401k Plan data: HIAWATHA RUBBER CO. 401K PLAN plan

HIAWATHA RUBBER CO. 401K PLAN 401k Plan overview

Plan Name	HIAWATHA RUBBER CO. 401K PLAN
Plan identification number	004

HIAWATHA RUBBER CO. 401K PLAN Benefits

401k Plan Type

Defined 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.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

HIAWATHA RUBBER CO. has sponsored the creation of one or more 401k plans.

Company Name: HIAWATHA RUBBER CO.

Employer identification number (EIN): 410683256

NAIC Classification: 326200

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HIAWATHA RUBBER CO. 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
004 2022-01-01 PLAN SPONSOR 2023-07-24
004 2021-01-01 PLAN SPONSOR 2022-07-26
004 2020-01-01 PLAN SPONSOR 2021-06-11
004 2019-01-01 PLAN SPONSOR 2020-07-31
004 2018-01-01 PLAN SPONSOR 2019-06-20
004 2017-01-01 PLAN SPONSOR 2018-05-11
004 2016-01-01 PLAN SPONSOR 2017-09-01
004 2016-01-01 PLAN SPONSOR 2019-01-14
004 2016-01-01 PLAN SPONSOR 2018-12-06
004 2015-01-01 THELMA BOCANEGRA 2016-10-06
004 2014-01-01 THELMA BOCANEGRA 2015-08-24
004 2013-01-01 THOMAS POPEHN 2014-07-15 THOMAS POPEHN 2014-07-15
004 2012-01-01 THOMAS POPEHN 2013-10-10 THOMAS POPEHN 2013-10-10
004 2011-01-01 TOM J POPEHN
004 2010-01-01 RICHARD L. DORALE

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
004	2022-01-01	PLAN SPONSOR	2023-07-24
004	2021-01-01	PLAN SPONSOR	2022-07-26
004	2020-01-01	PLAN SPONSOR	2021-06-11
004	2019-01-01	PLAN SPONSOR	2020-07-31
004	2018-01-01	PLAN SPONSOR	2019-06-20
004	2017-01-01	PLAN SPONSOR	2018-05-11
004	2016-01-01	PLAN SPONSOR	2017-09-01
004	2016-01-01	PLAN SPONSOR	2019-01-14
004	2016-01-01	PLAN SPONSOR	2018-12-06
004	2015-01-01	THELMA BOCANEGRA	2016-10-06
004	2014-01-01	THELMA BOCANEGRA	2015-08-24
004	2013-01-01	THOMAS POPEHN	2014-07-15	THOMAS POPEHN	2014-07-15
004	2012-01-01	THOMAS POPEHN	2013-10-10	THOMAS POPEHN	2013-10-10
004	2011-01-01	TOM J POPEHN
004	2010-01-01	RICHARD L. DORALE

Plan Statistics for HIAWATHA RUBBER CO. 401K PLAN

401k plan membership statisitcs for HIAWATHA RUBBER CO. 401K PLAN

Measure Date Value
2011: HIAWATHA RUBBER CO. 401K PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 67
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 56
Number of retired or separated participants receiving benefits 2011-01-01 1
Number of other retired or separated participants entitled to future benefits 2011-01-01 5
Total of all active and inactive participants 2011-01-01 62
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 62
Number of participants with account balances 2011-01-01 62
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 4
2010: HIAWATHA RUBBER CO. 401K PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 66
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 59
Number of retired or separated participants receiving benefits 2010-01-01 1
Number of other retired or separated participants entitled to future benefits 2010-01-01 7
Total of all active and inactive participants 2010-01-01 67
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 67
Number of participants with account balances 2010-01-01 66
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 2

Measure	Date	Value
2011: HIAWATHA RUBBER CO. 401K PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	67
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	56
Number of retired or separated participants receiving benefits	2011-01-01	1
Number of other retired or separated participants entitled to future benefits	2011-01-01	5
Total of all active and inactive participants	2011-01-01	62
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	62
Number of participants with account balances	2011-01-01	62
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	4
2010: HIAWATHA RUBBER CO. 401K PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	66
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	59
Number of retired or separated participants receiving benefits	2010-01-01	1
Number of other retired or separated participants entitled to future benefits	2010-01-01	7
Total of all active and inactive participants	2010-01-01	67
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	67
Number of participants with account balances	2010-01-01	66
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	2

Financial Data on HIAWATHA RUBBER CO. 401K PLAN

Measure	Date	Value
2011 : HIAWATHA RUBBER CO. 401K PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$366,962
Expenses. Total of all expenses incurred	2011-12-31	$607,039
Benefits paid (including direct rollovers)	2011-12-31	$585,064
Total plan assets at end of year	2011-12-31	$4,322,131
Total plan assets at beginning of year	2011-12-31	$4,562,208
Total contributions received or receivable from participants	2011-12-31	$187,977
Expenses. Other expenses not covered elsewhere	2011-12-31	$0
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$21,046
Net income (gross income less expenses)	2011-12-31	$-240,077
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$4,322,131
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$4,562,208
Assets. Value of participant loans	2011-12-31	$184,919
Total contributions received or receivable from employer(s)	2011-12-31	$157,939
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$21,975
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : HIAWATHA RUBBER CO. 401K PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$728,425
Expenses. Total of all expenses incurred	2010-12-31	$216,674
Benefits paid (including direct rollovers)	2010-12-31	$196,343
Total plan assets at end of year	2010-12-31	$4,562,208
Total plan assets at beginning of year	2010-12-31	$4,050,457
Total contributions received or receivable from participants	2010-12-31	$205,271
Expenses. Other expenses not covered elsewhere	2010-12-31	$0
Contributions received from other sources (not participants or employers)	2010-12-31	$5,293
Other income received	2010-12-31	$351,724
Net income (gross income less expenses)	2010-12-31	$511,751
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$4,562,208
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$4,050,457
Assets. Value of participant loans	2010-12-31	$194,330
Total contributions received or receivable from employer(s)	2010-12-31	$166,137
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$20,331
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0

Form 5500 Responses for HIAWATHA RUBBER CO. 401K PLAN

2011: HIAWATHA RUBBER CO. 401K PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: HIAWATHA RUBBER CO. 401K PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	Yes
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

FL 9761

Policy instance

Insurance contract or identification number	FL 9761
Number of Individuals Covered	62
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $5,000
Total amount of fees paid to insurance company	USD $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 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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

FL 9761

Policy instance

Insurance contract or identification number	FL 9761
Number of Individuals Covered	67
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $5,000
Total amount of fees paid to insurance company	USD $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 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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	HIAWATHA RUBBER CO.
Employer identification number (EIN):	410683256
NAIC Classification:	326200