-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, MYIaxr0qvqwN2K0V7xx8EoCSV375ISSU/itYsIJRrxZpepiQ3P/cf7n+RnNnr/7k clwvVDKBG/PHhIQ48aW/fA== 0000912057-99-002716.txt : 19991101 0000912057-99-002716.hdr.sgml : 19991101 ACCESSION NUMBER: 0000912057-99-002716 CONFORMED SUBMISSION TYPE: 11-K PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19981231 FILED AS OF DATE: 19991029 FILER: COMPANY DATA: COMPANY CONFORMED NAME: HCC INSURANCE HOLDINGS INC/DE/ CENTRAL INDEX KEY: 0000888919 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 760336636 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 11-K SEC ACT: SEC FILE NUMBER: 001-13790 FILM NUMBER: 99736870 BUSINESS ADDRESS: STREET 1: 13403 NORTHWEST FRWY CITY: HOUSTON STATE: TX ZIP: 77040-6094 BUSINESS PHONE: 7136907300 11-K 1 11-K UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 FORM 11-K (Mark one) [X] ANNUAL REPORT PURSUANT TO SECTION 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 FOR THE FISCAL YEAR ENDED DECEMBER 31, 1998 OR [ ] TRANSITION REPORT PURSUANT TO SECTION 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 FOR THE TRANSITION PERIOD FROM __________________ TO _______________________ COMMISSION FILE NUMBER 0-20766 J.E. STONE & ASSOCIATES, INC. EMPLOYEE SAVINGS AND PROFIT SHARING PLAN (Full title of the Plan) 5555 SAN FELIPE, SUITE 100 HOUSTON, TEXAS 77056 (Address of the Plan) HCC INSURANCE HOLDINGS, INC. (Name of the Issuer of the securities held pursuant to the Plan) 13403 NORTHWEST FREEWAY HOUSTON, TEXAS 77040 (Address of the principal executive office of the Issuer) ---------------------------- REQUIRED INFORMATION ITEM 1. Not applicable. ITEM 2. Not applicable. ITEM 3. Not applicable. ITEM 4. 1998 Return / Report of Employee Benefit Plan (with fewer than 100 participants) prepared in accordance with Section 104(a)(2)(A) of ERISA has been included as Exhibit 1 hereto. EXHIBITS 1 -- 1998 Return / Report of Employee Benefit Plan (with fewer than 100 participants) SIGNATURES THE PLAN. Pursuant to the requirements of the Securities Exchange Act of 1934, J.E. Stone & Associates, Inc. Employee Savings and Profit Sharing Plan has duly caused this annual report to be signed on its behalf by the undersigned thereunto duly authorized. Date: October 27, 1999 J.E. STONE & ASSOCIATES EMPLOYEE SAVINGS AND PROFIT SHARING PLAN By: HCC Employee Benefits, Inc., Administrator By: /s/ JOHN N. MOLBECK, JR. -------------------------------- Name: John N. Molbeck, Jr. ------------------------------ Title: EXECUTIVE VICE PRESIDENT ----------------------------- RETURN/REPORT OF EMPLOYEE BENEFIT PLAN (WITH FEWER THAN 100 PARTICIPANTS) THIS FORM IS REQUIRED TO BE FILED UNDER SECTIONS 104 AND 4065 OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 AND SECTIONS 6039D, 6047(e), 6057(b), AND 6058(a) OF THE INTERNAL REVENUE CODE. - SEE SEPARATE INSTRUCTIONS. FORM 5500-C/R OMB NOS. 1210-0016 DEPARTMENT OF THE TREASURY 1210-0089 INTERNAL REVENUE SERVICE ------------------------ ---------- 1998 DEPARTMENT OF LABOR THIS FORM IS OPEN PENSION AND WELFARE BENEFITS ADMINISTRATION TO PUBLIC INSPECTION. ---------- ------------------------ PENSION BENEFIT GUARANTY CORPORATION - -------------------------------------------------------------------------------- For the calendar plan year 1998 or fiscal plan year beginning , 1998, and ending , 19 - -------------------------------------------------------------------------------- For IRS Use Only EP-ID ------------------------- If A(1) through A(4), B, C, and D do not apply to this year's return/report, leave the boxes unmarked. You must check either box A95) or A(6), whichever is applicable. See instructions. A This return/report is: (1) / / the first return/report filed for the plan; (2) / / an amended return/report; (3) / / the final return/report filed for the plan; or (4) / / a short plan year return/report (less than 12 months). (5) / / Form 5500-C filer check here.................................. / / (Complete only pages 1 and 3 through 6.) (Code section 6039D filers use instructions on page 5.) (6) Form 5500-R filer check here.................................. /X/ (Complete only pages 1 and 2. Detach pages 3 through 6 before filing.) If you checked box (1) or (3), you must file a Form 5500-C. (See page 5 of the instructions.) B Check here if any information reported in 1a, 2a, 2b, or 5a changed since the last return/report for this plan.......................... - /X/ C If your plan year changed since the last return/report, check here.. - / / D If you filed for an extension of time to file this return/report, check here and attach a copy of the extension....................... - /X/ - -------------------------------------------------------------------------------- 1a (Illegible) ***** P28 PK3362 ***************ECRLOT**C-013 LI 76-0560487 P 001 199812 SC49 I HCC Employee Benefits, Inc. R 5555 SAN FELIPE ST STE 1100 S HOUSTON, TX 77056-2725 [BAR CODE] - -------------------------------------------------------------------------------- 1b Employer Identification number (EIN) 76 | 0560487 - -------------------------------------------------------------------------------- 1c Sponsors telephone number (713) 622 8940 - -------------------------------------------------------------------------------- 1d Business code (see instructions, page 18) 541 600 - -------------------------------------------------------------------------------- 1e CUSIP issuer number - -------------------------------------------------------------------------------- 2a Name and address of plan administrator (if same as plan sponsor, enter "Same") Same - -------------------------------------------------------------------------------- 2b Administrator's EIN - -------------------------------------------------------------------------------- 2c Administrator's telephone number - -------------------------------------------------------------------------------- 3 If the name, address, and EIN of the plan sponsor or plan administrator has changed since the last return/report filed for this plan, enter the information from the last return/report on lines 3a and/or 3b and complete line 3c. a Sponsor JE Stone & Associates, Inc. EIN 760228729 Plan number 001 --------------------------------- ----------- --- b Administrator JE Stone & Associates, Inc. EIN 760228729 --------------------------- ---------------------------- c If line 3a indicates a change in the sponsor's name, address, and EIN, is this a change in sponsorship only? (See line 3c on page 8 of the instructions for the definition of sponsorship.) Enter "Yes" or "No." - Yes - -------------------------------------------------------------------------------- 4 ENTITY CODE. (If not shown, enter applicable code from page 8 of the instructions.) - A - -------------------------------------------------------------------------------- 5a Name of plan - J E Stone & Associates, Inc. Employee Savings and Profit Sharing Plan - -------------------------------------------------------------------------------- 5b Effective date of plan (mo., day, yr.) 8/19/87 - -------------------------------------------------------------------------------- 5c Three-digit plan number - 001 - -------------------------------------------------------------------------------- All filers must complete 6a through 6d, as applicable. --------------- 6a / / Welfare benefit plan 6b /X/ Pension benefit plan 2 --------------- (Enter the applicable codes from page 9 of the instructions in the boxes.) --------------- --------------- 6c Pension plan features. (Enter the applicable pension plan C G H I K feature codes from page 9 of the instructions in the boxes.)--------------- 6d / / Fringe benefit plan. Attach Schedule F (Form 5500). See instructions. - -------------------------------------------------------------------------------- CAUTION: A PENALTY FOR THE LATE OR INCOMPLETE FILING OF THIS RETURN/REPORT WILL BE ASSESSED UNLESS REASONABLE CAUSE IS ESTABLISHED. - -------------------------------------------------------------------------------- Under penalties of perjury and other penalties set forth in the instructions, I declare that I have examined this return/report, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Signature of employer/plan sponsor - /s/ Larry M. Kachler Date - 10/14/99 ------------------------ ------------ Type or print name of individual signing above Larry Kachler --------------------------------- Signature of plan administrator - /s/ Larry M. Kachler Date - 10/14/99 ------------------------ ------------ Type or print name of individual signing above Larry Kachler - -------------------------------------------------------------------------------- FOR PAPERWORK REDUCTION ACT NOTICE, see the instructions for Form 5500-C/R. MGA Form 5500-C/R (1998) Form 5500-C/R (1998) Form 5500-R filers, complete pages 1 and 2 only. Form 5500-c filers, complete page 1, skip page 2, and complete pages 3 through 6. Page 2 - -------------------------------------------------------------------------------- 6e Check investment arrangement(s): (1) / / Master trust Yes No (2) / / Common/Collective trust (3) / / Pooled separate - -------------------------------------------------------------------------------- 7a Total participants: (1) At the beginning of plan year - 77 (2) At the end of plan year - 82 b Enter number of participants with account balances at the end of the plan year (defined benefit plans do not complete this item) - 82 c (1) Were any participants in the pension benefit plan separated from service with a deferred vested benefit for which a Schedule SSA (Form 5500) is required to be attached? (See instructions.)......................... 7c(1) / / /X/ (2) If "Yes," enter the number of separated participants required to be reported - - -------------------------------------------------------------------------------- 8a Was this plan terminated during this plan year or any prior plan year? If "Yes," enter the year - 1998 8a /X/ b Were all the plan assets either distributed to participants or beneficiaries, transferred to another plan, or brought under the control of PBGC? 8b /X/ c If line 8a is "Yes" and the plan is covered by PBGC, is the plan continuing to file PBGC Form 1 and pay premiums until the end of the plan year in which assets are distributed or brought under the control of PBGC?......... 8c - -------------------------------------------------------------------------------- 9 Is this a plan established of maintained pursuant to one or more collective bargaining agreements?................. 9 /X/ - -------------------------------------------------------------------------------- 10 If any benefits are provided by an insurance company, insurance service, or similar organization, enter the number of Schedules A (Form 5500), insurance information, that are attached. If none, enter -0-. - 0 - -------------------------------------------------------------------------------- 11a (1) Were any plan amendments adopted during this plan year?................................................ 11a(1) /X/ (2) Enter the date the most recent amendment was adopted - Month 9 Day 18 Year 98 b If line 11a is "Yes," did any amendment result in a retroactive reduction of accrued benefits for any participant?............................................. 11b /X/ c If line 11a is "Yes," did any amendment change the information contained in the latest summary plan description or summary description of modifications available at the time of the amendment?.................. 11c /X/ d If line 11c is "Yes," has a summary plan description or summary description of modifications that reflects the plan amendments referred to on line 11c been furnished to participants? (see instructions.)........... 11d /X/ - -------------------------------------------------------------------------------- 12a If this is a pension benefit plan subject to the minimum funding standards, has the plan experienced a funding deficiency for this plan year? (See instructions.)....... 12a b If line 2a is "Yes," have you filed Form 5330 to pay the excise tax?.............................................. 12b c Is the plan administrator making an election under section 412(c)(8) for an amendment adopted after the end of the plan year? (See instructions.).................... 12c /X/ d If a change in the actuarial funding method was made for the plan year pursuant to a Revenue Procedure providing automatic approval for the change, indicate whether the plan sponsor/administrator agrees to the change.......... 12d - -------------------------------------------------------------------------------- 13a Total plan assets as of the beginning 3182423 and end 4308150 of the plan year b Total liabilities as of the beginning 0 and end 0 of the plan year c Net assets as of the beginning - 3182423 and end - 4308150 of the plan year - -------------------------------------------------------------------------------- 14 For this plan year, enter: a Plan income 1145014 b Expenses 19287 c Net income (loss) (subtract 14b from 14a) 1125727 d Plan contributions 298834 e Total benefits paid 19128 - -------------------------------------------------------------------------------- 15 You may NOT use N/A in response to lines 15a Yes No Amount through 15o. If you check "Yes," you must enter a dollar amount in the amount column. During this plan year: a Was this plan covered by a fidelity bond?...... 15a /X/ 50,000 b If line 15a is "Yes," enter the name of the surety company - Hartford Lloyds Ins. Co. c Was there any losses to the plan, whether or not reimbursed, caused by fraud or dishonesty?..... 15c /X/ d Was there any sale, exchange, or losses of any property between the plan and the employer, any fiduciary, any of the five most highly paid employees of the employer, any owner of a 10% or more interest in the employer, or relatives of any such persons?........................... 15d e Was there any loan or extension of credit by the plan to the employer, any fiduciary, any of the five most highly paid employees of the employer, any owner of a 10% or more interest in the employer, or relatives of any such persons?....................................... 15e /X/ 42,000 f Did the plan acquire or hold any employer security or employer real property?............ 15f /X/ 1,121,870 g Has the plan granted an extension on any delinquent loan owed to the plan?.............. 15g /X/ h Were any participant contributions transmitted to the plan more than 31 days after receipt or withholding by the employer?................ 15h /X/ I Were any loans by the plan or fixed income obligations due the plan classified as uncollectible or in default as of the close of the plan year?.............................. 15i /X/ j Has any plan fiduciary had a financial interest in excess of 10% in any party providing services to the plan or received anything of value from any such party?..................... 15j /X/ k Did the plan at any time hold 20% or more of its assets in any single security, debt, mortgage, parcel of real estate, or partnership/joint venture interests?........... 15k /X/ 1,121,870 l Did the plan at any time engage in any transaction or series of related transactions involving 20% or more of the current value of plan assets?................................... 15l /X/ 1,121,870 m Were there any noncash contributions made to the plan the value of which was set without an appraisal by an independent third party?.... 15m /X/ n Were there any purchases of nonpublicly traded securities by the plan the value of which was set without an appraisal by an independent third party?....................... 15n /X/ o Has the plan reduced or failed to provide any benefit when due under the plan because of insufficient assets:........................ /X/ - -------------------------------------------------------------------------------- 15a Is the plan covered under the Pension Benefit Guaranty Corporation termination insurance program? / / Yes /X/ No / / Not determined b If line 16a is "Yes" or "Not determined," enter the employer identification number and the plan number used to identify it. Employer identification number - Plan number - - -------------------------------------------------------------------------------- ANNUAL RETURN OF FIDUCIARY OF EMPLOYEE BENEFIT TRUST - FILE AS AN ATTACHMENT TO FORM 5500, 5500-C/R, OR 5500-EZ - FOR THE PAPERWORK REDUCTION NOTICE, SEE THE FORM 5500 INSTRUCTIONS SCHEDULE P OMB NO. 1210-0016 (FORM 5500) ----------------------- 1998 DEPARTMENT OF TREASURY ----------------------- INTERNAL REVENUE SERVICE THIS FORM IS OPEN TO PUBLIC INSPECTION - -------------------------------------------------------------------------------- For trust calendar year 1998 or fiscal year beginning , 1998, and ending , 19 - -------------------------------------------------------------------------------- 1a Name of trustee or custodian Please Jim Stone type ------------------------------------------------------------------------- b Number, street, and room or suite no. (If a P.O. box, see the or instructions for Form 5500, 5500-C/R, or 5500-EZ) print 5555 San Felipe, Suite 1100 ------------------------------------------------------------------------- c City or town, state, and ZIP code Houston, TX 77056 - -------------------------------------------------------------------------------- 2a Name of trust b Trust's employer identification number J.E. Stone & Associates Inc. 7516310488 Savings & Profit Sharing Plan - -------------------------------------------------------------------------------- 3 Name of plan if different from name of trust - -------------------------------------------------------------------------------- 4 Have you furnished the participating employee benefit plan(s) with the trust financial information required to be reported by the plan(s)?............................................. /X/ Yes / / No - -------------------------------------------------------------------------------- 5 Enter the plan sponsor's employer identification number as shown on form 5500, 5500-C/R, or 55000-EZ................... 76 | 0560487 - -------------------------------------------------------------------------------- Under penalties of perjury, I declare that I have examined this schedule, and to the best of my knowledge and belief it is true, correct, and complete. Signature of fiduciary - /s/ J E Stone Date - 10/15/99 - -------------------------------------------------------------------------------- INSTRUCTIONS SECTION REFERENCES ARE TO THE INTERNAL REVENUE CODE. PURPOSE OF FORM You may use this schedule to satisfy the requirements under section 6033(a) for an annual information return from every section 401(a) organization exempt from tax under section 501(a). Filing this form will start the running of the statute of limitations under section 6501(a) for any trust described in section 401(a), which is exempt from tax under section 501(a). WHO MAY FILE 1. Every trustee of a trust created as part of an employee benefit plan as described in section 401(a). 2. Every custodian of a custodial account described in section 401(f). HOW TO FILE File Schedule P (Form 5500) for the trust year ending with or within any participating plan's plan year. Attach it to the Form 5500, 5500-C/R, or 5500-EZ filed by the plan for that plan year. A separately filed schedule P (Form 5500) will not be accepted. If the trust or custodial account is used by more than one plan, file one Schedule P (Form 5500). If a plan uses more than one trust or custodial account for its funds, file one Schedule P (form 5500) for each trust or custodial account. TRUST'S EMPLOYER IDENTIFICATION NUMBER Enter the trust employer identification number (EIN) assigned to the employee benefit trust or custodial account, if one has been issued to you. The trust EIN should be used for transactions conducted for the trust. If you do not have a trust EIN, enter the EIN you would use on Form 1099-R to report distributions from employee benefit plans and on Form 945 to report withheld amounts of income tax from those payments. Note: TRUSTEES WHO DO NOT HAVE AN EIN MAY APPLY FOR ONE ON FORM SS-4, APPLICATION FOR EMPLOYER IDENTIFICATION NUMBER. YOU MUST BE CONSISTENT AND USE THE SAME EIN FOR ALL TRUST REPORTING PURPOSES. SIGNATURE The fiduciary (trustee or custodian) must sign this schedule. If there is more than one fiduciary, the fiduciary authorized by the others may sign. OTHER RETURNS AND FORMS THAT MAY BE REQUIRED - - FORM 990-T -- for trusts described in section 401(a), a tax is imposed on income derived from business that is unrelated to the purpose for which the trust received a tax exemption. Report this income and tax on Form 990-T, Exempt Organization Business Income Tax Return. (See sections 511 through 514 and the related regulations.) - - FORM 1099-R -- If you made payments or distributions to individual beneficiaries of a plan, report those payments on Form 1099-R. (See the instructions for Forms 1099, 1098, 5498, and W-2G.) - - FORM 945 -- If you made payments or distributions to individual beneficiaries of a plan, you may be required to withhold income tax from those payments. Use Form 945, Annual Return of Withheld Federal Income Tax, to report taxes withheld from nonpayroll items. (See Circular E, Employer's Tax Guide (Pub.15), for more information.) - -------------------------------------------------------------------------------- MGA Schedule P (Form 8500) 1998 APPLICATION FOR EXTENSION OF TIME TO FILE CERTAIN EMPLOYEE PLAN RETURNS - FOR PAPERWORK REDUCTION ACT NOTICE, SEE INSTRUCTIONS. FORM 5558 OMB NO. 1545-0212 (REV. MARCH 1999) ------------------------- DEPARTMENT OF THE TREASURY FILE WITH IRS ONLY INTERNAL REVENUE SERVICE - -------------------------------------------------------------------------------- File before the Name of filer, plan administrator, or plan sponsor normal due date of the J. E. Stone & Associates, Inc. Form 5500 ------------------------------------------------------------ 5500-C/R Number, street, and room or suite no. (if a P.O. box, see 5500-EZ, or instructions.) 5330 (see instructions) 5555 San Felipe, Suite 1100 ------------------------------------------------------------ City or town, state, and ZIP code Houston, TX 77056 - -------------------------------------------------------------------------------- Filer's Identifying Number-check applicable box and enter number (See instructions). /XX/ Employer identification number (EIN). Filers checking box 1a must enter an EIN. All other filers, see specific instructions). - 76-0228729 OR ---------------------------------------------------------------- / / Social security number (see Specific Instructions) - - -------------------------------------------------------------------------------- 1 I request an extension of time until (see instructions) - 10/15/99 ------------------- (check appropriate box(es)): a /XX/ Form 5500, 5500-C/R or 5500-EZ (doe more than 2 1/2 months). The application IS automatically approved to the date shown on line 1 (above) IF: (1) box 1a is checked, (2) the Form 5558 is signed and filed on or before the normal due date of Form 5500, 5500-C/R or 5500-EZ for which this extension is requested, and (3) the date on line 1 is no more than 2 1/2 months after the normal due date. You must attach a copy of this Form 5558 to each Form 5500, 5500-C/R and 5500-EZ filed after the due date for the plans listed below. b / / Form 5330 (no more than 6 months). Payment amount attached is $_______ 2 Complete the following for the plan(s) covered by this application (see How To File): - --------------------------------------------------------------------------------
Type of plan (check) Plan your ending -------------------------- Plan ------------------------ Plan name/filer Pension Welfare Fringe number Month Day Year - ----------------------------------------------------------------------------------------------------------------------- ` J. E. Stone & Associates Savings and X 001 12 31 98 Profit Sharing Plan - ----------------------------------------------------------------------------------------------------------------------- J. E. Stone & Associates Pension Plan X 002 12 31 98 - ----------------------------------------------------------------------------------------------------------------------- - -----------------------------------------------------------------------------------------------------------------------
3 State in detail why you need the extension (if line 1b is checked)________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ Under penalties of perjury, I declare that to the best of my knowledge and belief the statements made on this form are true, correct, and complete, and that I am authorized to prepare this application. Signature - /s/ Kenneth L. Haynes EA #99-2768 Date - 7/21/99 - -------------------------------------------------------------------------------- Notice to To Be Completed by the IRS if line 1b is checked - Applicant / / This application for extension to file Form 5330 IS approved to the date shown on line 1, if line 1b is checked. (You MUST attach an approved copy of this form to each Form 5330 that was granted an extension.) To be / / The date entered on line 1 is more than the 6-month maximum time allowed for Form 5330. This application is approved to _________ Completed ____________ (You MUST attach an approved copy of this form to each Form 5530 that was granted an extension.) by the IRS / / The application for an extension for Form 5330 IS NOT approved, if line 1b because it was filed after the normal due date of the return. (A 10-day grace period is NOT granted.) is checked / / This application for an extension for Form 5330 IS NOT approved, because / / The application was not signed. / / No reason was given on this application or the reason was not acceptable. / / No payment was attached for the tax due on Form 5330. / / Other - ____________________________________________________ A 10-day grace period is granted from the date shown below or the due date of the return, whichever is later. (You MUST attach a copy of this form to each return you file that is granted a grace period.) By: ----------- ----------------------------------- --------------- (Date) (Director) - -------------------------------------------------------------------------------- Applicants for extension of Form 5330; Complete if you want this Form 5558 returned to an address other than the address shown above. - -------------------------------------------------------------------------------- Name Please --------------------------------------------------------- Print Number, street, and room or suite no. (If a P.O. box, see or instructions.) Type --------------------------------------------------------- City or town, state, and ZIP code - -------------------------------------------------------------------------------- -----END PRIVACY-ENHANCED MESSAGE-----