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ST. MARYS PHARMACY, INC. PROFIT SHARING PLAN 401k Plan overview

Plan NameST. MARYS PHARMACY, INC. PROFIT SHARING PLAN
Plan identification number 001

ST. MARYS PHARMACY, INC. PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

ST. MARYS PHARMACY, INC. has sponsored the creation of one or more 401k plans.

Company Name:ST. MARYS PHARMACY, INC.
Employer identification number (EIN):251211032
NAIC Classification:621610
NAIC Description:Home Health Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ST. MARYS PHARMACY, INC. PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-09-01CHRISTOPHER KOVSKI2024-05-15
0012021-09-01CHRISTOPHER KOVSKI2023-06-02
0012020-09-01MICHAEL VAVALA2022-05-27
0012019-09-01JUDE VAVALA2021-01-05
0012018-09-01
0012017-09-01
0012016-09-01
0012015-09-01
0012014-09-01
0012013-09-01JUDE VAVALA
0012012-09-01JUDE VAVALA
0012011-09-01JUDE VAVALA
0012009-09-01JUDE VAVALA

Plan Statistics for ST. MARYS PHARMACY, INC. PROFIT SHARING PLAN

401k plan membership statisitcs for ST. MARYS PHARMACY, INC. PROFIT SHARING PLAN

Measure Date Value
2014: ST. MARYS PHARMACY, INC. PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-09-0169
Total number of active participants reported on line 7a of the Form 55002014-09-0156
Number of retired or separated participants receiving benefits2014-09-014
Number of other retired or separated participants entitled to future benefits2014-09-014
Total of all active and inactive participants2014-09-0164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-09-010
Total participants2014-09-0164
Number of participants with account balances2014-09-0164
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-09-015
2013: ST. MARYS PHARMACY, INC. PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-09-0167
Total number of active participants reported on line 7a of the Form 55002013-09-0156
Number of retired or separated participants receiving benefits2013-09-011
Number of other retired or separated participants entitled to future benefits2013-09-0110
Total of all active and inactive participants2013-09-0167
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-09-010
Total participants2013-09-0167
Number of participants with account balances2013-09-0167
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-09-010
2012: ST. MARYS PHARMACY, INC. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-09-0165
Total number of active participants reported on line 7a of the Form 55002012-09-0148
Number of retired or separated participants receiving benefits2012-09-015
Number of other retired or separated participants entitled to future benefits2012-09-0110
Total of all active and inactive participants2012-09-0163
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-09-010
Total participants2012-09-0163
Number of participants with account balances2012-09-0163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-09-013
2011: ST. MARYS PHARMACY, INC. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-09-0153
Total number of active participants reported on line 7a of the Form 55002011-09-0147
Number of retired or separated participants receiving benefits2011-09-014
Number of other retired or separated participants entitled to future benefits2011-09-0110
Total of all active and inactive participants2011-09-0161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-09-011
Total participants2011-09-0162
Number of participants with account balances2011-09-0162
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-09-012
2009: ST. MARYS PHARMACY, INC. PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-09-0142
Total number of active participants reported on line 7a of the Form 55002009-09-0138
Number of retired or separated participants receiving benefits2009-09-010
Number of other retired or separated participants entitled to future benefits2009-09-016
Total of all active and inactive participants2009-09-0144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-09-010
Total participants2009-09-0144
Number of participants with account balances2009-09-0144
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-09-012

Financial Data on ST. MARYS PHARMACY, INC. PROFIT SHARING PLAN

Measure Date Value
2015 : ST. MARYS PHARMACY, INC. PROFIT SHARING PLAN 2015 401k financial data
Total plan liabilities at end of year2015-08-31$100
Total income from all sources2015-08-31$330,400
Expenses. Total of all expenses incurred2015-08-31$648,292
Benefits paid (including direct rollovers)2015-08-31$642,559
Total plan assets at end of year2015-08-31$2,849,552
Total plan assets at beginning of year2015-08-31$3,167,344
Value of fidelity bond covering the plan2015-08-31$150,000
Total contributions received or receivable from participants2015-08-31$198,976
Expenses. Other expenses not covered elsewhere2015-08-31$5,733
Contributions received from other sources (not participants or employers)2015-08-31$40,089
Other income received2015-08-31$10,661
Net income (gross income less expenses)2015-08-31$-317,892
Net plan assets at end of year (total assets less liabilities)2015-08-31$2,849,452
Net plan assets at beginning of year (total assets less liabilities)2015-08-31$3,167,344
Total contributions received or receivable from employer(s)2015-08-31$80,674
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-08-31$0
2014 : ST. MARYS PHARMACY, INC. PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources2014-08-31$461,247
Expenses. Total of all expenses incurred2014-08-31$40,568
Benefits paid (including direct rollovers)2014-08-31$32,455
Total plan assets at end of year2014-08-31$3,167,344
Total plan assets at beginning of year2014-08-31$2,746,665
Value of fidelity bond covering the plan2014-08-31$150,000
Total contributions received or receivable from participants2014-08-31$178,070
Other income received2014-08-31$206,456
Net income (gross income less expenses)2014-08-31$420,679
Net plan assets at end of year (total assets less liabilities)2014-08-31$3,167,344
Net plan assets at beginning of year (total assets less liabilities)2014-08-31$2,746,665
Total contributions received or receivable from employer(s)2014-08-31$76,721
Expenses. Administrative service providers (salaries,fees and commissions)2014-08-31$8,113
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-08-31$0
2013 : ST. MARYS PHARMACY, INC. PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources2013-08-31$499,288
Expenses. Total of all expenses incurred2013-08-31$419,247
Benefits paid (including direct rollovers)2013-08-31$409,798
Total plan assets at end of year2013-08-31$2,746,665
Total plan assets at beginning of year2013-08-31$2,666,624
Value of fidelity bond covering the plan2013-08-31$150,000
Total contributions received or receivable from participants2013-08-31$152,809
Expenses. Other expenses not covered elsewhere2013-08-31$9,449
Contributions received from other sources (not participants or employers)2013-08-31$132,374
Other income received2013-08-31$145,393
Net income (gross income less expenses)2013-08-31$80,041
Net plan assets at end of year (total assets less liabilities)2013-08-31$2,746,665
Net plan assets at beginning of year (total assets less liabilities)2013-08-31$2,666,624
Total contributions received or receivable from employer(s)2013-08-31$68,712
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-08-31$0
2012 : ST. MARYS PHARMACY, INC. PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources2012-08-31$370,490
Expenses. Total of all expenses incurred2012-08-31$31,398
Benefits paid (including direct rollovers)2012-08-31$28,206
Total plan assets at end of year2012-08-31$2,666,624
Total plan assets at beginning of year2012-08-31$2,327,532
Value of fidelity bond covering the plan2012-08-31$150,000
Total contributions received or receivable from participants2012-08-31$147,577
Other income received2012-08-31$159,720
Net income (gross income less expenses)2012-08-31$339,092
Net plan assets at end of year (total assets less liabilities)2012-08-31$2,666,624
Net plan assets at beginning of year (total assets less liabilities)2012-08-31$2,327,532
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-1022012-08-31$2,702
Total contributions received or receivable from employer(s)2012-08-31$63,193
Expenses. Administrative service providers (salaries,fees and commissions)2012-08-31$3,192
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-08-31$0
2011 : ST. MARYS PHARMACY, INC. PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources2011-08-31$436,188
Expenses. Total of all expenses incurred2011-08-31$55,441
Benefits paid (including direct rollovers)2011-08-31$52,209
Total plan assets at end of year2011-08-31$2,327,532
Total plan assets at beginning of year2011-08-31$1,946,785
Value of fidelity bond covering the plan2011-08-31$180,000
Total contributions received or receivable from participants2011-08-31$121,706
Other income received2011-08-31$256,687
Net income (gross income less expenses)2011-08-31$380,747
Net plan assets at end of year (total assets less liabilities)2011-08-31$2,327,532
Net plan assets at beginning of year (total assets less liabilities)2011-08-31$1,946,785
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-1022011-08-31$2,702
Total contributions received or receivable from employer(s)2011-08-31$57,795
Expenses. Administrative service providers (salaries,fees and commissions)2011-08-31$3,232
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-08-31$0
2010 : ST. MARYS PHARMACY, INC. PROFIT SHARING PLAN 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-08-31$0

Form 5500 Responses for ST. MARYS PHARMACY, INC. PROFIT SHARING PLAN

2014: ST. MARYS PHARMACY, INC. PROFIT SHARING PLAN 2014 form 5500 responses
2014-09-01Type of plan entitySingle employer plan
2014-09-01Submission has been amendedNo
2014-09-01This submission is the final filingNo
2014-09-01This return/report is a short plan year return/report (less than 12 months)No
2014-09-01Plan is a collectively bargained planNo
2014-09-01Plan funding arrangement – InsuranceYes
2014-09-01Plan funding arrangement – TrustYes
2014-09-01Plan benefit arrangement - TrustYes
2013: ST. MARYS PHARMACY, INC. PROFIT SHARING PLAN 2013 form 5500 responses
2013-09-01Type of plan entitySingle employer plan
2013-09-01Submission has been amendedNo
2013-09-01This submission is the final filingNo
2013-09-01This return/report is a short plan year return/report (less than 12 months)No
2013-09-01Plan is a collectively bargained planNo
2013-09-01Plan funding arrangement – InsuranceYes
2013-09-01Plan funding arrangement – TrustYes
2013-09-01Plan benefit arrangement - TrustYes
2012: ST. MARYS PHARMACY, INC. PROFIT SHARING PLAN 2012 form 5500 responses
2012-09-01Type of plan entitySingle employer plan
2012-09-01Submission has been amendedNo
2012-09-01This submission is the final filingNo
2012-09-01This return/report is a short plan year return/report (less than 12 months)No
2012-09-01Plan is a collectively bargained planNo
2012-09-01Plan funding arrangement – InsuranceYes
2012-09-01Plan funding arrangement – TrustYes
2012-09-01Plan benefit arrangement - TrustYes
2011: ST. MARYS PHARMACY, INC. PROFIT SHARING PLAN 2011 form 5500 responses
2011-09-01Type of plan entitySingle employer plan
2011-09-01Submission has been amendedNo
2011-09-01This submission is the final filingNo
2011-09-01This return/report is a short plan year return/report (less than 12 months)No
2011-09-01Plan is a collectively bargained planNo
2011-09-01Plan funding arrangement – InsuranceYes
2011-09-01Plan funding arrangement – TrustYes
2011-09-01Plan benefit arrangement - TrustYes
2009: ST. MARYS PHARMACY, INC. PROFIT SHARING PLAN 2009 form 5500 responses
2009-09-01Type of plan entitySingle employer plan
2009-09-01Submission has been amendedNo
2009-09-01This submission is the final filingNo
2009-09-01This return/report is a short plan year return/report (less than 12 months)No
2009-09-01Plan is a collectively bargained planNo
2009-09-01Plan funding arrangement – InsuranceYes
2009-09-01Plan funding arrangement – TrustYes
2009-09-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

ZURICH AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90537 )
Policy contract numberK9832A
Policy instance 1
Insurance contract or identification numberK9832A
Number of Individuals Covered0
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number999416-000
Policy instance 2
Insurance contract or identification number999416-000
Number of Individuals Covered64
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $7,482
Total amount of fees paid to insurance companyUSD $1,198
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,600
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker namePENSION RESOURCES, INC
ZURICH AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90537 )
Policy contract numberK9832A
Policy instance 1
Insurance contract or identification numberK9832A
Number of Individuals Covered9
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $9,437
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,437
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameGERALD J. BAVERO
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number999416-000
Policy instance 2
Insurance contract or identification number999416-000
Number of Individuals Covered13
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $1,652
Total amount of fees paid to insurance companyUSD $242
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,652
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker namePENSION RESOURCES, INC
ZURICH AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90537 )
Policy contract numberK9832A
Policy instance 1
Insurance contract or identification numberK9832A
Number of Individuals Covered45
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $17,470
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,470
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameGERALD J. BAVERO
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number999416-000
Policy instance 2
Insurance contract or identification number999416-000
Number of Individuals Covered24
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $1,602
Total amount of fees paid to insurance companyUSD $192
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,602
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker namePENSION RESOURCES, INC
ZURICH AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90537 )
Policy contract numberK9832A
Policy instance 1
Insurance contract or identification numberK9832A
Number of Individuals Covered40
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $5,346
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number999416-000
Policy instance 2
Insurance contract or identification number999416-000
Number of Individuals Covered13
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $1,498
Total amount of fees paid to insurance companyUSD $142
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ZURICH AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90537 )
Policy contract numberK005259490
Policy instance 3
Insurance contract or identification numberK005259490
Number of Individuals Covered62
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $3,799
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ZURICH AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90537 )
Policy contract numberK9832A
Policy instance 1
Insurance contract or identification numberK9832A
Number of Individuals Covered39
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $3,587
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number999416-000
Policy instance 2
Insurance contract or identification number999416-000
Number of Individuals Covered24
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $1,244
Total amount of fees paid to insurance companyUSD $111
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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