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PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan NamePEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN
Plan identification number 001

PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • 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.
  • 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

PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. has sponsored the creation of one or more 401k plans.

Company Name:PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC.
Employer identification number (EIN):941754129
NAIC Classification:621112
NAIC Description:Offices of Physicians, Mental Health Specialists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012023-01-01TIMOTHY W. HANSEN, M.D.2024-07-19
0012022-01-01TIMOTHY W. HANSEN, M.D.2023-10-01
0012021-01-01PEDIATRIC ANESTHESIA ASSOC.2022-09-11 PEDIATRIC ANESTHESIA ASSOC.2022-09-11
0012020-01-01TIMOTHY W. HANSEN, M.D.2021-09-22 TIMOTHY W. HANSEN, M.D.2021-09-22
0012019-01-01TIMOTHY W. HANSEN, M.D.2020-06-24 TIMOTHY W. HANSEN, M.D.2020-06-24
0012018-01-01
0012017-01-01
0012016-01-01
0012015-01-01
0012014-01-01
0012013-01-01
0012012-01-01TIMOTHY W. HANSEN , M.D.2013-10-01 TIMOTHY W. HANSEN , M.D.2013-10-01
0012011-01-01TIMOTHY W. HANSEN , M.D.2012-10-15 TIMOTHY W. HANSEN , M.D.2012-10-15
0012010-01-01RICHARD AUNE2011-10-11

Plan Statistics for PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2023: PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-0154
Total number of active participants reported on line 7a of the Form 55002023-01-0137
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-0119
Total of all active and inactive participants2023-01-0156
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2023-01-010
Total participants2023-01-0156
Number of participants with account balances2023-01-0156
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2023-01-011
2022: PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0155
Total number of active participants reported on line 7a of the Form 55002022-01-0137
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0117
Total of all active and inactive participants2022-01-0154
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-0154
Number of participants with account balances2022-01-0154
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0151
Total number of active participants reported on line 7a of the Form 55002021-01-0138
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0116
Total of all active and inactive participants2021-01-0154
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-011
Total participants2021-01-0155
Number of participants with account balances2021-01-0155
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0151
Total number of active participants reported on line 7a of the Form 55002020-01-0135
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0115
Total of all active and inactive participants2020-01-0150
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-011
Total participants2020-01-0151
Number of participants with account balances2020-01-0151
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0151
Total number of active participants reported on line 7a of the Form 55002019-01-0136
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0114
Total of all active and inactive participants2019-01-0150
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-011
Total participants2019-01-0151
Number of participants with account balances2019-01-0151
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-014
2018: PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0149
Total number of active participants reported on line 7a of the Form 55002018-01-0138
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0112
Total of all active and inactive participants2018-01-0150
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-011
Total participants2018-01-0151
Number of participants with account balances2018-01-0151
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0148
Total number of active participants reported on line 7a of the Form 55002017-01-0135
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0113
Total of all active and inactive participants2017-01-0148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-011
Total participants2017-01-0149
Number of participants with account balances2017-01-0149
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-011
2016: PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0140
Total number of active participants reported on line 7a of the Form 55002016-01-0137
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0111
Total of all active and inactive participants2016-01-0148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0148
Number of participants with account balances2016-01-0148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010

Financial Data on PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2023 : PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN 2023 401k financial data
Total income from all sources2023-12-31$8,760,601
Expenses. Total of all expenses incurred2023-12-31$973,886
Benefits paid (including direct rollovers)2023-12-31$958,475
Total plan assets at end of year2023-12-31$36,722,956
Total plan assets at beginning of year2023-12-31$28,936,241
Value of fidelity bond covering the plan2023-12-31$500,000
Total contributions received or receivable from participants2023-12-31$909,947
Other income received2023-12-31$6,363,372
Net income (gross income less expenses)2023-12-31$7,786,715
Net plan assets at end of year (total assets less liabilities)2023-12-31$36,722,956
Net plan assets at beginning of year (total assets less liabilities)2023-12-31$28,936,241
Assets. Value of participant loans2023-12-31$66,765
Assets. Value of assets in partnership/joint-venture interests2023-12-31$206,498
Total contributions received or receivable from employer(s)2023-12-31$1,487,282
Expenses. Administrative service providers (salaries,fees and commissions)2023-12-31$15,411
2022 : PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN 2022 401k financial data
Total income from all sources2022-12-31$-4,917,441
Expenses. Total of all expenses incurred2022-12-31$3,472,075
Benefits paid (including direct rollovers)2022-12-31$3,443,925
Total plan assets at end of year2022-12-31$28,936,241
Total plan assets at beginning of year2022-12-31$37,325,757
Value of fidelity bond covering the plan2022-12-31$500,000
Total contributions received or receivable from participants2022-12-31$824,300
Other income received2022-12-31$-7,143,042
Net income (gross income less expenses)2022-12-31$-8,389,516
Net plan assets at end of year (total assets less liabilities)2022-12-31$28,936,241
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$37,325,757
Assets. Value of participant loans2022-12-31$31,506
Assets. Value of assets in partnership/joint-venture interests2022-12-31$213,791
Total contributions received or receivable from employer(s)2022-12-31$1,401,301
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$28,150
2021 : PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN 2021 401k financial data
Total income from all sources2021-12-31$6,989,257
Expenses. Total of all expenses incurred2021-12-31$843,181
Benefits paid (including direct rollovers)2021-12-31$815,527
Total plan assets at end of year2021-12-31$37,325,757
Total plan assets at beginning of year2021-12-31$31,179,681
Value of fidelity bond covering the plan2021-12-31$500,000
Total contributions received or receivable from participants2021-12-31$845,700
Other income received2021-12-31$4,735,367
Net income (gross income less expenses)2021-12-31$6,146,076
Net plan assets at end of year (total assets less liabilities)2021-12-31$37,325,757
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$31,179,681
Assets. Value of participant loans2021-12-31$11,256
Assets. Value of assets in partnership/joint-venture interests2021-12-31$228,358
Total contributions received or receivable from employer(s)2021-12-31$1,408,190
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$27,654
2020 : PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN 2020 401k financial data
Total income from all sources2020-12-31$6,103,416
Expenses. Total of all expenses incurred2020-12-31$3,135,028
Benefits paid (including direct rollovers)2020-12-31$3,111,861
Total plan assets at end of year2020-12-31$31,179,681
Total plan assets at beginning of year2020-12-31$28,211,293
Value of fidelity bond covering the plan2020-12-31$500,000
Total contributions received or receivable from participants2020-12-31$795,000
Contributions received from other sources (not participants or employers)2020-12-31$15,713
Other income received2020-12-31$4,008,703
Net income (gross income less expenses)2020-12-31$2,968,388
Net plan assets at end of year (total assets less liabilities)2020-12-31$31,179,681
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$28,211,293
Assets. Value of participant loans2020-12-31$23,331
Assets. Value of assets in partnership/joint-venture interests2020-12-31$242,145
Total contributions received or receivable from employer(s)2020-12-31$1,284,000
Value of certain deemed distributions of participant loans2020-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$23,167
2019 : PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN 2019 401k financial data
Total income from all sources2019-12-31$7,003,396
Expenses. Total of all expenses incurred2019-12-31$3,687,241
Benefits paid (including direct rollovers)2019-12-31$3,661,334
Total plan assets at end of year2019-12-31$28,211,293
Total plan assets at beginning of year2019-12-31$24,895,138
Value of fidelity bond covering the plan2019-12-31$500,000
Total contributions received or receivable from participants2019-12-31$796,705
Contributions received from other sources (not participants or employers)2019-12-31$15,754
Other income received2019-12-31$4,769,767
Net income (gross income less expenses)2019-12-31$3,316,155
Net plan assets at end of year (total assets less liabilities)2019-12-31$28,211,293
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$24,895,138
Assets. Value of participant loans2019-12-31$34,513
Assets. Value of assets in partnership/joint-venture interests2019-12-31$257,507
Total contributions received or receivable from employer(s)2019-12-31$1,421,170
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$25,907
2018 : PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN 2018 401k financial data
Total income from all sources2018-12-31$774,643
Expenses. Total of all expenses incurred2018-12-31$8,479,542
Benefits paid (including direct rollovers)2018-12-31$8,441,666
Total plan assets at end of year2018-12-31$24,895,138
Total plan assets at beginning of year2018-12-31$32,600,037
Value of fidelity bond covering the plan2018-12-31$500,000
Total contributions received or receivable from participants2018-12-31$857,000
Contributions received from other sources (not participants or employers)2018-12-31$4,546
Other income received2018-12-31$-1,562,384
Net income (gross income less expenses)2018-12-31$-7,704,899
Net plan assets at end of year (total assets less liabilities)2018-12-31$24,895,138
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$32,600,037
Assets. Value of participant loans2018-12-31$56,629
Assets. Value of assets in partnership/joint-venture interests2018-12-31$264,748
Total contributions received or receivable from employer(s)2018-12-31$1,475,481
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$37,876
2017 : PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources2017-12-31$6,387,805
Expenses. Total of all expenses incurred2017-12-31$2,460,106
Benefits paid (including direct rollovers)2017-12-31$2,425,558
Total plan assets at end of year2017-12-31$32,600,037
Total plan assets at beginning of year2017-12-31$28,672,338
Value of fidelity bond covering the plan2017-12-31$500,000
Total contributions received or receivable from participants2017-12-31$791,380
Other income received2017-12-31$4,245,919
Net income (gross income less expenses)2017-12-31$3,927,699
Net plan assets at end of year (total assets less liabilities)2017-12-31$32,600,037
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$28,672,338
Assets. Value of participant loans2017-12-31$120,843
Assets. Value of assets in partnership/joint-venture interests2017-12-31$278,092
Total contributions received or receivable from employer(s)2017-12-31$1,350,506
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$34,548
2016 : PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources2016-12-31$3,753,493
Expenses. Total of all expenses incurred2016-12-31$890,917
Benefits paid (including direct rollovers)2016-12-31$859,208
Total plan assets at end of year2016-12-31$28,672,338
Total plan assets at beginning of year2016-12-31$25,809,762
Value of fidelity bond covering the plan2016-12-31$500,000
Total contributions received or receivable from participants2016-12-31$825,900
Expenses. Other expenses not covered elsewhere2016-12-31$0
Contributions received from other sources (not participants or employers)2016-12-31$37,134
Other income received2016-12-31$1,502,900
Net income (gross income less expenses)2016-12-31$2,862,576
Net plan assets at end of year (total assets less liabilities)2016-12-31$28,672,338
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$25,809,762
Assets. Value of participant loans2016-12-31$181,544
Assets. Value of assets in partnership/joint-venture interests2016-12-31$280,215
Total contributions received or receivable from employer(s)2016-12-31$1,387,559
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$31,709

Form 5500 Responses for PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN

2023: PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement - TrustYes
2022: PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement - TrustYes
2016: PEDIATRIC ANESTHESIA ASSOCIATES MEDICAL GROUP, INC. 401(K) PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number15B0896868
Policy instance 1
Insurance contract or identification number15B0896868
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number15B0896868
Policy instance 1
Insurance contract or identification number15B0896868
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Insurance broker organization code?3
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number36456
Policy instance 2
Insurance contract or identification number36456
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number15B0896868
Policy instance 1
Insurance contract or identification number15B0896868
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Insurance broker organization code?3
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number36456
Policy instance 2
Insurance contract or identification number36456
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number15B0896868
Policy instance 1
Insurance contract or identification number15B0896868
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $272
Total amount of fees paid to insurance companyUSD $0
Commission paid to Insurance BrokerUSD $272
Insurance broker organization code?3
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number36456
Policy instance 2
Insurance contract or identification number36456
Number of Individuals Covered1
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number15B0896868
Policy instance 1
Insurance contract or identification number15B0896868
Number of Individuals Covered1
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $245
Total amount of fees paid to insurance companyUSD $0
Commission paid to Insurance BrokerUSD $245
Insurance broker organization code?3
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number36456
Policy instance 2
Insurance contract or identification number36456
Number of Individuals Covered2
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number15B0896868
Policy instance 1
Insurance contract or identification number15B0896868
Number of Individuals Covered1
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $246
Total amount of fees paid to insurance companyUSD $0
Commission paid to Insurance BrokerUSD $246
Insurance broker organization code?3

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