401k Plan data: KOVACH INC. EMPLOYEE WELFARE BENEFIT PLAN plan

KOVACH INC. EMPLOYEE WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	KOVACH INC. EMPLOYEE WELFARE BENEFIT PLAN
Plan identification number	506

KOVACH INC. EMPLOYEE WELFARE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

KOVACH INC. has sponsored the creation of one or more 401k plans.

Company Name: KOVACH INC.

Employer identification number (EIN): 860252803

NAIC Classification: 236200

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KOVACH INC. EMPLOYEE WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
506 2016-07-01 MELISSA HUBER
506 2015-07-01 MELISSA HUBER
506 2014-07-01 MELISSA HUBER
506 2013-07-01 MELISSA HUBER

Plan id#	Filing Submission Date	Name of Administrator
506	2016-07-01	MELISSA HUBER
506	2015-07-01	MELISSA HUBER
506	2014-07-01	MELISSA HUBER
506	2013-07-01	MELISSA HUBER

Plan Statistics for KOVACH INC. EMPLOYEE WELFARE BENEFIT PLAN

401k plan membership statisitcs for KOVACH INC. EMPLOYEE WELFARE BENEFIT PLAN

Measure Date Value
2016: KOVACH INC. EMPLOYEE WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-07-01 270
Total number of active participants reported on line 7a of the Form 5500 2016-07-01 380
Number of retired or separated participants receiving benefits 2016-07-01 0
Number of other retired or separated participants entitled to future benefits 2016-07-01 0
Total of all active and inactive participants 2016-07-01 380
2015: KOVACH INC. EMPLOYEE WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 254
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 241
Number of retired or separated participants receiving benefits 2015-07-01 0
Number of other retired or separated participants entitled to future benefits 2015-07-01 0
Total of all active and inactive participants 2015-07-01 241
2014: KOVACH INC. EMPLOYEE WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 205
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 231
Number of retired or separated participants receiving benefits 2014-07-01 0
Number of other retired or separated participants entitled to future benefits 2014-07-01 0
Total of all active and inactive participants 2014-07-01 231
2013: KOVACH INC. EMPLOYEE WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-07-01 183
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 183
Number of retired or separated participants receiving benefits 2013-07-01 0
Number of other retired or separated participants entitled to future benefits 2013-07-01 0
Total of all active and inactive participants 2013-07-01 183

Measure	Date	Value
2016: KOVACH INC. EMPLOYEE WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-07-01	270
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	380
Number of retired or separated participants receiving benefits	2016-07-01	0
Number of other retired or separated participants entitled to future benefits	2016-07-01	0
Total of all active and inactive participants	2016-07-01	380
2015: KOVACH INC. EMPLOYEE WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	254
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	241
Number of retired or separated participants receiving benefits	2015-07-01	0
Number of other retired or separated participants entitled to future benefits	2015-07-01	0
Total of all active and inactive participants	2015-07-01	241
2014: KOVACH INC. EMPLOYEE WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	205
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	231
Number of retired or separated participants receiving benefits	2014-07-01	0
Number of other retired or separated participants entitled to future benefits	2014-07-01	0
Total of all active and inactive participants	2014-07-01	231
2013: KOVACH INC. EMPLOYEE WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-07-01	183
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	183
Number of retired or separated participants receiving benefits	2013-07-01	0
Number of other retired or separated participants entitled to future benefits	2013-07-01	0
Total of all active and inactive participants	2013-07-01	183

Form 5500 Responses for KOVACH INC. EMPLOYEE WELFARE BENEFIT PLAN

2016: KOVACH INC. EMPLOYEE WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-07-01	Type of plan entity	Single employer plan
2016-07-01	Submission has been amended	No
2016-07-01	This submission is the final filing	No
2016-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-07-01	Plan is a collectively bargained plan	No
2016-07-01	Plan funding arrangement – Insurance	Yes
2016-07-01	Plan benefit arrangement – Insurance	Yes
2015: KOVACH INC. EMPLOYEE WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	Submission has been amended	No
2015-07-01	This submission is the final filing	No
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-07-01	Plan is a collectively bargained plan	No
2015-07-01	Plan funding arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes
2014: KOVACH INC. EMPLOYEE WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	Submission has been amended	No
2014-07-01	This submission is the final filing	No
2014-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-07-01	Plan is a collectively bargained plan	No
2014-07-01	Plan funding arrangement – Insurance	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes
2013: KOVACH INC. EMPLOYEE WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
2013-07-01	First time form 5500 has been submitted	Yes
2013-07-01	Submission has been amended	No
2013-07-01	This submission is the final filing	No
2013-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-07-01	Plan is a collectively bargained plan	No
2013-07-01	Plan funding arrangement – Insurance	Yes
2013-07-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00294760
Policy instance	1
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number	29133
Policy instance	2
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00294760
Policy instance	1
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number	29133
Policy instance	2
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	000CD884
Policy instance	1

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Company Name:	KOVACH INC.
Employer identification number (EIN):	860252803
NAIC Classification:	236200