401k Plan data: AL SELF INSURED WORKERS COMP FUND EMPLOYEES RET FUND plan

AL SELF INSURED WORKERS COMP FUND EMPLOYEES RET FUND 401k Plan overview

Plan Name	AL SELF INSURED WORKERS COMP FUND EMPLOYEES RET FUND
Plan identification number	001

AL SELF INSURED WORKERS COMP FUND EMPLOYEES RET FUND Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

ALABAMA SELF INSURED WORKERS COMPEN ATION FUND has sponsored the creation of one or more 401k plans.

Company Name: ALABAMA SELF INSURED WORKERS COMPEN ATION FUND

Employer identification number (EIN): 630773197

NAIC Classification: 525100
NAIC Description: Insurance and Employee Benefit Funds

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AL SELF INSURED WORKERS COMP FUND EMPLOYEES RET FUND

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2023-01-01 JARED MCCOY 2024-09-18
001 2022-01-01 JARED MCCOY 2023-10-02
001 2021-01-01 JARED R MCCOY 2022-04-13 JARED R MCCOY 2022-04-13
001 2020-01-01 JARED R MCCOY 2021-09-22 JARED R MCCOY 2021-09-22
001 2019-01-01 JARED MCCOY 2020-07-24 JARED MCCOY 2020-07-24
001 2018-01-01 FREDA BACON 2019-10-14 FREDA BACON 2019-10-14
001 2018-01-01
001 2017-01-01 JEAN LORINO 2018-07-16 JEAN LORINO 2018-07-16
001 2016-01-01 JEAN LORINO 2017-07-27 JEAN LORINO 2017-07-27
001 2015-01-01 JEAN LORINO 2016-09-29 JEAN LORINO 2016-09-29
001 2014-01-01 JEAN LORINO 2015-09-14 JEAN LORINO 2015-09-14
001 2013-01-01 JEAN LORINO 2014-07-28 JEAN LORINO 2014-07-28
001 2012-01-01 JEAN LORINO 2013-07-26
001 2011-01-01 JEAN LORINO 2012-10-15
001 2010-01-01 JEAN LORINO 2012-10-29
001 2009-01-01 JEAN LORINO
001 2009-01-01 JEAN LORINO
001 2009-01-01 JEAN LORINO JEAN LORINO 2010-07-28
001 2009-01-01 JEAN LORINO
001 2009-01-01 JEAN LORINO
001 2009-01-01 JEAN LORINO
001 2009-01-01 JEAN LORINO
001 2009-01-01 JEAN LORINO
001 2009-01-01 JEAN LORINO
001 2009-01-01 JEAN LORINO
001 2009-01-01 JEAN LORINO
001 2009-01-01 JEAN LORINO JEAN LORINO 2010-07-28
001 2008-01-01 JEAN LORINO
001 2007-01-01 JEAN LORINO
001 2006-01-01 JEAN LORINO
001 2005-01-01 JEAN LORINO

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2023-01-01	JARED MCCOY	2024-09-18
001	2022-01-01	JARED MCCOY	2023-10-02
001	2021-01-01	JARED R MCCOY	2022-04-13	JARED R MCCOY	2022-04-13
001	2020-01-01	JARED R MCCOY	2021-09-22	JARED R MCCOY	2021-09-22
001	2019-01-01	JARED MCCOY	2020-07-24	JARED MCCOY	2020-07-24
001	2018-01-01	FREDA BACON	2019-10-14	FREDA BACON	2019-10-14
001	2018-01-01
001	2017-01-01	JEAN LORINO	2018-07-16	JEAN LORINO	2018-07-16
001	2016-01-01	JEAN LORINO	2017-07-27	JEAN LORINO	2017-07-27
001	2015-01-01	JEAN LORINO	2016-09-29	JEAN LORINO	2016-09-29
001	2014-01-01	JEAN LORINO	2015-09-14	JEAN LORINO	2015-09-14
001	2013-01-01	JEAN LORINO	2014-07-28	JEAN LORINO	2014-07-28
001	2012-01-01	JEAN LORINO	2013-07-26
001	2011-01-01	JEAN LORINO	2012-10-15
001	2010-01-01	JEAN LORINO	2012-10-29
001	2009-01-01	JEAN LORINO
001	2009-01-01	JEAN LORINO
001	2009-01-01	JEAN LORINO		JEAN LORINO	2010-07-28
001	2009-01-01	JEAN LORINO
001	2009-01-01	JEAN LORINO
001	2009-01-01	JEAN LORINO
001	2009-01-01	JEAN LORINO
001	2009-01-01	JEAN LORINO
001	2009-01-01	JEAN LORINO
001	2009-01-01	JEAN LORINO
001	2009-01-01	JEAN LORINO
001	2009-01-01	JEAN LORINO		JEAN LORINO	2010-07-28
001	2008-01-01	JEAN LORINO
001	2007-01-01	JEAN LORINO
001	2006-01-01	JEAN LORINO
001	2005-01-01	JEAN LORINO

Plan Statistics for AL SELF INSURED WORKERS COMP FUND EMPLOYEES RET FUND

401k plan membership statisitcs for AL SELF INSURED WORKERS COMP FUND EMPLOYEES RET FUND

Measure Date Value
2009: AL SELF INSURED WORKERS COMP FUND EMPLOYEES RET FUND 2009 401k membership
Total participants, beginning-of-year 2009-01-01 17
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 15
Number of retired or separated participants receiving benefits 2009-01-01 0
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 15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 15
Number of participants with account balances 2009-01-01 14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0
2008: AL SELF INSURED WORKERS COMP FUND EMPLOYEES RET FUND 2008 401k membership
Total participants, beginning-of-year 2008-01-01 17
Total number of active participants reported on line 7a of the Form 5500 2008-01-01 14
Number of retired or separated participants receiving benefits 2008-01-01 2
Number of other retired or separated participants entitled to future benefits 2008-01-01 0
Total of all active and inactive participants 2008-01-01 16
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2008-01-01 0
Total participants 2008-01-01 16
Number of participants with account balances 2008-01-01 16
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2008-01-01 0
2007: AL SELF INSURED WORKERS COMP FUND EMPLOYEES RET FUND 2007 401k membership
Total participants, beginning-of-year 2007-01-01 15
Total number of active participants reported on line 7a of the Form 5500 2007-01-01 14
Number of retired or separated participants receiving benefits 2007-01-01 0
Number of other retired or separated participants entitled to future benefits 2007-01-01 3
Total of all active and inactive participants 2007-01-01 17
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2007-01-01 0
Total participants 2007-01-01 17
Number of participants with account balances 2007-01-01 17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2007-01-01 0
2006: AL SELF INSURED WORKERS COMP FUND EMPLOYEES RET FUND 2006 401k membership
Total participants, beginning-of-year 2006-01-01 14
Total number of active participants reported on line 7a of the Form 5500 2006-01-01 14
Number of other retired or separated participants entitled to future benefits 2006-01-01 1
Total of all active and inactive participants 2006-01-01 15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2006-01-01 0
Total participants 2006-01-01 15
Number of participants with account balances 2006-01-01 15
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2006-01-01 0
2005: AL SELF INSURED WORKERS COMP FUND EMPLOYEES RET FUND 2005 401k membership
Total participants, beginning-of-year 2005-01-01 14
Total number of active participants reported on line 7a of the Form 5500 2005-01-01 14
Number of retired or separated participants receiving benefits 2005-01-01 0
Number of other retired or separated participants entitled to future benefits 2005-01-01 0
Total of all active and inactive participants 2005-01-01 14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2005-01-01 0
Total participants 2005-01-01 14
Number of participants with account balances 2005-01-01 14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2005-01-01 0

Measure	Date	Value
2009: AL SELF INSURED WORKERS COMP FUND EMPLOYEES RET FUND 2009 401k membership
Total participants, beginning-of-year	2009-01-01	17
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	15
Number of retired or separated participants receiving benefits	2009-01-01	0
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	15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	15
Number of participants with account balances	2009-01-01	14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0
2008: AL SELF INSURED WORKERS COMP FUND EMPLOYEES RET FUND 2008 401k membership
Total participants, beginning-of-year	2008-01-01	17
Total number of active participants reported on line 7a of the Form 5500	2008-01-01	14
Number of retired or separated participants receiving benefits	2008-01-01	2
Number of other retired or separated participants entitled to future benefits	2008-01-01	0
Total of all active and inactive participants	2008-01-01	16
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2008-01-01	0
Total participants	2008-01-01	16
Number of participants with account balances	2008-01-01	16
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2008-01-01	0
2007: AL SELF INSURED WORKERS COMP FUND EMPLOYEES RET FUND 2007 401k membership
Total participants, beginning-of-year	2007-01-01	15
Total number of active participants reported on line 7a of the Form 5500	2007-01-01	14
Number of retired or separated participants receiving benefits	2007-01-01	0
Number of other retired or separated participants entitled to future benefits	2007-01-01	3
Total of all active and inactive participants	2007-01-01	17
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2007-01-01	0
Total participants	2007-01-01	17
Number of participants with account balances	2007-01-01	17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2007-01-01	0
2006: AL SELF INSURED WORKERS COMP FUND EMPLOYEES RET FUND 2006 401k membership
Total participants, beginning-of-year	2006-01-01	14
Total number of active participants reported on line 7a of the Form 5500	2006-01-01	14
Number of other retired or separated participants entitled to future benefits	2006-01-01	1
Total of all active and inactive participants	2006-01-01	15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2006-01-01	0
Total participants	2006-01-01	15
Number of participants with account balances	2006-01-01	15
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2006-01-01	0
2005: AL SELF INSURED WORKERS COMP FUND EMPLOYEES RET FUND 2005 401k membership
Total participants, beginning-of-year	2005-01-01	14
Total number of active participants reported on line 7a of the Form 5500	2005-01-01	14
Number of retired or separated participants receiving benefits	2005-01-01	0
Number of other retired or separated participants entitled to future benefits	2005-01-01	0
Total of all active and inactive participants	2005-01-01	14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2005-01-01	0
Total participants	2005-01-01	14
Number of participants with account balances	2005-01-01	14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2005-01-01	0

Financial Data on AL SELF INSURED WORKERS COMP FUND EMPLOYEES RET FUND

Measure	Date	Value
2009 : AL SELF INSURED WORKERS COMP FUND EMPLOYEES RET FUND 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0
2008 : AL SELF INSURED WORKERS COMP FUND EMPLOYEES RET FUND 2008 401k financial data
Total income from all sources	2008-12-31	$-537,844
Expenses. Total of all expenses incurred	2008-12-31	$6,876
Benefits paid (including direct rollovers)	2008-12-31	$6,876
Total plan assets at end of year	2008-12-31	$1,612,051
Total plan assets at beginning of year	2008-12-31	$2,156,771
Value of fidelity bond covering the plan	2008-12-31	$500,000
Total contributions received or receivable from participants	2008-12-31	$66,485
Other income received	2008-12-31	$-738,376
Net income (gross income less expenses)	2008-12-31	$-544,720
Net plan assets at end of year (total assets less liabilities)	2008-12-31	$1,612,051
Net plan assets at beginning of year (total assets less liabilities)	2008-12-31	$2,156,771
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2008-12-31	$24,465
Total contributions received or receivable from employer(s)	2008-12-31	$134,047
2007 : AL SELF INSURED WORKERS COMP FUND EMPLOYEES RET FUND 2007 401k financial data
Total income from all sources	2007-12-31	$395,324
Expenses. Total of all expenses incurred	2007-12-31	$0
Total plan assets at end of year	2007-12-31	$2,156,771
Total plan assets at beginning of year	2007-12-31	$1,761,447
Value of fidelity bond covering the plan	2007-12-31	$500,000
Total contributions received or receivable from participants	2007-12-31	$73,043
Other income received	2007-12-31	$181,017
Net income (gross income less expenses)	2007-12-31	$395,324
Net plan assets at end of year (total assets less liabilities)	2007-12-31	$2,156,771
Net plan assets at beginning of year (total assets less liabilities)	2007-12-31	$1,761,447
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2007-12-31	$16,969
Total contributions received or receivable from employer(s)	2007-12-31	$141,264
2006 : AL SELF INSURED WORKERS COMP FUND EMPLOYEES RET FUND 2006 401k financial data
Total income from all sources	2006-12-31	$398,852
Expenses. Total of all expenses incurred	2006-12-31	$25,121
Benefits paid (including direct rollovers)	2006-12-31	$25,121
Total plan assets at end of year	2006-12-31	$1,761,447
Total plan assets at beginning of year	2006-12-31	$1,387,716
Value of fidelity bond covering the plan	2006-12-31	$500,000
Total contributions received or receivable from participants	2006-12-31	$53,137
Other income received	2006-12-31	$213,739
Net income (gross income less expenses)	2006-12-31	$373,731
Net plan assets at end of year (total assets less liabilities)	2006-12-31	$1,761,447
Net plan assets at beginning of year (total assets less liabilities)	2006-12-31	$1,387,716
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2006-12-31	$8,017
Total contributions received or receivable from employer(s)	2006-12-31	$131,976
2005 : AL SELF INSURED WORKERS COMP FUND EMPLOYEES RET FUND 2005 401k financial data
Total income from all sources	2005-12-31	$307,025
Expenses. Total of all expenses incurred	2005-12-31	$0
Total plan assets at end of year	2005-12-31	$1,387,716
Total plan assets at beginning of year	2005-12-31	$1,080,691
Value of fidelity bond covering the plan	2005-12-31	$500,000
Total contributions received or receivable from participants	2005-12-31	$59,641
Contributions received from other sources (not participants or employers)	2005-12-31	$3,873
Other income received	2005-12-31	$119,453
Net income (gross income less expenses)	2005-12-31	$307,025
Net plan assets at end of year (total assets less liabilities)	2005-12-31	$1,387,716
Net plan assets at beginning of year (total assets less liabilities)	2005-12-31	$1,080,691
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2005-12-31	$3,200
Total contributions received or receivable from employer(s)	2005-12-31	$124,058

Form 5500 Responses for AL SELF INSURED WORKERS COMP FUND EMPLOYEES RET FUND

2009: AL SELF INSURED WORKERS COMP FUND EMPLOYEES RET FUND 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes
2008: AL SELF INSURED WORKERS COMP FUND EMPLOYEES RET FUND 2008 form 5500 responses
2008-01-01	Type of plan entity	Single employer plan
2008-01-01	Submission has been amended	Yes
2008-01-01	This submission is the final filing	No
2008-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-01-01	Plan is a collectively bargained plan	No
2008-01-01	Plan funding arrangement – Trust	Yes
2008-01-01	Plan benefit arrangement - Trust	Yes
2007: AL SELF INSURED WORKERS COMP FUND EMPLOYEES RET FUND 2007 form 5500 responses
2007-01-01	Type of plan entity	Single employer plan
2007-01-01	Submission has been amended	Yes
2007-01-01	This submission is the final filing	No
2007-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2007-01-01	Plan is a collectively bargained plan	No
2007-01-01	Plan funding arrangement – Trust	Yes
2007-01-01	Plan benefit arrangement - Trust	Yes
2006: AL SELF INSURED WORKERS COMP FUND EMPLOYEES RET FUND 2006 form 5500 responses
2006-01-01	Type of plan entity	Single employer plan
2006-01-01	Submission has been amended	Yes
2006-01-01	This submission is the final filing	No
2006-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2006-01-01	Plan is a collectively bargained plan	No
2006-01-01	Plan funding arrangement – Trust	Yes
2006-01-01	Plan benefit arrangement - Trust	Yes
2005: AL SELF INSURED WORKERS COMP FUND EMPLOYEES RET FUND 2005 form 5500 responses
2005-01-01	Type of plan entity	Single employer plan
2005-01-01	Submission has been amended	Yes
2005-01-01	This submission is the final filing	No
2005-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2005-01-01	Plan is a collectively bargained plan	No
2005-01-01	Plan funding arrangement – Trust	Yes
2005-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	ALABAMA SELF INSURED WORKERS COMPEN ATION FUND
Employer identification number (EIN):	630773197
NAIC Classification:	525100
NAIC Description:	Insurance and Employee Benefit Funds