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LIL' DRUG STORE PRODUCTS, INC. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan NameLIL' DRUG STORE PRODUCTS, INC. 401(K) PROFIT SHARING PLAN
Plan identification number 002

LIL' DRUG STORE PRODUCTS, INC. 401(K) PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • 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.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

LIL DRUG STORE PRODUCTS, INC. has sponsored the creation of one or more 401k plans.

Company Name:LIL DRUG STORE PRODUCTS, INC.
Employer identification number (EIN):421286385
NAIC Classification:445110
NAIC Description:Supermarkets and Other Grocery (except Convenience) Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LIL' DRUG STORE PRODUCTS, INC. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022022-01-01
0022021-01-01AMANDA BARNES2022-06-16
0022020-01-01
0022019-01-01
0022018-01-01AMANDA BARNES
0022017-01-01AMANDA BARNES
0022017-01-01AMANDA BARNES
0022016-01-01AMANDA BARNES
0022015-01-01LESA STOLLEY
0022014-01-01CHRISTOPHER DEWOLF2015-02-24
0022013-01-01CHRISTOPHER DEWOLF2014-02-25
0022012-01-01CHRISTOPHER DEWOLF2013-02-12
0022011-01-01CHRISTOPHER DEWOLF2012-02-29
0022010-01-01CHRISTOPHER DEWOLF2012-04-10

Plan Statistics for LIL' DRUG STORE PRODUCTS, INC. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for LIL' DRUG STORE PRODUCTS, INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2022: LIL' DRUG STORE PRODUCTS, INC. 401(K) PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01152
Total number of active participants reported on line 7a of the Form 55002022-01-01136
Number of retired or separated participants receiving benefits2022-01-011
Number of other retired or separated participants entitled to future benefits2022-01-0115
Total of all active and inactive participants2022-01-01152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01152
Number of participants with account balances2022-01-01142
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-013
2020: LIL' DRUG STORE PRODUCTS, INC. 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01105
Total number of active participants reported on line 7a of the Form 55002020-01-01102
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-017
Total of all active and inactive participants2020-01-01109
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01109
Number of participants with account balances2020-01-0174
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-013
2019: LIL' DRUG STORE PRODUCTS, INC. 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0173
Total number of active participants reported on line 7a of the Form 55002019-01-01100
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-015
Total of all active and inactive participants2019-01-01105
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01105
Number of participants with account balances2019-01-0170
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-011
2018: LIL' DRUG STORE PRODUCTS, INC. 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0167
Total number of active participants reported on line 7a of the Form 55002018-01-0169
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-014
Total of all active and inactive participants2018-01-0173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0173
Number of participants with account balances2018-01-0159
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: LIL' DRUG STORE PRODUCTS, INC. 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0162
Total number of active participants reported on line 7a of the Form 55002017-01-0160
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-017
Total of all active and inactive participants2017-01-0167
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0167
Number of participants with account balances2017-01-0155
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: LIL' DRUG STORE PRODUCTS, INC. 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0162
Total number of active participants reported on line 7a of the Form 55002016-01-0156
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-016
Total of all active and inactive participants2016-01-0162
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0162
Number of participants with account balances2016-01-0149
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-012
2015: LIL' DRUG STORE PRODUCTS, INC. 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0181
Total number of active participants reported on line 7a of the Form 55002015-01-0158
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-014
Total of all active and inactive participants2015-01-0162
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0162
Number of participants with account balances2015-01-0148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010

Financial Data on LIL' DRUG STORE PRODUCTS, INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2022 : LIL' DRUG STORE PRODUCTS, INC. 401(K) PROFIT SHARING PLAN 2022 401k financial data
Total income from all sources (including contributions)2022-12-31$-858,181
Total of all expenses incurred2022-12-31$594,727
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$544,833
Value of total corrective distributions2022-12-31$2,145
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$1,735,533
Value of total assets at end of year2022-12-31$14,353,812
Value of total assets at beginning of year2022-12-31$15,806,720
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$47,749
Total interest from all sources2022-12-31$8,593
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$215,327
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$215,327
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$1,000,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$1,021,088
Participant contributions at end of year2022-12-31$74,637
Participant contributions at beginning of year2022-12-31$103,586
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$10,802
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$33
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$0
Administrative expenses (other) incurred2022-12-31$44,838
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-1,452,908
Value of net assets at end of year (total assets less liabilities)2022-12-31$14,353,812
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$15,806,720
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Investment advisory and management fees2022-12-31$2,911
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$13,566,897
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$14,971,464
Interest on participant loans2022-12-31$5,769
Interest earned on other investments2022-12-31$2,824
Value of interest in common/collective trusts at end of year2022-12-31$383,104
Value of interest in common/collective trusts at beginning of year2022-12-31$281,715
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$4
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$4
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$329,141
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$449,951
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-2,739,125
Net investment gain or loss from common/collective trusts2022-12-31$-78,509
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$703,643
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$544,833
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32022-12-31No
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31JMM CPA
Accountancy firm EIN2022-12-31472940358
2020 : LIL' DRUG STORE PRODUCTS, INC. 401(K) PROFIT SHARING PLAN 2020 401k financial data
Transfers to/from the plan2020-12-31$0
Total plan liabilities at end of year2020-12-31$0
Total plan liabilities at beginning of year2020-12-31$0
Total income from all sources2020-12-31$2,410,702
Expenses. Total of all expenses incurred2020-12-31$1,180,906
Benefits paid (including direct rollovers)2020-12-31$1,179,571
Total plan assets at end of year2020-12-31$10,205,078
Total plan assets at beginning of year2020-12-31$8,975,282
Value of fidelity bond covering the plan2020-12-31$500,000
Assets. Value of tangible personal property2020-12-31$0
Total contributions received or receivable from participants2020-12-31$514,342
Assets. Value of loans (other than to participants)2020-12-31$0
Expenses. Other expenses not covered elsewhere2020-12-31$0
Contributions received from other sources (not participants or employers)2020-12-31$88,397
Other income received2020-12-31$1,635,086
Noncash contributions received2020-12-31$0
Net income (gross income less expenses)2020-12-31$1,229,796
Net plan assets at end of year (total assets less liabilities)2020-12-31$10,205,078
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$8,975,282
Assets. Value of participant loans2020-12-31$0
Assets. Value of assets in partnership/joint-venture interests2020-12-31$0
Assets. Value of real-estate (other than employer real property)2020-12-31$0
Assets. Value of employer securities2020-12-31$0
Assets. Value of employer real property2020-12-31$0
Total contributions received or receivable from employer(s)2020-12-31$172,877
Value of certain deemed distributions of participant loans2020-12-31$0
Value of corrective distributions2020-12-31$1,235
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$100
2019 : LIL' DRUG STORE PRODUCTS, INC. 401(K) PROFIT SHARING PLAN 2019 401k financial data
Transfers to/from the plan2019-12-31$0
Total plan liabilities at end of year2019-12-31$0
Total plan liabilities at beginning of year2019-12-31$0
Total income from all sources2019-12-31$2,532,958
Expenses. Total of all expenses incurred2019-12-31$407,536
Benefits paid (including direct rollovers)2019-12-31$407,511
Total plan assets at end of year2019-12-31$8,975,282
Total plan assets at beginning of year2019-12-31$6,849,860
Value of fidelity bond covering the plan2019-12-31$500,000
Total contributions received or receivable from participants2019-12-31$464,137
Expenses. Other expenses not covered elsewhere2019-12-31$0
Contributions received from other sources (not participants or employers)2019-12-31$180,234
Other income received2019-12-31$1,733,591
Noncash contributions received2019-12-31$0
Net income (gross income less expenses)2019-12-31$2,125,422
Net plan assets at end of year (total assets less liabilities)2019-12-31$8,975,282
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$6,849,860
Total contributions received or receivable from employer(s)2019-12-31$154,996
Value of certain deemed distributions of participant loans2019-12-31$0
Value of corrective distributions2019-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$25
2018 : LIL' DRUG STORE PRODUCTS, INC. 401(K) PROFIT SHARING PLAN 2018 401k financial data
Transfers to/from the plan2018-12-31$0
Total plan liabilities at end of year2018-12-31$0
Total plan liabilities at beginning of year2018-12-31$0
Total income from all sources2018-12-31$273,061
Expenses. Total of all expenses incurred2018-12-31$616,869
Benefits paid (including direct rollovers)2018-12-31$616,844
Total plan assets at end of year2018-12-31$6,849,860
Total plan assets at beginning of year2018-12-31$7,193,668
Value of fidelity bond covering the plan2018-12-31$500,000
Total contributions received or receivable from participants2018-12-31$389,489
Expenses. Other expenses not covered elsewhere2018-12-31$0
Contributions received from other sources (not participants or employers)2018-12-31$216,289
Other income received2018-12-31$-463,741
Noncash contributions received2018-12-31$0
Net income (gross income less expenses)2018-12-31$-343,808
Net plan assets at end of year (total assets less liabilities)2018-12-31$6,849,860
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$7,193,668
Total contributions received or receivable from employer(s)2018-12-31$131,024
Value of certain deemed distributions of participant loans2018-12-31$0
Value of corrective distributions2018-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$25
2017 : LIL' DRUG STORE PRODUCTS, INC. 401(K) PROFIT SHARING PLAN 2017 401k financial data
Transfers to/from the plan2017-12-31$0
Total plan liabilities at end of year2017-12-31$0
Total plan liabilities at beginning of year2017-12-31$0
Total income from all sources2017-12-31$1,687,020
Expenses. Total of all expenses incurred2017-12-31$864,850
Benefits paid (including direct rollovers)2017-12-31$860,020
Total plan assets at end of year2017-12-31$7,193,668
Total plan assets at beginning of year2017-12-31$6,371,498
Value of fidelity bond covering the plan2017-12-31$500,000
Assets. Value of tangible personal property2017-12-31$0
Total contributions received or receivable from participants2017-12-31$338,032
Assets. Value of loans (other than to participants)2017-12-31$0
Expenses. Other expenses not covered elsewhere2017-12-31$0
Contributions received from other sources (not participants or employers)2017-12-31$0
Other income received2017-12-31$1,216,663
Noncash contributions received2017-12-31$0
Net income (gross income less expenses)2017-12-31$822,170
Net plan assets at end of year (total assets less liabilities)2017-12-31$7,193,668
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$6,371,498
Assets. Value of participant loans2017-12-31$0
Assets. Value of assets in partnership/joint-venture interests2017-12-31$0
Assets. Value of real-estate (other than employer real property)2017-12-31$0
Assets. Value of employer securities2017-12-31$0
Assets. Value of employer real property2017-12-31$0
Total contributions received or receivable from employer(s)2017-12-31$132,325
Value of certain deemed distributions of participant loans2017-12-31$0
Value of corrective distributions2017-12-31$4,805
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$25
2016 : LIL' DRUG STORE PRODUCTS, INC. 401(K) PROFIT SHARING PLAN 2016 401k financial data
Transfers to/from the plan2016-12-31$0
Total plan liabilities at end of year2016-12-31$0
Total plan liabilities at beginning of year2016-12-31$0
Total income from all sources2016-12-31$924,200
Expenses. Total of all expenses incurred2016-12-31$210,626
Benefits paid (including direct rollovers)2016-12-31$210,626
Total plan assets at end of year2016-12-31$6,371,498
Total plan assets at beginning of year2016-12-31$5,657,924
Value of fidelity bond covering the plan2016-12-31$500,000
Total contributions received or receivable from participants2016-12-31$351,304
Expenses. Other expenses not covered elsewhere2016-12-31$0
Contributions received from other sources (not participants or employers)2016-12-31$20,218
Other income received2016-12-31$424,256
Noncash contributions received2016-12-31$0
Net income (gross income less expenses)2016-12-31$713,574
Net plan assets at end of year (total assets less liabilities)2016-12-31$6,371,498
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$5,657,924
Total contributions received or receivable from employer(s)2016-12-31$128,422
Value of certain deemed distributions of participant loans2016-12-31$0
Value of corrective distributions2016-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$0
2015 : LIL' DRUG STORE PRODUCTS, INC. 401(K) PROFIT SHARING PLAN 2015 401k financial data
Transfers to/from the plan2015-12-31$0
Total plan liabilities at end of year2015-12-31$0
Total plan liabilities at beginning of year2015-12-31$0
Total income from all sources2015-12-31$429,935
Expenses. Total of all expenses incurred2015-12-31$966,385
Benefits paid (including direct rollovers)2015-12-31$966,385
Total plan assets at end of year2015-12-31$5,657,924
Total plan assets at beginning of year2015-12-31$6,194,374
Value of fidelity bond covering the plan2015-12-31$500,000
Total contributions received or receivable from participants2015-12-31$356,548
Expenses. Other expenses not covered elsewhere2015-12-31$0
Contributions received from other sources (not participants or employers)2015-12-31$0
Other income received2015-12-31$73,387
Noncash contributions received2015-12-31$0
Net income (gross income less expenses)2015-12-31$-536,450
Net plan assets at end of year (total assets less liabilities)2015-12-31$5,657,924
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$6,194,374
Total contributions received or receivable from employer(s)2015-12-31$0
Value of certain deemed distributions of participant loans2015-12-31$0
Value of corrective distributions2015-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$0

Form 5500 Responses for LIL' DRUG STORE PRODUCTS, INC. 401(K) PROFIT SHARING PLAN

2022: LIL' DRUG STORE PRODUCTS, INC. 401(K) PROFIT SHARING PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2020: LIL' DRUG STORE PRODUCTS, INC. 401(K) PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01This submission is the final filingNo
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement - TrustYes
2019: LIL' DRUG STORE PRODUCTS, INC. 401(K) PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement - TrustYes
2018: LIL' DRUG STORE PRODUCTS, INC. 401(K) PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement - TrustYes
2017: LIL' DRUG STORE PRODUCTS, INC. 401(K) PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement - TrustYes
2016: LIL' DRUG STORE PRODUCTS, INC. 401(K) PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: LIL' DRUG STORE PRODUCTS, INC. 401(K) PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number53878
Policy instance 1
Insurance contract or identification number53878
Number of Individuals Covered142
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $800
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $200
Insurance broker organization code?3

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