401k Plan data: THE SELECT FAMILY 401(K) PLAN plan

THE SELECT FAMILY 401(K) PLAN 401k Plan overview

Plan Name	THE SELECT FAMILY 401(K) PLAN
Plan identification number	333

THE SELECT FAMILY 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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.
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.

401k Sponsoring company profile

KOOSHAREM LLC DBA SELECT STAFFING, INC. has sponsored the creation of one or more 401k plans.

Company Name: KOOSHAREM LLC DBA SELECT STAFFING, INC.

Employer identification number (EIN): 930994537

NAIC Classification: 561490

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE SELECT FAMILY 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
333 2016-01-01 TOM MEADE
333 2015-01-01 TOM MEADE
333 2014-01-01 DAVID TRENT
333 2013-01-01 DAVID TRENT
333 2012-01-01 DAVID TRENT
333 2011-01-01 DAVID TRENT
333 2010-01-01 DAVID TRENT

Plan id#	Filing Submission Date	Name of Administrator
333	2016-01-01	TOM MEADE
333	2015-01-01	TOM MEADE
333	2014-01-01	DAVID TRENT
333	2013-01-01	DAVID TRENT
333	2012-01-01	DAVID TRENT
333	2011-01-01	DAVID TRENT
333	2010-01-01	DAVID TRENT

Plan Statistics for THE SELECT FAMILY 401(K) PLAN

401k plan membership statisitcs for THE SELECT FAMILY 401(K) PLAN

Measure Date Value
2016: THE SELECT FAMILY 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 35,537
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 12
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 12
Number of participants with account balances 2016-01-01 12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 17
2015: THE SELECT FAMILY 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 44,194
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 35,397
Number of other retired or separated participants entitled to future benefits 2015-01-01 140
Total of all active and inactive participants 2015-01-01 35,537
Total participants 2015-01-01 35,537
Number of participants with account balances 2015-01-01 702
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 9
2014: THE SELECT FAMILY 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 32,557
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 43,465
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 151
Total of all active and inactive participants 2014-01-01 43,616
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 43,616
Number of participants with account balances 2014-01-01 606
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 7
2013: THE SELECT FAMILY 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 4,145
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 1,298
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 210
Total of all active and inactive participants 2013-01-01 1,508
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 1,508
Number of participants with account balances 2013-01-01 611
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 4
2012: THE SELECT FAMILY 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 2,285
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 3,517
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 335
Total of all active and inactive participants 2012-01-01 3,852
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 3,852
Number of participants with account balances 2012-01-01 709
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 2
2011: THE SELECT FAMILY 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 34,860
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 1,863
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 406
Total of all active and inactive participants 2011-01-01 2,269
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 1
Total participants 2011-01-01 2,270
Number of participants with account balances 2011-01-01 714
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: THE SELECT FAMILY 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 1,519
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 34,491
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 369
Total of all active and inactive participants 2010-01-01 34,860
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 34,860
Number of participants with account balances 2010-01-01 860
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0

Measure	Date	Value
2016: THE SELECT FAMILY 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	35,537
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	12
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	12
Number of participants with account balances	2016-01-01	12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	17
2015: THE SELECT FAMILY 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	44,194
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	35,397
Number of other retired or separated participants entitled to future benefits	2015-01-01	140
Total of all active and inactive participants	2015-01-01	35,537
Total participants	2015-01-01	35,537
Number of participants with account balances	2015-01-01	702
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	9
2014: THE SELECT FAMILY 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	32,557
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	43,465
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	151
Total of all active and inactive participants	2014-01-01	43,616
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	43,616
Number of participants with account balances	2014-01-01	606
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	7
2013: THE SELECT FAMILY 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	4,145
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	1,298
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	210
Total of all active and inactive participants	2013-01-01	1,508
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	1,508
Number of participants with account balances	2013-01-01	611
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	4
2012: THE SELECT FAMILY 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	2,285
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	3,517
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	335
Total of all active and inactive participants	2012-01-01	3,852
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	3,852
Number of participants with account balances	2012-01-01	709
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	2
2011: THE SELECT FAMILY 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	34,860
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1,863
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	406
Total of all active and inactive participants	2011-01-01	2,269
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	1
Total participants	2011-01-01	2,270
Number of participants with account balances	2011-01-01	714
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: THE SELECT FAMILY 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	1,519
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	34,491
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	369
Total of all active and inactive participants	2010-01-01	34,860
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	34,860
Number of participants with account balances	2010-01-01	860
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0

Financial Data on THE SELECT FAMILY 401(K) PLAN

Measure	Date	Value
2016 : THE SELECT FAMILY 401(K) PLAN 2016 401k financial data
Total transfer of assets from this plan	2016-12-31	$17,828,960
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$40,008
Total income from all sources (including contributions)	2016-12-31	$3,168,237
Total of all expenses incurred	2016-12-31	$2,273,106
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$2,133,041
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$1,894,230
Value of total assets at end of year	2016-12-31	$19,561
Value of total assets at beginning of year	2016-12-31	$16,993,398
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$140,065
Total interest from all sources	2016-12-31	$50,105
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2016-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$1,433,417
Participant contributions at end of year	2016-12-31	$0
Participant contributions at beginning of year	2016-12-31	$550,207
Participant contributions at end of year	2016-12-31	$0
Participant contributions at beginning of year	2016-12-31	$45,413
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$131,952
Administrative expenses (other) incurred	2016-12-31	$140,065
Total non interest bearing cash at end of year	2016-12-31	$0
Total non interest bearing cash at beginning of year	2016-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$895,131
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$19,561
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$16,953,390
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in pooled separate accounts at end of year	2016-12-31	$19,559
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$14,402,378
Interest on participant loans	2016-12-31	$22,049
Interest earned on other investments	2016-12-31	$28,056
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$2
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$1,986,660
Net investment gain/loss from pooled separate accounts	2016-12-31	$1,223,902
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$328,861
Employer contributions (assets) at end of year	2016-12-31	$0
Employer contributions (assets) at beginning of year	2016-12-31	$8,740
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$2,133,041
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2016-12-31	Yes
Liabilities. Value of benefit claims payable at end of year	2016-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2016-12-31	$40,008
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	SIKICH LLP
Accountancy firm EIN	2016-12-31	363168081
2015 : THE SELECT FAMILY 401(K) PLAN 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$40,008
Total income from all sources (including contributions)	2015-12-31	$1,562,900
Total of all expenses incurred	2015-12-31	$1,338,020
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$1,192,221
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$1,621,996
Value of total assets at end of year	2015-12-31	$16,993,398
Value of total assets at beginning of year	2015-12-31	$16,728,510
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$145,799
Total interest from all sources	2015-12-31	$51,758
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$1,306,099
Participant contributions at end of year	2015-12-31	$550,207
Participant contributions at beginning of year	2015-12-31	$507,350
Participant contributions at end of year	2015-12-31	$45,413
Participant contributions at beginning of year	2015-12-31	$90,862
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$29,117
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$224,880
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$16,953,390
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$16,728,510
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in pooled separate accounts at end of year	2015-12-31	$14,402,378
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$14,125,634
Interest on participant loans	2015-12-31	$21,044
Interest earned on other investments	2015-12-31	$30,714
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$1,986,660
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$1,986,036
Net investment gain/loss from pooled separate accounts	2015-12-31	$-110,854
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$286,780
Employer contributions (assets) at end of year	2015-12-31	$8,740
Employer contributions (assets) at beginning of year	2015-12-31	$18,628
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$1,192,221
Contract administrator fees	2015-12-31	$145,799
Liabilities. Value of benefit claims payable at end of year	2015-12-31	$40,008
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	SIKICH LLP
Accountancy firm EIN	2015-12-31	363168081
2014 : THE SELECT FAMILY 401(K) PLAN 2014 401k financial data
Total income from all sources (including contributions)	2014-12-31	$2,270,394
Total of all expenses incurred	2014-12-31	$1,642,415
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$1,510,760
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$1,400,533
Value of total assets at end of year	2014-12-31	$16,728,510
Value of total assets at beginning of year	2014-12-31	$16,100,531
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$131,655
Total interest from all sources	2014-12-31	$24,438
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$1,056,334
Participant contributions at end of year	2014-12-31	$507,350
Participant contributions at beginning of year	2014-12-31	$415,948
Participant contributions at end of year	2014-12-31	$90,862
Participant contributions at beginning of year	2014-12-31	$14,375
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$128,789
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$627,979
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$16,728,510
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$16,100,531
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in pooled separate accounts at end of year	2014-12-31	$14,125,634
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$13,713,818
Interest on participant loans	2014-12-31	$18,133
Interest earned on other investments	2014-12-31	$6,305
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$1,986,036
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$1,953,541
Net investment gain/loss from pooled separate accounts	2014-12-31	$845,423
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$215,410
Employer contributions (assets) at end of year	2014-12-31	$18,628
Employer contributions (assets) at beginning of year	2014-12-31	$2,849
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$1,510,760
Contract administrator fees	2014-12-31	$131,655
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	SIKICH LLP
Accountancy firm EIN	2014-12-31	363168081
2013 : THE SELECT FAMILY 401(K) PLAN 2013 401k financial data
Total income from all sources (including contributions)	2013-12-31	$3,406,415
Total of all expenses incurred	2013-12-31	$1,763,117
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$1,673,580
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$1,026,752
Value of total assets at end of year	2013-12-31	$16,100,531
Value of total assets at beginning of year	2013-12-31	$14,457,233
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$89,537
Total interest from all sources	2013-12-31	$53,859
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$949,563
Participant contributions at end of year	2013-12-31	$415,948
Participant contributions at beginning of year	2013-12-31	$409,873
Participant contributions at end of year	2013-12-31	$14,375
Participant contributions at beginning of year	2013-12-31	$44,036
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$1,643,298
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$16,100,531
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$14,457,233
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in pooled separate accounts at end of year	2013-12-31	$13,713,818
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$11,706,949
Interest on participant loans	2013-12-31	$18,603
Interest earned on other investments	2013-12-31	$35,256
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$1,953,541
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$2,288,196
Net investment gain/loss from pooled separate accounts	2013-12-31	$2,325,804
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$77,189
Employer contributions (assets) at end of year	2013-12-31	$2,849
Employer contributions (assets) at beginning of year	2013-12-31	$8,179
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$1,673,580
Contract administrator fees	2013-12-31	$89,537
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2013-12-31	No
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	SIKICH LLP
Accountancy firm EIN	2013-12-31	363168081
2012 : THE SELECT FAMILY 401(K) PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$2,458,203
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$2,560,675
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$2,472,245
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$869,202
Value of total assets at end of year	2012-12-31	$14,457,233
Value of total assets at beginning of year	2012-12-31	$14,559,705
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$88,430
Total interest from all sources	2012-12-31	$16,564
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$780,527
Participant contributions at end of year	2012-12-31	$409,873
Participant contributions at beginning of year	2012-12-31	$347,117
Participant contributions at end of year	2012-12-31	$44,036
Participant contributions at beginning of year	2012-12-31	$60,070
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$72,240
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$-102,472
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$14,457,233
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$14,559,705
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in pooled separate accounts at end of year	2012-12-31	$11,706,949
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$11,655,001
Interest on participant loans	2012-12-31	$16,564
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$2,288,196
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$2,497,517
Net investment gain/loss from pooled separate accounts	2012-12-31	$1,572,437
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$16,435
Employer contributions (assets) at end of year	2012-12-31	$8,179
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$2,472,245
Contract administrator fees	2012-12-31	$88,430
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2012-12-31	No
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	SIKICH LLP
Accountancy firm EIN	2012-12-31	363168081
2011 : THE SELECT FAMILY 401(K) PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total transfer of assets from this plan	2011-12-31	$2,290,851
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$385,916
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$1,269,817
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$1,168,585
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$704,519
Value of total assets at end of year	2011-12-31	$14,559,705
Value of total assets at beginning of year	2011-12-31	$17,734,457
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$101,232
Total interest from all sources	2011-12-31	$14,417
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$665,659
Participant contributions at end of year	2011-12-31	$347,117
Participant contributions at beginning of year	2011-12-31	$485,199
Participant contributions at end of year	2011-12-31	$60,070
Participant contributions at beginning of year	2011-12-31	$61,660
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$38,342
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$6,855
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$-883,901
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$14,559,705
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$17,734,457
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in pooled separate accounts at end of year	2011-12-31	$11,655,001
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$14,796,614
Interest on participant loans	2011-12-31	$14,417
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$2,497,517
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$2,373,154
Net investment gain/loss from pooled separate accounts	2011-12-31	$-333,020
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$518
Employer contributions (assets) at beginning of year	2011-12-31	$10,975
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$1,168,585
Contract administrator fees	2011-12-31	$101,232
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2011-12-31	No
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	SIKICK LLP
Accountancy firm EIN	2011-12-31	363168081
2010 : THE SELECT FAMILY 401(K) PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total transfer of assets to this plan	2010-12-31	$16,890,971
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$1,996
Total income from all sources (including contributions)	2010-12-31	$3,157,537
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$6,467,408
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$6,308,833
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$1,413,422
Value of total assets at end of year	2010-12-31	$17,654,967
Value of total assets at beginning of year	2010-12-31	$4,075,863
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$158,575
Total interest from all sources	2010-12-31	$26,003
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$1,232,462
Participant contributions at end of year	2010-12-31	$485,199
Participant contributions at beginning of year	2010-12-31	$173,107
Participant contributions at end of year	2010-12-31	$61,660
Participant contributions at beginning of year	2010-12-31	$63,872
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$24,213
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$6,855
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$12,353
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$1,996
Other income not declared elsewhere	2010-12-31	$75,966
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$-3,309,871
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$17,654,967
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$4,073,867
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in pooled separate accounts at end of year	2010-12-31	$14,796,614
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$3,738,001
Interest on participant loans	2010-12-31	$26,003
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$2,373,154
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$60,718
Net investment gain/loss from pooled separate accounts	2010-12-31	$1,642,146
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$156,747
Employer contributions (assets) at end of year	2010-12-31	$10,975
Employer contributions (assets) at beginning of year	2010-12-31	$27,812
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$6,308,833
Contract administrator fees	2010-12-31	$158,575
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2010-12-31	No
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	FARBER HASS HURLEY LLP
Accountancy firm EIN	2010-12-31	204207759

Form 5500 Responses for THE SELECT FAMILY 401(K) PLAN

2016: THE SELECT FAMILY 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Mulitple employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: THE SELECT FAMILY 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Mulitple employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: THE SELECT FAMILY 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Mulitple employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: THE SELECT FAMILY 401(K) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Mulitple employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: THE SELECT FAMILY 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Mulitple employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: THE SELECT FAMILY 401(K) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Mulitple employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: THE SELECT FAMILY 401(K) PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Mulitple employer plan
2010-01-01	Submission has been amended	Yes
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

932206

Policy instance

Insurance contract or identification number	932206
Number of Individuals Covered	702
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $53,576
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $53,576
Insurance broker organization code?	3
Insurance broker name	HORNOR TOWNSEND & KENT INC

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

932206

Policy instance

Insurance contract or identification number	932206
Number of Individuals Covered	606
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $56,683
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $56,683
Insurance broker organization code?	3
Insurance broker name	HORNOR TOWNSEND & KENT INC

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

932206

Policy instance

Insurance contract or identification number	932206
Number of Individuals Covered	1508
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $30,110
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $30,110
Insurance broker organization code?	1
Insurance broker name	CES AGENCY INC

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

932206

Policy instance

Insurance contract or identification number	932206
Number of Individuals Covered	3852
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $41,955
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
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
Commission paid to Insurance Broker	USD $41,955
Insurance broker organization code?	1
Insurance broker name	CES AGENCY INC

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

932206

Policy instance

Insurance contract or identification number	932206
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $46,809
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
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

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

932206

Policy instance

Insurance contract or identification number	932206
Number of Individuals Covered	34860
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $88,000
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
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

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Company Name:	KOOSHAREM LLC DBA SELECT STAFFING, INC.
Employer identification number (EIN):	930994537
NAIC Classification:	561490