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BLAIN SUPPLY AND FARM & FLEET EMPLOYEE WELFARE BENEFIT PLAN 401k Plan overview

Plan NameBLAIN SUPPLY AND FARM & FLEET EMPLOYEE WELFARE BENEFIT PLAN
Plan identification number 501

BLAIN SUPPLY AND FARM & FLEET EMPLOYEE WELFARE BENEFIT PLAN Benefits

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

BLAIN SUPPLY, INC. has sponsored the creation of one or more 401k plans.

Company Name:BLAIN SUPPLY, INC.
Employer identification number (EIN):391104710
NAIC Classification:444130
NAIC Description:Hardware Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BLAIN SUPPLY AND FARM & FLEET EMPLOYEE WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-07-01
5012023-07-01AMY TAUBENHEIM
5012022-07-01
5012022-07-01AMY TAUBENHEIM
5012021-07-01
5012021-07-01AMY TAUBENHEIM
5012020-07-01
5012019-07-01
5012018-07-01
5012017-07-01CORINNA FIORVANTI
5012016-07-01CORINNA FIORVANTI
5012015-07-01CORINNA FIORVANTI
5012014-07-01LORI WETZEL
5012013-07-01WILLIAM SCHENDT WILLIAM SCHENDT2015-01-05
5012012-07-01WILLIAM SCHENDT WILLIAM SCHENDT2013-12-27
5012011-07-01WILLIAM SCHENDT WILLIAM SCHENDT2013-01-16
5012009-07-01WILLIAM SCHENDT WILLIAM SCHENDT2011-01-18

Financial Data on BLAIN SUPPLY AND FARM & FLEET EMPLOYEE WELFARE BENEFIT PLAN

Measure Date Value
2018 : BLAIN SUPPLY AND FARM & FLEET EMPLOYEE WELFARE BENEFIT PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-06-30$1,314,435
Total income from all sources (including contributions)2018-06-30$991,115
Total loss/gain on sale of assets2018-06-30$0
Total of all expenses incurred2018-06-30$5,291,506
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-06-30$5,141,817
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-06-30$987,784
Value of total assets at end of year2018-06-30$0
Value of total assets at beginning of year2018-06-30$5,614,826
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-06-30$149,689
Total interest from all sources2018-06-30$3,331
Total dividends received (eg from common stock, registered investment company shares)2018-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-06-30No
Administrative expenses professional fees incurred2018-06-30$149,689
Was this plan covered by a fidelity bond2018-06-30Yes
Value of fidelity bond cover2018-06-30$2,500,000
If this is an individual account plan, was there a blackout period2018-06-30No
Were there any nonexempt tranactions with any party-in-interest2018-06-30No
Contributions received from participants2018-06-30$308,135
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-06-30$4,849,806
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-06-30$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-06-30$959
Liabilities. Value of operating payables at end of year2018-06-30$0
Liabilities. Value of operating payables at beginning of year2018-06-30$261,210
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-06-30No
Value of net income/loss2018-06-30$-4,300,391
Value of net assets at end of year (total assets less liabilities)2018-06-30$0
Value of net assets at beginning of year (total assets less liabilities)2018-06-30$4,300,391
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2018-06-30No
Were any leases to which the plan was party in default or uncollectible2018-06-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-06-30$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-06-30$5,613,867
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-06-30$5,613,867
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-06-30$3,331
Expenses. Payments to insurance carriers foe the provision of benefits2018-06-30$292,011
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-06-30No
Was there a failure to transmit to the plan any participant contributions2018-06-30No
Has the plan failed to provide any benefit when due under the plan2018-06-30No
Contributions received in cash from employer2018-06-30$679,649
Liabilities. Value of benefit claims payable at end of year2018-06-30$0
Liabilities. Value of benefit claims payable at beginning of year2018-06-30$1,053,225
Did the plan have assets held for investment2018-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-06-30No
Opinion of an independent qualified public accountant for this plan2018-06-30Unqualified
Accountancy firm name2018-06-30WIPFLI LLP
Accountancy firm EIN2018-06-30390758449
2017 : BLAIN SUPPLY AND FARM & FLEET EMPLOYEE WELFARE BENEFIT PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-06-30$1,314,435
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-06-30$1,058,829
Total income from all sources (including contributions)2017-06-30$11,701,547
Total loss/gain on sale of assets2017-06-30$0
Total of all expenses incurred2017-06-30$10,266,993
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-06-30$8,904,529
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-06-30$11,692,628
Value of total assets at end of year2017-06-30$5,614,826
Value of total assets at beginning of year2017-06-30$3,924,666
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-06-30$1,362,464
Total interest from all sources2017-06-30$8,919
Total dividends received (eg from common stock, registered investment company shares)2017-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-06-30No
Administrative expenses professional fees incurred2017-06-30$629,267
Was this plan covered by a fidelity bond2017-06-30Yes
Value of fidelity bond cover2017-06-30$2,500,000
If this is an individual account plan, was there a blackout period2017-06-30No
Were there any nonexempt tranactions with any party-in-interest2017-06-30No
Contributions received from participants2017-06-30$3,476,170
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2017-06-30$8,319,116
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-06-30$959
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-06-30$103,448
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-06-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-06-30$0
Administrative expenses (other) incurred2017-06-30$733,197
Liabilities. Value of operating payables at end of year2017-06-30$261,210
Liabilities. Value of operating payables at beginning of year2017-06-30$120,829
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-06-30No
Value of net income/loss2017-06-30$1,434,554
Value of net assets at end of year (total assets less liabilities)2017-06-30$4,300,391
Value of net assets at beginning of year (total assets less liabilities)2017-06-30$2,865,837
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2017-06-30No
Were any leases to which the plan was party in default or uncollectible2017-06-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-06-30$5,613,867
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-06-30$3,821,218
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-06-30$3,821,218
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-06-30$8,919
Expenses. Payments to insurance carriers foe the provision of benefits2017-06-30$585,413
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-06-30No
Was there a failure to transmit to the plan any participant contributions2017-06-30No
Has the plan failed to provide any benefit when due under the plan2017-06-30No
Contributions received in cash from employer2017-06-30$8,216,458
Liabilities. Value of benefit claims payable at end of year2017-06-30$1,053,225
Liabilities. Value of benefit claims payable at beginning of year2017-06-30$938,000
Did the plan have assets held for investment2017-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-06-30No
Opinion of an independent qualified public accountant for this plan2017-06-30Unqualified
Accountancy firm name2017-06-30WIPFLI LLP
Accountancy firm EIN2017-06-30390758449
2016 : BLAIN SUPPLY AND FARM & FLEET EMPLOYEE WELFARE BENEFIT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-06-30$1,058,829
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-06-30$1,265,602
Total income from all sources (including contributions)2016-06-30$11,495,841
Total loss/gain on sale of assets2016-06-30$0
Total of all expenses incurred2016-06-30$11,185,959
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-06-30$9,928,418
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-06-30$11,491,761
Value of total assets at end of year2016-06-30$3,924,666
Value of total assets at beginning of year2016-06-30$3,821,557
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-06-30$1,257,541
Total interest from all sources2016-06-30$4,080
Total dividends received (eg from common stock, registered investment company shares)2016-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-06-30No
Administrative expenses professional fees incurred2016-06-30$694,958
Was this plan covered by a fidelity bond2016-06-30Yes
Value of fidelity bond cover2016-06-30$5,000,000
If this is an individual account plan, was there a blackout period2016-06-30No
Were there any nonexempt tranactions with any party-in-interest2016-06-30No
Contributions received from participants2016-06-30$3,393,989
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2016-06-30$9,362,604
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-06-30$103,448
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-06-30$315
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-06-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-06-30$0
Administrative expenses (other) incurred2016-06-30$562,583
Liabilities. Value of operating payables at end of year2016-06-30$120,829
Liabilities. Value of operating payables at beginning of year2016-06-30$262,602
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-06-30No
Value of net income/loss2016-06-30$309,882
Value of net assets at end of year (total assets less liabilities)2016-06-30$2,865,837
Value of net assets at beginning of year (total assets less liabilities)2016-06-30$2,555,955
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2016-06-30No
Were any leases to which the plan was party in default or uncollectible2016-06-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-06-30$3,821,218
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-06-30$3,821,242
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-06-30$3,821,242
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-06-30$4,080
Expenses. Payments to insurance carriers foe the provision of benefits2016-06-30$565,814
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-06-30No
Was there a failure to transmit to the plan any participant contributions2016-06-30No
Has the plan failed to provide any benefit when due under the plan2016-06-30No
Contributions received in cash from employer2016-06-30$8,097,772
Liabilities. Value of benefit claims payable at end of year2016-06-30$938,000
Liabilities. Value of benefit claims payable at beginning of year2016-06-30$1,003,000
Did the plan have assets held for investment2016-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-06-30No
Opinion of an independent qualified public accountant for this plan2016-06-30Unqualified
Accountancy firm name2016-06-30WIPFLI LLP
Accountancy firm EIN2016-06-30390758449
2015 : BLAIN SUPPLY AND FARM & FLEET EMPLOYEE WELFARE BENEFIT PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-06-30$1,265,602
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-06-30$844,459
Total income from all sources (including contributions)2015-06-30$10,841,927
Total loss/gain on sale of assets2015-06-30$0
Total of all expenses incurred2015-06-30$11,359,045
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-06-30$10,021,370
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-06-30$10,837,699
Value of total assets at end of year2015-06-30$3,821,557
Value of total assets at beginning of year2015-06-30$3,917,532
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-06-30$1,337,675
Total interest from all sources2015-06-30$4,228
Total dividends received (eg from common stock, registered investment company shares)2015-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-06-30No
Administrative expenses professional fees incurred2015-06-30$793,811
Was this plan covered by a fidelity bond2015-06-30Yes
Value of fidelity bond cover2015-06-30$5,000,000
If this is an individual account plan, was there a blackout period2015-06-30No
Were there any nonexempt tranactions with any party-in-interest2015-06-30No
Contributions received from participants2015-06-30$3,144,338
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2015-06-30$9,456,562
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-06-30$315
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-06-30$341
Administrative expenses (other) incurred2015-06-30$543,864
Liabilities. Value of operating payables at end of year2015-06-30$262,602
Liabilities. Value of operating payables at beginning of year2015-06-30$459
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-06-30No
Value of net income/loss2015-06-30$-517,118
Value of net assets at end of year (total assets less liabilities)2015-06-30$2,555,955
Value of net assets at beginning of year (total assets less liabilities)2015-06-30$3,073,073
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2015-06-30No
Were any leases to which the plan was party in default or uncollectible2015-06-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-06-30$3,821,242
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-06-30$3,917,191
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-06-30$3,917,191
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-06-30$4,228
Expenses. Payments to insurance carriers foe the provision of benefits2015-06-30$564,808
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-06-30No
Was there a failure to transmit to the plan any participant contributions2015-06-30No
Has the plan failed to provide any benefit when due under the plan2015-06-30No
Contributions received in cash from employer2015-06-30$7,693,361
Liabilities. Value of benefit claims payable at end of year2015-06-30$1,003,000
Liabilities. Value of benefit claims payable at beginning of year2015-06-30$844,000
Did the plan have assets held for investment2015-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-06-30No
Opinion of an independent qualified public accountant for this plan2015-06-30Unqualified
Accountancy firm name2015-06-30WIPFLI LLP
Accountancy firm EIN2015-06-30390758449
2014 : BLAIN SUPPLY AND FARM & FLEET EMPLOYEE WELFARE BENEFIT PLAN 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-06-30$844,459
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-06-30$828,451
Total income from all sources (including contributions)2014-06-30$10,055,286
Total of all expenses incurred2014-06-30$10,186,382
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-06-30$8,965,018
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-06-30$10,051,022
Value of total assets at end of year2014-06-30$3,917,532
Value of total assets at beginning of year2014-06-30$4,032,620
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-06-30$1,221,364
Total interest from all sources2014-06-30$4,264
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-06-30No
Administrative expenses professional fees incurred2014-06-30$787,559
Was this plan covered by a fidelity bond2014-06-30Yes
Value of fidelity bond cover2014-06-30$5,000,000
If this is an individual account plan, was there a blackout period2014-06-30No
Were there any nonexempt tranactions with any party-in-interest2014-06-30No
Contributions received from participants2014-06-30$2,966,007
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2014-06-30$8,336,770
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-06-30$341
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-06-30$343
Administrative expenses (other) incurred2014-06-30$433,805
Liabilities. Value of operating payables at end of year2014-06-30$459
Liabilities. Value of operating payables at beginning of year2014-06-30$451
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-06-30No
Value of net income/loss2014-06-30$-131,096
Value of net assets at end of year (total assets less liabilities)2014-06-30$3,073,073
Value of net assets at beginning of year (total assets less liabilities)2014-06-30$3,204,169
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2014-06-30No
Were any leases to which the plan was party in default or uncollectible2014-06-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-06-30$3,917,191
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-06-30$4,032,277
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-06-30$4,032,277
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-06-30$4,264
Expenses. Payments to insurance carriers foe the provision of benefits2014-06-30$628,248
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-06-30No
Was there a failure to transmit to the plan any participant contributions2014-06-30No
Has the plan failed to provide any benefit when due under the plan2014-06-30No
Contributions received in cash from employer2014-06-30$7,085,015
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-06-30No
Liabilities. Value of benefit claims payable at end of year2014-06-30$844,000
Liabilities. Value of benefit claims payable at beginning of year2014-06-30$828,000
Did the plan have assets held for investment2014-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-06-30No
Opinion of an independent qualified public accountant for this plan2014-06-30Unqualified
Accountancy firm name2014-06-30BAKER TILLY VIRCHOW KRAUSE, LLP
Accountancy firm EIN2014-06-30390859910
2013 : BLAIN SUPPLY AND FARM & FLEET EMPLOYEE WELFARE BENEFIT PLAN 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-06-30$828,451
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-06-30$779,375
Total income from all sources (including contributions)2013-06-30$9,347,205
Total of all expenses incurred2013-06-30$8,913,816
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-06-30$7,838,434
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-06-30$9,343,234
Value of total assets at end of year2013-06-30$4,032,620
Value of total assets at beginning of year2013-06-30$3,550,155
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-06-30$1,075,382
Total interest from all sources2013-06-30$3,971
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-06-30No
Administrative expenses professional fees incurred2013-06-30$648,937
Was this plan covered by a fidelity bond2013-06-30Yes
Value of fidelity bond cover2013-06-30$5,000,000
If this is an individual account plan, was there a blackout period2013-06-30No
Were there any nonexempt tranactions with any party-in-interest2013-06-30No
Contributions received from participants2013-06-30$2,768,221
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-06-30$7,281,385
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-06-30$343
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-06-30$302
Administrative expenses (other) incurred2013-06-30$426,445
Liabilities. Value of operating payables at end of year2013-06-30$451
Liabilities. Value of operating payables at beginning of year2013-06-30$375
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-06-30No
Value of net income/loss2013-06-30$433,389
Value of net assets at end of year (total assets less liabilities)2013-06-30$3,204,169
Value of net assets at beginning of year (total assets less liabilities)2013-06-30$2,770,780
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2013-06-30No
Were any leases to which the plan was party in default or uncollectible2013-06-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-06-30$4,032,277
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-06-30$3,549,853
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-06-30$3,549,853
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-06-30$3,971
Expenses. Payments to insurance carriers foe the provision of benefits2013-06-30$557,049
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-06-30No
Was there a failure to transmit to the plan any participant contributions2013-06-30No
Has the plan failed to provide any benefit when due under the plan2013-06-30No
Contributions received in cash from employer2013-06-30$6,575,013
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-06-30No
Liabilities. Value of benefit claims payable at end of year2013-06-30$828,000
Liabilities. Value of benefit claims payable at beginning of year2013-06-30$779,000
Did the plan have assets held for investment2013-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-06-30No
Opinion of an independent qualified public accountant for this plan2013-06-30Unqualified
Accountancy firm name2013-06-30BAKER TILLY VIRCHOW KRAUSE, LLP
Accountancy firm EIN2013-06-30390859910
2012 : BLAIN SUPPLY AND FARM & FLEET EMPLOYEE WELFARE BENEFIT PLAN 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-06-30$779,375
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-06-30$512,371
Total income from all sources (including contributions)2012-06-30$8,285,197
Total of all expenses incurred2012-06-30$8,719,366
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-06-30$7,733,815
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-06-30$8,280,982
Value of total assets at end of year2012-06-30$3,550,155
Value of total assets at beginning of year2012-06-30$3,717,320
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-06-30$985,551
Total interest from all sources2012-06-30$4,215
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-06-30No
Administrative expenses professional fees incurred2012-06-30$545,721
Was this plan covered by a fidelity bond2012-06-30Yes
Value of fidelity bond cover2012-06-30$5,000,000
If this is an individual account plan, was there a blackout period2012-06-30No
Were there any nonexempt tranactions with any party-in-interest2012-06-30No
Contributions received from participants2012-06-30$2,519,369
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2012-06-30$7,202,155
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-06-30$302
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-06-30$426
Administrative expenses (other) incurred2012-06-30$439,830
Liabilities. Value of operating payables at end of year2012-06-30$375
Liabilities. Value of operating payables at beginning of year2012-06-30$371
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-06-30No
Value of net income/loss2012-06-30$-434,169
Value of net assets at end of year (total assets less liabilities)2012-06-30$2,770,780
Value of net assets at beginning of year (total assets less liabilities)2012-06-30$3,204,949
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2012-06-30No
Were any leases to which the plan was party in default or uncollectible2012-06-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-06-30$3,549,853
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-06-30$3,716,894
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-06-30$3,716,894
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-06-30$4,215
Expenses. Payments to insurance carriers foe the provision of benefits2012-06-30$531,660
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-06-30No
Was there a failure to transmit to the plan any participant contributions2012-06-30No
Has the plan failed to provide any benefit when due under the plan2012-06-30No
Contributions received in cash from employer2012-06-30$5,761,613
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-06-30No
Liabilities. Value of benefit claims payable at end of year2012-06-30$779,000
Liabilities. Value of benefit claims payable at beginning of year2012-06-30$512,000
Did the plan have assets held for investment2012-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-06-30No
Opinion of an independent qualified public accountant for this plan2012-06-30Unqualified
Accountancy firm name2012-06-30BAKER TILLY VIRCHOW KRAUSE, LLP
Accountancy firm EIN2012-06-30390859910
2011 : BLAIN SUPPLY AND FARM & FLEET EMPLOYEE WELFARE BENEFIT PLAN 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-06-30$512,371
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-06-30$525,370
Total income from all sources (including contributions)2011-06-30$8,156,345
Total of all expenses incurred2011-06-30$9,423,471
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-06-30$8,492,421
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-06-30$8,149,248
Value of total assets at end of year2011-06-30$3,717,320
Value of total assets at beginning of year2011-06-30$4,997,444
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-06-30$931,050
Total interest from all sources2011-06-30$7,097
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-06-30No
Administrative expenses professional fees incurred2011-06-30$486,818
Was this plan covered by a fidelity bond2011-06-30Yes
Value of fidelity bond cover2011-06-30$2,500,000
If this is an individual account plan, was there a blackout period2011-06-30No
Were there any nonexempt tranactions with any party-in-interest2011-06-30No
Contributions received from participants2011-06-30$2,255,049
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2011-06-30$8,084,589
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-06-30$426
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-06-30$856
Administrative expenses (other) incurred2011-06-30$444,232
Liabilities. Value of operating payables at end of year2011-06-30$371
Liabilities. Value of operating payables at beginning of year2011-06-30$370
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-06-30No
Value of net income/loss2011-06-30$-1,267,126
Value of net assets at end of year (total assets less liabilities)2011-06-30$3,204,949
Value of net assets at beginning of year (total assets less liabilities)2011-06-30$4,472,074
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2011-06-30No
Were any leases to which the plan was party in default or uncollectible2011-06-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-06-30$3,716,894
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-06-30$4,996,588
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-06-30$4,996,588
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-06-30$7,097
Expenses. Payments to insurance carriers foe the provision of benefits2011-06-30$407,832
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-06-30No
Was there a failure to transmit to the plan any participant contributions2011-06-30No
Has the plan failed to provide any benefit when due under the plan2011-06-30No
Contributions received in cash from employer2011-06-30$5,894,199
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-06-30No
Liabilities. Value of benefit claims payable at end of year2011-06-30$512,000
Liabilities. Value of benefit claims payable at beginning of year2011-06-30$525,000
Did the plan have assets held for investment2011-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-06-30No
Opinion of an independent qualified public accountant for this plan2011-06-30Unqualified
Accountancy firm name2011-06-30BAKER TILLY VIRCHOW KRAUSE, LLP
Accountancy firm EIN2011-06-30390859910

Form 5500 Responses for BLAIN SUPPLY AND FARM & FLEET EMPLOYEE WELFARE BENEFIT PLAN

2023: BLAIN SUPPLY AND FARM & FLEET EMPLOYEE WELFARE BENEFIT PLAN 2023 form 5500 responses
2023-07-01Type of plan entitySingle employer plan
2023-07-01Submission has been amendedNo
2023-07-01This submission is the final filingNo
2023-07-01This return/report is a short plan year return/report (less than 12 months)No
2023-07-01Plan is a collectively bargained planNo
2023-07-01Plan funding arrangement – InsuranceYes
2023-07-01Plan funding arrangement – General assets of the sponsorYes
2023-07-01Plan benefit arrangement – InsuranceYes
2023-07-01Plan benefit arrangement – General assets of the sponsorYes
2022: BLAIN SUPPLY AND FARM & FLEET EMPLOYEE WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-07-01Type of plan entitySingle employer plan
2022-07-01Submission has been amendedNo
2022-07-01This submission is the final filingNo
2022-07-01This return/report is a short plan year return/report (less than 12 months)No
2022-07-01Plan is a collectively bargained planNo
2022-07-01Plan funding arrangement – InsuranceYes
2022-07-01Plan funding arrangement – General assets of the sponsorYes
2022-07-01Plan benefit arrangement – InsuranceYes
2022-07-01Plan benefit arrangement – General assets of the sponsorYes
2021: BLAIN SUPPLY AND FARM & FLEET EMPLOYEE WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Submission has been amendedNo
2021-07-01This submission is the final filingNo
2021-07-01This return/report is a short plan year return/report (less than 12 months)No
2021-07-01Plan is a collectively bargained planNo
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan funding arrangement – General assets of the sponsorYes
2021-07-01Plan benefit arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – General assets of the sponsorYes
2020: BLAIN SUPPLY AND FARM & FLEET EMPLOYEE WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Submission has been amendedNo
2020-07-01This submission is the final filingNo
2020-07-01This return/report is a short plan year return/report (less than 12 months)No
2020-07-01Plan is a collectively bargained planNo
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – General assets of the sponsorYes
2020-07-01Plan benefit arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – General assets of the sponsorYes
2019: BLAIN SUPPLY AND FARM & FLEET EMPLOYEE WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Submission has been amendedNo
2019-07-01This submission is the final filingNo
2019-07-01This return/report is a short plan year return/report (less than 12 months)No
2019-07-01Plan is a collectively bargained planNo
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan funding arrangement – General assets of the sponsorYes
2019-07-01Plan benefit arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – General assets of the sponsorYes
2018: BLAIN SUPPLY AND FARM & FLEET EMPLOYEE WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Submission has been amendedNo
2018-07-01This submission is the final filingNo
2018-07-01This return/report is a short plan year return/report (less than 12 months)No
2018-07-01Plan is a collectively bargained planNo
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan funding arrangement – General assets of the sponsorYes
2018-07-01Plan benefit arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – General assets of the sponsorYes
2017: BLAIN SUPPLY AND FARM & FLEET EMPLOYEE WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Submission has been amendedNo
2017-07-01This submission is the final filingNo
2017-07-01This return/report is a short plan year return/report (less than 12 months)No
2017-07-01Plan is a collectively bargained planNo
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan funding arrangement – TrustYes
2017-07-01Plan benefit arrangement – InsuranceYes
2017-07-01Plan benefit arrangement - TrustYes
2016: BLAIN SUPPLY AND FARM & FLEET EMPLOYEE WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Submission has been amendedNo
2016-07-01This submission is the final filingNo
2016-07-01This return/report is a short plan year return/report (less than 12 months)No
2016-07-01Plan is a collectively bargained planNo
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan funding arrangement – TrustYes
2016-07-01Plan benefit arrangement – InsuranceYes
2016-07-01Plan benefit arrangement - TrustYes
2015: BLAIN SUPPLY AND FARM & FLEET EMPLOYEE WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan funding arrangement – TrustYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-07-01Plan benefit arrangement - TrustYes
2014: BLAIN SUPPLY AND FARM & FLEET EMPLOYEE WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan funding arrangement – TrustYes
2014-07-01Plan benefit arrangement – InsuranceYes
2014-07-01Plan benefit arrangement - TrustYes
2013: BLAIN SUPPLY AND FARM & FLEET EMPLOYEE WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-07-01Type of plan entityMulitple employer plan
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan funding arrangement – TrustYes
2013-07-01Plan benefit arrangement – InsuranceYes
2013-07-01Plan benefit arrangement - TrustYes
2012: BLAIN SUPPLY AND FARM & FLEET EMPLOYEE WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-07-01Type of plan entityMulitple employer plan
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan funding arrangement – TrustYes
2012-07-01Plan benefit arrangement – InsuranceYes
2012-07-01Plan benefit arrangement - TrustYes
2011: BLAIN SUPPLY AND FARM & FLEET EMPLOYEE WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-07-01Type of plan entityMulitple employer plan
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan funding arrangement – TrustYes
2011-07-01Plan benefit arrangement – InsuranceYes
2011-07-01Plan benefit arrangement - TrustYes
2009: BLAIN SUPPLY AND FARM & FLEET EMPLOYEE WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-07-01Type of plan entityMulitple employer plan
2009-07-01This submission is the final filingNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan funding arrangement – TrustYes
2009-07-01Plan benefit arrangement – InsuranceYes
2009-07-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number56606
Policy instance 7
Insurance contract or identification number56606
Number of Individuals Covered992
Insurance policy start date2023-07-01
Insurance policy end date2024-06-30
Total amount of commissions paid to insurance brokerUSD $63,604
Total amount of fees paid to insurance companyUSD $0
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number56406
Policy instance 1
Insurance contract or identification number56406
Number of Individuals Covered454
Insurance policy start date2023-07-01
Insurance policy end date2024-06-30
Total amount of commissions paid to insurance brokerUSD $17,503
Total amount of fees paid to insurance companyUSD $0
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $0
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 number760503
Policy instance 2
Insurance contract or identification number760503
Number of Individuals Covered2583
Insurance policy start date2023-07-01
Insurance policy end date2024-06-30
Total amount of commissions paid to insurance brokerUSD $28,126
Total amount of fees paid to insurance companyUSD $28,385
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $0
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 number760503
Policy instance 3
Insurance contract or identification number760503
Number of Individuals Covered886
Insurance policy start date2023-07-01
Insurance policy end date2024-06-30
Total amount of commissions paid to insurance brokerUSD $121,603
Total amount of fees paid to insurance companyUSD $24,104
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?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
Welfare Benefit Premiums Paid to CarrierUSD $263,181
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 number760503
Policy instance 4
Insurance contract or identification number760503
Number of Individuals Covered1126
Insurance policy start date2023-07-01
Insurance policy end date2024-06-30
Total amount of commissions paid to insurance brokerUSD $73,701
Total amount of fees paid to insurance companyUSD $53,012
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $0
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 number760503
Policy instance 5
Insurance contract or identification number760503
Number of Individuals Covered1067
Insurance policy start date2023-07-01
Insurance policy end date2024-06-30
Total amount of commissions paid to insurance brokerUSD $26,407
Total amount of fees paid to insurance companyUSD $17,754
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?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 BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30103917
Policy instance 6
Insurance contract or identification number30103917
Number of Individuals Covered2177
Insurance policy start date2023-07-01
Insurance policy end date2024-06-30
Total amount of commissions paid to insurance brokerUSD $14,958
Total amount of fees paid to insurance companyUSD $0
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $150,064
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number56406
Policy instance 1
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number760503
Policy instance 2
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number56606
Policy instance 3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number760503
Policy instance 4
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number760503
Policy instance 5
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number760503
Policy instance 6
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30103917
Policy instance 7
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number56406
Policy instance 1
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10251234
Policy instance 2
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number56606
Policy instance 3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number400251235
Policy instance 4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10251236
Policy instance 5
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10251198
Policy instance 6
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number403007278
Policy instance 7
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30103917
Policy instance 8
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number40329
Policy instance 5
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10251234
Policy instance 6
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number56606
Policy instance 7
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number400251235
Policy instance 8
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10251236
Policy instance 9
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10251198
Policy instance 10
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number40128
Policy instance 4
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number40328
Policy instance 3
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number56406
Policy instance 2
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number40127
Policy instance 1
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number403007278
Policy instance 11
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10251198
Policy instance 10
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10251236
Policy instance 9
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number400251235
Policy instance 8
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number56606
Policy instance 7
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10251234
Policy instance 6
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number40329
Policy instance 5
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number40128
Policy instance 4
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number40328
Policy instance 3
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number56406
Policy instance 2
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number40127
Policy instance 1
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number40127
Policy instance 1
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0686030
Policy instance 8
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number56406
Policy instance 7
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number602645
Policy instance 6
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number40128
Policy instance 4
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number40329
Policy instance 5
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number40328
Policy instance 3
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number56606
Policy instance 2
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number56406
Policy instance 7
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0011481192
Policy instance 9
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number40127
Policy instance 1
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number56606
Policy instance 2
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number40128
Policy instance 4
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number40328
Policy instance 3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0686030
Policy instance 8
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number602645
Policy instance 6
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 )
Policy contract number40329
Policy instance 5

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