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MSD LLC & AFFILIATES 401(K) PLAN 401k Plan overview

Plan NameMSD LLC & AFFILIATES 401(K) PLAN
Plan identification number 001

MSD LLC & AFFILIATES 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.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

MSD LLC has sponsored the creation of one or more 401k plans.

Company Name:MSD LLC
Employer identification number (EIN):371745630
NAIC Classification:336300

Additional information about MSD LLC

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2013-12-11
Company Identification Number: 0801897234
Legal Registered Office Address: 1350 PULLMAN DR STE 200

EL PASO
United States of America (USA)
79936

More information about MSD LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MSD LLC & AFFILIATES 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012016-01-01MARIA SOTO
0012015-01-01MARIA SOTO
0012014-01-01KAREN SERVER
0012013-01-01KAREN SERVER

Plan Statistics for MSD LLC & AFFILIATES 401(K) PLAN

401k plan membership statisitcs for MSD LLC & AFFILIATES 401(K) PLAN

Measure Date Value
2016: MSD LLC & AFFILIATES 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01394
Total number of active participants reported on line 7a of the Form 55002016-01-010
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-010
Number of participants with account balances2016-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: MSD LLC & AFFILIATES 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01445
Total number of active participants reported on line 7a of the Form 55002015-01-01320
Number of retired or separated participants receiving benefits2015-01-011
Number of other retired or separated participants entitled to future benefits2015-01-0166
Total of all active and inactive participants2015-01-01387
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-011
Total participants2015-01-01388
Number of participants with account balances2015-01-01316
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: MSD LLC & AFFILIATES 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01331
Total number of active participants reported on line 7a of the Form 55002014-01-01283
Number of retired or separated participants receiving benefits2014-01-011
Number of other retired or separated participants entitled to future benefits2014-01-0133
Total of all active and inactive participants2014-01-01317
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-011
Total participants2014-01-01318
Number of participants with account balances2014-01-01250
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: MSD LLC & AFFILIATES 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01319
Total number of active participants reported on line 7a of the Form 55002013-01-01286
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0130
Total of all active and inactive participants2013-01-01316
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-012
Total participants2013-01-01318
Number of participants with account balances2013-01-01249
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010

Financial Data on MSD LLC & AFFILIATES 401(K) PLAN

Measure Date Value
2016 : MSD LLC & AFFILIATES 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-03-10$0
Total transfer of assets from this plan2016-03-10$10,919,225
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-03-10$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-03-10$180
Total income from all sources (including contributions)2016-03-10$-502,676
Total loss/gain on sale of assets2016-03-10$0
Total of all expenses incurred2016-03-10$275,672
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-03-10$250,162
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-03-10$68,655
Value of total assets at end of year2016-03-10$0
Value of total assets at beginning of year2016-03-10$11,697,753
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-03-10$25,510
Total interest from all sources2016-03-10$4,161
Total dividends received (eg from common stock, registered investment company shares)2016-03-10$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-03-10Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2016-03-10$0
Was this plan covered by a fidelity bond2016-03-10Yes
Value of fidelity bond cover2016-03-10$500,000
If this is an individual account plan, was there a blackout period2016-03-10Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-03-10$0
Were there any nonexempt tranactions with any party-in-interest2016-03-10No
Contributions received from participants2016-03-10$43,588
Participant contributions at end of year2016-03-10$0
Participant contributions at beginning of year2016-03-10$408,835
Participant contributions at end of year2016-03-10$0
Participant contributions at beginning of year2016-03-10$5,567
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-03-10$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-03-10$180
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-03-10No
Value of net income/loss2016-03-10$-778,348
Value of net assets at end of year (total assets less liabilities)2016-03-10$0
Value of net assets at beginning of year (total assets less liabilities)2016-03-10$11,697,573
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-03-10No
Were any loans by the plan or fixed income obligations due to the plan in default2016-03-10No
Were any leases to which the plan was party in default or uncollectible2016-03-10No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-03-10$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-03-10$9,481,105
Value of interest in pooled separate accounts at beginning of year2016-03-10$0
Interest on participant loans2016-03-10$955
Interest earned on other investments2016-03-10$3,206
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-03-10$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-03-10$1,799,049
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-03-10$-575,492
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-03-10No
Was there a failure to transmit to the plan any participant contributions2016-03-10No
Has the plan failed to provide any benefit when due under the plan2016-03-10No
Contributions received in cash from employer2016-03-10$25,067
Employer contributions (assets) at end of year2016-03-10$0
Employer contributions (assets) at beginning of year2016-03-10$3,197
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-03-10$250,162
Contract administrator fees2016-03-10$25,510
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-03-10Yes
Did the plan have assets held for investment2016-03-10No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-03-10No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-03-10Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-03-10Yes
Opinion of an independent qualified public accountant for this plan2016-03-10Disclaimer
Accountancy firm name2016-03-10BKD LLP
Accountancy firm EIN2016-03-10440160260
2015 : MSD LLC & AFFILIATES 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total transfer of assets to this plan2015-12-31$2,860,554
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$180
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$3,730
Total income from all sources (including contributions)2015-12-31$1,256,996
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$1,218,035
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$1,142,085
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$1,472,272
Value of total assets at end of year2015-12-31$11,697,753
Value of total assets at beginning of year2015-12-31$8,801,788
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$75,950
Total interest from all sources2015-12-31$53,349
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$354,532
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$354,532
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$816,697
Participant contributions at end of year2015-12-31$408,835
Participant contributions at beginning of year2015-12-31$484,125
Participant contributions at end of year2015-12-31$5,567
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$86,439
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$180
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$3,730
Total non interest bearing cash at beginning of year2015-12-31$3,730
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$38,961
Value of net assets at end of year (total assets less liabilities)2015-12-31$11,697,573
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$8,798,058
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$9,481,105
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$6,727,207
Value of interest in pooled separate accounts at beginning of year2015-12-31$0
Interest on participant loans2015-12-31$14,894
Interest earned on other investments2015-12-31$38,455
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$1,799,049
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$1,586,726
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-623,157
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$569,136
Employer contributions (assets) at end of year2015-12-31$3,197
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$1,142,085
Contract administrator fees2015-12-31$75,950
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-12-31Yes
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31BKD LLP
Accountancy firm EIN2015-12-31440160260
2014 : MSD LLC & AFFILIATES 401(K) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$3,730
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$1,139,097
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$619,737
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$607,114
Value of total corrective distributions2014-12-31$1,503
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$631,973
Value of total assets at end of year2014-12-31$8,801,788
Value of total assets at beginning of year2014-12-31$8,278,698
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$11,120
Total interest from all sources2014-12-31$41,302
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
If this is an individual account plan, was there a blackout period2014-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$513,986
Participant contributions at end of year2014-12-31$484,125
Participant contributions at beginning of year2014-12-31$411,481
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$3,730
Total non interest bearing cash at end of year2014-12-31$3,730
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$519,360
Value of net assets at end of year (total assets less liabilities)2014-12-31$8,798,058
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$8,278,698
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$6,727,207
Value of interest in pooled separate accounts at end of year2014-12-31$0
Value of interest in pooled separate accounts at beginning of year2014-12-31$6,483,465
Interest on participant loans2014-12-31$14,784
Interest earned on other investments2014-12-31$26,518
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$1,586,726
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$1,383,752
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$585,385
Net investment gain/loss from pooled separate accounts2014-12-31$-119,563
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$117,987
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$607,114
Contract administrator fees2014-12-31$11,120
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-12-31Yes
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31BKD LLP
Accountancy firm EIN2014-12-31440160260
2013 : MSD LLC & AFFILIATES 401(K) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total income from all sources (including contributions)2013-12-31$2,211,816
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$481,011
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$469,983
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$644,154
Value of total assets at end of year2013-12-31$8,278,698
Value of total assets at beginning of year2013-12-31$6,547,893
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$11,028
Total interest from all sources2013-12-31$36,865
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$500,000
If this is an individual account plan, was there a blackout period2013-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$486,057
Participant contributions at end of year2013-12-31$411,481
Participant contributions at beginning of year2013-12-31$400,394
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$38,337
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$1,730,805
Value of net assets at end of year (total assets less liabilities)2013-12-31$8,278,698
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$6,547,893
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in pooled separate accounts at end of year2013-12-31$6,483,465
Value of interest in pooled separate accounts at beginning of year2013-12-31$4,945,136
Interest on participant loans2013-12-31$12,888
Interest earned on other investments2013-12-31$23,977
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$1,383,752
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$1,202,363
Net investment gain/loss from pooled separate accounts2013-12-31$1,530,797
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$119,760
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$469,983
Contract administrator fees2013-12-31$11,028
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31MSD LLC
Accountancy firm EIN2013-12-31371745630

Form 5500 Responses for MSD LLC & AFFILIATES 401(K) PLAN

2016: MSD LLC & AFFILIATES 401(K) PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingYes
2016-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: MSD LLC & AFFILIATES 401(K) PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: MSD LLC & AFFILIATES 401(K) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: MSD LLC & AFFILIATES 401(K) PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number802052
Policy instance 1
Insurance contract or identification number802052
Number of Individuals Covered0
Insurance policy start date2016-01-01
Insurance policy end date2016-03-10
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare 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
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number802052
Policy instance 1
Insurance contract or identification number802052
Number of Individuals Covered388
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare 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
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number802052
Policy instance 1
Insurance contract or identification number802052
Number of Individuals Covered318
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $496,698
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare 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 $496,698
Insurance broker organization code?3
Insurance broker nameMARSH INSURANCE AND INVESTMENTS CO
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number802052
Policy instance 1
Insurance contract or identification number802052
Number of Individuals Covered318
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $17,943
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare 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 $17,943
Insurance broker organization code?3
Insurance broker nameMARSH INSURANCE AND INVESTMENTS CO

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