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CUMBERLAND ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan NameCUMBERLAND ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN
Plan identification number 001

CUMBERLAND ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • 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.
  • 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.

401k Sponsoring company profile

CUMBERLAND ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES, P.A. has sponsored the creation of one or more 401k plans.

Company Name:CUMBERLAND ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES, P.A.
Employer identification number (EIN):521981940
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CUMBERLAND ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012018-01-01VIVEK GUPTA, MD2019-07-11
0012017-01-01VIVEK GUPTA, MD2018-06-20
0012016-01-01VIVEK GUPTA, MD2017-10-13
0012015-01-01GERALD GOLDSTEIN2016-10-03
0012014-01-01GERALD GOLDSTEIN
0012013-01-01GERALD GOLDSTEIN
0012012-01-01GERALD GOLDSTEIN
0012011-01-01GERALD GOLDSTEIN
0012010-01-01WILLIAM KELLERMEYER
0012009-01-01
0012009-01-01WILLIAM KELLERMEYER WILLIAM KELLERMEYER2010-08-04

Plan Statistics for CUMBERLAND ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for CUMBERLAND ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN

Measure Date Value
2014: CUMBERLAND ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0141
Total number of active participants reported on line 7a of the Form 55002014-01-0129
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0111
Total of all active and inactive participants2014-01-0140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0140
Number of participants with account balances2014-01-0133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: CUMBERLAND ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0144
Total number of active participants reported on line 7a of the Form 55002013-01-0132
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-019
Total of all active and inactive participants2013-01-0141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0141
Number of participants with account balances2013-01-0134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: CUMBERLAND ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0144
Total number of active participants reported on line 7a of the Form 55002012-01-0137
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-016
Total of all active and inactive participants2012-01-0143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0143
Number of participants with account balances2012-01-0133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: CUMBERLAND ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0139
Total number of active participants reported on line 7a of the Form 55002011-01-0135
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-019
Total of all active and inactive participants2011-01-0144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0144
Number of participants with account balances2011-01-0135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: CUMBERLAND ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0136
Total number of active participants reported on line 7a of the Form 55002010-01-0132
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-017
Total of all active and inactive participants2010-01-0139
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0139
Number of participants with account balances2010-01-0134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: CUMBERLAND ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0136
Total number of active participants reported on line 7a of the Form 55002009-01-0132
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-014
Total of all active and inactive participants2009-01-0136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0136
Number of participants with account balances2009-01-0133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on CUMBERLAND ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN

Measure Date Value
2014 : CUMBERLAND ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN 2014 401k financial data
Transfers to/from the plan2014-12-31$0
Total plan liabilities at end of year2014-12-31$0
Total plan liabilities at beginning of year2014-12-31$0
Total income from all sources2014-12-31$544,517
Expenses. Total of all expenses incurred2014-12-31$62,164
Benefits paid (including direct rollovers)2014-12-31$54,915
Total plan assets at end of year2014-12-31$6,605,410
Total plan assets at beginning of year2014-12-31$6,123,057
Value of fidelity bond covering the plan2014-12-31$500,000
Total contributions received or receivable from participants2014-12-31$359,722
Expenses. Other expenses not covered elsewhere2014-12-31$0
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$-53,076
Noncash contributions received2014-12-31$0
Net income (gross income less expenses)2014-12-31$482,353
Net plan assets at end of year (total assets less liabilities)2014-12-31$6,605,410
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$6,123,057
Assets. Value of participant loans2014-12-31$36,945
Total contributions received or receivable from employer(s)2014-12-31$237,871
Value of certain deemed distributions of participant loans2014-12-31$0
Value of corrective distributions2014-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$7,249
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : CUMBERLAND ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN 2013 401k financial data
Transfers to/from the plan2013-12-31$0
Total plan liabilities at end of year2013-12-31$0
Total plan liabilities at beginning of year2013-12-31$825
Total income from all sources2013-12-31$969,814
Expenses. Total of all expenses incurred2013-12-31$566,709
Benefits paid (including direct rollovers)2013-12-31$560,871
Total plan assets at end of year2013-12-31$6,123,057
Total plan assets at beginning of year2013-12-31$5,720,777
Value of fidelity bond covering the plan2013-12-31$500,000
Total contributions received or receivable from participants2013-12-31$330,039
Expenses. Other expenses not covered elsewhere2013-12-31$0
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$351,085
Noncash contributions received2013-12-31$0
Net income (gross income less expenses)2013-12-31$403,105
Net plan assets at end of year (total assets less liabilities)2013-12-31$6,123,057
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$5,719,952
Assets. Value of participant loans2013-12-31$46,331
Assets. Value of assets in partnership/joint-venture interests2013-12-31$275,495
Total contributions received or receivable from employer(s)2013-12-31$288,690
Value of certain deemed distributions of participant loans2013-12-31$0
Value of corrective distributions2013-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$5,838
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : CUMBERLAND ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN 2012 401k financial data
Transfers to/from the plan2012-12-31$0
Total plan liabilities at end of year2012-12-31$825
Total plan liabilities at beginning of year2012-12-31$0
Total income from all sources2012-12-31$996,905
Expenses. Total of all expenses incurred2012-12-31$1,606,583
Benefits paid (including direct rollovers)2012-12-31$1,602,309
Total plan assets at end of year2012-12-31$5,720,777
Total plan assets at beginning of year2012-12-31$6,329,630
Value of fidelity bond covering the plan2012-12-31$500,000
Total contributions received or receivable from participants2012-12-31$331,649
Expenses. Other expenses not covered elsewhere2012-12-31$0
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$387,397
Noncash contributions received2012-12-31$0
Net income (gross income less expenses)2012-12-31$-609,678
Net plan assets at end of year (total assets less liabilities)2012-12-31$5,719,952
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$6,329,630
Assets. Value of participant loans2012-12-31$47,820
Assets. Value of assets in partnership/joint-venture interests2012-12-31$275,495
Total contributions received or receivable from employer(s)2012-12-31$277,859
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$4,274
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : CUMBERLAND ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN 2011 401k financial data
Transfers to/from the plan2011-12-31$0
Total plan liabilities at end of year2011-12-31$0
Total plan liabilities at beginning of year2011-12-31$0
Total income from all sources2011-12-31$459,617
Expenses. Total of all expenses incurred2011-12-31$961,552
Benefits paid (including direct rollovers)2011-12-31$954,525
Total plan assets at end of year2011-12-31$6,329,630
Total plan assets at beginning of year2011-12-31$6,831,565
Value of fidelity bond covering the plan2011-12-31$500,000
Total contributions received or receivable from participants2011-12-31$317,154
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-130,973
Noncash contributions received2011-12-31$0
Net income (gross income less expenses)2011-12-31$-501,935
Net plan assets at end of year (total assets less liabilities)2011-12-31$6,329,630
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$6,831,565
Assets. Value of assets in partnership/joint-venture interests2011-12-31$275,495
Total contributions received or receivable from employer(s)2011-12-31$273,436
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$7,027
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : CUMBERLAND ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN 2010 401k financial data
Transfers to/from the plan2010-12-31$0
Total plan liabilities at end of year2010-12-31$0
Total plan liabilities at beginning of year2010-12-31$0
Total income from all sources2010-12-31$1,429,959
Expenses. Total of all expenses incurred2010-12-31$152,725
Benefits paid (including direct rollovers)2010-12-31$145,386
Total plan assets at end of year2010-12-31$6,831,565
Total plan assets at beginning of year2010-12-31$5,554,331
Value of fidelity bond covering the plan2010-12-31$500,000
Total contributions received or receivable from participants2010-12-31$373,979
Expenses. Other expenses not covered elsewhere2010-12-31$0
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$723,980
Noncash contributions received2010-12-31$0
Net income (gross income less expenses)2010-12-31$1,277,234
Net plan assets at end of year (total assets less liabilities)2010-12-31$6,831,565
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$5,554,331
Assets. Value of assets in partnership/joint-venture interests2010-12-31$275,495
Total contributions received or receivable from employer(s)2010-12-31$332,000
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$7,339
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
2009 : CUMBERLAND ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES, P.A. 401(K) PROFIT SHARING 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 CUMBERLAND ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN

2014: CUMBERLAND ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES, P.A. 401(K) PROFIT SHARING 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 – TrustYes
2014-01-01Plan benefit arrangement - TrustYes
2013: CUMBERLAND ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES, P.A. 401(K) PROFIT SHARING 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: CUMBERLAND ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES, P.A. 401(K) PROFIT SHARING 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: CUMBERLAND ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES, P.A. 401(K) PROFIT SHARING 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: CUMBERLAND ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES, P.A. 401(K) PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
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: CUMBERLAND ANESTHESIA AND PAIN MANAGEMENT ASSOCIATES, P.A. 401(K) PROFIT SHARING 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 – TrustYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

SUNTRUST INVESTMENT SERVICES (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number712229166
Policy instance 1
Insurance contract or identification number712229166
Number of Individuals Covered0
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Are there contracts with allocated funds for individual policies?Yes
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
Insurance broker organization code?3
Insurance broker nameSUNTRUST INVESTMENT SERVICES
SUNTRUST INVESTMENT SERVICES (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number712229166
Policy instance 1
Insurance contract or identification number712229166
Number of Individuals Covered1
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,305
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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 $1,305
Insurance broker organization code?3
Insurance broker nameSUNTRUST INVESTMENT SERVICES
SUNTRUST INVESTMENT SERVICES (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number712229166
Policy instance 1
Insurance contract or identification number712229166
Number of Individuals Covered1
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $859
Total amount of fees paid to insurance companyUSD $3
Are there contracts with allocated funds for individual policies?Yes
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
SUNTRUST INVESTMENT SERVICES (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number712229166
Policy instance 1
Insurance contract or identification number712229166
Number of Individuals Covered1
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $1,059
Total amount of fees paid to insurance companyUSD $2
Are there contracts with allocated funds for individual policies?Yes
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 $1,059
Amount paid for insurance broker fees2
Additional information about fees paid to insurance brokerOTHER COMPENSATION PAID TO BROKER
Insurance broker organization code?3
Insurance broker nameSUNTRUST INVESTMENT SERVICES

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