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FORM 5500 DATA

The Kansas City Country Club Employee 401k Plan

Overview

Plan Information

  • Plan Year01/01/2019 — 12/31/2019
  • Date of Plan01/01/1996
  • Net Assets as of 12/31/2019 $5,151,308
  • Plan Number2
  • 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 12/31/2019

  • Active (Eligible) Participants78
  • Retired or separated participants receiving benefits3
  • Other retired or separated participants entitled to future benefits14
  • Subtotal95
  • Deceased participants whose beneficiaries are receiving or are entitled to receive benefits0
  • Total95
  • Total number of participants as of 01/01/2019128
  • Number of participants with account balances72
  • Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested11

Expenses

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

Sponsor Information

  • Address6200 Indian Lane
  • CityMission Hills
  • StateKS
  • Zip66208
  • Telephone(913) 236-2103
  • EIN48-0668424
  • Industry Code713900
  • Named AdministratorNathan Stewart

Audit Information

  • Audit StatusAudited
  • AuditorHouse Park Dobratz & Wiebler, Pc
  • Auditor EIN43-1562209
  • 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? No
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? No

Financials

Income and Expense Statement

Income $1,230,303
Contributions $455,931
Cash Contributions $455,931
Cash from Employers $172,618
Cash from Participants $239,577
Others (including rollovers) $43,736
Noncash Contributions $0
Total Earnings on Investments $774,094
Total Interest $743
Interest-Bearing Cash $0
U.S. Government Securities $0
Corporate Debt Instruments $0
Loans (other than to participants) $0
Participant Loans $0
Interest from Other Investments $743
Total Dividends $436
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 $425,585
Net investment gain (loss) from pooled separate accounts $340,487
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 $6,843
Other Income $278
Expenses $162,030
Total Benefit Payments $135,704
Directly to participants or beneficiaries, including direct rollovers $135,704
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 $26,326
Professional Fees $50
Contract Administrator Fees $26,276
Investment Advisory and management fees $0
Other Administrative Fees $0
Net Income $1,068,273
Transfers of Assets to this Plan $0
Transfers of Assets from this Plan $0

Asset and Liability Statement

12/31/2019 12/31/2018 Change YOY
Total Assets $5,151,308 $4,083,035 26.16%
Total noninterest-bearing cash $0 $0 0.0%
Receivables $2,732 $2,312 18.17%
Employer Contributions $2,732 $2,312 18.17%
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 $0 $0 0.0%
Value of interest in common/collective trusts $5,030,083 $0 0.0%
Value of interest in pooled separate accounts $30,211 $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 $78,392 $3,893,055 -97.99%
Value of funds held in insurance co. general account $9,890 $187,668 -94.73%
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 $5,151,308 $4,083,035 26.16%

Service Providers

Persons Receiving Only Eligible Indirect Compensation

  • John Hancock Life Insurance Company

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
Principal Life Insurance Company Contract Administrator, Direct payment from the plan, Recordkeeping fees Contract Administrator $25,076 $0 $25,076
Eip Corp Other services, Other fees, Contract Administrator, Direct payment from the plan Other Services $1,200 $9,233 $10,433
Cetera Advisors LLC Other services, Other commissions Other Services $0 $8,103 $8,103
John Hancock Life Insurance Co. Recordkeeping and information management (computing, tabulating, data processing, etc.), Investment management, Sub-transfer agency fees, Float revenue, Distribution (12b-1) fees, Soft dollars commissions Recordkeeper $0 $0 $0
Wilshire Associates Incorporated Investment advisory (plan), Other investment fees and expenses Investment Advisory $0 $0 $0
Total $26,276 $17,336 $43,612

Indirect Compensation

Name Source of Indirect Compensation* Nature of Service Description of Indirect Compensation Indirect Compensation Paid by Plan
Cetera Advisors Insurance Service Principal Life Insurance Company Other services, Other commissions Commissions $8,103
Eip Corp Principal Life Insurance Company Other services, Other fees, Contract Administrator, Direct payment from the plan Referral/Service Fee $9,233
Wilshire Associates Principal Life Insurance Company Investment advisory (plan), Other investment fees and expenses 5 Basis Points Annually On eligible Plan Assets In Wilshire 3(38) Fiduciary Service $0
*As outlined by the Form 5500 Instructions for service providers with indirect compensation.

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
American Balanced Fund John Hancock USA DFE: Pooled Separate Account $342,547
Equity Income Fund John Hancock USA DFE: Pooled Separate Account $272,761
Blue Chip Growth Fund John Hancock USA DFE: Pooled Separate Account $198,880
John Hancock Bond Fund John Hancock USA DFE: Pooled Separate Account $158,344
Vanguard Short-Term Federal John Hancock USA DFE: Pooled Separate Account $141,201
Fidelity Advisor Total Bond John Hancock USA DFE: Pooled Separate Account $127,641
Jpmorgan U.S. Equity Fund John Hancock USA DFE: Pooled Separate Account $75,225
Money Market Fund John Hancock USA DFE: Pooled Separate Account $72,387
Fundamental Large Cap Value John Hancock USA DFE: Pooled Separate Account $33,202
Washington Mutual Investors John Hancock USA DFE: Pooled Separate Account $21,803
Strategic Income Opp Fund John Hancock USA DFE: Pooled Separate Account $19,475
High Yield Fund John Hancock USA DFE: Pooled Separate Account $10,586
500 Index Fund John Hancock USA DFE: Pooled Separate Account $9,567
Blackrock Global Allocation John Hancock USA DFE: Pooled Separate Account $3,438
Small Company Value Fund John Hancock USA DFE: Pooled Separate Account $1,819
Vanguard Small Cap Grow Index John Hancock USA DFE: Pooled Separate Account $0
Templeton Foreign Smaller Co John Hancock USA DFE: Pooled Separate Account $0
Jh Multimanager Growth Ls John Hancock USA DFE: Pooled Separate Account $0
Jh Multimanager Balanced Ls John Hancock USA DFE: Pooled Separate Account $0
Jh Multimanager Moderate Ls John Hancock USA DFE: Pooled Separate Account $0
Jh Multimanager Conserv Ls John Hancock USA DFE: Pooled Separate Account $0
American Century Heritage John Hancock USA DFE: Pooled Separate Account $0
Europacific Growth Fund John Hancock USA DFE: Pooled Separate Account $0
Intl Equity Index Fund John Hancock USA DFE: Pooled Separate Account $0
International Value Fund John Hancock USA DFE: Pooled Separate Account $0
Mid Cap Index Fund John Hancock USA DFE: Pooled Separate Account $0
Mid Cap Stock Fund John Hancock USA DFE: Pooled Separate Account $0
Mid Value Fund John Hancock USA DFE: Pooled Separate Account $0
Real Est. Securities Fund John Hancock USA DFE: Pooled Separate Account $0
Science & Technology Fund John Hancock USA DFE: Pooled Separate Account $0
T. Rowe Price New Era Fund John Hancock USA DFE: Pooled Separate Account $0
Jh Multimanager Aggressive Ls John Hancock USA DFE: Pooled Separate Account $0
Total $1,488,876

Insurance Information

Insurance Information

Insurance Carrier Summary Persons Covered
Principal Life Insurance Company 129
EIN 42-0127290
Industry Code 61271
Contract Number 613953
Contract Year 03/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
Insurance Fees and Commissions $14
Persons Receiving Commissions and Fees
Agent/Broker Organization Code Commissions Paid Fees Paid Purpose of Fees Paid
Cetera Advisors LLC 200 N. Pacific Coast Highway El Segundo, CA 90245 Insurance Agent or Broker $12 $0
Eip Corp. 7300 W. 110th Street Overland Park, KS 66210 Insurance Agent or Broker $0 $2 REFERRAL/SERVICE FEE
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 CUSTODIAL GUARANTEED INTEREST CONTRACT
Balance at the end of the previous year $0
Additions $19,362
Contributions Deposited during the year $2,512
Dividends and credits $0
Interest credited during the year $140
Transferred from separate account $0
Other $16,710
Total of Balance and Additions $19,362
Deductions $9,472
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $27
Transferred to Separate Account $0
Other $9,445
Balance at the end of the current year $9,890
Principal Life Insurance Company 129
EIN 42-0127290
Industry Code 61271
Contract Number 627998
Contract Year 03/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $30,211
Insurance Fees and Commissions $27
Persons Receiving Commissions and Fees
Agent/Broker Organization Code Commissions Paid Fees Paid Purpose of Fees Paid
Cetera Advisors LLC 200 N. Pacific Coast Hwy El Segundo, CA 90245 Insurance Agent or Broker $23 $0
Eip Corp. 7300 W. 110th Street Overland Park, KS 66210 Insurance Agent or Broker $0 $4 REFERRAL/SERVICE FEE
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
John Hancock Life Insurance Company (USA) 0
EIN 01-0233346
Industry Code 65838
Contract Number 83521
Contract Year 01/01/2019 — 03/18/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
Insurance Fees and Commissions $3,440
Persons Receiving Commissions and Fees
Agent/Broker Organization Code Commissions Paid Fees Paid Purpose of Fees Paid
Cetera Advisors LLC 200 N Pacific Coast Hwy El Segundo, CA 90245 Insurance Agent or Broker $3,040 $0
Eip Corp. 7300 W. 110th Street, Suite 450 Overland Park, KS 66210 Third Party Administrator $350 $50 DISTRIBUTION FEES AND OTHER ALLOWANCES PAID
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 GROUP ANNUITY
Balance at the end of the previous year $189,686
Additions $1,049
Contributions Deposited during the year $780
Dividends and credits $0
Interest credited during the year $254
Transferred from separate account $0
Other $15
Total of Balance and Additions $190,735
Deductions $190,735
Disbursed from fund to pay benefits or purchase annuities during the year $190,579
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $156
Balance at the end of the current year $0