401k Plan data: CURT G. JOA, INC. HEALTH BENEFIT PLAN plan

CURT G. JOA, INC. HEALTH BENEFIT PLAN 401k Plan overview

Plan Name	CURT G. JOA, INC. HEALTH BENEFIT PLAN
Plan identification number	503

CURT G. JOA, INC. HEALTH BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

CURT G. JOA, INC. has sponsored the creation of one or more 401k plans.

Company Name: CURT G. JOA, INC.

Employer identification number (EIN): 390376520

NAIC Classification: 333200

Additional information about CURT G. JOA, INC.

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 2014-08-13

Company Identification Number: 0802044886

Legal Registered Office Address: 100 CROCKER AVE

SHEBOYGAN FLS
United States of America (USA)
53085

More information about CURT G. JOA, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CURT G. JOA, INC. HEALTH BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2014-01-01 GREGORY BROGHAMMER
503 2013-01-01 GREGORY BROGHAMMER
503 2012-01-01 GREGORY BROGHAMMER
503 2011-09-01 GREGORY BROGHAMMER
503 2009-09-01 GREGORY BROGHAMMER

Plan id#	Filing Submission Date	Name of Administrator
503	2014-01-01	GREGORY BROGHAMMER
503	2013-01-01	GREGORY BROGHAMMER
503	2012-01-01	GREGORY BROGHAMMER
503	2011-09-01	GREGORY BROGHAMMER
503	2009-09-01	GREGORY BROGHAMMER

Plan Statistics for CURT G. JOA, INC. HEALTH BENEFIT PLAN

401k plan membership statisitcs for CURT G. JOA, INC. HEALTH BENEFIT PLAN

Measure Date Value
2014: CURT G. JOA, INC. HEALTH BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 347
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 0
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 0
2013: CURT G. JOA, INC. HEALTH BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 358
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 345
Number of retired or separated participants receiving benefits 2013-01-01 1
Number of other retired or separated participants entitled to future benefits 2013-01-01 1
Total of all active and inactive participants 2013-01-01 347
2012: CURT G. JOA, INC. HEALTH BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 366
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 349
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 9
Total of all active and inactive participants 2012-01-01 358
2011: CURT G. JOA, INC. HEALTH BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-09-01 370
Total number of active participants reported on line 7a of the Form 5500 2011-09-01 342
Number of retired or separated participants receiving benefits 2011-09-01 50
Number of other retired or separated participants entitled to future benefits 2011-09-01 16
Total of all active and inactive participants 2011-09-01 408
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-09-01 4
Total participants 2011-09-01 412
2009: CURT G. JOA, INC. HEALTH BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-09-01 353
Total number of active participants reported on line 7a of the Form 5500 2009-09-01 355
Number of retired or separated participants receiving benefits 2009-09-01 10
Number of other retired or separated participants entitled to future benefits 2009-09-01 13
Total of all active and inactive participants 2009-09-01 378
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-09-01 2
Total participants 2009-09-01 380

Measure	Date	Value
2014: CURT G. JOA, INC. HEALTH BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	347
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	0
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	0
2013: CURT G. JOA, INC. HEALTH BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	358
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	345
Number of retired or separated participants receiving benefits	2013-01-01	1
Number of other retired or separated participants entitled to future benefits	2013-01-01	1
Total of all active and inactive participants	2013-01-01	347
2012: CURT G. JOA, INC. HEALTH BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	366
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	349
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	9
Total of all active and inactive participants	2012-01-01	358
2011: CURT G. JOA, INC. HEALTH BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-09-01	370
Total number of active participants reported on line 7a of the Form 5500	2011-09-01	342
Number of retired or separated participants receiving benefits	2011-09-01	50
Number of other retired or separated participants entitled to future benefits	2011-09-01	16
Total of all active and inactive participants	2011-09-01	408
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-09-01	4
Total participants	2011-09-01	412
2009: CURT G. JOA, INC. HEALTH BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-09-01	353
Total number of active participants reported on line 7a of the Form 5500	2009-09-01	355
Number of retired or separated participants receiving benefits	2009-09-01	10
Number of other retired or separated participants entitled to future benefits	2009-09-01	13
Total of all active and inactive participants	2009-09-01	378
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-09-01	2
Total participants	2009-09-01	380

Form 5500 Responses for CURT G. JOA, INC. HEALTH BENEFIT PLAN

2014: CURT G. JOA, INC. HEALTH BENEFIT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	Yes
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: CURT G. JOA, INC. HEALTH BENEFIT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: CURT G. JOA, INC. HEALTH BENEFIT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: CURT G. JOA, INC. HEALTH BENEFIT PLAN 2011 form 5500 responses
2011-09-01	Type of plan entity	Single employer plan
2011-09-01	Submission has been amended	No
2011-09-01	This submission is the final filing	No
2011-09-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2011-09-01	Plan is a collectively bargained plan	No
2011-09-01	Plan funding arrangement – Insurance	Yes
2011-09-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-09-01	Plan benefit arrangement – Insurance	Yes
2011-09-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: CURT G. JOA, INC. HEALTH BENEFIT PLAN 2009 form 5500 responses
2009-09-01	Type of plan entity	Single employer plan
2009-09-01	Submission has been amended	No
2009-09-01	This submission is the final filing	No
2009-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-09-01	Plan is a collectively bargained plan	No
2009-09-01	Plan funding arrangement – Insurance	Yes
2009-09-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-09-01	Plan benefit arrangement – Insurance	Yes
2009-09-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

KANAWHA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65110 )
Policy contract number	7209222000
Policy instance	3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number	62544-2
Policy instance	1
KANAWHA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65110 )
Policy contract number	K100783
Policy instance	2
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number	62544-2
Policy instance	1
KANAWHA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65110 )
Policy contract number	K100783
Policy instance	2
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number	62544-2
Policy instance	1
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number	625162
Policy instance	1
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number	62544-2
Policy instance	2
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number	625162
Policy instance	1
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number	62544-2
Policy instance	2
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number	661404
Policy instance	3

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Company Name:	CURT G. JOA, INC.
Employer identification number (EIN):	390376520
NAIC Classification:	333200

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	2014-08-13
Company Identification Number:	0802044886
Legal Registered Office Address:	100 CROCKER AVE SHEBOYGAN FLS United States of America (USA) 53085