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EXCALIBUR ASSOCIATES, INC. 401(K) SAVINGS & PROFIT SHARING PLAN 401k Plan overview

Plan NameEXCALIBUR ASSOCIATES, INC. 401(K) SAVINGS & PROFIT SHARING PLAN
Plan identification number 001

EXCALIBUR ASSOCIATES, INC. 401(K) SAVINGS & PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • 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.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • 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.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

EXCALIBUR ASSOCIATES, INC. has sponsored the creation of one or more 401k plans.

Company Name:EXCALIBUR ASSOCIATES, INC.
Employer identification number (EIN):841348594
NAIC Classification:561110
NAIC Description:Office Administrative Services

Additional information about EXCALIBUR ASSOCIATES, INC.

Jurisdiction of Incorporation: Colorado Department of State
Incorporation Date: 1996-06-14
Company Identification Number: 19961080090
Legal Registered Office Address: 12000 N Pecos St
Suite 201
Westminster
United States of America (USA)
80234

More information about EXCALIBUR ASSOCIATES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EXCALIBUR ASSOCIATES, INC. 401(K) SAVINGS & PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01CARRIE MCCOY2023-10-12
0012021-01-01CARRIE MCCOY2023-01-08
0012020-01-01
0012019-01-01
0012018-01-01
0012017-01-01
0012016-01-01KARLEE WARREN2017-07-06
0012015-01-01KARLEE WARREN
0012014-01-01CHARLIE BURNS, JR.
0012013-01-01CHARLIE BURNS, JR.2014-06-25
0012012-01-01CHARLIE BURNS, JR.2013-07-01
0012011-01-01CHARLIE BURNS, JR.2012-07-06
0012010-01-01CHARLIE BURNS, JR.2011-06-21

Plan Statistics for EXCALIBUR ASSOCIATES, INC. 401(K) SAVINGS & PROFIT SHARING PLAN

401k plan membership statisitcs for EXCALIBUR ASSOCIATES, INC. 401(K) SAVINGS & PROFIT SHARING PLAN

Measure Date Value
2022: EXCALIBUR ASSOCIATES, INC. 401(K) SAVINGS & PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01231
Total number of active participants reported on line 7a of the Form 55002022-01-01238
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0135
Total of all active and inactive participants2022-01-01273
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01273
Number of participants with account balances2022-01-01216
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-011
2021: EXCALIBUR ASSOCIATES, INC. 401(K) SAVINGS & PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01143
Total number of active participants reported on line 7a of the Form 55002021-01-01186
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0135
Total of all active and inactive participants2021-01-01221
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01221
Number of participants with account balances2021-01-01188
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2015: EXCALIBUR ASSOCIATES, INC. 401(K) SAVINGS & PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01107
Total number of active participants reported on line 7a of the Form 55002015-01-0164
Number of retired or separated participants receiving benefits2015-01-011
Number of other retired or separated participants entitled to future benefits2015-01-0119
Total of all active and inactive participants2015-01-0184
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0184
Number of participants with account balances2015-01-0159
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: EXCALIBUR ASSOCIATES, INC. 401(K) SAVINGS & PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01124
Total number of active participants reported on line 7a of the Form 55002014-01-0183
Number of retired or separated participants receiving benefits2014-01-011
Number of other retired or separated participants entitled to future benefits2014-01-0120
Total of all active and inactive participants2014-01-01104
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01104
Number of participants with account balances2014-01-0168
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010

Financial Data on EXCALIBUR ASSOCIATES, INC. 401(K) SAVINGS & PROFIT SHARING PLAN

Measure Date Value
2022 : EXCALIBUR ASSOCIATES, INC. 401(K) SAVINGS & PROFIT SHARING PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$302,338
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$458,101
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$443,907
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$737,247
Value of total assets at end of year2022-12-31$2,731,629
Value of total assets at beginning of year2022-12-31$2,887,392
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$14,194
Total interest from all sources2022-12-31$8,419
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$1,000,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$146,773
Participant contributions at end of year2022-12-31$125,814
Participant contributions at beginning of year2022-12-31$64,006
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$23,363
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-155,763
Value of net assets at end of year (total assets less liabilities)2022-12-31$2,731,629
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$2,887,392
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in pooled separate accounts at end of year2022-12-31$2,201,942
Value of interest in pooled separate accounts at beginning of year2022-12-31$2,382,783
Interest on participant loans2022-12-31$2,529
Interest earned on other investments2022-12-31$5,890
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$403,873
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$440,603
Net investment gain/loss from pooled separate accounts2022-12-31$-443,328
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$567,111
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$443,907
Contract administrator fees2022-12-31$14,194
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31RUSHTON, LLC
Accountancy firm EIN2022-12-31582282374
2021 : EXCALIBUR ASSOCIATES, INC. 401(K) SAVINGS & PROFIT SHARING PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$1,182,627
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$1,029,163
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$1,017,830
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$792,135
Value of total assets at end of year2021-12-31$2,887,392
Value of total assets at beginning of year2021-12-31$2,733,928
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$11,333
Total interest from all sources2021-12-31$8,092
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$1,000,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$134,523
Participant contributions at end of year2021-12-31$64,006
Participant contributions at beginning of year2021-12-31$2,010
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$9,854
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$153,464
Value of net assets at end of year (total assets less liabilities)2021-12-31$2,887,392
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$2,733,928
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in pooled separate accounts at end of year2021-12-31$2,382,783
Value of interest in pooled separate accounts at beginning of year2021-12-31$2,340,317
Interest on participant loans2021-12-31$973
Interest earned on other investments2021-12-31$7,119
Value of interest in master investment trust accounts at beginning of year2021-12-31$2,340,317
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$440,603
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$391,601
Net investment gain/loss from pooled separate accounts2021-12-31$382,400
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$647,758
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$1,017,830
Contract administrator fees2021-12-31$11,333
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31TORY LIVINGSTON
Accountancy firm EIN2021-12-31461497033
2015 : EXCALIBUR ASSOCIATES, INC. 401(K) SAVINGS & PROFIT SHARING PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$662,907
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$659,460
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$654,049
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$605,453
Value of total assets at end of year2015-12-31$4,803,405
Value of total assets at beginning of year2015-12-31$4,799,958
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$5,411
Total interest from all sources2015-12-31$24,865
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$1,000,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$347,277
Participant contributions at beginning of year2015-12-31$18,472
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$120,336
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$3,447
Value of net assets at end of year (total assets less liabilities)2015-12-31$4,803,405
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$4,799,958
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in pooled separate accounts at end of year2015-12-31$3,253,777
Value of interest in pooled separate accounts at beginning of year2015-12-31$3,235,906
Interest earned on other investments2015-12-31$24,865
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$1,549,628
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$1,538,826
Net investment gain/loss from pooled separate accounts2015-12-31$32,589
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$137,840
Employer contributions (assets) at beginning of year2015-12-31$6,754
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$654,049
Contract administrator fees2015-12-31$5,411
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31EKS & H, LLLP
Accountancy firm EIN2015-12-31461497033
2014 : EXCALIBUR ASSOCIATES, INC. 401(K) SAVINGS & PROFIT SHARING PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$892,619
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$1,323,623
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$1,320,051
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$578,238
Value of total assets at end of year2014-12-31$4,799,958
Value of total assets at beginning of year2014-12-31$5,230,962
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$3,572
Total interest from all sources2014-12-31$23,997
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$1,000,000
If this is an individual account plan, was there a blackout period2014-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$418,742
Participant contributions at end of year2014-12-31$18,472
Participant contributions at beginning of year2014-12-31$26,191
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-431,004
Value of net assets at end of year (total assets less liabilities)2014-12-31$4,799,958
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$5,230,962
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in pooled separate accounts at end of year2014-12-31$3,235,906
Value of interest in pooled separate accounts at beginning of year2014-12-31$3,390,171
Interest earned on other investments2014-12-31$23,997
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$1,538,826
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$1,807,138
Net investment gain/loss from pooled separate accounts2014-12-31$290,384
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$159,496
Employer contributions (assets) at end of year2014-12-31$6,754
Employer contributions (assets) at beginning of year2014-12-31$7,462
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$1,320,051
Contract administrator fees2014-12-31$3,572
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31EKS & H LLLP
Accountancy firm EIN2014-12-31461497033

Form 5500 Responses for EXCALIBUR ASSOCIATES, INC. 401(K) SAVINGS & PROFIT SHARING PLAN

2022: EXCALIBUR ASSOCIATES, INC. 401(K) SAVINGS & PROFIT SHARING PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: EXCALIBUR ASSOCIATES, INC. 401(K) SAVINGS & PROFIT SHARING PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedYes
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2015: EXCALIBUR ASSOCIATES, INC. 401(K) SAVINGS & PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: EXCALIBUR ASSOCIATES, INC. 401(K) SAVINGS & PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number801179
Policy instance 1
Insurance contract or identification number801179
Number of Individuals Covered273
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration1
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number801179
Policy instance 1
Insurance contract or identification number801179
Number of Individuals Covered221
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration1
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number801179
Policy instance 1
Insurance contract or identification number801179
Number of Individuals Covered84
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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 planNo
Contracts With Unallocated Funds Deposit Administration1
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker name
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number801179
Policy instance 1
Insurance contract or identification number801179
Number of Individuals Covered104
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $17,255
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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 planNo
Contracts With Unallocated Funds Deposit Administration1
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,255
Insurance broker organization code?3
Insurance broker nameNAME NFP INSURANCE SERVICES INC

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