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ROBERT B. PAYNE, INC. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan NameROBERT B. PAYNE, INC. 401(K) PROFIT SHARING PLAN
Plan identification number 001

ROBERT B. PAYNE, INC. 401(K) PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • 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.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Plan covering Self-Employed individuals.
  • 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

ROBERT B. PAYNE, INC. has sponsored the creation of one or more 401k plans.

Company Name:ROBERT B. PAYNE, INC.
Employer identification number (EIN):540332070
NAIC Classification:238220
NAIC Description:Plumbing, Heating, and Air-Conditioning Contractors

Additional information about ROBERT B. PAYNE, INC.

Jurisdiction of Incorporation: Virginia Secretary of State
Incorporation Date: 1930-10-21
Company Identification Number: 0036263
Legal Registered Office Address: 1209 LAFAYETTE BLVD

FREDERICKSBURG
United States of America (USA)
22401

More information about ROBERT B. PAYNE, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ROBERT B. PAYNE, INC. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012023-01-01ANITA M LONG2024-07-26
0012022-01-01ANITA M LONG2023-07-24
0012021-01-01ANITA M LONG2022-07-26 ROBERT B P THOMPSON2022-07-26
0012020-01-01ANITA M LONG2021-07-27 ROBERT B P THOMPSON2021-07-27
0012019-01-01ANITA M LONG2020-07-24 ROBERT B THOMPSON2020-07-24
0012018-01-01ANITA M LONG2019-07-05 ROBERT THOMPSON2019-07-05
0012017-01-01ANITA LONG2018-07-26 ROBERT B P THOMPSON2018-07-26
0012016-01-01ANITA LONG2017-07-21 ROBERT THOMPSON2017-07-21
0012015-01-01ANITA M LONG2016-07-14 ROBERT B P THOMPSON2016-07-14
0012014-01-01ANITA M LONG ROBERT B P THOMPSON2015-07-22
0012013-01-01ANITA LONG ROBERT THOMPSON2014-07-16
0012012-01-01ANITA LONG ROBERT THOMPSON2013-07-19
0012011-01-01ANITA LONG ROBERT THOMPSON2012-07-16
0012010-01-01ANITA LONG
0012009-01-01ANITA M LONG ROBERT THOMPSON2010-07-23

Plan Statistics for ROBERT B. PAYNE, INC. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for ROBERT B. PAYNE, INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2014: ROBERT B. PAYNE, INC. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0144
Total number of active participants reported on line 7a of the Form 55002014-01-0133
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0112
Total of all active and inactive participants2014-01-0145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0145
Number of participants with account balances2014-01-0145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: ROBERT B. PAYNE, INC. 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0143
Total number of active participants reported on line 7a of the Form 55002013-01-0136
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 participants2013-01-0145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0145
Number of participants with account balances2013-01-0140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-018
2012: ROBERT B. PAYNE, INC. 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0143
Total number of active participants reported on line 7a of the Form 55002012-01-0134
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0110
Total of all active and inactive participants2012-01-0144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0144
Number of participants with account balances2012-01-0134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-016
2011: ROBERT B. PAYNE, INC. 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0141
Total number of active participants reported on line 7a of the Form 55002011-01-0132
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-014
Total of all active and inactive participants2011-01-0136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0136
Number of participants with account balances2011-01-0136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: ROBERT B. PAYNE, INC. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0132
Total number of active participants reported on line 7a of the Form 55002010-01-0135
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-012
Total of all active and inactive participants2010-01-0137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0137
Number of participants with account balances2010-01-0137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: ROBERT B. PAYNE, INC. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0142
Total number of active participants reported on line 7a of the Form 55002009-01-0131
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-013
Total of all active and inactive participants2009-01-0134
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0134
Number of participants with account balances2009-01-0134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-015

Financial Data on ROBERT B. PAYNE, INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2014 : ROBERT B. PAYNE, INC. 401(K) PROFIT SHARING PLAN 2014 401k financial data
Transfers to/from the plan2014-12-31$0
Total income from all sources2014-12-31$268,857
Expenses. Total of all expenses incurred2014-12-31$71,309
Benefits paid (including direct rollovers)2014-12-31$59,475
Total plan assets at end of year2014-12-31$2,926,864
Total plan assets at beginning of year2014-12-31$2,729,316
Value of fidelity bond covering the plan2014-12-31$1,000,000
Total contributions received or receivable from participants2014-12-31$146,833
Expenses. Other expenses not covered elsewhere2014-12-31$919
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$95,422
Net income (gross income less expenses)2014-12-31$197,548
Net plan assets at end of year (total assets less liabilities)2014-12-31$2,926,864
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$2,729,316
Assets. Value of participant loans2014-12-31$0
Total contributions received or receivable from employer(s)2014-12-31$26,602
Value of certain deemed distributions of participant loans2014-12-31$0
Value of corrective distributions2014-12-31$10,915
Funding deficiency by the employer to the plan for this plan year2014-12-31$0
Minimum employer required contribution for this plan year2014-12-31$0
Amount contributed by the employer to the plan for this plan year2014-12-31$0
2013 : ROBERT B. PAYNE, INC. 401(K) PROFIT SHARING PLAN 2013 401k financial data
Transfers to/from the plan2013-12-31$0
Total income from all sources2013-12-31$646,352
Expenses. Total of all expenses incurred2013-12-31$25,178
Benefits paid (including direct rollovers)2013-12-31$12,440
Total plan assets at end of year2013-12-31$2,729,316
Total plan assets at beginning of year2013-12-31$2,108,142
Value of fidelity bond covering the plan2013-12-31$1,000,000
Total contributions received or receivable from participants2013-12-31$131,911
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$491,054
Net income (gross income less expenses)2013-12-31$621,174
Net plan assets at end of year (total assets less liabilities)2013-12-31$2,729,316
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$2,108,142
Assets. Value of participant loans2013-12-31$0
Total contributions received or receivable from employer(s)2013-12-31$23,387
Value of certain deemed distributions of participant loans2013-12-31$0
Value of corrective distributions2013-12-31$12,738
Funding deficiency by the employer to the plan for this plan year2013-12-31$0
Minimum employer required contribution for this plan year2013-12-31$0
Amount contributed by the employer to the plan for this plan year2013-12-31$0
2012 : ROBERT B. PAYNE, INC. 401(K) PROFIT SHARING PLAN 2012 401k financial data
Transfers to/from the plan2012-12-31$0
Total income from all sources2012-12-31$437,886
Expenses. Total of all expenses incurred2012-12-31$7,478
Benefits paid (including direct rollovers)2012-12-31$7,478
Total plan assets at end of year2012-12-31$2,108,142
Total plan assets at beginning of year2012-12-31$1,677,734
Value of fidelity bond covering the plan2012-12-31$1,000,000
Total contributions received or receivable from participants2012-12-31$125,481
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$265,292
Net income (gross income less expenses)2012-12-31$430,408
Net plan assets at end of year (total assets less liabilities)2012-12-31$2,108,142
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$1,677,734
Assets. Value of participant loans2012-12-31$0
Total contributions received or receivable from employer(s)2012-12-31$47,113
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$0
Funding deficiency by the employer to the plan for this plan year2012-12-31$0
Minimum employer required contribution for this plan year2012-12-31$0
Amount contributed by the employer to the plan for this plan year2012-12-31$0
2011 : ROBERT B. PAYNE, INC. 401(K) PROFIT SHARING PLAN 2011 401k financial data
Transfers to/from the plan2011-12-31$0
Total income from all sources2011-12-31$61,903
Expenses. Total of all expenses incurred2011-12-31$17,422
Benefits paid (including direct rollovers)2011-12-31$7,657
Total plan assets at end of year2011-12-31$1,677,734
Total plan assets at beginning of year2011-12-31$1,633,253
Value of fidelity bond covering the plan2011-12-31$1,000,000
Total contributions received or receivable from participants2011-12-31$148,252
Expenses. Other expenses not covered elsewhere2011-12-31$0
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-137,178
Net income (gross income less expenses)2011-12-31$44,481
Net plan assets at end of year (total assets less liabilities)2011-12-31$1,677,734
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$1,633,253
Assets. Value of participant loans2011-12-31$0
Total contributions received or receivable from employer(s)2011-12-31$50,829
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$9,765
Funding deficiency by the employer to the plan for this plan year2011-12-31$0
Minimum employer required contribution for this plan year2011-12-31$0
Amount contributed by the employer to the plan for this plan year2011-12-31$0
2010 : ROBERT B. PAYNE, INC. 401(K) PROFIT SHARING PLAN 2010 401k financial data
Transfers to/from the plan2010-12-31$0
Total income from all sources2010-12-31$352,067
Expenses. Total of all expenses incurred2010-12-31$10,007
Benefits paid (including direct rollovers)2010-12-31$10,007
Total plan assets at end of year2010-12-31$1,633,253
Total plan assets at beginning of year2010-12-31$1,291,193
Value of fidelity bond covering the plan2010-12-31$1,000,000
Total contributions received or receivable from participants2010-12-31$130,409
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$195,422
Net income (gross income less expenses)2010-12-31$342,060
Net plan assets at end of year (total assets less liabilities)2010-12-31$1,633,253
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$1,291,193
Assets. Value of participant loans2010-12-31$0
Total contributions received or receivable from employer(s)2010-12-31$26,236
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$0
Funding deficiency by the employer to the plan for this plan year2010-12-31$0
Minimum employer required contribution for this plan year2010-12-31$0
Amount contributed by the employer to the plan for this plan year2010-12-31$0
2009 : ROBERT B. PAYNE, INC. 401(K) PROFIT SHARING PLAN 2009 401k financial data
Funding deficiency by the employer to the plan for this plan year2009-12-31$0
Minimum employer required contribution for this plan year2009-12-31$0
Amount contributed by the employer to the plan for this plan year2009-12-31$0

Form 5500 Responses for ROBERT B. PAYNE, INC. 401(K) PROFIT SHARING PLAN

2014: ROBERT B. PAYNE, INC. 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 – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: ROBERT B. PAYNE, INC. 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
2012: ROBERT B. PAYNE, INC. 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
2011: ROBERT B. PAYNE, INC. 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
2010: ROBERT B. PAYNE, INC. 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
2009: ROBERT B. PAYNE, INC. 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 – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-028433
Policy instance 1
Insurance contract or identification numberGA-028433
Number of Individuals Covered45
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $11,091
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
Commission paid to Insurance BrokerUSD $11,091
Insurance broker organization code?3
Insurance broker nameCARY STREET PARTNERS LLC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-028433
Policy instance 1
Insurance contract or identification numberGA-028433
Number of Individuals Covered40
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $9,127
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
Commission paid to Insurance BrokerUSD $9,127
Insurance broker organization code?3
Insurance broker nameCARY STREET PARTNERS LLC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-028433
Policy instance 1
Insurance contract or identification numberGA-028433
Number of Individuals Covered34
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $7,361
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
Commission paid to Insurance BrokerUSD $7,361
Insurance broker organization code?3
Insurance broker nameCARY STREET PARTNERS LLC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-028433
Policy instance 1
Insurance contract or identification numberGA-028433
Number of Individuals Covered36
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $6,824
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 numberGA-028433
Policy instance 1
Insurance contract or identification numberGA-028433
Number of Individuals Covered37
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $5,387
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

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