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EMPORIA WHOLESALE COFFEE COMPANY EMPLOYEE BENEFIT TRUST 401k Plan overview

Plan NameEMPORIA WHOLESALE COFFEE COMPANY EMPLOYEE BENEFIT TRUST
Plan identification number 503

EMPORIA WHOLESALE COFFEE COMPANY EMPLOYEE BENEFIT TRUST Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Temporary disability (accident and sickness)

401k Sponsoring company profile

EMPORIA WHOLESALE COFFEE COMPANY has sponsored the creation of one or more 401k plans.

Company Name:EMPORIA WHOLESALE COFFEE COMPANY
Employer identification number (EIN):480209630
NAIC Classification:424400

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPORIA WHOLESALE COFFEE COMPANY EMPLOYEE BENEFIT TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032022-01-01DAVID C EVANS2023-07-31
5032021-01-01DAVID C EVANS2022-07-31
5032020-01-01DAVID C EVANS2021-08-31
5032019-01-01DAVID C EVANS2020-07-25
5032018-01-01DAVID C EVANS2019-07-29
5032017-01-01DAVID C EVANS2018-10-15
5032016-01-01DAVID C EVANS2017-07-25
5032015-01-01DAVID C EVANS2016-07-12
5032014-01-01DAVID C. EVANS2015-08-17
5032013-01-01DAVID C. EVANS2014-09-02
5032012-01-01DAVID C. EVANS
5032011-01-01DAVID C. EVANS
5032010-01-01DAVID C. EVANS
5032009-01-01DAVID C. EVANS

Plan Statistics for EMPORIA WHOLESALE COFFEE COMPANY EMPLOYEE BENEFIT TRUST

401k plan membership statisitcs for EMPORIA WHOLESALE COFFEE COMPANY EMPLOYEE BENEFIT TRUST

Measure Date Value
2012: EMPORIA WHOLESALE COFFEE COMPANY EMPLOYEE BENEFIT TRUST 2012 401k membership
Total participants, beginning-of-year2012-01-01106
Total number of active participants reported on line 7a of the Form 55002012-01-01161
Total of all active and inactive participants2012-01-01161
2011: EMPORIA WHOLESALE COFFEE COMPANY EMPLOYEE BENEFIT TRUST 2011 401k membership
Total participants, beginning-of-year2011-01-01102
Total number of active participants reported on line 7a of the Form 55002011-01-01106
Total of all active and inactive participants2011-01-01106
2010: EMPORIA WHOLESALE COFFEE COMPANY EMPLOYEE BENEFIT TRUST 2010 401k membership
Total participants, beginning-of-year2010-01-01114
Total number of active participants reported on line 7a of the Form 55002010-01-01102
Total of all active and inactive participants2010-01-01102
2009: EMPORIA WHOLESALE COFFEE COMPANY EMPLOYEE BENEFIT TRUST 2009 401k membership
Total participants, beginning-of-year2009-01-01135
Total number of active participants reported on line 7a of the Form 55002009-01-01114
Total of all active and inactive participants2009-01-01114

Financial Data on EMPORIA WHOLESALE COFFEE COMPANY EMPLOYEE BENEFIT TRUST

Measure Date Value
2012 : EMPORIA WHOLESALE COFFEE COMPANY EMPLOYEE BENEFIT TRUST 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$580
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$323
Total income from all sources (including contributions)2012-12-31$760,821
Total of all expenses incurred2012-12-31$867,975
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$825,067
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$754,749
Value of total assets at end of year2012-12-31$486,471
Value of total assets at beginning of year2012-12-31$593,368
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$42,908
Total interest from all sources2012-12-31$1,807
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$325,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$273,015
Participant contributions at end of year2012-12-31$20,604
Participant contributions at beginning of year2012-12-31$21,290
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$32,014
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$17,948
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$1,508
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-12-31$580
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$323
Other income not declared elsewhere2012-12-31$4,265
Total non interest bearing cash at end of year2012-12-31$166,073
Total non interest bearing cash at beginning of year2012-12-31$365,397
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$-107,154
Value of net assets at end of year (total assets less liabilities)2012-12-31$485,891
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$593,045
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$281,846
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$205,173
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$205,173
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$1,807
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$199,658
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$449,720
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$625,409
Contract administrator fees2012-12-31$42,908
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-12-31No
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31THOMAS H. SEWELL, CPA, LLC
Accountancy firm EIN2012-12-31383805788
2011 : EMPORIA WHOLESALE COFFEE COMPANY EMPLOYEE BENEFIT TRUST 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$323
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$1,496
Total income from all sources (including contributions)2011-12-31$994,232
Total of all expenses incurred2011-12-31$867,202
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$835,184
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$943,656
Value of total assets at end of year2011-12-31$593,368
Value of total assets at beginning of year2011-12-31$467,511
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$32,018
Total interest from all sources2011-12-31$1,693
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$300,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$294,602
Participant contributions at end of year2011-12-31$21,290
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$12,652
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$1,508
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$1,153
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-12-31$323
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-12-31$1,496
Other income not declared elsewhere2011-12-31$48,883
Total non interest bearing cash at end of year2011-12-31$365,397
Total non interest bearing cash at beginning of year2011-12-31$272,878
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$127,030
Value of net assets at end of year (total assets less liabilities)2011-12-31$593,045
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$466,015
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$205,173
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$193,480
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$193,480
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$1,693
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$219,840
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$636,402
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$615,344
Contract administrator fees2011-12-31$32,018
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-12-31No
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31THOMAS H. SEWELL, CPA, LLC
Accountancy firm EIN2011-12-31383805788
2010 : EMPORIA WHOLESALE COFFEE COMPANY EMPLOYEE BENEFIT TRUST 2010 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$1,496
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$1,333
Total income from all sources (including contributions)2010-12-31$1,236,993
Total of all expenses incurred2010-12-31$939,793
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$898,149
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$972,100
Value of total assets at end of year2010-12-31$467,511
Value of total assets at beginning of year2010-12-31$170,149
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$41,644
Total interest from all sources2010-12-31$1,459
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$300,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$299,246
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$1,153
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$4,289
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2010-12-31$1,496
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$1,333
Other income not declared elsewhere2010-12-31$263,434
Total non interest bearing cash at end of year2010-12-31$272,878
Total non interest bearing cash at beginning of year2010-12-31$74,017
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$297,200
Value of net assets at end of year (total assets less liabilities)2010-12-31$466,015
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$168,816
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$193,480
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$91,843
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$91,843
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$1,459
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$221,401
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$672,854
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$676,748
Contract administrator fees2010-12-31$41,644
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31No
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31THOMAS H. SEWELL, CPA, LLC
Accountancy firm EIN2010-12-31383805788

Form 5500 Responses for EMPORIA WHOLESALE COFFEE COMPANY EMPLOYEE BENEFIT TRUST

2012: EMPORIA WHOLESALE COFFEE COMPANY EMPLOYEE BENEFIT TRUST 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: EMPORIA WHOLESALE COFFEE COMPANY EMPLOYEE BENEFIT TRUST 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: EMPORIA WHOLESALE COFFEE COMPANY EMPLOYEE BENEFIT TRUST 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: EMPORIA WHOLESALE COFFEE COMPANY EMPLOYEE BENEFIT TRUST 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number403861
Policy instance 1
Insurance contract or identification number403861
Number of Individuals Covered87
Insurance policy start date2012-01-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $17,073
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $155,210
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,073
Insurance broker organization code?3
Insurance broker nameMUTUAL ASSURANCE AGENCY INC
BLUE CROSS BLUE SHIELD OF KANSAS (National Association of Insurance Commissioners NAIC id number: 70729 )
Policy contract number96450
Policy instance 2
Insurance contract or identification number96450
Number of Individuals Covered161
Insurance policy start date2012-09-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $59,076
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number013847
Policy instance 1
Insurance contract or identification number013847
Number of Individuals Covered103
Insurance policy start date2011-01-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $15,897
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $144,627
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number403861
Policy instance 2
Insurance contract or identification number403861
Number of Individuals Covered106
Insurance policy start date2011-09-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $6,179
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $58,234
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number013847
Policy instance 1
Insurance contract or identification number013847
Number of Individuals Covered102
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $29,977
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $221,401
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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