401k Plan data: FULGHUM FIBRES, INC EMPLOYEE HEALTH BENEFIT PLAN plan

FULGHUM FIBRES, INC EMPLOYEE HEALTH BENEFIT PLAN 401k Plan overview

Plan Name	FULGHUM FIBRES, INC EMPLOYEE HEALTH BENEFIT PLAN
Plan identification number	501

FULGHUM FIBRES, INC EMPLOYEE HEALTH BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

FULGHUM FIBRES, INC. has sponsored the creation of one or more 401k plans.

Company Name: FULGHUM FIBRES, INC.

Employer identification number (EIN): 581851973

NAIC Classification: 324190

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FULGHUM FIBRES, INC EMPLOYEE HEALTH BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2018-01-01
501 2013-01-01 JOE HEROLD JOE HEROLD 2014-10-08
501 2012-01-01 ANTHONY M. HAUFF
501 2011-01-01 ANTHONY M. HAUFF
501 2009-01-01 ANTHONY M. HAUFF

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2018-01-01
501	2013-01-01	JOE HEROLD	JOE HEROLD	2014-10-08
501	2012-01-01	ANTHONY M. HAUFF
501	2011-01-01	ANTHONY M. HAUFF
501	2009-01-01	ANTHONY M. HAUFF

Plan Statistics for FULGHUM FIBRES, INC EMPLOYEE HEALTH BENEFIT PLAN

401k plan membership statisitcs for FULGHUM FIBRES, INC EMPLOYEE HEALTH BENEFIT PLAN

Measure Date Value
2018: FULGHUM FIBRES, INC EMPLOYEE HEALTH BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 207
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 0
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 0
Total of all active and inactive participants 2018-01-01 0
2013: FULGHUM FIBRES, INC EMPLOYEE HEALTH BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 251
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 252
Total of all active and inactive participants 2013-01-01 252
Total participants 2013-01-01 252
2012: FULGHUM FIBRES, INC EMPLOYEE HEALTH BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 241
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 250
Number of retired or separated participants receiving benefits 2012-01-01 1
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 251
2011: FULGHUM FIBRES, INC EMPLOYEE HEALTH BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 247
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 241
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 241
2009: FULGHUM FIBRES, INC EMPLOYEE HEALTH BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 239
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 235
Number of retired or separated participants receiving benefits 2009-01-01 1
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 236

Measure	Date	Value
2018: FULGHUM FIBRES, INC EMPLOYEE HEALTH BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	207
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	0
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	0
2013: FULGHUM FIBRES, INC EMPLOYEE HEALTH BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	251
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	252
Total of all active and inactive participants	2013-01-01	252
Total participants	2013-01-01	252
2012: FULGHUM FIBRES, INC EMPLOYEE HEALTH BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	241
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	250
Number of retired or separated participants receiving benefits	2012-01-01	1
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	251
2011: FULGHUM FIBRES, INC EMPLOYEE HEALTH BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	247
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	241
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	241
2009: FULGHUM FIBRES, INC EMPLOYEE HEALTH BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	239
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	235
Number of retired or separated participants receiving benefits	2009-01-01	1
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	236

Financial Data on FULGHUM FIBRES, INC EMPLOYEE HEALTH BENEFIT PLAN

Measure	Date	Value
2013 : FULGHUM FIBRES, INC EMPLOYEE HEALTH BENEFIT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$309,297
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$237,584
Total income from all sources (including contributions)	2013-12-31	$2,196,216
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$2,662,462
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$1,911,171
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$2,136,632
Value of total assets at end of year	2013-12-31	$377,953
Value of total assets at beginning of year	2013-12-31	$772,486
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$751,291
Total interest from all sources	2013-12-31	$5
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$507,429
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$20,325
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$82,542
Other income not declared elsewhere	2013-12-31	$59,579
Administrative expenses (other) incurred	2013-12-31	$529,004
Total non interest bearing cash at end of year	2013-12-31	$42,076
Total non interest bearing cash at beginning of year	2013-12-31	$40,293
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$-466,246
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$68,656
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$534,902
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$23,052
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$56,979
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$56,979
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$5
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$1,629,203
Employer contributions (assets) at end of year	2013-12-31	$292,500
Employer contributions (assets) at beginning of year	2013-12-31	$592,672
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$1,911,171
Contract administrator fees	2013-12-31	$222,287
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2013-12-31	No
Liabilities. Value of benefit claims payable at end of year	2013-12-31	$309,297
Liabilities. Value of benefit claims payable at beginning of year	2013-12-31	$237,584
Did the plan have assets held for investment	2013-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	No
Opinion of an independent qualified public accountant for this plan	2013-12-31	Unqualified
Accountancy firm name	2013-12-31	FULLER, FROST & ASSOCIATES, CPA'S P
Accountancy firm EIN	2013-12-31	581631179
2012 : FULGHUM FIBRES, INC EMPLOYEE HEALTH BENEFIT PLAN 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$237,584
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$231,144
Total income from all sources (including contributions)	2012-12-31	$2,331,482
Total of all expenses incurred	2012-12-31	$2,658,485
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$1,953,404
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$2,017,325
Value of total assets at end of year	2012-12-31	$772,486
Value of total assets at beginning of year	2012-12-31	$1,093,049
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$705,081
Total interest from all sources	2012-12-31	$11
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$513,362
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-12-31	$82,542
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$79,603
Other income not declared elsewhere	2012-12-31	$314,146
Administrative expenses (other) incurred	2012-12-31	$522,865
Total non interest bearing cash at end of year	2012-12-31	$40,293
Total non interest bearing cash at beginning of year	2012-12-31	$38,411
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$-327,003
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$534,902
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$861,905
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$56,979
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$47,775
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$47,775
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$11
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$1,503,963
Employer contributions (assets) at end of year	2012-12-31	$592,672
Employer contributions (assets) at beginning of year	2012-12-31	$927,260
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$1,953,404
Contract administrator fees	2012-12-31	$182,216
Liabilities. Value of benefit claims payable at end of year	2012-12-31	$237,584
Liabilities. Value of benefit claims payable at beginning of year	2012-12-31	$231,144
Did the plan have assets held for investment	2012-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	No
Opinion of an independent qualified public accountant for this plan	2012-12-31	Unqualified
Accountancy firm name	2012-12-31	FULLER, FROST & ASSOCIATES,CPA'S PC
Accountancy firm EIN	2012-12-31	581631179
2011 : FULGHUM FIBRES, INC EMPLOYEE HEALTH BENEFIT PLAN 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$231,144
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$166,648
Total income from all sources (including contributions)	2011-12-31	$2,386,496
Total of all expenses incurred	2011-12-31	$2,819,865
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$2,149,366
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$2,204,751
Value of total assets at end of year	2011-12-31	$1,093,049
Value of total assets at beginning of year	2011-12-31	$1,461,922
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$670,499
Total interest from all sources	2011-12-31	$43
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$521,225
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$79,603
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$26,456
Other income not declared elsewhere	2011-12-31	$181,702
Administrative expenses (other) incurred	2011-12-31	$487,973
Total non interest bearing cash at end of year	2011-12-31	$38,411
Total non interest bearing cash at beginning of year	2011-12-31	$44,967
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$-433,369
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$861,905
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$1,295,274
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$47,775
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$44,279
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$44,279
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$43
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$1,683,526
Employer contributions (assets) at end of year	2011-12-31	$927,260
Employer contributions (assets) at beginning of year	2011-12-31	$1,346,220
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$2,149,366
Contract administrator fees	2011-12-31	$182,526
Liabilities. Value of benefit claims payable at end of year	2011-12-31	$231,144
Liabilities. Value of benefit claims payable at beginning of year	2011-12-31	$166,648
Did the plan have assets held for investment	2011-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	No
Opinion of an independent qualified public accountant for this plan	2011-12-31	Unqualified
Accountancy firm name	2011-12-31	FULLER, FROST & ASSOCIATES,CPA'S PC
Accountancy firm EIN	2011-12-31	581631179
2010 : FULGHUM FIBRES, INC EMPLOYEE HEALTH BENEFIT PLAN 2010 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$166,648
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$182,611
Total income from all sources (including contributions)	2010-12-31	$2,835,609
Total of all expenses incurred	2010-12-31	$2,783,004
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$2,121,205
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$2,755,319
Value of total assets at end of year	2010-12-31	$1,461,922
Value of total assets at beginning of year	2010-12-31	$1,425,280
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$661,799
Total interest from all sources	2010-12-31	$166
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$491,639
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$26,456
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$131,770
Other income not declared elsewhere	2010-12-31	$80,124
Administrative expenses (other) incurred	2010-12-31	$497,279
Total non interest bearing cash at end of year	2010-12-31	$44,967
Total non interest bearing cash at beginning of year	2010-12-31	$250
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$52,605
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$1,295,274
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$1,242,669
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$44,279
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$515,360
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$515,360
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$166
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$2,263,680
Employer contributions (assets) at end of year	2010-12-31	$1,346,220
Employer contributions (assets) at beginning of year	2010-12-31	$777,900
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$2,121,205
Contract administrator fees	2010-12-31	$164,520
Liabilities. Value of benefit claims payable at end of year	2010-12-31	$166,648
Liabilities. Value of benefit claims payable at beginning of year	2010-12-31	$182,611
Did the plan have assets held for investment	2010-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	No
Opinion of an independent qualified public accountant for this plan	2010-12-31	Unqualified
Accountancy firm name	2010-12-31	FULLER, FROST & ASSOCIATES,CPAS PC
Accountancy firm EIN	2010-12-31	581631179

Form 5500 Responses for FULGHUM FIBRES, INC EMPLOYEE HEALTH BENEFIT PLAN

2018: FULGHUM FIBRES, INC EMPLOYEE HEALTH BENEFIT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	This submission is the final filing	Yes
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2013: FULGHUM FIBRES, INC EMPLOYEE HEALTH BENEFIT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: FULGHUM FIBRES, INC EMPLOYEE HEALTH BENEFIT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: FULGHUM FIBRES, INC EMPLOYEE HEALTH BENEFIT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: FULGHUM FIBRES, INC EMPLOYEE HEALTH BENEFIT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

621366

Policy instance

Insurance contract or identification number	621366
Number of Individuals Covered	307
Insurance policy start date	2018-01-01
Insurance policy end date	2018-02-28
Total amount of commissions paid to insurance broker	USD $7,425
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $108,580
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $7,425
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	ABD INS. AND FINANCIAL SVCS., INC.

DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )

Policy contract number

19233

Policy instance

Insurance contract or identification number	19233
Number of Individuals Covered	454
Insurance policy start date	2018-01-01
Insurance policy end date	2018-02-28
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $20,384
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 32395 )

Policy contract number

30080732

Policy instance

Insurance contract or identification number	30080732
Number of Individuals Covered	150
Insurance policy start date	2018-01-01
Insurance policy end date	2018-02-28
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,885
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

10239781

Policy instance

Insurance contract or identification number	10239781
Number of Individuals Covered	195
Insurance policy start date	2018-01-01
Insurance policy end date	2018-02-28
Total amount of commissions paid to insurance broker	USD $3,330
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $24,985
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,330
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	ABD INS. AND FINANCIAL SVCS., INC.

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Company Name:	FULGHUM FIBRES, INC.
Employer identification number (EIN):	581851973
NAIC Classification:	324190