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CLARK COMPANIES MEDICAL BENEFIT PLAN 401k Plan overview

Plan NameCLARK COMPANIES MEDICAL BENEFIT PLAN
Plan identification number 501

CLARK COMPANIES MEDICAL BENEFIT PLAN Benefits

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

401k Sponsoring company profile

C.C. CLARK, INC. has sponsored the creation of one or more 401k plans.

Company Name:C.C. CLARK, INC.
Employer identification number (EIN):611084986
NAIC Classification:423990
NAIC Description:Other Miscellaneous Durable Goods Merchant Wholesalers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CLARK COMPANIES MEDICAL BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012016-01-01JIMMY BRIGGS JIMMY BRIGGS2017-10-13
5012015-01-01JIMMY BRIGGS JIMMY BRIGGS2016-10-17
5012014-01-01JIMMY BRIGGS JIMMY BRIGGS2015-10-12
5012013-01-01JIMMY BRIGGS JIMMY BRIGGS2014-10-14
5012012-01-01JIMMY BRIGGS JIMMY BRIGGS2013-10-11
5012011-01-01JIMMY BRIGGS JIMMY BRIGGS2012-10-09
5012009-01-01JIMMY BRIGGS

Plan Statistics for CLARK COMPANIES MEDICAL BENEFIT PLAN

401k plan membership statisitcs for CLARK COMPANIES MEDICAL BENEFIT PLAN

Measure Date Value
2016: CLARK COMPANIES MEDICAL BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01630
Total number of active participants reported on line 7a of the Form 55002016-01-01948
Number of retired or separated participants receiving benefits2016-01-016
Total of all active and inactive participants2016-01-01954
2015: CLARK COMPANIES MEDICAL BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01651
Total number of active participants reported on line 7a of the Form 55002015-01-01626
Number of retired or separated participants receiving benefits2015-01-014
Total of all active and inactive participants2015-01-01630
2014: CLARK COMPANIES MEDICAL BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01646
Total number of active participants reported on line 7a of the Form 55002014-01-01650
Number of retired or separated participants receiving benefits2014-01-011
Total of all active and inactive participants2014-01-01651
2013: CLARK COMPANIES MEDICAL BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01532
Total number of active participants reported on line 7a of the Form 55002013-01-01642
Number of retired or separated participants receiving benefits2013-01-014
Total of all active and inactive participants2013-01-01646
2012: CLARK COMPANIES MEDICAL BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01546
Total number of active participants reported on line 7a of the Form 55002012-01-01530
Number of retired or separated participants receiving benefits2012-01-012
Total of all active and inactive participants2012-01-01532
2011: CLARK COMPANIES MEDICAL BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01534
Total number of active participants reported on line 7a of the Form 55002011-01-01544
Number of retired or separated participants receiving benefits2011-01-012
Total of all active and inactive participants2011-01-01546
2009: CLARK COMPANIES MEDICAL BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01473
Total number of active participants reported on line 7a of the Form 55002009-01-01541
Number of retired or separated participants receiving benefits2009-01-016
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01547
Total participants2009-01-010

Financial Data on CLARK COMPANIES MEDICAL BENEFIT PLAN

Measure Date Value
2016 : CLARK COMPANIES MEDICAL BENEFIT PLAN 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$137,470
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$30,537
Total income from all sources (including contributions)2016-12-31$5,565,125
Total of all expenses incurred2016-12-31$5,009,169
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$4,388,218
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$5,565,125
Value of total assets at end of year2016-12-31$1,328,436
Value of total assets at beginning of year2016-12-31$665,547
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$620,951
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Administrative expenses professional fees incurred2016-12-31$15,056
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$2,384,887
Participant contributions at beginning of year2016-12-31$117,222
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$12,322
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2016-12-31$4,388,218
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$200,386
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$121,654
Administrative expenses (other) incurred2016-12-31$2,448
Liabilities. Value of operating payables at end of year2016-12-31$137,470
Liabilities. Value of operating payables at beginning of year2016-12-31$30,537
Total non interest bearing cash at end of year2016-12-31$1,128,050
Total non interest bearing cash at beginning of year2016-12-31$277,630
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$555,956
Value of net assets at end of year (total assets less liabilities)2016-12-31$1,190,966
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$635,010
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
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$3,167,916
Employer contributions (assets) at beginning of year2016-12-31$149,041
Contract administrator fees2016-12-31$603,447
Did the plan have assets held for investment2016-12-31No
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)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31BKD, LLP
Accountancy firm EIN2016-12-31440160260
2015 : CLARK COMPANIES MEDICAL BENEFIT PLAN 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$30,537
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$39,227
Total income from all sources (including contributions)2015-12-31$3,960,464
Total of all expenses incurred2015-12-31$3,641,826
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$3,221,285
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$3,960,464
Value of total assets at end of year2015-12-31$665,547
Value of total assets at beginning of year2015-12-31$355,599
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$420,541
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Administrative expenses professional fees incurred2015-12-31$15,237
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$1,681,939
Participant contributions at end of year2015-12-31$117,222
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$9,834
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2015-12-31$3,221,285
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$121,654
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$100,500
Administrative expenses (other) incurred2015-12-31$2,712
Liabilities. Value of operating payables at end of year2015-12-31$30,537
Liabilities. Value of operating payables at beginning of year2015-12-31$39,227
Total non interest bearing cash at end of year2015-12-31$277,630
Total non interest bearing cash at beginning of year2015-12-31$255,099
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$318,638
Value of net assets at end of year (total assets less liabilities)2015-12-31$635,010
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$316,372
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$2,268,691
Employer contributions (assets) at end of year2015-12-31$149,041
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$0
Contract administrator fees2015-12-31$402,592
Did the plan have assets held for investment2015-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31BKD, LLP
Accountancy firm EIN2015-12-31440160260
2014 : CLARK COMPANIES MEDICAL BENEFIT PLAN 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$39,227
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$45,860
Total income from all sources (including contributions)2014-12-31$4,245,049
Total of all expenses incurred2014-12-31$4,127,253
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$3,809,804
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$4,245,049
Value of total assets at end of year2014-12-31$355,599
Value of total assets at beginning of year2014-12-31$244,436
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$317,449
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Administrative expenses professional fees incurred2014-12-31$14,896
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$1,710,318
Assets. Other investments not covered elsewhere at beginning of year2014-12-31$205,536
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$14,938
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2014-12-31$3,809,804
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$100,500
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$38,900
Administrative expenses (other) incurred2014-12-31$2,697
Liabilities. Value of operating payables at end of year2014-12-31$39,227
Liabilities. Value of operating payables at beginning of year2014-12-31$45,860
Total non interest bearing cash at end of year2014-12-31$255,099
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$117,796
Value of net assets at end of year (total assets less liabilities)2014-12-31$316,372
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$198,576
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31Yes
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$2,519,793
Contract administrator fees2014-12-31$299,856
Did the plan have assets held for investment2014-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31BKD, LLP
Accountancy firm EIN2014-12-31440160260
2013 : CLARK COMPANIES MEDICAL BENEFIT PLAN 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$45,860
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$131,820
Total income from all sources (including contributions)2013-12-31$3,893,015
Total of all expenses incurred2013-12-31$4,418,309
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$4,117,020
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$3,893,015
Value of total assets at end of year2013-12-31$244,436
Value of total assets at beginning of year2013-12-31$855,690
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$301,289
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Administrative expenses professional fees incurred2013-12-31$15,675
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$1,596,114
Assets. Other investments not covered elsewhere at end of year2013-12-31$205,536
Assets. Other investments not covered elsewhere at beginning of year2013-12-31$816,790
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$15,739
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-12-31$4,117,020
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$38,900
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$38,900
Administrative expenses (other) incurred2013-12-31$2,470
Liabilities. Value of operating payables at end of year2013-12-31$45,860
Liabilities. Value of operating payables at beginning of year2013-12-31$131,820
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$-525,294
Value of net assets at end of year (total assets less liabilities)2013-12-31$198,576
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$723,870
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$2,281,162
Contract administrator fees2013-12-31$283,144
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31BKD, LLP
Accountancy firm EIN2013-12-31440160260
2012 : CLARK COMPANIES MEDICAL 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$131,820
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$20,671
Total income from all sources (including contributions)2012-12-31$3,507,352
Total of all expenses incurred2012-12-31$3,850,063
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$3,588,732
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$3,507,249
Value of total assets at end of year2012-12-31$855,690
Value of total assets at beginning of year2012-12-31$1,087,252
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$261,331
Total interest from all sources2012-12-31$103
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Administrative expenses professional fees incurred2012-12-31$13,782
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$500,000
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$1,616,005
Assets. Other investments not covered elsewhere at end of year2012-12-31$816,790
Assets. Other investments not covered elsewhere at beginning of year2012-12-31$1,048,352
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$10,892
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2012-12-31$3,549,411
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$38,900
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$38,900
Liabilities. Value of operating payables at end of year2012-12-31$131,820
Liabilities. Value of operating payables at beginning of year2012-12-31$20,671
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$-342,711
Value of net assets at end of year (total assets less liabilities)2012-12-31$723,870
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$1,066,581
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
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$103
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$39,321
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31Yes
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$1,880,352
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$0
Contract administrator fees2012-12-31$247,549
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 name2012-12-31BKD, LLP
Accountancy firm EIN2012-12-31440160260
2011 : CLARK COMPANIES MEDICAL 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$20,671
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$86,719
Total income from all sources (including contributions)2011-12-31$3,176,889
Total of all expenses incurred2011-12-31$3,005,684
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$2,739,880
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$3,176,530
Value of total assets at end of year2011-12-31$1,087,252
Value of total assets at beginning of year2011-12-31$982,095
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$265,804
Total interest from all sources2011-12-31$359
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Administrative expenses professional fees incurred2011-12-31$20,010
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$1,474,938
Assets. Other investments not covered elsewhere at end of year2011-12-31$1,048,352
Assets. Other investments not covered elsewhere at beginning of year2011-12-31$943,195
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$24,744
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2011-12-31$2,698,252
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$38,900
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$38,900
Administrative expenses (other) incurred2011-12-31$0
Liabilities. Value of operating payables at end of year2011-12-31$20,671
Liabilities. Value of operating payables at beginning of year2011-12-31$86,719
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$171,205
Value of net assets at end of year (total assets less liabilities)2011-12-31$1,066,581
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$895,376
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
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$359
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$41,628
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31Yes
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$1,676,848
Contract administrator fees2011-12-31$245,794
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 name2011-12-31BKD, LLP
Accountancy firm EIN2011-12-31440160260
2010 : CLARK COMPANIES MEDICAL BENEFIT PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$86,719
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$27,194
Total income from all sources (including contributions)2010-12-31$2,933,854
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$2,932,210
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$2,676,721
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$2,933,012
Value of total assets at end of year2010-12-31$982,095
Value of total assets at beginning of year2010-12-31$920,926
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$255,489
Total interest from all sources2010-12-31$842
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Administrative expenses professional fees incurred2010-12-31$13,030
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$1,412,915
Assets. Other investments not covered elsewhere at end of year2010-12-31$943,195
Assets. Other investments not covered elsewhere at beginning of year2010-12-31$782,026
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$18,573
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2010-12-31$2,676,721
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$38,900
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$38,900
Administrative expenses (other) incurred2010-12-31$48
Liabilities. Value of operating payables at end of year2010-12-31$86,719
Liabilities. Value of operating payables at beginning of year2010-12-31$27,194
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$1,644
Value of net assets at end of year (total assets less liabilities)2010-12-31$895,376
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$893,732
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
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$842
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31Yes
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$1,501,524
Employer contributions (assets) at beginning of year2010-12-31$100,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$0
Contract administrator fees2010-12-31$242,411
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 name2010-12-31BKD, LLP
Accountancy firm EIN2010-12-31440160260

Form 5500 Responses for CLARK COMPANIES MEDICAL BENEFIT PLAN

2016: CLARK COMPANIES MEDICAL BENEFIT 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
2015: CLARK COMPANIES MEDICAL BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: CLARK COMPANIES MEDICAL BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: CLARK COMPANIES MEDICAL BENEFIT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: CLARK COMPANIES MEDICAL BENEFIT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: CLARK COMPANIES MEDICAL BENEFIT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: CLARK COMPANIES MEDICAL BENEFIT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number707889
Policy instance 1
Insurance contract or identification number707889
Number of Individuals Covered491
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $29,666
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,496
Insurance broker organization code?3
Insurance broker nameASSURED NL INS AGENCY INC-LOUI
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number707889
Policy instance 1
Insurance contract or identification number707889
Number of Individuals Covered505
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $31,365
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,958
Insurance broker organization code?3
Insurance broker nameASSURED NL INS AGENCY INC - BOWLING
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number707889
Policy instance 1
Insurance contract or identification number707889
Number of Individuals Covered524
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $18,007
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,473
Insurance broker organization code?3
Insurance broker nameASSURED NL INS AGENCY INC - BOWLING
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number707889
Policy instance 1
Insurance contract or identification number707889
Number of Individuals Covered527
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $16,273
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $39,321
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,826
Insurance broker organization code?3
Insurance broker nameASSURED NL INS AGENCY INC - LOUISVI
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number707889
Policy instance 1
Insurance contract or identification number707889
Number of Individuals Covered532
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $15,417
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $41,628
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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