401k Plan data: SPECIALTY CONSUMER SERVICES HEALTH AND WELFARE PLAN plan

SPECIALTY CONSUMER SERVICES HEALTH AND WELFARE PLAN 401k Plan overview

Plan Name	SPECIALTY CONSUMER SERVICES HEALTH AND WELFARE PLAN
Plan identification number	501

SPECIALTY CONSUMER SERVICES HEALTH AND 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 Other welfare benefit cover

401k Sponsoring company profile

SPECIALTY CONSUMER SERVICES, LP has sponsored the creation of one or more 401k plans.

Company Name: SPECIALTY CONSUMER SERVICES, LP

Employer identification number (EIN): 800955823

NAIC Classification: 522291
NAIC Description: Consumer Lending

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SPECIALTY CONSUMER SERVICES HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2016-04-01 MARK BARFIELD
501 2015-04-01 MARK BARFIELD
501 2014-04-01 MARK BARFIELD

Plan id#	Filing Submission Date	Name of Administrator
501	2016-04-01	MARK BARFIELD
501	2015-04-01	MARK BARFIELD
501	2014-04-01	MARK BARFIELD

Plan Statistics for SPECIALTY CONSUMER SERVICES HEALTH AND WELFARE PLAN

401k plan membership statisitcs for SPECIALTY CONSUMER SERVICES HEALTH AND WELFARE PLAN

Measure Date Value
2016: SPECIALTY CONSUMER SERVICES HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year 2016-04-01 159
Total number of active participants reported on line 7a of the Form 5500 2016-04-01 0
Number of retired or separated participants receiving benefits 2016-04-01 0
Total of all active and inactive participants 2016-04-01 0
Total participants 2016-04-01 0
2015: SPECIALTY CONSUMER SERVICES HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-04-01 188
Total number of active participants reported on line 7a of the Form 5500 2015-04-01 144
Number of retired or separated participants receiving benefits 2015-04-01 0
Total of all active and inactive participants 2015-04-01 144
Total participants 2015-04-01 144
2014: SPECIALTY CONSUMER SERVICES HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-04-01 189
Total number of active participants reported on line 7a of the Form 5500 2014-04-01 171
Number of retired or separated participants receiving benefits 2014-04-01 0
Total of all active and inactive participants 2014-04-01 171
Total participants 2014-04-01 171

Measure	Date	Value
2016: SPECIALTY CONSUMER SERVICES HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year	2016-04-01	159
Total number of active participants reported on line 7a of the Form 5500	2016-04-01	0
Number of retired or separated participants receiving benefits	2016-04-01	0
Total of all active and inactive participants	2016-04-01	0
Total participants	2016-04-01	0
2015: SPECIALTY CONSUMER SERVICES HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-04-01	188
Total number of active participants reported on line 7a of the Form 5500	2015-04-01	144
Number of retired or separated participants receiving benefits	2015-04-01	0
Total of all active and inactive participants	2015-04-01	144
Total participants	2015-04-01	144
2014: SPECIALTY CONSUMER SERVICES HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-04-01	189
Total number of active participants reported on line 7a of the Form 5500	2014-04-01	171
Number of retired or separated participants receiving benefits	2014-04-01	0
Total of all active and inactive participants	2014-04-01	171
Total participants	2014-04-01	171

Form 5500 Responses for SPECIALTY CONSUMER SERVICES HEALTH AND WELFARE PLAN

2016: SPECIALTY CONSUMER SERVICES HEALTH AND WELFARE PLAN 2016 form 5500 responses
2016-04-01	Type of plan entity	Single employer plan
2016-04-01	Submission has been amended	No
2016-04-01	This submission is the final filing	Yes
2016-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-04-01	Plan is a collectively bargained plan	No
2016-04-01	Plan funding arrangement – Insurance	Yes
2016-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-04-01	Plan benefit arrangement – Insurance	Yes
2016-04-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: SPECIALTY CONSUMER SERVICES HEALTH AND WELFARE PLAN 2015 form 5500 responses
2015-04-01	Type of plan entity	Single employer plan
2015-04-01	Submission has been amended	No
2015-04-01	This submission is the final filing	No
2015-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-04-01	Plan is a collectively bargained plan	No
2015-04-01	Plan funding arrangement – Insurance	Yes
2015-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-04-01	Plan benefit arrangement – Insurance	Yes
2015-04-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: SPECIALTY CONSUMER SERVICES HEALTH AND WELFARE PLAN 2014 form 5500 responses
2014-04-01	Type of plan entity	Single employer plan
2014-04-01	First time form 5500 has been submitted	Yes
2014-04-01	Submission has been amended	No
2014-04-01	This submission is the final filing	No
2014-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-04-01	Plan is a collectively bargained plan	No
2014-04-01	Plan funding arrangement – Insurance	Yes
2014-04-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )

Policy contract number

235736

Policy instance

Insurance contract or identification number	235736
Number of Individuals Covered	177
Insurance policy start date	2015-04-01
Insurance policy end date	2016-03-31
Total amount of commissions paid to insurance broker	USD $2,603
Total amount of fees paid to insurance company	USD $287
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	ACCIDENT, 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 $18,471
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,603
Amount paid for insurance broker fees	287
Additional information about fees paid to insurance broker	BONUS
Insurance broker organization code?	3
Insurance broker name	HIGGINBOTHAM INSURANCE AGENCY INC

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

142506/142507

Policy instance

Insurance contract or identification number	142506/142507
Number of Individuals Covered	194
Insurance policy start date	2014-04-01
Insurance policy end date	2015-03-31
Total amount of commissions paid to insurance broker	USD $30,119
Total amount of fees paid to insurance company	USD $0
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	No
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 $580,306
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $30,119
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	HIGGINBOTHAM INSURANCE AGENCY INC

HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )

Policy contract number

540587

Policy instance

Insurance contract or identification number	540587
Number of Individuals Covered	109
Insurance policy start date	2014-04-01
Insurance policy end date	2015-03-31
Total amount of commissions paid to insurance broker	USD $690
Total amount of fees paid to insurance company	USD $0
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	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 $6,903
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $690
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	HIGGINBOTHAM INSURANCE AGENCY INC

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )

Policy contract number

235736

Policy instance

Insurance contract or identification number	235736
Number of Individuals Covered	252
Insurance policy start date	2014-05-01
Insurance policy end date	2015-03-31
Total amount of commissions paid to insurance broker	USD $1,490
Total amount of fees paid to insurance company	USD $0
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	ACCIDENT, 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 $10,371
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,490
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	HIGGINBOTHAM INSURANCE AGENCY INC

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Company Name:	SPECIALTY CONSUMER SERVICES, LP
Employer identification number (EIN):	800955823
NAIC Classification:	522291
NAIC Description:	Consumer Lending