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MICHAEL R ROSENTHAL MD PROFIT SHARING PLAN 401k Plan overview

Plan NameMICHAEL R ROSENTHAL MD PROFIT SHARING PLAN
Plan identification number 001

MICHAEL R ROSENTHAL MD 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.
  • 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

MICHAEL R ROSENTHAL MD has sponsored the creation of one or more 401k plans.

Company Name:MICHAEL R ROSENTHAL MD
Employer identification number (EIN):752055869
NAIC Classification:621112
NAIC Description:Offices of Physicians, Mental Health Specialists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MICHAEL R ROSENTHAL MD PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012015-01-01MICHAEL R ROSENTHAL MD2016-07-27
0012014-01-01MICHAEL R ROSENTHAL MD
0012013-01-01MICHAEL R ROSENTHAL MD
0012012-01-01MICHAEL R ROSENTHAL MD
0012011-01-01MICHAEL R ROSENTHAL MD
0012009-01-01MICHAEL R ROSENTHAL MD MICHAEL R ROSENTHAL MD2010-10-15

Plan Statistics for MICHAEL R ROSENTHAL MD PROFIT SHARING PLAN

401k plan membership statisitcs for MICHAEL R ROSENTHAL MD PROFIT SHARING PLAN

Measure Date Value
2014: MICHAEL R ROSENTHAL MD PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-012
Total number of active participants reported on line 7a of the Form 55002014-01-012
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-012
Number of participants with account balances2014-01-012
2013: MICHAEL R ROSENTHAL MD PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-012
Total number of active participants reported on line 7a of the Form 55002013-01-012
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-012
Number of participants with account balances2013-01-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: MICHAEL R ROSENTHAL MD PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-012
Total number of active participants reported on line 7a of the Form 55002012-01-012
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-012
Number of participants with account balances2012-01-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: MICHAEL R ROSENTHAL MD PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-012
Total number of active participants reported on line 7a of the Form 55002011-01-012
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-012
Number of participants with account balances2011-01-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: MICHAEL R ROSENTHAL MD PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-012
Total number of active participants reported on line 7a of the Form 55002009-01-012
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-012
Number of participants with account balances2009-01-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on MICHAEL R ROSENTHAL MD PROFIT SHARING PLAN

Measure Date Value
2014 : MICHAEL R ROSENTHAL MD PROFIT SHARING PLAN 2014 401k financial data
Total plan liabilities at beginning of year2014-12-31$0
Total income from all sources2014-12-31$122,500
Expenses. Total of all expenses incurred2014-12-31$1,724,561
Benefits paid (including direct rollovers)2014-12-31$1,724,061
Total plan assets at end of year2014-12-31$64,863
Total plan assets at beginning of year2014-12-31$1,666,924
Expenses. Other expenses not covered elsewhere2014-12-31$500
Other income received2014-12-31$57,637
Net income (gross income less expenses)2014-12-31$-1,602,061
Net plan assets at end of year (total assets less liabilities)2014-12-31$64,863
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$1,666,924
Total contributions received or receivable from employer(s)2014-12-31$64,863
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : MICHAEL R ROSENTHAL MD 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$0
Total income from all sources2013-12-31$445,971
Expenses. Total of all expenses incurred2013-12-31$0
Benefits paid (including direct rollovers)2013-12-31$0
Total plan assets at end of year2013-12-31$1,666,924
Total plan assets at beginning of year2013-12-31$1,220,953
Total contributions received or receivable from participants2013-12-31$0
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$415,971
Noncash contributions received2013-12-31$0
Net income (gross income less expenses)2013-12-31$445,971
Net plan assets at end of year (total assets less liabilities)2013-12-31$1,666,924
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$1,220,953
Total contributions received or receivable from employer(s)2013-12-31$30,000
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$0
2012 : MICHAEL R ROSENTHAL MD PROFIT SHARING PLAN 2012 401k financial data
Transfers to/from the plan2012-12-31$0
Total plan liabilities at end of year2012-12-31$0
Total plan liabilities at beginning of year2012-12-31$0
Total income from all sources2012-12-31$59,816
Expenses. Total of all expenses incurred2012-12-31$1,754
Benefits paid (including direct rollovers)2012-12-31$0
Total plan assets at end of year2012-12-31$1,220,953
Total plan assets at beginning of year2012-12-31$1,162,891
Total contributions received or receivable from participants2012-12-31$0
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$35,316
Noncash contributions received2012-12-31$0
Net income (gross income less expenses)2012-12-31$58,062
Net plan assets at end of year (total assets less liabilities)2012-12-31$1,220,953
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$1,162,891
Total contributions received or receivable from employer(s)2012-12-31$24,500
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$1,754
2011 : MICHAEL R ROSENTHAL MD 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$0
Total income from all sources2011-12-31$-22,205
Expenses. Total of all expenses incurred2011-12-31$1,379
Benefits paid (including direct rollovers)2011-12-31$0
Total plan assets at end of year2011-12-31$1,162,891
Total plan assets at beginning of year2011-12-31$1,186,475
Total contributions received or receivable from participants2011-12-31$0
Expenses. Other expenses not covered elsewhere2011-12-31$1,379
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-42,205
Noncash contributions received2011-12-31$0
Net income (gross income less expenses)2011-12-31$-23,584
Net plan assets at end of year (total assets less liabilities)2011-12-31$1,162,891
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$1,186,475
Total contributions received or receivable from employer(s)2011-12-31$20,000
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$0
2010 : MICHAEL R ROSENTHAL MD 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$99,685
Expenses. Total of all expenses incurred2010-12-31$2,912
Benefits paid (including direct rollovers)2010-12-31$0
Total plan assets at end of year2010-12-31$1,186,475
Total plan assets at beginning of year2010-12-31$1,089,702
Total contributions received or receivable from participants2010-12-31$0
Expenses. Other expenses not covered elsewhere2010-12-31$2,912
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$99,685
Noncash contributions received2010-12-31$0
Net income (gross income less expenses)2010-12-31$96,773
Net plan assets at end of year (total assets less liabilities)2010-12-31$1,186,475
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$1,089,702
Total contributions received or receivable from employer(s)2010-12-31$0
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$0

Form 5500 Responses for MICHAEL R ROSENTHAL MD PROFIT SHARING PLAN

2014: MICHAEL R ROSENTHAL MD 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
2014-01-01Plan benefit arrangement - TrustYes
2013: MICHAEL R ROSENTHAL MD 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: MICHAEL R ROSENTHAL MD 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: MICHAEL R ROSENTHAL MD PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedYes
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
2009: MICHAEL R ROSENTHAL MD 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
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52421 )
Policy contract numberVA35111112
Policy instance 3
Insurance contract or identification numberVA35111112
Number of Individuals Covered0
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
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 nameCURTIS T LADD
JACKSON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65056 )
Policy contract number1003537451
Policy instance 4
Insurance contract or identification number1003537451
Number of Individuals Covered0
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
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 nameCURTIS T LADD
PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52421 )
Policy contract numberVA0003526
Policy instance 2
Insurance contract or identification numberVA0003526
Number of Individuals Covered0
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
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 nameCURTIS T LADD
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number7568284
Policy instance 1
Insurance contract or identification number7568284
Number of Individuals Covered0
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
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 nameCHRIS YOUNG
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number7568284
Policy instance 1
Insurance contract or identification number7568284
Number of Individuals Covered1
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 nameCHRIS YOUNG
PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52421 )
Policy contract numberVA0003526
Policy instance 2
Insurance contract or identification numberVA0003526
Number of Individuals Covered1
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 nameCURTIS T LADD
PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52421 )
Policy contract numberVA35111112
Policy instance 3
Insurance contract or identification numberVA35111112
Number of Individuals Covered1
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 nameCURTIS T LADD
JACKSON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65056 )
Policy contract number1003537451
Policy instance 4
Insurance contract or identification number1003537451
Number of Individuals Covered1
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 nameCURTIS T LADD
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number7568284
Policy instance 1
Insurance contract or identification number7568284
Number of Individuals Covered1
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
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 nameCHRIS YOUNG
JACKSON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65056 )
Policy contract number1003537451
Policy instance 4
Insurance contract or identification number1003537451
Number of Individuals Covered1
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
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 nameCURTIS T LADD
PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52421 )
Policy contract numberVA35111112
Policy instance 3
Insurance contract or identification numberVA35111112
Number of Individuals Covered1
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
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 nameCURTIS T LADD
PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52421 )
Policy contract numberVA0003526
Policy instance 2
Insurance contract or identification numberVA0003526
Number of Individuals Covered1
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
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 nameCURTIS T LADD
PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52421 )
Policy contract numberVA35111112
Policy instance 3
Insurance contract or identification numberVA35111112
Number of Individuals Covered1
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
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
PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52421 )
Policy contract numberVA0003526
Policy instance 2
Insurance contract or identification numberVA0003526
Number of Individuals Covered1
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
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
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number7568284
Policy instance 1
Insurance contract or identification number7568284
Number of Individuals Covered1
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
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
JACKSON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65056 )
Policy contract number1003537451
Policy instance 4
Insurance contract or identification number1003537451
Number of Individuals Covered1
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
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
JACKSON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65056 )
Policy contract number1003537451
Policy instance 4
Insurance contract or identification number1003537451
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?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 $0
Amount paid for insurance broker fees0
Additional information about fees paid to insurance broker3
Insurance broker organization code?3
Insurance broker nameCURTIS T LADD
PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52421 )
Policy contract numberVA0003526
Policy instance 2
Insurance contract or identification numberVA0003526
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?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 $0
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameCURTIS T LADD
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number7568284
Policy instance 1
Insurance contract or identification number7568284
Number of Individuals Covered1
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
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 nameCURTIN T LADD
PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52421 )
Policy contract numberVA35111112
Policy instance 3
Insurance contract or identification numberVA35111112
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?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 $0
Amount paid for insurance broker fees0
Additional information about fees paid to insurance broker3
Insurance broker organization code?3
Insurance broker nameCURTIS T LADD

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