Civic Intelligence
Filing

Kent Moore Cabinets Health Plan

Kent Moore Cabinets Ltd • EIN 74-1904799 • Plan year 2007

Company ProfileSource Archive
Filing Insights

Participants

Up

551 → 575

24 • 4.36%

Assets

No comparison

- → -

No earlier value available.

Investment Management Fee

-

Admin expenses - • Total expenses -

Filing Details

Context

No event flags were generated for this filing.

Status Flags

Fidelity bond in place

Not reported

Limited-scope audit performed

Not reported

Contributions transmitted on time

Not reported

Participant loans in default

Not reported

Leases in default

Not reported

Reportable party-in-interest issues

Not reported

Loss discovered during year

Not reported

Assets with undetermined value

Not reported

Non-cash contributions

Not reported

Assets held for investment

Not reported

5% transactions reported

Not reported

All plan assets distributed

Not reported

Benefits paid when due

Not reported

Plan blackout period

Not reported

Plan termination resolution adopted

Not reported

Counterparties

Company Timeline

This filing is highlighted inside the broader sponsor history.

Year / FilingFilingsParticipantsAssetsContributionsContrib./Participant
20243705$32,270,169$3,926,535$5,570iApproximate average salary by contribution assumption: employee only about $139,239 at 4% or $92,826 at 6%; with 50% employer match about $92,826 at 4% or $61,884 at 6%; with 100% employer match about $69,619 at 4% or $46,413 at 6%.
Kent Moore Cabinets Ltd 401K Profit Sharing Plan-705$32,270,169$3,926,535$5,570iApproximate average salary by contribution assumption: employee only about $139,239 at 4% or $92,826 at 6%; with 50% employer match about $92,826 at 4% or $61,884 at 6%; with 100% employer match about $69,619 at 4% or $46,413 at 6%.
Kent Moore Cabinets Health Plan-698---
Kent Moore Cabinets LLC Wrap Plan-0---
20233701$26,556,140$3,446,150$4,916iApproximate average salary by contribution assumption: employee only about $122,901 at 4% or $81,934 at 6%; with 50% employer match about $81,934 at 4% or $54,623 at 6%; with 100% employer match about $61,451 at 4% or $40,967 at 6%.
Kent Moore Cabinets Ltd 401K Profit Sharing Plan-554$26,556,140$3,446,150$6,220iApproximate average salary by contribution assumption: employee only about $155,512 at 4% or $103,675 at 6%; with 50% employer match about $103,675 at 4% or $69,117 at 6%; with 100% employer match about $77,756 at 4% or $51,837 at 6%.
Kent Moore Cabinets Health Plan-701---
Kent Moore Cabinets LLC Wrap Plan-499---
20222679$19,960,812$2,966,173$4,368iApproximate average salary by contribution assumption: employee only about $109,211 at 4% or $72,807 at 6%; with 50% employer match about $72,807 at 4% or $48,538 at 6%; with 100% employer match about $54,606 at 4% or $36,404 at 6%.
Kent Moore Cabinets Ltd 401K Profit Sharing Plan-507$19,960,812$2,966,173$5,850iApproximate average salary by contribution assumption: employee only about $146,261 at 4% or $97,507 at 6%; with 50% employer match about $97,507 at 4% or $65,005 at 6%; with 100% employer match about $73,130 at 4% or $48,754 at 6%.
Kent Moore Cabinets Health Plan-679---
20212624$22,954,358$2,148,853$3,444iApproximate average salary by contribution assumption: employee only about $86,092 at 4% or $57,395 at 6%; with 50% employer match about $57,395 at 4% or $38,263 at 6%; with 100% employer match about $43,046 at 4% or $28,697 at 6%.
Kent Moore Cabinets Ltd 401K Profit Sharing Plan-464$22,954,358$2,148,853$4,631iApproximate average salary by contribution assumption: employee only about $115,779 at 4% or $77,186 at 6%; with 50% employer match about $77,186 at 4% or $51,457 at 6%; with 100% employer match about $57,889 at 4% or $38,593 at 6%.
Kent Moore Cabinets Health Plan-624---
20202580$19,410,070$1,844,839$3,181iApproximate average salary by contribution assumption: employee only about $79,519 at 4% or $53,013 at 6%; with 50% employer match about $53,013 at 4% or $35,342 at 6%; with 100% employer match about $39,759 at 4% or $26,506 at 6%.
Kent Moore Cabinets Ltd 401K Profit Sharing Plan-463$19,410,070$1,844,839$3,985iApproximate average salary by contribution assumption: employee only about $99,613 at 4% or $66,409 at 6%; with 50% employer match about $66,409 at 4% or $44,273 at 6%; with 100% employer match about $49,807 at 4% or $33,204 at 6%.
Kent Moore Cabinets Health Plan-580---
20192440$16,197,910$1,448,134$3,291iApproximate average salary by contribution assumption: employee only about $82,280 at 4% or $54,854 at 6%; with 50% employer match about $54,854 at 4% or $36,569 at 6%; with 100% employer match about $41,140 at 4% or $27,427 at 6%.
Kent Moore Cabinets Ltd 401K Profit Sharing Plan-440$16,197,910$1,448,134$3,291iApproximate average salary by contribution assumption: employee only about $82,280 at 4% or $54,854 at 6%; with 50% employer match about $54,854 at 4% or $36,569 at 6%; with 100% employer match about $41,140 at 4% or $27,427 at 6%.
Kent Moore Cabinets Health Plan-423---
20182459$12,610,745$1,439,953$3,137iApproximate average salary by contribution assumption: employee only about $78,429 at 4% or $52,286 at 6%; with 50% employer match about $52,286 at 4% or $34,857 at 6%; with 100% employer match about $39,214 at 4% or $26,143 at 6%.
Kent Moore Cabinets Ltd 401K Profit Sharing Plan-459$12,610,745$1,439,953$3,137iApproximate average salary by contribution assumption: employee only about $78,429 at 4% or $52,286 at 6%; with 50% employer match about $52,286 at 4% or $34,857 at 6%; with 100% employer match about $39,214 at 4% or $26,143 at 6%.
Kent Moore Cabinets Health Plan-420---
20172546$12,330,796$1,040,245$1,905iApproximate average salary by contribution assumption: employee only about $47,630 at 4% or $31,754 at 6%; with 50% employer match about $31,754 at 4% or $21,169 at 6%; with 100% employer match about $23,815 at 4% or $15,877 at 6%.
Kent Moore Cabinets Ltd 401K Profit Sharing Plan-440$12,330,796$1,040,245$2,364iApproximate average salary by contribution assumption: employee only about $59,105 at 4% or $39,403 at 6%; with 50% employer match about $39,403 at 4% or $26,269 at 6%; with 100% employer match about $29,552 at 4% or $19,702 at 6%.
Kent Moore Cabinets Health Plan-546---
20162462$10,282,508$868,885$1,881iApproximate average salary by contribution assumption: employee only about $47,018 at 4% or $31,345 at 6%; with 50% employer match about $31,345 at 4% or $20,897 at 6%; with 100% employer match about $23,509 at 4% or $15,673 at 6%.
Kent Moore Cabinets Ltd 401K Profit Sharing Plan-462$10,282,508$868,885$1,881iApproximate average salary by contribution assumption: employee only about $47,018 at 4% or $31,345 at 6%; with 50% employer match about $31,345 at 4% or $20,897 at 6%; with 100% employer match about $23,509 at 4% or $15,673 at 6%.
Kent Moore Cabinets Health Plan-447---
20152463$9,936,556$708,942$1,531iApproximate average salary by contribution assumption: employee only about $38,280 at 4% or $25,520 at 6%; with 50% employer match about $25,520 at 4% or $17,013 at 6%; with 100% employer match about $19,140 at 4% or $12,760 at 6%.
Kent Moore Cabinets Ltd 401K Profit Sharing Plan-420$9,936,556$708,942$1,688iApproximate average salary by contribution assumption: employee only about $42,199 at 4% or $28,133 at 6%; with 50% employer match about $28,133 at 4% or $18,755 at 6%; with 100% employer match about $21,099 at 4% or $14,066 at 6%.
Kent Moore Cabinets Health Plan-463---
20142391$9,806,227$553,447$1,415iApproximate average salary by contribution assumption: employee only about $35,387 at 4% or $23,591 at 6%; with 50% employer match about $23,591 at 4% or $15,727 at 6%; with 100% employer match about $17,693 at 4% or $11,796 at 6%.
Kent Moore Cabinets Ltd 401K Profit Sharing Plan-391$9,806,227$553,447$1,415iApproximate average salary by contribution assumption: employee only about $35,387 at 4% or $23,591 at 6%; with 50% employer match about $23,591 at 4% or $15,727 at 6%; with 100% employer match about $17,693 at 4% or $11,796 at 6%.
Kent Moore Cabinets Health Plan-293---
20132521$9,013,742$461,472$886iApproximate average salary by contribution assumption: employee only about $22,144 at 4% or $14,762 at 6%; with 50% employer match about $14,762 at 4% or $9,842 at 6%; with 100% employer match about $11,072 at 4% or $7,381 at 6%.
Kent Moore Cabinets Ltd 401K Profit Sharing Plan-350$9,013,742$461,472$1,318iApproximate average salary by contribution assumption: employee only about $32,962 at 4% or $21,975 at 6%; with 50% employer match about $21,975 at 4% or $14,650 at 6%; with 100% employer match about $16,481 at 4% or $10,987 at 6%.
Kent Moore Cabinets Health Plan-521---
20122460$7,962,308$356,767$776iApproximate average salary by contribution assumption: employee only about $19,390 at 4% or $12,926 at 6%; with 50% employer match about $12,926 at 4% or $8,618 at 6%; with 100% employer match about $9,695 at 4% or $6,463 at 6%.
Kent Moore Cabinets Ltd 401K Profit Sharing Plan-326$7,962,308$356,767$1,094iApproximate average salary by contribution assumption: employee only about $27,359 at 4% or $18,240 at 6%; with 50% employer match about $18,240 at 4% or $12,160 at 6%; with 100% employer match about $13,680 at 4% or $9,120 at 6%.
Kent Moore Cabinets Health Plan-460---
20112429$7,200,522$393,973$918iApproximate average salary by contribution assumption: employee only about $22,959 at 4% or $15,306 at 6%; with 50% employer match about $15,306 at 4% or $10,204 at 6%; with 100% employer match about $11,479 at 4% or $7,653 at 6%.
Kent Moore Cabinets Ltd 401K Profit Sharing Plan-309$7,200,522$393,973$1,275iApproximate average salary by contribution assumption: employee only about $31,875 at 4% or $21,250 at 6%; with 50% employer match about $21,250 at 4% or $14,167 at 6%; with 100% employer match about $15,937 at 4% or $10,625 at 6%.
Kent Moore Cabinets Health Plan-429---
20102551$7,501,142$438,837$796iApproximate average salary by contribution assumption: employee only about $19,911 at 4% or $13,274 at 6%; with 50% employer match about $13,274 at 4% or $8,849 at 6%; with 100% employer match about $9,955 at 4% or $6,637 at 6%.
Kent Moore Cabinets Ltd 401K Profit Sharing Plan-300$7,501,142$438,837$1,463iApproximate average salary by contribution assumption: employee only about $36,570 at 4% or $24,380 at 6%; with 50% employer match about $24,380 at 4% or $16,253 at 6%; with 100% employer match about $18,285 at 4% or $12,190 at 6%.
Kent Moore Cabinets Health Plan-551---
20092533$6,985,293$442,661$831iApproximate average salary by contribution assumption: employee only about $20,763 at 4% or $13,842 at 6%; with 50% employer match about $13,842 at 4% or $9,228 at 6%; with 100% employer match about $10,381 at 4% or $6,921 at 6%.
Kent Moore Cabinets Ltd 401K Profit Sharing Plan-316$6,985,293$442,661$1,401iApproximate average salary by contribution assumption: employee only about $35,021 at 4% or $23,347 at 6%; with 50% employer match about $23,347 at 4% or $15,565 at 6%; with 100% employer match about $17,510 at 4% or $11,674 at 6%.
Kent Moore Cabinets Health Plan-533---
20082553$5,996,118$798,501$1,444iApproximate average salary by contribution assumption: employee only about $36,099 at 4% or $24,066 at 6%; with 50% employer match about $24,066 at 4% or $16,044 at 6%; with 100% employer match about $18,049 at 4% or $12,033 at 6%.
Kent Moore Cabinets Ltd 401K Profit Sharing Plan-338$5,996,118$798,501$2,362iApproximate average salary by contribution assumption: employee only about $59,061 at 4% or $39,374 at 6%; with 50% employer match about $39,374 at 4% or $26,249 at 6%; with 100% employer match about $29,530 at 4% or $19,687 at 6%.
Kent Moore Cabinets Health Plan-553---
20073575$7,847,691$1,043,713$1,815iApproximate average salary by contribution assumption: employee only about $45,379 at 4% or $30,253 at 6%; with 50% employer match about $30,253 at 4% or $20,168 at 6%; with 100% employer match about $22,689 at 4% or $15,126 at 6%.
Kent Moore Cabinets Ltd 401K Profit Sharing Plan-327$7,847,691$1,043,713$3,192iApproximate average salary by contribution assumption: employee only about $79,795 at 4% or $53,196 at 6%; with 50% employer match about $53,196 at 4% or $35,464 at 6%; with 100% employer match about $39,897 at 4% or $26,598 at 6%.
Kent Moore Cabinets Health PlanCurrent575---
Kent Moore Cabinets Ltd. Occupational Injury Benefits Plan-448---
20063551$6,466,130$505,102$917iApproximate average salary by contribution assumption: employee only about $22,918 at 4% or $15,278 at 6%; with 50% employer match about $15,278 at 4% or $10,186 at 6%; with 100% employer match about $11,459 at 4% or $7,639 at 6%.
Kent Moore Cabinets Ltd 401K Profit Sharing Plan-319$6,466,130$505,102$1,583iApproximate average salary by contribution assumption: employee only about $39,585 at 4% or $26,390 at 6%; with 50% employer match about $26,390 at 4% or $17,593 at 6%; with 100% employer match about $19,792 at 4% or $13,195 at 6%.
Kent Moore Cabinets Ltd. Occupational Injury Benefits Plan-434---
Kent Moore Cabinets Health Plan-551---
20052407$5,983,442$420,561$1,033iApproximate average salary by contribution assumption: employee only about $25,833 at 4% or $17,222 at 6%; with 50% employer match about $17,222 at 4% or $11,481 at 6%; with 100% employer match about $12,916 at 4% or $8,611 at 6%.
Kent Moore Cabinets Ltd 401K Profit Sharing Plan-333$5,983,442$420,561$1,263iApproximate average salary by contribution assumption: employee only about $31,574 at 4% or $21,049 at 6%; with 50% employer match about $21,049 at 4% or $14,033 at 6%; with 100% employer match about $15,787 at 4% or $10,525 at 6%.
Kent Moore Cabinets Ltd. Occupational Injury Benefits Plan-407---
20042427$5,851,770$672,017$1,574iApproximate average salary by contribution assumption: employee only about $39,345 at 4% or $26,230 at 6%; with 50% employer match about $26,230 at 4% or $17,487 at 6%; with 100% employer match about $19,673 at 4% or $13,115 at 6%.
Kent Moore Cabinets Ltd 401K Profit Sharing Plan-427$5,851,770$672,017$1,574iApproximate average salary by contribution assumption: employee only about $39,345 at 4% or $26,230 at 6%; with 50% employer match about $26,230 at 4% or $17,487 at 6%; with 100% employer match about $19,673 at 4% or $13,115 at 6%.
Kent Moore Cabinets Ltd. Occupational Injury Benefits Plan-406---
20032533$5,023,769$797,268$1,496iApproximate average salary by contribution assumption: employee only about $37,395 at 4% or $24,930 at 6%; with 50% employer match about $24,930 at 4% or $16,620 at 6%; with 100% employer match about $18,698 at 4% or $12,465 at 6%.
Kent Moore Cabinets Ltd 401K Profit Sharing Plan-278$5,023,769$797,268$2,868iApproximate average salary by contribution assumption: employee only about $71,697 at 4% or $47,798 at 6%; with 50% employer match about $47,798 at 4% or $31,865 at 6%; with 100% employer match about $35,848 at 4% or $23,899 at 6%.
Kent Moore Cabinets Ltd. Occupational Injury Benefits Plan-533---
20023430$7,665,964$1,555,400$3,617iApproximate average salary by contribution assumption: employee only about $90,430 at 4% or $60,287 at 6%; with 50% employer match about $60,287 at 4% or $40,191 at 6%; with 100% employer match about $45,215 at 4% or $30,143 at 6%.
Kent Moore Cabinets Ltd 401K Profit Sharing Plan-278$3,832,982$777,700$2,797iApproximate average salary by contribution assumption: employee only about $69,937 at 4% or $46,625 at 6%; with 50% employer match about $46,625 at 4% or $31,083 at 6%; with 100% employer match about $34,969 at 4% or $23,312 at 6%.
Kent Moore Cabinets Ltd 401K Profit Sharing Plan-278$3,832,982$777,700$2,797iApproximate average salary by contribution assumption: employee only about $69,937 at 4% or $46,625 at 6%; with 50% employer match about $46,625 at 4% or $31,083 at 6%; with 100% employer match about $34,969 at 4% or $23,312 at 6%.
Kent Moore Cabinets Ltd. Occupational Injury Benefits Plan-430---
20012400$3,677,992$1,005,993$2,515iApproximate average salary by contribution assumption: employee only about $62,875 at 4% or $41,916 at 6%; with 50% employer match about $41,916 at 4% or $27,944 at 6%; with 100% employer match about $31,437 at 4% or $20,958 at 6%.
Kent Moore Cabinets Ltd 401K Profit Sharing Plan-179$3,677,992$1,005,993$5,620iApproximate average salary by contribution assumption: employee only about $140,502 at 4% or $93,668 at 6%; with 50% employer match about $93,668 at 4% or $62,445 at 6%; with 100% employer match about $70,251 at 4% or $46,834 at 6%.
Kent Moore Cabinets Ltd. Occupational Injury Benefits Plan-400---
20002367$0$0-
Kent Moore Cabinets Ltd. Occupational Injury Benefits Plan-367---
Kent Moore Cabinets Ltd 401K Profit Sharing Plan-137---
19992325$2,556,531$619,560$1,906iApproximate average salary by contribution assumption: employee only about $47,658 at 4% or $31,772 at 6%; with 50% employer match about $31,772 at 4% or $21,182 at 6%; with 100% employer match about $23,829 at 4% or $15,886 at 6%.
Kent Moore Cabinets Ltd 401K Profit Sharing Plan-0$2,556,531$619,560-
Kent Moore Cabinets Ltd. Occupational Injury Benefits Plan-325---
Schedule Details

Schedule A

Row 1
Filing Id
84037347317548
Form Id
93429554
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
7030378347317040005
Ins Broker 01 Name
WEALTH DESIGN GROUP LLC
Ins Broker 01 Street Addr
3040 POST OAK BLVD, SUITE 400
Ins Broker 01 City
HOUSTON
Ins Broker 01 State
TX
Ins Broker 01 ZIP Code
77056
Ins Broker Comm Pd 01 Amount
$1
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 2
Filing Id
84037347317548
Form Id
93429552
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
7030378347317040003
Ins Broker 01 Name
BROWN & COMPANY INSURANCE
Ins Broker 01 Street Addr
1825 BROTHERS BLVD
Ins Broker 01 City
COLLEGE STATION
Ins Broker 01 State
TX
Ins Broker 01 ZIP Code
77845
Ins Broker Comm Pd 01 Amount
$8,457
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 3
Filing Id
84037347317548
Form Id
93429551
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
7030378347317040002
Ins Broker 01 Name
PHILLIP D. ADAMS
Ins Broker 01 Street Addr
300 BRIARCREST DRIVE, SUITE 508
Ins Broker 01 City
BRYAN
Ins Broker 01 State
TX
Ins Broker 01 ZIP Code
77802
Ins Broker Comm Pd 01 Amount
$22,830
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 4
Filing Id
84037347317548
Form Id
93429553
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
7030378347317040004
Ins Broker 01 Name
BROWN & COMPANY INSURANCE
Ins Broker 01 Street Addr
1825 BROTHERS BLVD
Ins Broker 01 City
COLLEGE STATION
Ins Broker 01 State
TX
Ins Broker 01 ZIP Code
77845
Ins Broker Comm Pd 01 Amount
$11,190
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 5
Filing Id
84037347317548
Form Id
93429555
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
7030378347317040006
Ins Broker 01 Name
BROWN & COMPANY INSURANCE SERV LP
Ins Broker 01 Street Addr
1825 BROTHERS BLVD
Ins Broker 01 City
COLLEGE STATION
Ins Broker 01 State
TX
Ins Broker 01 ZIP Code
77845
Ins Broker Comm Pd 01 Amount
$2,402
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 6
Filing Id
84037347317548
Form Id
93429556
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
7030378347317040007
Ins Broker 01 Name
PHILLIP D. ADAMS
Ins Broker 01 Street Addr
300 BRIARCREST DRIVE, SUITE 508
Ins Broker 01 City
BRYAN
Ins Broker 01 State
TX
Ins Broker 01 ZIP Code
77802
Ins Broker Comm Pd 01 Amount
$3,764
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 7
Filing Id
84037347317548
Form Id
93429554
Page Id
2
Page Seq
0
Page Row Num
2
Row Num
1
Image Form Id
7030378347317040005
Ins Broker 01 Name
PLUMHOFF & ASSOCIATES, INC.
Ins Broker 01 Street Addr
1220 AUGUSTA DRIVE, SUITE 300
Ins Broker 01 City
HOUSTON
Ins Broker 01 State
TX
Ins Broker 01 ZIP Code
77057
Ins Broker Comm Pd 01 Amount
$98
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 8
Filing Id
84037347317548
Form Id
93429553
Page Id
2
Page Seq
0
Page Row Num
2
Row Num
1
Image Form Id
7030378347317040004
Ins Broker 01 Name
BRAZOS VALLEY FINANCIAL SERVICES
Ins Broker 01 Street Addr
3040 POST OAK BLVD, SUITE 400
Ins Broker 01 City
HOUSTON
Ins Broker 01 State
TX
Ins Broker 01 ZIP Code
77056
Ins Broker Comm Pd 01 Amount
$2,361
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 9
Filing Id
84037347317548
Form Id
93429551
Page Id
2
Page Seq
0
Page Row Num
2
Row Num
1
Image Form Id
7030378347317040002
Ins Broker 01 Name
PLUMHOFF & ASSOCIATES, INC.
Ins Broker 01 Street Addr
1220 AUGUSTA DRIVE, SUITE 300
Ins Broker 01 City
HOUSTON
Ins Broker 01 State
TX
Ins Broker 01 ZIP Code
77057
Ins Broker Comm Pd 01 Amount
$22,830
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 10
Filing Id
84037347317548
Form Id
93429552
Page Id
2
Page Seq
0
Page Row Num
2
Row Num
1
Image Form Id
7030378347317040003
Ins Broker 01 Name
BRAZOS VALLEY FINANCIAL SERVICES
Ins Broker 01 Street Addr
3040 POST OAK BLVD, SUITE 400
Ins Broker 01 City
HOUSTON
Ins Broker 01 State
TX
Ins Broker 01 ZIP Code
77056
Ins Broker Comm Pd 01 Amount
$1,584
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 11
Filing Id
84037347317548
Form Id
93429554
Page Id
2
Page Seq
0
Page Row Num
3
Row Num
2
Image Form Id
7030378347317040005
Ins Broker 01 Name
BRAZOS VALLEY FINANCIAL SERVICES
Ins Broker 01 Street Addr
3040 POST OAK BLVD, SUITE 400
Ins Broker 01 City
HOUSTON
Ins Broker 01 State
TX
Ins Broker 01 ZIP Code
77056
Ins Broker Comm Pd 01 Amount
$2,466
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 12
Filing Id
84037347317548
Form Id
93429553
Page Id
2
Page Seq
0
Page Row Num
3
Row Num
2
Image Form Id
7030378347317040004
Ins Broker 01 Name
PLUMHOFF & ASSOCIATES, INC.
Ins Broker 01 Street Addr
1220 AUGUSTA DRIVE, SUITE 300
Ins Broker 01 City
HOUSTON
Ins Broker 01 State
TX
Ins Broker 01 ZIP Code
77057
Ins Broker Comm Pd 01 Amount
$559
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 13
Filing Id
84037347317548
Form Id
93429551
Page Id
2
Page Seq
0
Page Row Num
3
Row Num
2
Image Form Id
7030378347317040002
Ins Broker 01 Name
BRAZOS VALLEY FINANCIAL SERVICES
Ins Broker 01 Street Addr
3040 POST OAK BLVD, SUITE 400
Ins Broker 01 City
HOUSTON
Ins Broker 01 State
TX
Ins Broker 01 ZIP Code
77056
Ins Broker Comm Pd 01 Amount
$4,116
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 14
Filing Id
84037347317548
Form Id
93429552
Page Id
2
Page Seq
0
Page Row Num
3
Row Num
2
Image Form Id
7030378347317040003
Ins Broker 01 Name
PLUMHOFF & ASSOCIATES, INC.
Ins Broker 01 Street Addr
1220 AUGUSTA DRIVE, SUITE 300
Ins Broker 01 City
HOUSTON
Ins Broker 01 State
TX
Ins Broker 01 ZIP Code
77057
Ins Broker Comm Pd 01 Amount
$439
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 15
Filing Id
84037347317548
Form Id
93429552
Page Id
2
Page Seq
1
Page Row Num
1
Row Num
3
Image Form Id
7030378347317040003
Ins Broker 01 Name
PHILLIP D. ADAMS
Ins Broker 01 Street Addr
300 BRIARCREST DRIVE, SUITE 508
Ins Broker 01 City
BRYAN
Ins Broker 01 State
TX
Ins Broker 01 ZIP Code
77802
Ins Broker Comm Pd 01 Amount
$439
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 16
Filing Id
84037347317548
Form Id
93429553
Page Id
2
Page Seq
1
Page Row Num
1
Row Num
3
Image Form Id
7030378347317040004
Ins Broker 01 Name
PHILLIP D. ADAMS
Ins Broker 01 Street Addr
300 BRIARCREST DRIVE, SUITE 508
Ins Broker 01 City
BRYAN
Ins Broker 01 State
TX
Ins Broker 01 ZIP Code
77802
Ins Broker Comm Pd 01 Amount
$559
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 17
Filing Id
84037347317548
Form Id
93429554
Page Id
2
Page Seq
1
Page Row Num
1
Row Num
3
Image Form Id
7030378347317040005
Ins Broker 01 Name
SHARON BROWN
Ins Broker 01 Street Addr
914 PARK LANE
Ins Broker 01 City
BRYAN
Ins Broker 01 State
TX
Ins Broker 01 ZIP Code
77802
Ins Broker Comm Pd 01 Amount
$617
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 18
Filing Id
84037347317548
Form Id
93429554
Page Id
2
Page Seq
1
Page Row Num
2
Row Num
4
Image Form Id
7030378347317040005
Ins Broker 01 Name
RICHARD S. SMITH
Ins Broker Comm Pd 01 Amount
$454
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 19
Ins Carrier Name: LIFE INSURANCE COMPANY OF NORTH AMERICA
Filing Id
84037347317548
Form Id
93429556
Schedule A EIN
74-1904799
Schedule A Plan Num
501
Schedule A Plan Year Begin Date
2007-05-01
Schedule A Tax Period
20080430
Ins Carrier Name
LIFE INSURANCE COMPANY OF NORTH AMERICA
Ins Carrier EIN
23-1503749
Ins Carrier Naic Code
65498
Ins Contract Num
OK 818458
Ins Prsn Covered End of year Count
0
Ins Policy From Date
2007-05-01
Ins Policy To Date
2008-05-01
Ins Broker Comm Total Amount
$3,764
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
M
Wlfr Type Bnft Oth Text
ACCIDENTAL DEATH
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$25,090
Wlfr Acquis Cost Amount
$0
Row 20
Ins Carrier Name: UNITED OF OMAHA LIFE INSURANCE COMPANY
Filing Id
84037347317548
Form Id
93429552
Schedule A EIN
74-1904799
Schedule A Plan Num
501
Schedule A Plan Year Begin Date
2007-05-01
Schedule A Tax Period
20080430
Ins Carrier Name
UNITED OF OMAHA LIFE INSURANCE COMPANY
Ins Carrier EIN
47-0322111
Ins Carrier Naic Code
69868
Ins Contract Num
GVTL 097C9
Ins Prsn Covered End of year Count
167
Ins Policy From Date
2007-05-01
Ins Policy To Date
2008-04-30
Ins Broker Comm Total Amount
$10,919
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
D
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$54,600
Wlfr Acquis Cost Amount
$0
Row 21
Ins Carrier Name: GUARDIAN
Filing Id
84037347317548
Form Id
93429554
Schedule A EIN
74-1904799
Schedule A Plan Num
501
Schedule A Plan Year Begin Date
2007-05-01
Schedule A Tax Period
20080430
Ins Carrier Name
GUARDIAN
Ins Carrier EIN
13-5123390
Ins Carrier Naic Code
64246
Ins Contract Num
00404155
Ins Prsn Covered End of year Count
244
Ins Policy From Date
2007-05-01
Ins Policy To Date
2008-04-30
Ins Broker Comm Total Amount
$3,636
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
B
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$78,779
Wlfr Acquis Cost Amount
$0
Row 22
Ins Carrier Name: FORT DEARBORN LIFE INSURANCE COMPANY
Filing Id
84037347317548
Form Id
93429555
Schedule A EIN
74-1904799
Schedule A Plan Num
501
Schedule A Plan Year Begin Date
2007-05-01
Schedule A Tax Period
20080430
Ins Carrier Name
FORT DEARBORN LIFE INSURANCE COMPANY
Ins Carrier EIN
36-2598882
Ins Carrier Naic Code
71129
Ins Contract Num
GFZ5314
Ins Prsn Covered End of year Count
876
Ins Policy From Date
2007-04-01
Ins Policy To Date
2008-03-28
Ins Broker Comm Total Amount
$2,402
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
DM
Wlfr Type Bnft Oth Text
AD&D
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$25,159
Wlfr Acquis Cost Amount
$0
Row 23
Ins Carrier Name: HEALTH CARE SERVICE CORPORATION
Filing Id
84037347317548
Form Id
93429551
Schedule A EIN
74-1904799
Schedule A Plan Num
501
Schedule A Plan Year Begin Date
2007-05-01
Schedule A Tax Period
20080430
Ins Carrier Name
HEALTH CARE SERVICE CORPORATION
Ins Carrier EIN
36-1236610
Ins Carrier Naic Code
70670
Ins Contract Num
95314
Ins Prsn Covered End of year Count
575
Ins Policy From Date
2007-05-01
Ins Policy To Date
2008-04-30
Ins Broker Comm Total Amount
$49,776
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
AI
Wlfr Premium Rcvd Amount
$1,370,609
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$1,370,609
Wlfr Claims Paid Amount
$1,162,178
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$1,162,178
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$45,661
Wlfr Ret Admin Amount
$162,770
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$208,431
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$153,744
Wlfr Acquis Cost Amount
$0
Row 24
Ins Carrier Name: UNITED OF OMAHA LIFE INSURANCE COMPANY
Filing Id
84037347317548
Form Id
93429553
Schedule A EIN
74-1904799
Schedule A Plan Num
501
Schedule A Plan Year Begin Date
2007-05-01
Schedule A Tax Period
20080430
Ins Carrier Name
UNITED OF OMAHA LIFE INSURANCE COMPANY
Ins Carrier EIN
47-0322111
Ins Carrier Naic Code
69868
Ins Contract Num
GUC 097C9
Ins Prsn Covered End of year Count
100
Ins Policy From Date
2007-05-04
Ins Policy To Date
2008-04-30
Ins Broker Comm Total Amount
$14,669
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
E
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$6,006
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$6,006
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$73,344
Wlfr Acquis Cost Amount
$0