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MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC RETIREMENT SAVINGS PLAN 401k Plan overview

Plan NameMAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC RETIREMENT SAVINGS PLAN
Plan identification number 001

MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC RETIREMENT SAVINGS 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.
  • 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.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

MAYO CLINIC HEALTH SYSTEM - EAU CLAIRE CLINIC, INC. has sponsored the creation of one or more 401k plans.

Company Name:MAYO CLINIC HEALTH SYSTEM - EAU CLAIRE CLINIC, INC.
Employer identification number (EIN):391735831
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC RETIREMENT SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012015-01-01DAVID SCHUITEMA DAVID SCHUITEMA2016-07-13
0012014-01-01DAVID SCHUITEMA DAVID SCHUITEMA2015-10-07
0012013-01-01LESLIE SMITH LESLIE SMITH2014-10-14
0012012-01-01LESLIE SMITH LESLIE SMITH2013-10-08
0012011-01-01BLYTHE RINALDI BLYTHE RINALDI2012-10-08
0012010-01-01LESLIE SMITH
0012009-01-01BLYTHE RINALDI

Plan Statistics for MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC RETIREMENT SAVINGS PLAN

401k plan membership statisitcs for MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC RETIREMENT SAVINGS PLAN

Measure Date Value
2015: MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC RETIREMENT SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-012,169
Total number of active participants reported on line 7a of the Form 55002015-01-010
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-010
Number of participants with account balances2015-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-019
2014: MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC RETIREMENT SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-012,125
Total number of active participants reported on line 7a of the Form 55002014-01-011,817
Number of retired or separated participants receiving benefits2014-01-0114
Number of other retired or separated participants entitled to future benefits2014-01-01336
Total of all active and inactive participants2014-01-012,167
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-012
Total participants2014-01-012,169
Number of participants with account balances2014-01-012,038
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-0130
2013: MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC RETIREMENT SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-011,975
Total number of active participants reported on line 7a of the Form 55002013-01-011,821
Number of retired or separated participants receiving benefits2013-01-0112
Number of other retired or separated participants entitled to future benefits2013-01-01291
Total of all active and inactive participants2013-01-012,124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-011
Total participants2013-01-012,125
Number of participants with account balances2013-01-011,990
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-0122
2012: MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC RETIREMENT SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-012,005
Total number of active participants reported on line 7a of the Form 55002012-01-011,823
Number of retired or separated participants receiving benefits2012-01-0117
Number of other retired or separated participants entitled to future benefits2012-01-01267
Total of all active and inactive participants2012-01-012,107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-011
Total participants2012-01-012,108
Number of participants with account balances2012-01-011,975
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-0124
2011: MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC RETIREMENT SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-011,930
Total number of active participants reported on line 7a of the Form 55002011-01-011,752
Number of retired or separated participants receiving benefits2011-01-0113
Number of other retired or separated participants entitled to future benefits2011-01-01240
Total of all active and inactive participants2011-01-012,005
Total participants2011-01-012,005
Number of participants with account balances2011-01-011,883
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-0126
2010: MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC RETIREMENT SAVINGS PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-011,825
Total number of active participants reported on line 7a of the Form 55002010-01-011,688
Number of retired or separated participants receiving benefits2010-01-0111
Number of other retired or separated participants entitled to future benefits2010-01-01231
Total of all active and inactive participants2010-01-011,930
Total participants2010-01-011,930
Number of participants with account balances2010-01-0119
2009: MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC RETIREMENT SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-011,472
Total number of active participants reported on line 7a of the Form 55002009-01-011,595
Number of retired or separated participants receiving benefits2009-01-0112
Number of other retired or separated participants entitled to future benefits2009-01-01218
Total of all active and inactive participants2009-01-011,825
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-011,825
Number of participants with account balances2009-01-011,712
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-0118

Financial Data on MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC RETIREMENT SAVINGS PLAN

Measure Date Value
2015 : MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC RETIREMENT SAVINGS PLAN 2015 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2015-09-30$-294,568
Total unrealized appreciation/depreciation of assets2015-09-30$-294,568
Total transfer of assets from this plan2015-09-30$282,637,350
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-09-30$353,740
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-09-30$0
Total income from all sources (including contributions)2015-09-30$-10,039,079
Total loss/gain on sale of assets2015-09-30$0
Total of all expenses incurred2015-09-30$18,494,455
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-09-30$18,331,340
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-09-30$0
Value of total assets at end of year2015-09-30$353,740
Value of total assets at beginning of year2015-09-30$311,170,884
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-09-30$163,115
Total interest from all sources2015-09-30$70,451
Total dividends received (eg from common stock, registered investment company shares)2015-09-30$3,769,064
Total dividends received from registered investment company shares (eg mutual funds)2015-09-30$3,769,064
Was this plan covered by a fidelity bond2015-09-30Yes
Value of fidelity bond cover2015-09-30$5,000,000
If this is an individual account plan, was there a blackout period2015-09-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-09-30$0
Were there any nonexempt tranactions with any party-in-interest2015-09-30No
Participant contributions at end of year2015-09-30$0
Participant contributions at beginning of year2015-09-30$2,610,928
Assets. Other investments not covered elsewhere at end of year2015-09-30$353,740
Assets. Other investments not covered elsewhere at beginning of year2015-09-30$6,990,089
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-09-30$353,740
Other income not declared elsewhere2015-09-30$422,917
Administrative expenses (other) incurred2015-09-30$163,115
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-09-30No
Value of net income/loss2015-09-30$-28,533,534
Value of net assets at end of year (total assets less liabilities)2015-09-30$0
Value of net assets at beginning of year (total assets less liabilities)2015-09-30$311,170,884
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2015-09-30No
Were any leases to which the plan was party in default or uncollectible2015-09-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-09-30$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-09-30$272,326,365
Interest on participant loans2015-09-30$70,451
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-09-30$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-09-30$2,259,331
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-09-30$2,259,331
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-09-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-09-30$16,964,199
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-09-30$-14,006,943
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-09-30No
Was there a failure to transmit to the plan any participant contributions2015-09-30No
Has the plan failed to provide any benefit when due under the plan2015-09-30No
Employer contributions (assets) at end of year2015-09-30$0
Employer contributions (assets) at beginning of year2015-09-30$10,019,972
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-09-30$18,331,340
Did the plan have assets held for investment2015-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-09-30Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-09-30Yes
Opinion of an independent qualified public accountant for this plan2015-09-30Disclaimer
Accountancy firm name2015-09-30RSM US LLP
Accountancy firm EIN2015-09-30420714325
2014 : MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC RETIREMENT SAVINGS PLAN 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2014-12-31$311,667
Total unrealized appreciation/depreciation of assets2014-12-31$311,667
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$38,814,022
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$26,651,779
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$26,428,316
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$19,832,069
Value of total assets at end of year2014-12-31$311,170,884
Value of total assets at beginning of year2014-12-31$299,008,641
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$223,463
Total interest from all sources2014-12-31$104,892
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$14,105,059
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2014-12-31$14,105,059
Administrative expenses professional fees incurred2014-12-31$223,463
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$5,000,000
If this is an individual account plan, was there a blackout period2014-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$8,621,591
Participant contributions at end of year2014-12-31$2,610,928
Participant contributions at beginning of year2014-12-31$2,419,830
Assets. Other investments not covered elsewhere at end of year2014-12-31$6,990,089
Assets. Other investments not covered elsewhere at beginning of year2014-12-31$7,754,790
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$1,187,203
Other income not declared elsewhere2014-12-31$572,428
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$12,162,243
Value of net assets at end of year (total assets less liabilities)2014-12-31$311,170,884
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$299,008,641
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$272,326,365
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$259,695,322
Interest on participant loans2014-12-31$104,892
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$2,259,331
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$1,487,291
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$1,487,291
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$16,964,199
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$18,161,547
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$3,887,907
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$10,023,275
Employer contributions (assets) at end of year2014-12-31$10,019,972
Employer contributions (assets) at beginning of year2014-12-31$9,489,861
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$26,428,316
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31MCGLADREY LLP
Accountancy firm EIN2014-12-31420714325
2013 : MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC RETIREMENT SAVINGS PLAN 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2013-12-31$4,356
Total unrealized appreciation/depreciation of assets2013-12-31$4,356
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total income from all sources (including contributions)2013-12-31$64,388,736
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$17,053,646
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$16,854,767
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$18,854,542
Value of total assets at end of year2013-12-31$299,008,641
Value of total assets at beginning of year2013-12-31$251,673,551
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$198,879
Total interest from all sources2013-12-31$97,767
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$8,945,860
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$8,945,860
Administrative expenses professional fees incurred2013-12-31$198,879
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$5,000,000
If this is an individual account plan, was there a blackout period2013-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$8,164,471
Participant contributions at end of year2013-12-31$2,419,830
Participant contributions at beginning of year2013-12-31$2,058,895
Assets. Other investments not covered elsewhere at end of year2013-12-31$7,754,790
Assets. Other investments not covered elsewhere at beginning of year2013-12-31$5,974,475
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$1,214,634
Other income not declared elsewhere2013-12-31$454,912
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$47,335,090
Value of net assets at end of year (total assets less liabilities)2013-12-31$299,008,641
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$251,673,551
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$259,695,322
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$216,892,595
Interest on participant loans2013-12-31$97,767
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$1,487,291
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$2,076,062
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$2,076,062
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$18,161,547
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$15,453,233
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$35,465,838
Net investment gain or loss from common/collective trusts2013-12-31$565,461
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$9,475,437
Employer contributions (assets) at end of year2013-12-31$9,489,861
Employer contributions (assets) at beginning of year2013-12-31$9,218,291
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$16,854,767
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-12-31No
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31MCGLADREY LLC
Accountancy firm EIN2013-12-31420714325
2012 : MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC RETIREMENT SAVINGS PLAN 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2012-12-31$420,955
Total unrealized appreciation/depreciation of assets2012-12-31$420,955
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total income from all sources (including contributions)2012-12-31$45,389,877
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$17,880,887
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$17,701,097
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$17,326,307
Value of total assets at end of year2012-12-31$251,673,551
Value of total assets at beginning of year2012-12-31$224,164,561
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$179,790
Total interest from all sources2012-12-31$86,971
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$8,172,476
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2012-12-31$8,172,476
Administrative expenses professional fees incurred2012-12-31$179,790
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$5,000,000
If this is an individual account plan, was there a blackout period2012-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$7,650,384
Participant contributions at end of year2012-12-31$2,058,895
Participant contributions at beginning of year2012-12-31$1,729,630
Assets. Other investments not covered elsewhere at end of year2012-12-31$5,974,475
Assets. Other investments not covered elsewhere at beginning of year2012-12-31$5,334,626
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$457,632
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$27,508,990
Value of net assets at end of year (total assets less liabilities)2012-12-31$251,673,551
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$224,164,561
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$216,892,595
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$193,897,747
Interest on participant loans2012-12-31$86,971
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$2,076,062
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$905,136
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$905,136
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$15,453,233
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$13,487,603
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$19,383,168
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$9,218,291
Employer contributions (assets) at end of year2012-12-31$9,218,291
Employer contributions (assets) at beginning of year2012-12-31$8,809,819
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$17,701,097
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-12-31No
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31MCGLADREY LLP
Accountancy firm EIN2012-12-31420714325
2011 : MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC RETIREMENT SAVINGS PLAN 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2011-12-31$-240,859
Total unrealized appreciation/depreciation of assets2011-12-31$-240,859
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total income from all sources (including contributions)2011-12-31$15,220,453
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$23,173,080
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$22,999,966
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$16,431,252
Value of total assets at end of year2011-12-31$224,164,561
Value of total assets at beginning of year2011-12-31$232,117,188
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$173,114
Total interest from all sources2011-12-31$81,188
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$6,823,614
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$6,823,614
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$5,000,000
If this is an individual account plan, was there a blackout period2011-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$7,223,597
Participant contributions at end of year2011-12-31$1,729,630
Participant contributions at beginning of year2011-12-31$1,697,370
Assets. Other investments not covered elsewhere at end of year2011-12-31$5,334,626
Assets. Other investments not covered elsewhere at beginning of year2011-12-31$7,056,665
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$397,836
Other income not declared elsewhere2011-12-31$-133,197
Administrative expenses (other) incurred2011-12-31$173,114
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-7,952,627
Value of net assets at end of year (total assets less liabilities)2011-12-31$224,164,561
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$232,117,188
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$193,897,747
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$202,881,044
Interest on participant loans2011-12-31$79,940
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$905,136
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$1,338,464
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$1,338,464
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$1,248
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$13,487,603
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$10,669,494
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$-8,133,630
Net investment gain or loss from common/collective trusts2011-12-31$392,085
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$8,809,819
Employer contributions (assets) at end of year2011-12-31$8,809,819
Employer contributions (assets) at beginning of year2011-12-31$8,474,151
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$22,999,966
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-12-31No
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31MCGLADREY LLP
Accountancy firm EIN2011-12-31420714325
2010 : MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC RETIREMENT SAVINGS PLAN 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$631,597
Total unrealized appreciation/depreciation of assets2010-12-31$631,597
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total income from all sources (including contributions)2010-12-31$41,212,210
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$13,909,738
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$13,746,790
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$16,318,487
Value of total assets at end of year2010-12-31$232,117,188
Value of total assets at beginning of year2010-12-31$204,814,716
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$162,948
Total interest from all sources2010-12-31$89,588
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$5,470,890
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2010-12-31$5,470,890
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$5,000,000
If this is an individual account plan, was there a blackout period2010-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$6,702,594
Participant contributions at end of year2010-12-31$1,697,370
Participant contributions at beginning of year2010-12-31$1,512,397
Assets. Other investments not covered elsewhere at end of year2010-12-31$7,056,665
Assets. Other investments not covered elsewhere at beginning of year2010-12-31$7,741,892
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$1,141,742
Other income not declared elsewhere2010-12-31$-65,257
Administrative expenses (other) incurred2010-12-31$162,948
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$27,302,472
Value of net assets at end of year (total assets less liabilities)2010-12-31$232,117,188
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$204,814,716
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$202,881,044
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$179,324,743
Interest on participant loans2010-12-31$89,257
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$1,338,464
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$331
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$10,669,494
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$7,975,428
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$18,475,064
Net investment gain or loss from common/collective trusts2010-12-31$291,841
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$8,474,151
Employer contributions (assets) at end of year2010-12-31$8,474,151
Employer contributions (assets) at beginning of year2010-12-31$8,260,256
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$13,746,790
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31No
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31MCGLADREY & PULLEN, LLP
Accountancy firm EIN2010-12-31420714325
2009 : MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC RETIREMENT SAVINGS PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC RETIREMENT SAVINGS PLAN

2015: MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC RETIREMENT SAVINGS PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingYes
2015-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC RETIREMENT SAVINGS PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC RETIREMENT SAVINGS PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC RETIREMENT SAVINGS PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC RETIREMENT SAVINGS PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC RETIREMENT SAVINGS PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedYes
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC RETIREMENT SAVINGS PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )
Policy contract number151553
Policy instance 1
Insurance contract or identification number151553
Number of Individuals Covered0
Insurance policy start date2015-01-01
Insurance policy end date2015-09-30
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?Yes
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
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number150151
Policy instance 2
Insurance contract or identification number150151
Number of Individuals Covered0
Insurance policy start date2015-01-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $0
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?Yes
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
TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )
Policy contract number151553
Policy instance 1
Insurance contract or identification number151553
Number of Individuals Covered1
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
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?Yes
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
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number150151
Policy instance 2
Insurance contract or identification number150151
Number of Individuals Covered1
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
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?Yes
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
TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )
Policy contract number151553
Policy instance 1
Insurance contract or identification number151553
Number of Individuals Covered1
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
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?Yes
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
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number150151
Policy instance 2
Insurance contract or identification number150151
Number of Individuals Covered1
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
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?Yes
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
TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )
Policy contract number151553
Policy instance 1
Insurance contract or identification number151553
Number of Individuals Covered1
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
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?Yes
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
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number150151
Policy instance 2
Insurance contract or identification number150151
Number of Individuals Covered1
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
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?Yes
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
TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )
Policy contract number151553
Policy instance 1
Insurance contract or identification number151553
Number of Individuals Covered1
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
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?Yes
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
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number150151
Policy instance 2
Insurance contract or identification number150151
Number of Individuals Covered1
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
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
TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )
Policy contract number151553
Policy instance 1
Insurance contract or identification number151553
Number of Individuals Covered1
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
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?Yes
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
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number150151
Policy instance 2
Insurance contract or identification number150151
Number of Individuals Covered1
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
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

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