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ADAMS LAND & CATTLE LLC HEALTH PLAN 401k Plan overview

Plan NameADAMS LAND & CATTLE LLC HEALTH PLAN
Plan identification number 504

ADAMS LAND & CATTLE LLC HEALTH PLAN Benefits

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

401k Sponsoring company profile

ADAMS LAND AND CATTLE, LLC has sponsored the creation of one or more 401k plans.

Company Name:ADAMS LAND AND CATTLE, LLC
Employer identification number (EIN):470549633
NAIC Classification:112112
NAIC Description:Cattle Feedlots

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ADAMS LAND & CATTLE LLC HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042016-01-01AMY CYBORON AMY CYBORON2017-06-26
5042015-01-01AMY CYBORON AMY CYBORON2016-06-08
5042014-01-01STEPHANIE MILLER STEPHANIE MILLER2015-06-15
5042013-01-01STEPHANIE MILLER STEPHANIE MILLER2014-03-17
5042012-01-01STEPHANIE MILLER
5042011-01-01STEPHANIE MILLER
5042010-01-01STEPHANIE MILLER
5042009-01-01STEPHANIE MILLER STEPHANIE MILLER2010-07-28
5042009-01-01STEPHANIE MILLER STEPHANIE MILLER2010-07-29
5042009-01-01STEPHANIE MILLER
5042009-01-01STEPHANIE MILLER
5042009-01-01STEPHANIE MILLER STEPHANIE MILLER2010-07-29
5042008-01-01STEPHANIE MILLER
5042007-01-01STEPHANIE MILLER
5042006-01-01STEPHANIE MILLER
5042005-01-01STEPHANIE MILLER
5042005-01-01STEPHANIE MILLER
5042004-01-01STEPHANIE MILLER
5042004-01-01STEPHANIE MILLER
5042003-04-01STEPHANIE MILLER
5042003-04-01STEPHANIE MILLER
5042002-04-01STEPHANIE MILLER
5042002-04-01STEPHANIE MILLER
5042001-04-01STEPHANIE MILLER

Plan Statistics for ADAMS LAND & CATTLE LLC HEALTH PLAN

401k plan membership statisitcs for ADAMS LAND & CATTLE LLC HEALTH PLAN

Measure Date Value
2016: ADAMS LAND & CATTLE LLC HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01145
Total of all active and inactive participants2016-01-010
2015: ADAMS LAND & CATTLE LLC HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01121
Total number of active participants reported on line 7a of the Form 55002015-01-01145
Total of all active and inactive participants2015-01-01145
2014: ADAMS LAND & CATTLE LLC HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01126
Total number of active participants reported on line 7a of the Form 55002014-01-01121
Total of all active and inactive participants2014-01-01121
2013: ADAMS LAND & CATTLE LLC HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01142
Total number of active participants reported on line 7a of the Form 55002013-01-01127
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
2012: ADAMS LAND & CATTLE LLC HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01112
Total number of active participants reported on line 7a of the Form 55002012-01-01142
Total of all active and inactive participants2012-01-01142
2011: ADAMS LAND & CATTLE LLC HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01111
Total number of active participants reported on line 7a of the Form 55002011-01-01112
Total of all active and inactive participants2011-01-01112
2010: ADAMS LAND & CATTLE LLC HEALTH PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01110
Total number of active participants reported on line 7a of the Form 55002010-01-01111
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-01111
2009: ADAMS LAND & CATTLE LLC HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01103
Total number of active participants reported on line 7a of the Form 55002009-01-01110
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01110
2008: ADAMS LAND & CATTLE LLC HEALTH PLAN 2008 401k membership
Total participants, beginning-of-year2008-01-01103
Total number of active participants reported on line 7a of the Form 55002008-01-01103
Total of all active and inactive participants2008-01-01103
Total participants2008-01-01103
2007: ADAMS LAND & CATTLE LLC HEALTH PLAN 2007 401k membership
Total participants, beginning-of-year2007-01-01110
Total number of active participants reported on line 7a of the Form 55002007-01-01103
Total of all active and inactive participants2007-01-01103
Total participants2007-01-01103
2006: ADAMS LAND & CATTLE LLC HEALTH PLAN 2006 401k membership
Total participants, beginning-of-year2006-01-01110
Total number of active participants reported on line 7a of the Form 55002006-01-01102
Total of all active and inactive participants2006-01-01102
Total participants2006-01-01102
2005: ADAMS LAND & CATTLE LLC HEALTH PLAN 2005 401k membership
Total participants, beginning-of-year2005-01-01113
Total number of active participants reported on line 7a of the Form 55002005-01-01110
Total of all active and inactive participants2005-01-01110
Total participants2005-01-01110
2004: ADAMS LAND & CATTLE LLC HEALTH PLAN 2004 401k membership
Total participants, beginning-of-year2004-01-01100
Total number of active participants reported on line 7a of the Form 55002004-01-01113
Total of all active and inactive participants2004-01-01113
Total participants2004-01-01113
2003: ADAMS LAND & CATTLE LLC HEALTH PLAN 2003 401k membership
Total participants, beginning-of-year2003-04-01111
Total number of active participants reported on line 7a of the Form 55002003-04-01100
Total of all active and inactive participants2003-04-01100
Total participants2003-04-01100
2002: ADAMS LAND & CATTLE LLC HEALTH PLAN 2002 401k membership
Total participants, beginning-of-year2002-04-01124
Total number of active participants reported on line 7a of the Form 55002002-04-01111
Total of all active and inactive participants2002-04-01111
Total participants2002-04-01111
2001: ADAMS LAND & CATTLE LLC HEALTH PLAN 2001 401k membership
Total participants, beginning-of-year2001-04-01124
Total number of active participants reported on line 7a of the Form 55002001-04-01124
Total of all active and inactive participants2001-04-01124
Total participants2001-04-01124

Form 5500 Responses for ADAMS LAND & CATTLE LLC HEALTH PLAN

2016: ADAMS LAND & CATTLE LLC HEALTH 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 filingYes
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 – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: ADAMS LAND & CATTLE LLC HEALTH 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 – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: ADAMS LAND & CATTLE LLC HEALTH PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: ADAMS LAND & CATTLE LLC HEALTH PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: ADAMS LAND & CATTLE LLC HEALTH PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: ADAMS LAND & CATTLE LLC HEALTH PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedYes
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: ADAMS LAND & CATTLE LLC HEALTH PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: ADAMS LAND & CATTLE LLC HEALTH PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes
2008: ADAMS LAND & CATTLE LLC HEALTH PLAN 2008 form 5500 responses
2008-01-01Type of plan entitySingle employer plan
2008-01-01Plan funding arrangement – General assets of the sponsorYes
2008-01-01Plan benefit arrangement – General assets of the sponsorYes
2007: ADAMS LAND & CATTLE LLC HEALTH PLAN 2007 form 5500 responses
2007-01-01Type of plan entitySingle employer plan
2007-01-01Plan funding arrangement – InsuranceYes
2007-01-01Plan benefit arrangement – InsuranceYes
2006: ADAMS LAND & CATTLE LLC HEALTH PLAN 2006 form 5500 responses
2006-01-01Type of plan entitySingle employer plan
2006-01-01Plan funding arrangement – InsuranceYes
2006-01-01Plan benefit arrangement – InsuranceYes
2005: ADAMS LAND & CATTLE LLC HEALTH PLAN 2005 form 5500 responses
2005-01-01Type of plan entitySingle employer plan
2005-01-01Submission has been amendedYes
2005-01-01Plan funding arrangement – InsuranceYes
2005-01-01Plan benefit arrangement – InsuranceYes
2004: ADAMS LAND & CATTLE LLC HEALTH PLAN 2004 form 5500 responses
2004-01-01Type of plan entitySingle employer plan
2004-01-01Submission has been amendedYes
2004-01-01Plan funding arrangement – InsuranceYes
2004-01-01Plan benefit arrangement – InsuranceYes
2003: ADAMS LAND & CATTLE LLC HEALTH PLAN 2003 form 5500 responses
2003-04-01Type of plan entitySingle employer plan
2003-04-01Submission has been amendedYes
2003-04-01This return/report is a short plan year return/report (less than 12 months)Yes
2003-04-01Plan funding arrangement – InsuranceYes
2003-04-01Plan benefit arrangement – InsuranceYes
2002: ADAMS LAND & CATTLE LLC HEALTH PLAN 2002 form 5500 responses
2002-04-01Type of plan entitySingle employer plan
2002-04-01Submission has been amendedYes
2002-04-01Plan funding arrangement – InsuranceYes
2002-04-01Plan benefit arrangement – InsuranceYes
2001: ADAMS LAND & CATTLE LLC HEALTH PLAN 2001 form 5500 responses
2001-04-01Type of plan entitySingle employer plan
2001-04-01First time form 5500 has been submittedYes
2001-04-01Plan funding arrangement – InsuranceYes
2001-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 )
Policy contract numberUS439412
Policy instance 1
Insurance contract or identification numberUS439412
Number of Individuals Covered337
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $57,768
Total amount of fees paid to insurance companyUSD $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 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 $385,118
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,512
Insurance broker organization code?3
Insurance broker nameBENEFIT ADMINISTRATION SYSTEMS, LLC
INTERNATIONAL INSURANCE AGENCY (National Association of Insurance Commissioners NAIC id number: 86355 )
Policy contract numberXBS-10-0075-1
Policy instance 1
Insurance contract or identification numberXBS-10-0075-1
Number of Individuals Covered286
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $47,321
Total amount of fees paid to insurance companyUSD $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 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 $315,471
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,547
Insurance broker organization code?3
Insurance broker nameBENEFIT ADMINISTRATION SYSTEMS, LLC
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number404497-A
Policy instance 1
Insurance contract or identification number404497-A
Number of Individuals Covered296
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $39,403
Total amount of fees paid to insurance companyUSD $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 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 $262,687
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,269
Insurance broker organization code?3
Insurance broker nameBENEFIT ADMINISTRATION SYSTEMS, LLC
BLUE CROSS BLUE SHIELD OF NEBRASKA (National Association of Insurance Commissioners NAIC id number: 77780 )
Policy contract number300216
Policy instance 1
Insurance contract or identification number300216
Number of Individuals Covered277
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF NEBRASKA (National Association of Insurance Commissioners NAIC id number: 77780 )
Policy contract number04842
Policy instance 1
Insurance contract or identification number04842
Number of Individuals Covered224
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF NEBRASKA (National Association of Insurance Commissioners NAIC id number: 77780 )
Policy contract number04842
Policy instance 1
Insurance contract or identification number04842
Number of Individuals Covered217
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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