401k Plan data: A.A. ANDERSON & CO., INC. plan

A.A. ANDERSON & CO., INC. 401k Plan overview

Plan Name	A.A. ANDERSON & CO., INC.
Plan identification number	503

A.A. ANDERSON & CO., INC. Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Dental

401k Sponsoring company profile

A.A. ANDERSON & CO., INC. has sponsored the creation of one or more 401k plans.

Company Name: A.A. ANDERSON & CO., INC.

Employer identification number (EIN): 391017863

NAIC Classification: 423800

Form 5500 Filing Information

Submission information for form 5500 for 401k plan A.A. ANDERSON & CO., INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2019-01-01

Plan Statistics for A.A. ANDERSON & CO., INC.

401k plan membership statisitcs for A.A. ANDERSON & CO., INC.

Measure Date Value
2019: A.A. ANDERSON & CO., INC. 2019 401k membership
Total participants, beginning-of-year 2019-01-01 100
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 102
Total of all active and inactive participants 2019-01-01 102
Total participants 2019-01-01 102

Measure	Date	Value
2019: A.A. ANDERSON & CO., INC. 2019 401k membership
Total participants, beginning-of-year	2019-01-01	100
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	102
Total of all active and inactive participants	2019-01-01	102
Total participants	2019-01-01	102

Form 5500 Responses for A.A. ANDERSON & CO., INC.

2019: A.A. ANDERSON & CO., INC. 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	First time form 5500 has been submitted	Yes
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )

Policy contract number

01719 00000

Policy instance

Insurance contract or identification number	01719 00000
Number of Individuals Covered	102
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $3,849
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Insurance broker organization code?	3

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Company Name:	A.A. ANDERSON & CO., INC.
Employer identification number (EIN):	391017863
NAIC Classification:	423800