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FORM 5500 DATA

R & R Insurance Services, Inc. 401k Profit Sharing Plan

Overview

Plan Information

  • Plan Year01/01/2011 — 12/31/2011
  • Date of Plan01/01/1980
  • Net Assets as of 12/31/2011 $22,674,752
  • Plan Number1
  • Plan Type Single Employer
  • Is the plan collectively bargained? No
  • Did the plan file for an extension of time or the DFVC Program?Yes
  • Plan Funding ArrangementInsurance Trust
  • Plan Benefit ArrangementInsurance Trust

Participant Information as of 12/31/2011

  • Active (Eligible) Participants164
  • Retired or separated participants receiving benefits0
  • Other retired or separated participants entitled to future benefits18
  • Subtotal182
  • Deceased participants whose beneficiaries are receiving or are entitled to receive benefits0
  • Total182
  • Total number of participants as of 01/01/2011178
  • Number of participants with account balances182
  • Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested0

Expenses

  • Total Benefit Payments$0
  • Corrective Distributions$0
  • Administrative Service Providers$0
  • Other Expenses$0
  • Total Expenses$0
  • Total Transfers$0

Sponsor Information

  • Address1581 East Racine Ave.
  • CityWaukesha
  • StateWI
  • Zip53186-6826
  • Telephone(262) 574-7000
  • EIN39-1230987
  • Industry Code524210
  • Named AdministratorKen Kumrow

Plan Administrator Information

  • Administrator NameR & R Insurance Services, Inc.
  • Address1581 East Racine Ave.
  • CityWaukesha
  • StateWI
  • Zip53186-6826
  • Telephone(262) 574-7000
  • Administrator EIN39-1230987

Audit Information

  • Audit StatusAudited
  • AuditorKolb&Co Sc
  • Auditor EIN39-1214345
  • Audit Opinion Disclaimer
  • Audit TypeLimited Scope Audit

Benefits Provided Under the Plan

Code Benefit Description
2E Profit-sharing A defined contribution plan that allows employer discretionary contributions. These plans often contain a 401(k) feature.
2F ERISA section 404(c) Plan This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
2G 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.
2J 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.
2K 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 contributions 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.
2T Participant-directed Account Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
3D 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.

Questions and Answers

Question Answer Amount
During the plan year did the employer fail to transmit to the plan any participant contributions within the time period described in 29 CFT 2510.3-102? No
Were any loans by the plan or fixed income obligations due the plan in default as of the close of plan year or classified during the year as uncollectible? Disregard participant loans secured by participant's account balance. No
Were any leases to which the plan was a party in default or classified during the year as uncollectible? No
Were there any nonexempt transactions with any party-in-interest? No
Was this plan covered by a fidelity bond? Yes $1,000,000
Did the plan have a loss, whether or not reimbursed by the plan's fidelity bond, that was caused by fraud or dishonesty? No
Did the plan hold any assets whose current value was neither readily determinable on an established market nor set by an independent third party appraiser? No
Did the plan receive any noncash contributions whose value was neither readily determinable on an established market nor set by an independent third party appraiser? No
Did the plan have assets held for investment? Yes
Were any plan transactions or series of transactions in excess of 5% of the current value of plan assets? No
Were all the plan assets either distributed to participants or beneficiaries, transferred to another plan, or brought under the control of the PBGC? No
Has the plan failed to provide any benefit when due under the plan? No
If this is an individual account plan, was there a blackout period? Yes
If there was a blackout period, have you either provided the required notice or one of the exceptions to providing the notice applied under 29 CFR 2520.101-3? Yes

Financials

Income and Expense Statement

Income $2,388,802
Contributions $2,272,358
Cash Contributions $2,272,358
Cash from Employers $1,193,605
Cash from Participants $888,083
Others (including rollovers) $190,670
Noncash Contributions $0
Total Earnings on Investments $116,444
Total Interest $17,882
Interest-Bearing Cash $0
U.S. Government Securities $0
Corporate Debt Instruments $0
Loans (other than to participants) $0
Participant Loans $17,882
Interest from Other Investments $0
Total Dividends $0
Preferred Stock $0
Common Stock $0
Rents $0
Net gain (loss) on sale of assets $0
Aggregate Proceeds $0
Aggregate Carrying Amount $0
Total Unrealized Appreciation (depreciation) of assets $0
Real Estate $0
Other $0
Net investment gain (loss) from common/collective trusts $0
Net investment gain (loss) from pooled separate accounts $-1,156,901
Net investment gain (loss) from master trust investment accounts $0
Net investment gain (loss) from 103-12 investment entities $0
Net investment gain (loss) from registered investment companies $1,255,463
Other Income $0
Expenses $1,631,005
Total Benefit Payments $1,629,458
Directly to participants or beneficiaries, including direct rollovers $1,629,458
To insurance carriers for the provision of benefits $0
Other Benefit Payment Fees $0
Corrective Distributions $0
Certain deemed distributions of participant loans $0
Interest expense $0
Total Administrative Expenses $1,547
Professional Fees $1,547
Contract Administrator Fees $0
Investment Advisory and management fees $0
Other Administrative Fees $0
Net Income $757,797
Transfers of Assets to this Plan $0
Transfers of Assets from this Plan $0

Asset and Liability Statement

12/31/2011 12/31/2010 Change YOY
Total Assets $22,674,752 $21,916,955 3.46%
Total noninterest-bearing cash $47,477 $0 0.0%
Receivables $500,000 $0 0.0%
Employer Contributions $500,000 $0 0.0%
Participant Contributions $0 $0 0.0%
Other Contributions $0 $0 0.0%
General Investments $0 $0 0.0%
Interest-bearing cash $0 $0 0.0%
U.S. Government Securities $0 $0 0.0%
Corporate Debt Instruments $0 $0 0.0%
Preferred $0 $0 0.0%
All Other $0 $0 0.0%
Corporate Stocks $0 $0 0.0%
Preferred $0 $0 0.0%
Common $0 $0 0.0%
Partnership/joint venture interests $0 $0 0.0%
Real estate (other than employer real property) $0 $0 0.0%
Loans (other than to participants) $0 $0 0.0%
Participants Loans $288,708 $309,518 -6.72%
Value of interest in common/collective trusts $0 $3,591,967 -100.00%
Value of interest in pooled separate accounts $21,838,567 $0 0.0%
Value of interest in master trust investment accounts $0 $0 0.0%
Value of interest in 103-12 investment entities $0 $0 0.0%
Value of interest in registered investment companies $0 $18,015,470 -100.00%
Value of funds held in insurance co. general account $0 $0 0.0%
Other Investments $0 $0 0.0%
Employer-related Investments $0 $0 0.0%
Employer Securities $0 $0 0.0%
Employer Real Property $0 $0 0.0%
Buildings and other property used in plan operation $0 $0 0.0%
Total Liabilities $0 $0 0.0%
Benefit Claims Payable (1) $0 $0 0.0%
Operating Payables (1) $0 $0 0.0%
Acquisition Indebtedness (1) $0 $0 0.0%
Other liabilities (1) $0 $0 0.0%
Net Assets $22,674,752 $21,916,955 3.46%

Service Providers

Persons Receiving Only Eligible Indirect Compensation

There is no information on eligible indirect compensation for this plan.

Other Service Providers Receiving Direct or Indirect Compensation

Name Nature of Service Relationship to Plan Sponsor Direct Compensation Paid by Plan Indirect Compensation Paid by Plan Total Compensation
John Hancock Life Insurance Company Recordkeeping and information management (computing, tabulating, data processing, etc.), Investment management, Shareholder servicing fees, Sub-transfer agency fees, Float revenue, Distribution (12b-1) fees Recordkeeper $542 $0 $542
Total $542 $0 $542

Indirect Compensation

There are no service providers with indirect compensation listed for this plan.

Service Providers Who Fail or Refuse to Provide Information

There are no service providers who failed or refused to provide information.

Termination Information on Accountants and Enrolled Actuaries

There is no termination information for this plan.

Investments

Investments

Name of Investment Investment Manager Type of Investment Dollar Value
Lifestyle Moderate John Hancock Life Insurance Company DFE: Pooled Separate Account $3,055,932
Lifestyle Growth John Hancock Life Insurance Company DFE: Pooled Separate Account $2,974,709
Lifestyle Balanced John Hancock Life Insurance Company DFE: Pooled Separate Account $2,136,752
Money Market Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $1,290,226
Lifestyle Conservative John Hancock Life Insurance Company DFE: Pooled Separate Account $1,179,919
Pimco Total Return John Hancock Life Insurance Company DFE: Pooled Separate Account $1,026,158
Retirement Choices At 2025 John Hancock Life Insurance Company DFE: Pooled Separate Account $892,797
Retirement Living At 2025 John Hancock Life Insurance Company DFE: Pooled Separate Account $680,260
Retirement Choices At 2020 John Hancock Life Insurance Company DFE: Pooled Separate Account $448,809
Templeton Global Bond Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $382,561
Retirement Living At 2035 John Hancock Life Insurance Company DFE: Pooled Separate Account $336,648
Lifestyle Aggressive John Hancock Life Insurance Company DFE: Pooled Separate Account $332,286
T Rowe Price Equity Inc John Hancock Life Insurance Company DFE: Pooled Separate Account $248,656
Thornburg International Value John Hancock Life Insurance Company DFE: Pooled Separate Account $241,428
Pimco All Asset John Hancock Life Insurance Company DFE: Pooled Separate Account $226,962
T Rowe Price Health Ci John Hancock Life Insurance Company DFE: Pooled Separate Account $226,433
Federated High Yield Bond John Hancock Life Insurance Company DFE: Pooled Separate Account $204,242
Retirement Living At 2020 John Hancock Life Insurance Company DFE: Pooled Separate Account $202,035
Pimco Real Return John Hancock Life Insurance Company DFE: Pooled Separate Account $194,562
Dfa Emerging Markets Value John Hancock Life Insurance Company DFE: Pooled Separate Account $181,508
Oppenheimer Developing Market John Hancock Life Insurance Company DFE: Pooled Separate Account $180,279
Franklin Small-Mid Growth John Hancock Life Insurance Company DFE: Pooled Separate Account $172,385
Retirement Choices At 2010 John Hancock Life Insurance Company DFE: Pooled Separate Account $157,373
Retirement Choices At 2045 John Hancock Life Insurance Company DFE: Pooled Separate Account $156,410
Strategic Income Opp Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $155,511
Jpm Midcap Value Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $150,966
Fidelity Contrafund John Hancock Life Insurance Company DFE: Pooled Separate Account $145,750
Retirement Choices At 2035 John Hancock Life Insurance Company DFE: Pooled Separate Account $144,492
Mfs Utilities John Hancock Life Insurance Company DFE: Pooled Separate Account $143,040
Retirement Choices At 2015 John Hancock Life Insurance Company DFE: Pooled Separate Account $137,488
Retirement Living At 2030 John Hancock Life Insurance Company DFE: Pooled Separate Account $134,738
Total Bond Market Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $134,706
Dfa Us Small Cap Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $132,845
Retirement Choices At 2030 John Hancock Life Insurance Company DFE: Pooled Separate Account $130,303
Retirement Choices At 2040 John Hancock Life Insurance Company DFE: Pooled Separate Account $124,289
Lord Abbett Value Opps Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $121,422
Energy John Hancock Life Insurance Company DFE: Pooled Separate Account $116,032
T Rowe Price Cap Appreciation John Hancock Life Insurance Company DFE: Pooled Separate Account $115,858
Oppenheimer Intl Growth Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $113,379
Blackrock Global Allocation John Hancock Life Insurance Company DFE: Pooled Separate Account $110,125
Europacific Growth Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $110,039
Small Cap Value Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $108,222
Ivy Asset Strategy Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $107,733
T Rowe Price Sml Cap Val John Hancock Life Insurance Company DFE: Pooled Separate Account $107,580
Fidelity Advisor Gold Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $90,698
T Rowe Price Spectrum Inc John Hancock Life Insurance Company DFE: Pooled Separate Account $90,508
Royce Opportunity John Hancock Life Insurance Company DFE: Pooled Separate Account $89,606
Natural Resources Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $89,098
Aston/Fairpointe Mid Cap Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $86,671
Blackrock Basic Value John Hancock Life Insurance Company DFE: Pooled Separate Account $75,239
Dfa Inflation-Protected Sec John Hancock Life Insurance Company DFE: Pooled Separate Account $75,042
Eaton Vance Large-Cap Value John Hancock Life Insurance Company DFE: Pooled Separate Account $69,613
Blue Chip Growth Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $68,567
Pimco Global Bond John Hancock Life Insurance Company DFE: Pooled Separate Account $66,103
Global Bond Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $66,058
American Century Heritage John Hancock Life Insurance Company DFE: Pooled Separate Account $65,658
Oppenheimer Intl Bond John Hancock Life Insurance Company DFE: Pooled Separate Account $61,732
Columbia Mid Cap Value John Hancock Life Insurance Company DFE: Pooled Separate Account $56,328
Fidelity Adv New Insights John Hancock Life Insurance Company DFE: Pooled Separate Account $55,573
Fidelity Adv Leveraged Co Stk John Hancock Life Insurance Company DFE: Pooled Separate Account $55,005
Utilities Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $54,835
The Growth Fund of America John Hancock Life Insurance Company DFE: Pooled Separate Account $54,732
Retirement Living At 2015 John Hancock Life Insurance Company DFE: Pooled Separate Account $53,977
Mass Investors Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $46,534
Pru Jennison Mid Growth Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $44,722
Managers Amg Fq Global Allocation John Hancock Life Insurance Company DFE: Pooled Separate Account $44,709
Retirement Choices At 2050 John Hancock Life Insurance Company DFE: Pooled Separate Account $41,241
Oppenehimer Global John Hancock Life Insurance Company DFE: Pooled Separate Account $39,784
Columbia Equity Value John Hancock Life Insurance Company DFE: Pooled Separate Account $38,006
Ft Founding Allocation John Hancock Life Insurance Company DFE: Pooled Separate Account $37,942
Small Cap Growth Index John Hancock Life Insurance Company DFE: Pooled Separate Account $36,368
Mid Value Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $33,691
American Balanced Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $33,309
New Perspective Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $31,964
T Rowe Price Sci & Tech John Hancock Life Insurance Company DFE: Pooled Separate Account $30,909
Small Cap Opportunities Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $25,571
Retirement Living At 2040 John Hancock Life Insurance Company DFE: Pooled Separate Account $25,520
Mutual Global Discovery John Hancock Life Insurance Company DFE: Pooled Separate Account $25,199
Real Est. Securities Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $24,544
Inv Small Cap Growth John Hancock Life Insurance Company DFE: Pooled Separate Account $24,448
International Value Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $23,821
Mid Cap Index Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $21,503
Value Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $21,491
Active Bond Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $17,792
Small Cap World Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $16,758
John Hancock Disciplined Value John Hancock Life Insurance Company DFE: Pooled Separate Account $16,414
Small Cap Growth Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $16,391
Legg Mason Clearbr Agg Growth John Hancock Life Insurance Company DFE: Pooled Separate Account $16,253
American High-Income Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $14,049
New World Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $13,864
Capital Income Builder John Hancock Life Insurance Company DFE: Pooled Separate Account $12,900
Dfa Us Targeted Value Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $10,891
Davis New York Venture John Hancock Life Insurance Company DFE: Pooled Separate Account $10,854
Real Return Bond Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $10,491
Explorer John Hancock Life Insurance Company DFE: Pooled Separate Account $7,926
Fundamental Investors John Hancock Life Insurance Company DFE: Pooled Separate Account $6,953
International Core Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $6,408
Retirement Living At 2050 John Hancock Life Insurance Company DFE: Pooled Separate Account $5,074
Growth Index Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $3,487
Brandywine Blue Fund John Hancock Life Insurance Company DFE: Pooled Separate Account $1,895
Total $21,838,567

Insurance Information

Insurance Information

Insurance Carrier Summary Persons Covered
John Hancock Life Insurance Company 182
EIN 01-0233346
Industry Code 65838
Contract Number 101897
Contract Year 07/11/2011 — 12/31/2011
Value in General Account at Year End $0
Value in Separate Accounts at Year End $21,838,567
Insurance Fees and Commissions $70,016
Persons Receiving Commissions and Fees
Agent/Broker Organization Code Commissions Paid Fees Paid Purpose of Fees Paid
Ppg Retirement Plan Services 5525 Green Bay Road Kenosha, WI 53144 Third Party Administrator $0 $44,206 TPA COMPENSATION
1st Global Capital Corp 8150 North Global Expressway Dallas, TX 75206 Investment Manager/Adviser $18,567 $0
R&R Insurance Services 1581 E Racine Ave Waukesha, WI 53186 Other $0 $7,242 AUDIT FEES
Fidelity Management & Research Comp 82 Devonshire St Boston, MA 02109 Investment Company/Mutual Fund $0 $1 REDEMPTION FEES
Allocated Funds
Type of Contract Unspecified
Basis of premium rates
Premiums paid to carrier $0
Premiums due but unpaid at the end of the year $0
If the carrier, service, or other organization incurred any specific costs in connection with the acquisition or retention of the contract or policy, enter amount $0
Specify the nature of the costs
Unallocated Funds
Type of Contract Unspecified
Balance at the end of the previous year $0
Additions $0
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $0
Transferred from separate account $0
Other $0
Total of Balance and Additions $0
Deductions $0
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $0