401k Plan data: AMFUEL WELFARE BENEFITS PLAN plan

AMFUEL WELFARE BENEFITS PLAN 401k Plan overview

Plan Name	AMFUEL WELFARE BENEFITS PLAN
Plan identification number	503

AMFUEL WELFARE BENEFITS PLAN Benefits

401k Plan Type

Welfare Benefit

Plan Features/Benefits

Life insurance
Temporary disability (accident and sickness)
Long-term disability cover
Death benefits (include travel accident but not life insurance)
Other welfare benefit cover
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.
Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

AMFUEL CELL & COATED FABRICS CO. has sponsored the creation of one or more 401k plans.

Company Name: AMFUEL CELL & COATED FABRICS CO.

Employer identification number (EIN): 710567522

NAIC Classification: 326200

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AMFUEL WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2017-06-01 DIANNE STRICKLAND
503 2015-10-01 DIANNE STRICKLAND
503 2014-10-01 DIANNE STRICKLAND
503 2013-10-01 SUSAN BULLINGER
503 2012-10-01 SUSAN BULLINGER
503 2011-10-01 SUSAN BULLINGER
503 2010-10-01 SUSAN BULLINGER
503 2009-10-01 SUSAN BULLINGER
503 2008-10-01 SUSAN BULLINGER
503 2007-10-01 SUSAN BULLINGER

Plan id#	Filing Submission Date	Name of Administrator
503	2017-06-01	DIANNE STRICKLAND
503	2015-10-01	DIANNE STRICKLAND
503	2014-10-01	DIANNE STRICKLAND
503	2013-10-01	SUSAN BULLINGER
503	2012-10-01	SUSAN BULLINGER
503	2011-10-01	SUSAN BULLINGER
503	2010-10-01	SUSAN BULLINGER
503	2009-10-01	SUSAN BULLINGER
503	2008-10-01	SUSAN BULLINGER
503	2007-10-01	SUSAN BULLINGER

Plan Statistics for AMFUEL WELFARE BENEFITS PLAN

401k plan membership statisitcs for AMFUEL WELFARE BENEFITS PLAN

Measure Date Value
2017: AMFUEL WELFARE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-06-01 215
Total number of active participants reported on line 7a of the Form 5500 2017-06-01 0
Number of retired or separated participants receiving benefits 2017-06-01 0
Number of other retired or separated participants entitled to future benefits 2017-06-01 0
Total of all active and inactive participants 2017-06-01 0
2015: AMFUEL WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-10-01 241
Total number of active participants reported on line 7a of the Form 5500 2015-10-01 229
Number of retired or separated participants receiving benefits 2015-10-01 0
Number of other retired or separated participants entitled to future benefits 2015-10-01 0
Total of all active and inactive participants 2015-10-01 229
2014: AMFUEL WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-10-01 241
Total number of active participants reported on line 7a of the Form 5500 2014-10-01 241
Number of retired or separated participants receiving benefits 2014-10-01 0
Number of other retired or separated participants entitled to future benefits 2014-10-01 0
Total of all active and inactive participants 2014-10-01 241
2013: AMFUEL WELFARE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-10-01 214
Total number of active participants reported on line 7a of the Form 5500 2013-10-01 232
Number of retired or separated participants receiving benefits 2013-10-01 0
Number of other retired or separated participants entitled to future benefits 2013-10-01 0
Total of all active and inactive participants 2013-10-01 232
2012: AMFUEL WELFARE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-10-01 232
Total number of active participants reported on line 7a of the Form 5500 2012-10-01 214
Number of retired or separated participants receiving benefits 2012-10-01 0
Number of other retired or separated participants entitled to future benefits 2012-10-01 0
Total of all active and inactive participants 2012-10-01 214
2011: AMFUEL WELFARE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-10-01 275
Total number of active participants reported on line 7a of the Form 5500 2011-10-01 232
Number of retired or separated participants receiving benefits 2011-10-01 0
Number of other retired or separated participants entitled to future benefits 2011-10-01 0
Total of all active and inactive participants 2011-10-01 232
2010: AMFUEL WELFARE BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year 2010-10-01 237
Total number of active participants reported on line 7a of the Form 5500 2010-10-01 275
Number of retired or separated participants receiving benefits 2010-10-01 0
Number of other retired or separated participants entitled to future benefits 2010-10-01 0
Total of all active and inactive participants 2010-10-01 275
2009: AMFUEL WELFARE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-10-01 248
Total number of active participants reported on line 7a of the Form 5500 2009-10-01 237
Number of retired or separated participants receiving benefits 2009-10-01 0
Number of other retired or separated participants entitled to future benefits 2009-10-01 0
Total of all active and inactive participants 2009-10-01 237
2008: AMFUEL WELFARE BENEFITS PLAN 2008 401k membership
Total participants, beginning-of-year 2008-10-01 247
Total number of active participants reported on line 7a of the Form 5500 2008-10-01 248
Number of retired or separated participants receiving benefits 2008-10-01 0
Number of other retired or separated participants entitled to future benefits 2008-10-01 0
Total of all active and inactive participants 2008-10-01 248
2007: AMFUEL WELFARE BENEFITS PLAN 2007 401k membership
Total participants, beginning-of-year 2007-10-01 0
Total number of active participants reported on line 7a of the Form 5500 2007-10-01 247
Number of retired or separated participants receiving benefits 2007-10-01 0
Number of other retired or separated participants entitled to future benefits 2007-10-01 0
Total of all active and inactive participants 2007-10-01 247

Measure	Date	Value
2017: AMFUEL WELFARE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-06-01	215
Total number of active participants reported on line 7a of the Form 5500	2017-06-01	0
Number of retired or separated participants receiving benefits	2017-06-01	0
Number of other retired or separated participants entitled to future benefits	2017-06-01	0
Total of all active and inactive participants	2017-06-01	0
2015: AMFUEL WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-10-01	241
Total number of active participants reported on line 7a of the Form 5500	2015-10-01	229
Number of retired or separated participants receiving benefits	2015-10-01	0
Number of other retired or separated participants entitled to future benefits	2015-10-01	0
Total of all active and inactive participants	2015-10-01	229
2014: AMFUEL WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-10-01	241
Total number of active participants reported on line 7a of the Form 5500	2014-10-01	241
Number of retired or separated participants receiving benefits	2014-10-01	0
Number of other retired or separated participants entitled to future benefits	2014-10-01	0
Total of all active and inactive participants	2014-10-01	241
2013: AMFUEL WELFARE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-10-01	214
Total number of active participants reported on line 7a of the Form 5500	2013-10-01	232
Number of retired or separated participants receiving benefits	2013-10-01	0
Number of other retired or separated participants entitled to future benefits	2013-10-01	0
Total of all active and inactive participants	2013-10-01	232
2012: AMFUEL WELFARE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-10-01	232
Total number of active participants reported on line 7a of the Form 5500	2012-10-01	214
Number of retired or separated participants receiving benefits	2012-10-01	0
Number of other retired or separated participants entitled to future benefits	2012-10-01	0
Total of all active and inactive participants	2012-10-01	214
2011: AMFUEL WELFARE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-10-01	275
Total number of active participants reported on line 7a of the Form 5500	2011-10-01	232
Number of retired or separated participants receiving benefits	2011-10-01	0
Number of other retired or separated participants entitled to future benefits	2011-10-01	0
Total of all active and inactive participants	2011-10-01	232
2010: AMFUEL WELFARE BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year	2010-10-01	237
Total number of active participants reported on line 7a of the Form 5500	2010-10-01	275
Number of retired or separated participants receiving benefits	2010-10-01	0
Number of other retired or separated participants entitled to future benefits	2010-10-01	0
Total of all active and inactive participants	2010-10-01	275
2009: AMFUEL WELFARE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-10-01	248
Total number of active participants reported on line 7a of the Form 5500	2009-10-01	237
Number of retired or separated participants receiving benefits	2009-10-01	0
Number of other retired or separated participants entitled to future benefits	2009-10-01	0
Total of all active and inactive participants	2009-10-01	237
2008: AMFUEL WELFARE BENEFITS PLAN 2008 401k membership
Total participants, beginning-of-year	2008-10-01	247
Total number of active participants reported on line 7a of the Form 5500	2008-10-01	248
Number of retired or separated participants receiving benefits	2008-10-01	0
Number of other retired or separated participants entitled to future benefits	2008-10-01	0
Total of all active and inactive participants	2008-10-01	248
2007: AMFUEL WELFARE BENEFITS PLAN 2007 401k membership
Total participants, beginning-of-year	2007-10-01	0
Total number of active participants reported on line 7a of the Form 5500	2007-10-01	247
Number of retired or separated participants receiving benefits	2007-10-01	0
Number of other retired or separated participants entitled to future benefits	2007-10-01	0
Total of all active and inactive participants	2007-10-01	247

Form 5500 Responses for AMFUEL WELFARE BENEFITS PLAN

2017: AMFUEL WELFARE BENEFITS PLAN 2017 form 5500 responses
2017-06-01	Type of plan entity	Single employer plan
2017-06-01	Submission has been amended	No
2017-06-01	This submission is the final filing	Yes
2017-06-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2017-06-01	Plan is a collectively bargained plan	No
2017-06-01	Plan funding arrangement – Insurance	Yes
2017-06-01	Plan benefit arrangement – Insurance	Yes
2015: AMFUEL WELFARE BENEFITS PLAN 2015 form 5500 responses
2015-10-01	Type of plan entity	Single employer plan
2015-10-01	Submission has been amended	No
2015-10-01	This submission is the final filing	No
2015-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-10-01	Plan is a collectively bargained plan	No
2015-10-01	Plan funding arrangement – Insurance	Yes
2015-10-01	Plan benefit arrangement – Insurance	Yes
2014: AMFUEL WELFARE BENEFITS PLAN 2014 form 5500 responses
2014-10-01	Type of plan entity	Single employer plan
2014-10-01	Submission has been amended	No
2014-10-01	This submission is the final filing	No
2014-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-10-01	Plan is a collectively bargained plan	No
2014-10-01	Plan funding arrangement – Insurance	Yes
2014-10-01	Plan benefit arrangement – Insurance	Yes
2013: AMFUEL WELFARE BENEFITS PLAN 2013 form 5500 responses
2013-10-01	Type of plan entity	Single employer plan
2013-10-01	Submission has been amended	No
2013-10-01	This submission is the final filing	No
2013-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-10-01	Plan is a collectively bargained plan	No
2013-10-01	Plan funding arrangement – Insurance	Yes
2013-10-01	Plan benefit arrangement – Insurance	Yes
2012: AMFUEL WELFARE BENEFITS PLAN 2012 form 5500 responses
2012-10-01	Type of plan entity	Single employer plan
2012-10-01	Submission has been amended	No
2012-10-01	This submission is the final filing	No
2012-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-10-01	Plan is a collectively bargained plan	No
2012-10-01	Plan funding arrangement – Insurance	Yes
2012-10-01	Plan benefit arrangement – Insurance	Yes
2011: AMFUEL WELFARE BENEFITS PLAN 2011 form 5500 responses
2011-10-01	Type of plan entity	Single employer plan
2011-10-01	Submission has been amended	No
2011-10-01	This submission is the final filing	No
2011-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-10-01	Plan is a collectively bargained plan	No
2011-10-01	Plan funding arrangement – Insurance	Yes
2011-10-01	Plan benefit arrangement – Insurance	Yes
2010: AMFUEL WELFARE BENEFITS PLAN 2010 form 5500 responses
2010-10-01	Type of plan entity	Single employer plan
2010-10-01	Submission has been amended	No
2010-10-01	This submission is the final filing	No
2010-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-10-01	Plan is a collectively bargained plan	No
2010-10-01	Plan funding arrangement – Insurance	Yes
2010-10-01	Plan benefit arrangement – Insurance	Yes
2009: AMFUEL WELFARE BENEFITS PLAN 2009 form 5500 responses
2009-10-01	Type of plan entity	Single employer plan
2009-10-01	Submission has been amended	No
2009-10-01	This submission is the final filing	No
2009-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-10-01	Plan is a collectively bargained plan	No
2009-10-01	Plan funding arrangement – Insurance	Yes
2009-10-01	Plan benefit arrangement – Insurance	Yes
2008: AMFUEL WELFARE BENEFITS PLAN 2008 form 5500 responses
2008-10-01	Type of plan entity	Single employer plan
2008-10-01	Submission has been amended	No
2008-10-01	This submission is the final filing	No
2008-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-10-01	Plan is a collectively bargained plan	No
2008-10-01	Plan funding arrangement – Insurance	Yes
2008-10-01	Plan benefit arrangement – Insurance	Yes
2007: AMFUEL WELFARE BENEFITS PLAN 2007 form 5500 responses
2007-10-01	Type of plan entity	Single employer plan
2007-10-01	First time form 5500 has been submitted	Yes
2007-10-01	Submission has been amended	No
2007-10-01	This submission is the final filing	No
2007-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2007-10-01	Plan is a collectively bargained plan	No
2007-10-01	Plan funding arrangement – Insurance	Yes
2007-10-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

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

Policy contract number

GLUG0B6BQ

Policy instance

Insurance contract or identification number	GLUG0B6BQ
Number of Individuals Covered	215
Insurance policy start date	2017-06-01
Insurance policy end date	2017-09-30
Total amount of commissions paid to insurance broker	USD $776
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
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	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&D
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 $5,176
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $776
Insurance broker organization code?	3
Insurance broker name	BOLEY FEATHERSON HUFFMAN & DEAL CO

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Company Name:	AMFUEL CELL & COATED FABRICS CO.
Employer identification number (EIN):	710567522
NAIC Classification:	326200