-12-31$19
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$25,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$158,858
Participant contributions at end of year2020-12-31$6,559
Participant contributions at beginning of year2020-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$8,182
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$293,557
Value of net assets at end of year (total assets less liabilities)2020-12-31$572,714
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$279,157
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in pooled separate accounts at end of year2020-12-31$565,955
Value of interest in pooled separate accounts at beginning of year2020-12-31$276,682
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$19
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$4,382
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$2,113
Net investment gain/loss from pooled separate accounts2020-12-31$66,054
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31Yes
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$86,258
Employer contributions (assets) at end of year2020-12-31$4,000
Employer contributions (assets) at beginning of year2020-12-31$362
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$11,698
Contract administrator fees2020-12-31$5,934
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31PLANTE & MORAN, PLLC
Accountancy firm EIN2020-12-31381357951
2019 : K & G PETROLEUM, LLC 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$161,635
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$16,956
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$16,113
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$127,937
Value of total assets at end of year2019-12-31$279,157
Value of total assets at beginning of year2019-12-31$134,478
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$843
Total interest from all sources2019-12-31$12
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$25,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$104,596
Participant contributions at end of year2019-12-31$0
Participant contributions at beginning of year2019-12-31$6,488
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$144,679
Value of net assets at end of year (total assets less liabilities)2019-12-31$279,157
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$134,478
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in pooled separate accounts at end of year2019-12-31$276,682
Value of interest in pooled separate accounts at beginning of year2019-12-31$126,108
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$12
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$2,113
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$489
Net investment gain/loss from pooled separate accounts2019-12-31$33,686
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31Yes
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$23,341
Employer contributions (assets) at end of year2019-12-31$362
Employer contributions (assets) at beginning of year2019-12-31$1,393
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$16,113
Contract administrator fees2019-12-31$843
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31PLANTE MORAN
Accountancy firm EIN2019-12-31381357951
2018 : K & G PETROLEUM, LLC 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$56,410
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$20,507
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$19,712
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$66,508
Value of total assets at end of year2018-12-31$134,478
Value of total assets at beginning of year2018-12-31$98,575
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$795
Total interest from all sources2018-12-31$4
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$25,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$54,538
Participant contributions at end of year2018-12-31$6,488
Participant contributions at beginning of year2018-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$35,903
Value of net assets at end of year (total assets less liabilities)2018-12-31$134,478
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$98,575
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in pooled separate accounts at end of year2018-12-31$126,108
Value of interest in pooled separate accounts at beginning of year2018-12-31$98,023
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$4
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$489
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$552
Net investment gain/loss from pooled separate accounts2018-12-31$-10,102
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31Yes
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$11,970
Employer contributions (assets) at end of year2018-12-31$1,393
Employer contributions (assets) at beginning of year2018-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$19,712
Contract administrator fees2018-12-31$795
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31PLANTE MORAN
Accountancy firm EIN2018-12-31381357951
2017 : K & G PETROLEUM, LLC 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$83,455
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$2,227
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$1,848
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$75,771
Value of total assets at end of year2017-12-31$98,575
Value of total assets at beginning of year2017-12-31$17,347
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$379
Total interest from all sources2017-12-31$2
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$25,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$61,335
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$81,228
Value of net assets at end of year (total assets less liabilities)2017-12-31$98,575
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$17,347
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in pooled separate accounts at end of year2017-12-31$98,023
Value of interest in pooled separate accounts at beginning of year2017-12-31$17,234
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$2
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$552
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$113
Net investment gain/loss from pooled separate accounts2017-12-31$7,682
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$14,436
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$1,848
Contract administrator fees2017-12-31$379
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31EKS&H LLLP
Accountancy firm EIN2017-12-31840869721

Form 5500 Responses for K & G PETROLEUM, LLC 401(K) PLAN

2023: K & G PETROLEUM, LLC 401(K) PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement - TrustYes
2022: K & G PETROLEUM, LLC 401(K) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: K & G PETROLEUM, LLC 401(K) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: K & G PETROLEUM, LLC 401(K) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: K & G PETROLEUM, LLC 401(K) PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: K & G PETROLEUM, LLC 401(K) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: K & G PETROLEUM, LLC 401(K) PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number807452-000
Policy instance 1
Insurance contract or identification number807452-000
Number of Individuals Covered0
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $562
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number812620-000
Policy instance 2
Insurance contract or identification number812620-000
Number of Individuals Covered0
Insurance policy start date2023-08-14
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $138
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number807452-000
Policy instance 1
Insurance contract or identification number807452-000
Number of Individuals Covered186
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $457
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees457
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker organization code?5
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number807452-000
Policy instance 1
Insurance contract or identification number807452-000
Number of Individuals Covered177
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $362
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees362
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker organization code?5
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number807452-000
Policy instance 1
Insurance contract or identification number807452-000
Number of Individuals Covered115
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $193
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees193
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker organization code?5
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number807452-000
Policy instance 1
Insurance contract or identification number807452-000
Number of Individuals Covered64
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $97
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees97
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker organization code?5
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number807452-000
Policy instance 1
Insurance contract or identification number807452-000
Number of Individuals Covered22
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $499
Total amount of fees paid to insurance companyUSD $55
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $499
Insurance broker organization code?3
Amount paid for insurance broker fees55
Additional information about fees paid to insurance brokerTPA FEES
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number807452-000
Policy instance 1
Insurance contract or identification number807452-000
Number of Individuals Covered24
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $380
Total amount of fees paid to insurance companyUSD $28
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $380
Insurance broker organization code?3
Amount paid for insurance broker fees28
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker nameCBIZ RETIREMENT PLAN SERVICES

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