401k Plan data: IBC AIRWAYS HEALTH & WELFARE PLAN plan

IBC AIRWAYS HEALTH & WELFARE PLAN 401k Plan overview

Plan Name	IBC AIRWAYS HEALTH & WELFARE PLAN
Plan identification number	501

IBC AIRWAYS HEALTH & WELFARE 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) Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

IBC AIRWAYS has sponsored the creation of one or more 401k plans.

Company Name: IBC AIRWAYS

Employer identification number (EIN): 650265015

NAIC Classification: 492110
NAIC Description: Couriers and Express Delivery Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan IBC AIRWAYS HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2014-03-01 CHRIS COSTIGAN
501 2013-03-01 MARIA GARCIA

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2014-03-01	CHRIS COSTIGAN
501	2013-03-01	MARIA GARCIA

Plan Statistics for IBC AIRWAYS HEALTH & WELFARE PLAN

401k plan membership statisitcs for IBC AIRWAYS HEALTH & WELFARE PLAN

Measure Date Value
2014: IBC AIRWAYS HEALTH & WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-03-01 110
Total number of active participants reported on line 7a of the Form 5500 2014-03-01 89
Number of retired or separated participants receiving benefits 2014-03-01 1
Number of other retired or separated participants entitled to future benefits 2014-03-01 2
Total of all active and inactive participants 2014-03-01 92
2013: IBC AIRWAYS HEALTH & WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-03-01 125
Total number of active participants reported on line 7a of the Form 5500 2013-03-01 109
Number of retired or separated participants receiving benefits 2013-03-01 1
Number of other retired or separated participants entitled to future benefits 2013-03-01 1
Total of all active and inactive participants 2013-03-01 111

Measure	Date	Value
2014: IBC AIRWAYS HEALTH & WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-03-01	110
Total number of active participants reported on line 7a of the Form 5500	2014-03-01	89
Number of retired or separated participants receiving benefits	2014-03-01	1
Number of other retired or separated participants entitled to future benefits	2014-03-01	2
Total of all active and inactive participants	2014-03-01	92
2013: IBC AIRWAYS HEALTH & WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-03-01	125
Total number of active participants reported on line 7a of the Form 5500	2013-03-01	109
Number of retired or separated participants receiving benefits	2013-03-01	1
Number of other retired or separated participants entitled to future benefits	2013-03-01	1
Total of all active and inactive participants	2013-03-01	111

Form 5500 Responses for IBC AIRWAYS HEALTH & WELFARE PLAN

2014: IBC AIRWAYS HEALTH & WELFARE PLAN 2014 form 5500 responses
2014-03-01	Type of plan entity	Single employer plan
2014-03-01	Submission has been amended	No
2014-03-01	This submission is the final filing	No
2014-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-03-01	Plan is a collectively bargained plan	No
2014-03-01	Plan funding arrangement – Insurance	Yes
2014-03-01	Plan benefit arrangement – Insurance	Yes
2013: IBC AIRWAYS HEALTH & WELFARE PLAN 2013 form 5500 responses
2013-03-01	Type of plan entity	Single employer plan
2013-03-01	First time form 5500 has been submitted	Yes
2013-03-01	Submission has been amended	No
2013-03-01	This submission is the final filing	No
2013-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-03-01	Plan is a collectively bargained plan	No
2013-03-01	Plan funding arrangement – Insurance	Yes
2013-03-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )

Policy contract number

640609

Policy instance

Insurance contract or identification number	640609
Number of Individuals Covered	81
Insurance policy start date	2014-03-01
Insurance policy end date	2015-02-28
Total amount of commissions paid to insurance broker	USD $43,646
Total amount of fees paid to insurance company	USD $706
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $717,134
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,006
Insurance broker organization code?	3
Amount paid for insurance broker fees	706
Additional information about fees paid to insurance broker	VOLUME INCENTIVES
Insurance broker name	WILLIS AFFINITY PROG. OF COLORADO

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000AHJ7

Policy instance

Insurance contract or identification number	G000AHJ7
Number of Individuals Covered	89
Insurance policy start date	2014-03-01
Insurance policy end date	2015-02-28
Total amount of commissions paid to insurance broker	USD $7,139
Total amount of fees paid to insurance company	USD $1,581
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
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
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $56,973
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1581
Additional information about fees paid to insurance broker	ADDITIONAL COMPENSATION
Insurance broker organization code?	3
Commission paid to Insurance Broker	USD $7,139
Insurance broker name	WILLIS OF COLORADO INC.

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )

Policy contract number

640609

Policy instance

Insurance contract or identification number	640609
Number of Individuals Covered	95
Insurance policy start date	2013-03-01
Insurance policy end date	2014-02-28
Total amount of commissions paid to insurance broker	USD $38,417
Total amount of fees paid to insurance company	USD $854
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $838,440
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $37,029
Amount paid for insurance broker fees	854
Additional information about fees paid to insurance broker	VOLUME INCENTIVE PAID
Insurance broker organization code?	3
Insurance broker name	WILLIS OF COLORADO INC.

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000AHJ7

Policy instance

Insurance contract or identification number	G000AHJ7
Number of Individuals Covered	109
Insurance policy start date	2013-03-01
Insurance policy end date	2014-02-28
Total amount of commissions paid to insurance broker	USD $7,018
Total amount of fees paid to insurance company	USD $3,077
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
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	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $52,150
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,975
Insurance broker organization code?	3
Amount paid for insurance broker fees	3077
Additional information about fees paid to insurance broker	ADDITIONAL COMPENSATION
Insurance broker name	WILLIS OF COLORADO INC.

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Company Name:	IBC AIRWAYS
Employer identification number (EIN):	650265015
NAIC Classification:	492110
NAIC Description:	Couriers and Express Delivery Services