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LACK'S STORES, INC. HEALTH BENEFITS PLAN 401k Plan overview

Plan NameLACK'S STORES, INC. HEALTH BENEFITS PLAN
Plan identification number 505

LACK'S STORES, INC. HEALTH BENEFITS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental

401k Sponsoring company profile

LACKS'S STORES, INC. has sponsored the creation of one or more 401k plans.

Company Name:LACKS'S STORES, INC.
Employer identification number (EIN):741076528
NAIC Classification:442110
NAIC Description:Furniture Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LACK'S STORES, INC. HEALTH BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052013-01-01
5052012-01-01MELVIN LACK
5052011-01-01DONALD N TOOLE
5052010-01-01CRAIG SALTER
5052009-01-01CRAIG SALTER CRAIG SALTER2010-09-30

Financial Data on LACK'S STORES, INC. HEALTH BENEFITS PLAN

Measure Date Value
2012 : LACK'S STORES, INC. HEALTH BENEFITS PLAN 2012 401k financial data
Total income from all sources2012-12-31$386,496
Expenses. Total of all expenses incurred2012-12-31$436,578
Benefits paid (including direct rollovers)2012-12-31$402,575
Total plan assets at end of year2012-12-31$41,557
Total plan assets at beginning of year2012-12-31$91,639
Total contributions received or receivable from participants2012-12-31$45,499
Net income (gross income less expenses)2012-12-31$-50,082
Net plan assets at end of year (total assets less liabilities)2012-12-31$41,557
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$91,639
Total contributions received or receivable from employer(s)2012-12-31$340,997
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$34,003
2011 : LACK'S STORES, INC. HEALTH BENEFITS PLAN 2011 401k financial data
Total income from all sources (including contributions)2011-12-31$1,542,685
Total of all expenses incurred2011-12-31$1,627,376
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$1,567,073
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$1,503,025
Value of total assets at end of year2011-12-31$91,639
Value of total assets at beginning of year2011-12-31$176,330
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$60,303
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$12,399
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$500,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$172,640
Other income not declared elsewhere2011-12-31$39,660
Administrative expenses (other) incurred2011-12-31$156
Total non interest bearing cash at end of year2011-12-31$91,639
Total non interest bearing cash at beginning of year2011-12-31$176,330
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-84,691
Value of net assets at end of year (total assets less liabilities)2011-12-31$91,639
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$176,330
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
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
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$1,330,385
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$1,567,073
Contract administrator fees2011-12-31$47,748
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-12-31No
Did the plan have assets held for investment2011-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party 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 name2011-12-31COLLIER, JOHNSON & WOODS, P.C.
Accountancy firm EIN2011-12-31742520265
2010 : LACK'S STORES, INC. HEALTH BENEFITS PLAN 2010 401k financial data
Total income from all sources (including contributions)2010-12-31$3,344,371
Total of all expenses incurred2010-12-31$3,227,908
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$2,968,615
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$3,309,000
Value of total assets at end of year2010-12-31$176,330
Value of total assets at beginning of year2010-12-31$59,867
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$259,293
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$28,119
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$500,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$508,276
Other income not declared elsewhere2010-12-31$35,371
Administrative expenses (other) incurred2010-12-31$538
Total non interest bearing cash at end of year2010-12-31$176,330
Total non interest bearing cash at beginning of year2010-12-31$59,867
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$116,463
Value of net assets at end of year (total assets less liabilities)2010-12-31$176,330
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$59,867
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
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$53,627
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
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$2,800,724
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$2,914,988
Contract administrator fees2010-12-31$230,636
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31No
Did the plan have assets held for investment2010-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party 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 name2010-12-31COLLIER, JOHNSON & WOODS, P.C.
Accountancy firm EIN2010-12-31742520265

Form 5500 Responses for LACK'S STORES, INC. HEALTH BENEFITS PLAN

2012: LACK'S STORES, INC. HEALTH BENEFITS PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement - TrustYes
2011: LACK'S STORES, INC. HEALTH BENEFITS PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement - TrustYes
2010: LACK'S STORES, INC. HEALTH BENEFITS PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: LACK'S STORES, INC. HEALTH BENEFITS PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG00602205-0001
Policy instance 1

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