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LA COLOMBE HOLDINGS 401(K) PLAN 401k Plan overview

Plan NameLA COLOMBE HOLDINGS 401(K) PLAN
Plan identification number 001

LA COLOMBE HOLDINGS 401(K) 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.
  • 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

LA COLOMBE HOLDINGS, INC. has sponsored the creation of one or more 401k plans.

Company Name:LA COLOMBE HOLDINGS, INC.
Employer identification number (EIN):471649506
NAIC Classification:812990
NAIC Description:All Other Personal Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LA COLOMBE HOLDINGS 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01TIFFANY ARNOLD2023-10-16
0012021-01-01TIFFANY ARNOLD2022-10-14
0012020-01-01RACHEL HULTS2021-10-14
0012019-01-01CHUCK CHUPEIN2020-10-12
0012018-01-01CHUCK CHUPEIN2019-10-03
0012017-01-01
0012016-01-01

Plan Statistics for LA COLOMBE HOLDINGS 401(K) PLAN

401k plan membership statisitcs for LA COLOMBE HOLDINGS 401(K) PLAN

Measure Date Value
2022: LA COLOMBE HOLDINGS 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01560
Total number of active participants reported on line 7a of the Form 55002022-01-01472
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01472
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01472
Number of participants with account balances2022-01-01306
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-014
2021: LA COLOMBE HOLDINGS 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01569
Total number of active participants reported on line 7a of the Form 55002021-01-01540
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0120
Total of all active and inactive participants2021-01-01560
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01560
Number of participants with account balances2021-01-01223
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: LA COLOMBE HOLDINGS 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01727
Total number of active participants reported on line 7a of the Form 55002020-01-01518
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0151
Total of all active and inactive participants2020-01-01569
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01569
Number of participants with account balances2020-01-01197
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: LA COLOMBE HOLDINGS 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01578
Total number of active participants reported on line 7a of the Form 55002019-01-01541
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-01186
Total of all active and inactive participants2019-01-01727
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01727
Number of participants with account balances2019-01-01186
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: LA COLOMBE HOLDINGS 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01550
Total number of active participants reported on line 7a of the Form 55002018-01-01540
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0138
Total of all active and inactive participants2018-01-01578
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01578
Number of participants with account balances2018-01-01160
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: LA COLOMBE HOLDINGS 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01326
Total number of active participants reported on line 7a of the Form 55002017-01-01520
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0130
Total of all active and inactive participants2017-01-01550
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01550
Number of participants with account balances2017-01-01129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: LA COLOMBE HOLDINGS 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01198
Total number of active participants reported on line 7a of the Form 55002016-01-01299
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0127
Total of all active and inactive participants2016-01-01326
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01326
Number of participants with account balances2016-01-0198
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010

Financial Data on LA COLOMBE HOLDINGS 401(K) PLAN

Measure Date Value
2022 : LA COLOMBE HOLDINGS 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$881,434
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$548,337
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$481,591
Expenses. Certain deemed distributions of participant loans2022-12-31$10,343
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$2,205,856
Value of total assets at end of year2022-12-31$7,411,782
Value of total assets at beginning of year2022-12-31$7,078,685
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$56,403
Total interest from all sources2022-12-31$4,808
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Administrative expenses professional fees incurred2022-12-31$56,403
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
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$1,446,055
Participant contributions at end of year2022-12-31$41,275
Participant contributions at beginning of year2022-12-31$36,677
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$115,081
Other income not declared elsewhere2022-12-31$14,256
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$333,097
Value of net assets at end of year (total assets less liabilities)2022-12-31$7,411,782
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$7,078,685
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
Value of interest in pooled separate accounts at end of year2022-12-31$7,075,239
Value of interest in pooled separate accounts at beginning of year2022-12-31$6,925,535
Interest on participant loans2022-12-31$1,583
Interest earned on other investments2022-12-31$3,225
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$295,268
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$116,473
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-1,343,486
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$644,720
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$481,591
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 name2022-12-31BOWMAN & COMPANY LLP
Accountancy firm EIN2022-12-31210658561
2021 : LA COLOMBE HOLDINGS 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$2,086,214
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$287,848
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$236,710
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$1,064,657
Value of total assets at end of year2021-12-31$7,078,685
Value of total assets at beginning of year2021-12-31$5,280,319
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$51,138
Total interest from all sources2021-12-31$2,345
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Administrative expenses professional fees incurred2021-12-31$51,138
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$1,045,828
Participant contributions at end of year2021-12-31$36,677
Participant contributions at beginning of year2021-12-31$54,022
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$18,829
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$1,798,366
Value of net assets at end of year (total assets less liabilities)2021-12-31$7,078,685
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$5,280,319
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in pooled separate accounts at end of year2021-12-31$6,925,535
Value of interest in pooled separate accounts at beginning of year2021-12-31$5,130,275
Interest on participant loans2021-12-31$2,345
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$116,473
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$96,022
Net investment gain/loss from pooled separate accounts2021-12-31$1,019,212
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$236,710
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Disclaimer
Accountancy firm name2021-12-31BOWMAN & COMPANY LLP
Accountancy firm EIN2021-12-31210658561
2020 : LA COLOMBE HOLDINGS 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$1,627,022
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$226,250
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$190,087
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$895,172
Value of total assets at end of year2020-12-31$5,280,319
Value of total assets at beginning of year2020-12-31$3,879,547
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$36,163
Total interest from all sources2020-12-31$3,218
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Administrative expenses professional fees incurred2020-12-31$36,163
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$723,805
Participant contributions at end of year2020-12-31$54,022
Participant contributions at beginning of year2020-12-31$70,386
Participant contributions at end of year2020-12-31$0
Participant contributions at beginning of year2020-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$39,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$1,400,772
Value of net assets at end of year (total assets less liabilities)2020-12-31$5,280,319
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$3,879,547
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$0
Value of interest in pooled separate accounts at end of year2020-12-31$5,130,275
Value of interest in pooled separate accounts at beginning of year2020-12-31$3,730,291
Interest on participant loans2020-12-31$3,218
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$96,022
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$78,870
Net investment gain/loss from pooled separate accounts2020-12-31$728,632
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$132,367
Employer contributions (assets) at end of year2020-12-31$0
Employer contributions (assets) at beginning of year2020-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$190,087
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31HAEFELE, FLANAGAN & CO., P.C.
Accountancy firm EIN2020-12-31223008776
2019 : LA COLOMBE HOLDINGS 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$1,790,740
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$108,390
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$81,619
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$1,132,614
Value of total assets at end of year2019-12-31$3,879,547
Value of total assets at beginning of year2019-12-31$2,197,197
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$26,771
Total interest from all sources2019-12-31$3,505
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$752,246
Participant contributions at end of year2019-12-31$70,386
Participant contributions at beginning of year2019-12-31$36,779
Participant contributions at end of year2019-12-31$0
Participant contributions at beginning of year2019-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$12,186
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$1,682,350
Value of net assets at end of year (total assets less liabilities)2019-12-31$3,879,547
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$2,197,197
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$0
Value of interest in pooled separate accounts at end of year2019-12-31$3,730,291
Value of interest in pooled separate accounts at beginning of year2019-12-31$2,102,708
Interest on participant loans2019-12-31$3,505
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$78,870
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$57,710
Net investment gain/loss from pooled separate accounts2019-12-31$654,621
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$368,182
Employer contributions (assets) at end of year2019-12-31$0
Employer contributions (assets) at beginning of year2019-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$81,619
Contract administrator fees2019-12-31$26,771
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31HAEFELE, FLANAGAN & CO., P.C.
Accountancy firm EIN2019-12-31223008776
2018 : LA COLOMBE HOLDINGS 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$708,403
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$109,145
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$107,417
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$890,024
Value of total assets at end of year2018-12-31$2,197,197
Value of total assets at beginning of year2018-12-31$1,597,939
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$1,728
Total interest from all sources2018-12-31$1,902
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$599,924
Participant contributions at end of year2018-12-31$36,779
Participant contributions at beginning of year2018-12-31$31,190
Participant contributions at end of year2018-12-31$0
Participant contributions at beginning of year2018-12-31$8,185
Other income not declared elsewhere2018-12-31$4,637
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$599,258
Value of net assets at end of year (total assets less liabilities)2018-12-31$2,197,197
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$1,597,939
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$0
Value of interest in pooled separate accounts at end of year2018-12-31$2,102,708
Value of interest in pooled separate accounts at beginning of year2018-12-31$1,475,304
Income. Interest from loans (other than to participants)2018-12-31$1,902
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$57,710
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$66,927
Net investment gain/loss from pooled separate accounts2018-12-31$-188,160
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$290,100
Employer contributions (assets) at end of year2018-12-31$0
Employer contributions (assets) at beginning of year2018-12-31$16,333
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$107,417
Contract administrator fees2018-12-31$1,728
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31No
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31HAEFELE, FLANAGAN & CO., P.C.
Accountancy firm EIN2018-12-31223008776
2017 : LA COLOMBE HOLDINGS 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total transfer of assets to this plan2017-12-31$442
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$824,753
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$7,093
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$6,607
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$651,288
Value of total assets at end of year2017-12-31$1,597,939
Value of total assets at beginning of year2017-12-31$779,837
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$486
Total interest from all sources2017-12-31$778
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$417,194
Participant contributions at end of year2017-12-31$31,190
Participant contributions at beginning of year2017-12-31$16,318
Participant contributions at end of year2017-12-31$8,185
Participant contributions at beginning of year2017-12-31$0
Other income not declared elsewhere2017-12-31$539
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$817,660
Value of net assets at end of year (total assets less liabilities)2017-12-31$1,597,939
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$779,837
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$0
Value of interest in pooled separate accounts at end of year2017-12-31$1,475,304
Value of interest in pooled separate accounts at beginning of year2017-12-31$746,805
Income. Interest from loans (other than to participants)2017-12-31$778
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$66,927
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$16,714
Net investment gain/loss from pooled separate accounts2017-12-31$172,148
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$234,094
Employer contributions (assets) at end of year2017-12-31$16,333
Employer contributions (assets) at beginning of year2017-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$6,607
Contract administrator fees2017-12-31$486
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31HAEFELE, FLANAGAN & CO., P.C.
Accountancy firm EIN2017-12-31223008776
2016 : LA COLOMBE HOLDINGS 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total transfer of assets to this plan2016-12-31$88,947
Total transfer of assets from this plan2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total income from all sources (including contributions)2016-12-31$477,504
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$2,253
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$0
Value of total corrective distributions2016-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$437,591
Value of total assets at end of year2016-12-31$779,837
Value of total assets at beginning of year2016-12-31$215,639
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$2,253
Total interest from all sources2016-12-31$450
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$252,232
Participant contributions at end of year2016-12-31$16,318
Participant contributions at beginning of year2016-12-31$4,123
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$43,628
Other income not declared elsewhere2016-12-31$1,358
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$475,251
Value of net assets at end of year (total assets less liabilities)2016-12-31$779,837
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$215,639
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$199,515
Value of interest in pooled separate accounts at end of year2016-12-31$746,805
Value of interest in pooled separate accounts at beginning of year2016-12-31$0
Interest on participant loans2016-12-31$450
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$12,001
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$12,001
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$16,714
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$0
Net investment gain/loss from pooled separate accounts2016-12-31$38,105
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$141,731
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$0
Contract administrator fees2016-12-31$2,253
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31HAEFELE FLANAGAN
Accountancy firm EIN2016-12-31223008776

Form 5500 Responses for LA COLOMBE HOLDINGS 401(K) PLAN

2022: LA COLOMBE HOLDINGS 401(K) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: LA COLOMBE HOLDINGS 401(K) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: LA COLOMBE HOLDINGS 401(K) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: LA COLOMBE HOLDINGS 401(K) 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 – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: LA COLOMBE HOLDINGS 401(K) 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 – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: LA COLOMBE HOLDINGS 401(K) 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
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: LA COLOMBE HOLDINGS 401(K) 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 – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberGA-838622
Policy instance 1
Insurance contract or identification numberGA-838622
Number of Individuals Covered306
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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?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?Yes
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
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerTHIRD PARTY ADMINISTRATOR
Insurance broker organization code?5
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberGA-838622
Policy instance 1
Insurance contract or identification numberGA-838622
Number of Individuals Covered223
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $2,848
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?Yes
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
Amount paid for insurance broker fees2848
Additional information about fees paid to insurance brokerTHIRD PARTY ADMINISTRATOR
Insurance broker organization code?5
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberGA-838622
Policy instance 1
Insurance contract or identification numberGA-838622
Number of Individuals Covered197
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $1,935
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?Yes
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
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees1935
Additional information about fees paid to insurance brokerTHIRD PARTY ADMINISTRATOR
Insurance broker organization code?5
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberGA-838622
Policy instance 1
Insurance contract or identification numberGA-838622
Number of Individuals Covered185
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $219
Total amount of fees paid to insurance companyUSD $1,344
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?Yes
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
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees1344
Additional information about fees paid to insurance brokerTHIRD PARTY ADMINISTRATOR
Insurance broker organization code?5
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberGA-838622
Policy instance 1
Insurance contract or identification numberGA-838622
Number of Individuals Covered160
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $9,725
Total amount of fees paid to insurance companyUSD $1,406
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?Yes
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
Commission paid to Insurance BrokerUSD $9,725
Amount paid for insurance broker fees705
Additional information about fees paid to insurance brokerINSURANCE AGENT OR BROKER
Insurance broker organization code?3
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberGA-838622
Policy instance 1
Insurance contract or identification numberGA-838622
Number of Individuals Covered129
Insurance policy start date2017-04-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $5,312
Total amount of fees paid to insurance companyUSD $849
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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?Yes
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
Commission paid to Insurance BrokerUSD $5,312
Amount paid for insurance broker fees381
Additional information about fees paid to insurance brokerINSURANCE AGENT OR BROKER
Insurance broker organization code?3
Insurance broker nameCONTINENTAL BENEFITS GROUP, INC.

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