MARY JO FORD, M.D., INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan MARY JO FORD, M.D., INC. DEFINED BENEFIT PENSION PLAN
401k plan membership statisitcs for MARY JO FORD, M.D., INC. DEFINED BENEFIT PENSION PLAN
| Measure | Date | Value |
|---|
| 2016: MARY JO FORD, M.D., INC. DEFINED BENEFIT PENSION PLAN 2016 401k membership |
|---|
| Market value of plan assets | 2016-12-31 | 2,726,560 |
| Acturial value of plan assets | 2016-12-31 | 2,726,560 |
| Funding target for retired participants and beneficiaries receiving payment | 2016-12-31 | 0 |
| Number of terminated vested participants | 2016-12-31 | 1 |
| Fundng target for terminated vested participants | 2016-12-31 | 3,126 |
| Active participant vested funding target | 2016-12-31 | 2,338,496 |
| Number of active participants | 2016-12-31 | 3 |
| Total funding liabilities for active participants | 2016-12-31 | 2,338,496 |
| Total participant count | 2016-12-31 | 4 |
| Total funding target for all participants | 2016-12-31 | 2,341,622 |
| Balance at beginning of prior year after applicable adjustments | 2016-12-31 | 0 |
| Prefunding balance at beginning of prior year after applicable adjustments | 2016-12-31 | 0 |
| Carryover balanced portion elected for use to offset prior years funding requirement | 2016-12-31 | 0 |
| Prefunding balanced used to offset prior years funding requirement | 2016-12-31 | 0 |
| Amount remaining of carryover balance | 2016-12-31 | 0 |
| Amount remaining of prefunding balance | 2016-12-31 | 0 |
| Present value of excess contributions | 2016-12-31 | 0 |
| Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance | 2016-12-31 | 0 |
| Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance | 2016-12-31 | 0 |
| Reductions in caryover balances due to elections or deemed elections | 2016-12-31 | 0 |
| Reductions in prefunding balances due to elections or deemed elections | 2016-12-31 | 0 |
| Balance of carryovers at beginning of current year | 2016-12-31 | 0 |
| Balance of prefunding at beginning of current year | 2016-12-31 | 0 |
| Contributions allocated toward unpaid minimum require contributions from prior years | 2016-12-31 | 0 |
| Contributions made to avoid restrictions adjusted to valuation date | 2016-12-31 | 0 |
| Contributions allocated toward minimum required contributions for current year adjusted to valuation date | 2016-12-31 | 0 |
| Unpaid minimum required contributions for all prior years | 2016-12-31 | 0 |
| iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years | 2016-12-31 | 0 |
| Remaining amount of unpaid minimum required contributions | 2016-12-31 | 0 |
| Minimum required contributions for current year target normal cost | 2016-12-31 | 831 |
| Net shortfall amortization installment of oustanding balance | 2016-12-31 | 0 |
| Waiver amortization installment | 2016-12-31 | 0 |
| Total funding amount beforereflecting carryover/prefunding balances | 2016-12-31 | 0 |
| Carryover balance elected to use to offset funding requirement | 2016-12-31 | 0 |
| Prefunding balance elected to use to offset funding requirement | 2016-12-31 | 0 |
| Additional cash requirement | 2016-12-31 | 0 |
| Contributions allocatedtoward minimum required contributions for current year | 2016-12-31 | 0 |
| Unpaid minimum required contributions for current year | 2016-12-31 | 0 |
| Unpaid minimum required contributions for all years | 2016-12-31 | 0 |
| Total participants, beginning-of-year | 2016-01-01 | 4 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 0 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
| Total of all active and inactive participants | 2016-01-01 | 0 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2016-01-01 | 0 |
| Total participants | 2016-01-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2016-01-01 | 0 |
| 2015: MARY JO FORD, M.D., INC. DEFINED BENEFIT PENSION PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 4 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 3 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
| Total of all active and inactive participants | 2015-01-01 | 4 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2015-01-01 | 0 |
| Total participants | 2015-01-01 | 4 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2015-01-01 | 0 |
| 2014: MARY JO FORD, M.D., INC. DEFINED BENEFIT PENSION PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 4 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 4 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 0 |
| Total of all active and inactive participants | 2014-01-01 | 4 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-01-01 | 0 |
| Total participants | 2014-01-01 | 4 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2014-01-01 | 0 |
| 2013: MARY JO FORD, M.D., INC. DEFINED BENEFIT PENSION PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 4 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 4 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 0 |
| Total of all active and inactive participants | 2013-01-01 | 4 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-01-01 | 0 |
| Total participants | 2013-01-01 | 4 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-01-01 | 0 |
| 2012: MARY JO FORD, M.D., INC. DEFINED BENEFIT PENSION PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 5 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 4 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 0 |
| Total of all active and inactive participants | 2012-01-01 | 4 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-01-01 | 0 |
| Total participants | 2012-01-01 | 4 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-01-01 | 0 |
| 2011: MARY JO FORD, M.D., INC. DEFINED BENEFIT PENSION PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 6 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 4 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 1 |
| Total of all active and inactive participants | 2011-01-01 | 5 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-01-01 | 0 |
| Total participants | 2011-01-01 | 5 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2011-01-01 | 0 |
| 2010: MARY JO FORD, M.D., INC. DEFINED BENEFIT PENSION PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 7 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 5 |
| Number of retired or separated participants receiving benefits | 2010-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2010-01-01 | 2 |
| Total of all active and inactive participants | 2010-01-01 | 7 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2010-01-01 | 0 |
| Total participants | 2010-01-01 | 7 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2010-01-01 | 0 |
| 2009: MARY JO FORD, M.D., INC. DEFINED BENEFIT PENSION PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 4 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 4 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 0 |
| Total of all active and inactive participants | 2009-01-01 | 4 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-01-01 | 0 |
| Total participants | 2009-01-01 | 4 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-01-01 | 0 |
| Measure | Date | Value |
|---|
| 2016 : MARY JO FORD, M.D., INC. DEFINED BENEFIT PENSION PLAN 2016 401k financial data |
|---|
| Transfers to/from the plan | 2016-12-31 | $0 |
| Total plan liabilities at end of year | 2016-12-31 | $0 |
| Total plan liabilities at beginning of year | 2016-12-31 | $0 |
| Total income from all sources | 2016-12-31 | $334,905 |
| Expenses. Total of all expenses incurred | 2016-12-31 | $3,061,465 |
| Benefits paid (including direct rollovers) | 2016-12-31 | $3,061,465 |
| Total plan assets at end of year | 2016-12-31 | $0 |
| Total plan assets at beginning of year | 2016-12-31 | $2,726,560 |
| Total contributions received or receivable from participants | 2016-12-31 | $0 |
| Expenses. Other expenses not covered elsewhere | 2016-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2016-12-31 | $0 |
| Other income received | 2016-12-31 | $334,905 |
| Noncash contributions received | 2016-12-31 | $0 |
| Net income (gross income less expenses) | 2016-12-31 | $-2,726,560 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-31 | $2,726,560 |
| Total contributions received or receivable from employer(s) | 2016-12-31 | $0 |
| Value of certain deemed distributions of participant loans | 2016-12-31 | $0 |
| Value of corrective distributions | 2016-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-12-31 | $0 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2016-12-31 | $0 |
| 2015 : MARY JO FORD, M.D., INC. DEFINED BENEFIT PENSION PLAN 2015 401k financial data |
|---|
| Transfers to/from the plan | 2015-12-31 | $0 |
| Total plan liabilities at end of year | 2015-12-31 | $0 |
| Total plan liabilities at beginning of year | 2015-12-31 | $0 |
| Total income from all sources | 2015-12-31 | $320,774 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $0 |
| Benefits paid (including direct rollovers) | 2015-12-31 | $0 |
| Total plan assets at end of year | 2015-12-31 | $2,726,560 |
| Total plan assets at beginning of year | 2015-12-31 | $2,405,786 |
| Total contributions received or receivable from participants | 2015-12-31 | $0 |
| Expenses. Other expenses not covered elsewhere | 2015-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2015-12-31 | $0 |
| Other income received | 2015-12-31 | $320,774 |
| Noncash contributions received | 2015-12-31 | $0 |
| Net income (gross income less expenses) | 2015-12-31 | $320,774 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $2,726,560 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $2,405,786 |
| Total contributions received or receivable from employer(s) | 2015-12-31 | $0 |
| Value of certain deemed distributions of participant loans | 2015-12-31 | $0 |
| Value of corrective distributions | 2015-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-12-31 | $0 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2015-12-31 | $0 |
| 2014 : MARY JO FORD, M.D., INC. DEFINED BENEFIT PENSION PLAN 2014 401k financial data |
|---|
| Transfers to/from the plan | 2014-12-31 | $0 |
| Total plan liabilities at end of year | 2014-12-31 | $0 |
| Total plan liabilities at beginning of year | 2014-12-31 | $0 |
| Total income from all sources | 2014-12-31 | $307,240 |
| Expenses. Total of all expenses incurred | 2014-12-31 | $0 |
| Benefits paid (including direct rollovers) | 2014-12-31 | $0 |
| Total plan assets at end of year | 2014-12-31 | $2,405,786 |
| Total plan assets at beginning of year | 2014-12-31 | $2,098,546 |
| Total contributions received or receivable from participants | 2014-12-31 | $0 |
| Expenses. Other expenses not covered elsewhere | 2014-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2014-12-31 | $0 |
| Other income received | 2014-12-31 | $307,240 |
| Noncash contributions received | 2014-12-31 | $0 |
| Net income (gross income less expenses) | 2014-12-31 | $307,240 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $2,405,786 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $2,098,546 |
| Total contributions received or receivable from employer(s) | 2014-12-31 | $0 |
| Value of certain deemed distributions of participant loans | 2014-12-31 | $0 |
| Value of corrective distributions | 2014-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2014-12-31 | $0 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2014-12-31 | $0 |
| 2013 : MARY JO FORD, M.D., INC. DEFINED BENEFIT PENSION PLAN 2013 401k financial data |
|---|
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2013-12-31 | $0 |
| 2011 : MARY JO FORD, M.D., INC. DEFINED BENEFIT PENSION PLAN 2011 401k financial data |
|---|
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2011-12-31 | $0 |
| 2010 : MARY JO FORD, M.D., INC. DEFINED BENEFIT PENSION PLAN 2010 401k financial data |
|---|
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2010-12-31 | $0 |
| 2009 : MARY JO FORD, M.D., INC. DEFINED BENEFIT PENSION PLAN 2009 401k financial data |
|---|
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2009-12-31 | $0 |
| 2016: MARY JO FORD, M.D., INC. DEFINED BENEFIT PENSION PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | Yes |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – Trust | Yes |
| 2016-01-01 | Plan benefit arrangement - Trust | Yes |
| 2015: MARY JO FORD, M.D., INC. DEFINED BENEFIT PENSION PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – Trust | Yes |
| 2015-01-01 | Plan benefit arrangement - Trust | Yes |
| 2014: MARY JO FORD, M.D., INC. DEFINED BENEFIT PENSION PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Submission has been amended | No |
| 2014-01-01 | This submission is the final filing | No |
| 2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-01-01 | Plan is a collectively bargained plan | No |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – Trust | Yes |
| 2014-01-01 | Plan benefit arrangement - Trust | Yes |
| 2013: MARY JO FORD, M.D., INC. DEFINED BENEFIT PENSION PLAN 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Submission has been amended | No |
| 2013-01-01 | This submission is the final filing | No |
| 2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-01-01 | Plan is a collectively bargained plan | No |
| 2013-01-01 | Plan funding arrangement – Trust | Yes |
| 2013-01-01 | Plan benefit arrangement - Trust | Yes |
| 2012: MARY JO FORD, M.D., INC. DEFINED BENEFIT PENSION PLAN 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Submission has been amended | No |
| 2012-01-01 | This submission is the final filing | No |
| 2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-01-01 | Plan is a collectively bargained plan | No |
| 2012-01-01 | Plan funding arrangement – Section 412(e)(3) insurance Contracts | Yes |
| 2012-01-01 | Plan benefit arrangement – Section 412(e)(3) insurance Contracts | Yes |
| 2011: MARY JO FORD, M.D., INC. DEFINED BENEFIT PENSION PLAN 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Submission has been amended | No |
| 2011-01-01 | This submission is the final filing | No |
| 2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-01-01 | Plan is a collectively bargained plan | No |
| 2011-01-01 | Plan funding arrangement – Section 412(e)(3) insurance Contracts | Yes |
| 2011-01-01 | Plan benefit arrangement – Section 412(e)(3) insurance Contracts | Yes |
| 2010: MARY JO FORD, M.D., INC. DEFINED BENEFIT PENSION PLAN 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Submission has been amended | No |
| 2010-01-01 | This submission is the final filing | No |
| 2010-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-01-01 | Plan is a collectively bargained plan | No |
| 2010-01-01 | Plan funding arrangement – Section 412(e)(3) insurance Contracts | Yes |
| 2010-01-01 | Plan benefit arrangement – Section 412(e)(3) insurance Contracts | Yes |
| 2009: MARY JO FORD, M.D., INC. DEFINED BENEFIT PENSION PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Submission has been amended | No |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | No |
| 2009-01-01 | Plan funding arrangement – Section 412(e)(3) insurance Contracts | Yes |
| 2009-01-01 | Plan benefit arrangement – Section 412(e)(3) insurance Contracts | Yes |
| NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 ) |
| Policy contract number | 74034 |
| Policy instance | 1 |
| Insurance contract or identification number | 74034 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2016-01-01 | | Insurance policy end date | 2016-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Insurance broker organization code? | 3 | | Insurance broker name | DAVID MEYER SAMUELS |
|
| NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 ) |
| Policy contract number | 74034 |
| Policy instance | 1 |
| Insurance contract or identification number | 74034 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Insurance broker organization code? | 3 | | Insurance broker name | DAVID MEYER SAMUELS |
|
| NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 ) |
| Policy contract number | 74034 |
| Policy instance | 1 |
| Insurance contract or identification number | 74034 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $408 | | Total amount of fees paid to insurance company | USD $9,280 | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Commission paid to Insurance Broker | USD $408 | | Amount paid for insurance broker fees | 9280 | | Insurance broker organization code? | 3 | | Insurance broker name | DAVID MEYER SAMUELS |
|
| NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 ) |
| Policy contract number | 74034 |
| Policy instance | 1 |
| Insurance contract or identification number | 74034 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $400 | | Total amount of fees paid to insurance company | USD $9,280 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Broker | USD $400 | | Amount paid for insurance broker fees | 9280 | | Additional information about fees paid to insurance broker | 4 | | Insurance broker organization code? | 3 | | Insurance broker name | DAVID MEYER SAMUELS |
|
| NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 ) |
| Policy contract number | 74034 |
| Policy instance | 1 |
| Insurance contract or identification number | 74034 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $400 | | Total amount of fees paid to insurance company | USD $9,280 | | Commission paid to Insurance Broker | USD $400 | | Amount paid for insurance broker fees | 9280 | | Insurance broker organization code? | 3 | | Insurance broker name | DAVID MEYER SAMUELS |
|
| NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 ) |
| Policy contract number | 74034 |
| Policy instance | 1 |
| Insurance contract or identification number | 74034 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $9,408 |
|
| NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 ) |
| Policy contract number | 74034 |
| Policy instance | 1 |
| Insurance contract or identification number | 74034 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $9,885 | | Amount paid for insurance broker fees | 9885 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 | | Insurance broker name | DAVID MEYER SAMUELS |
|
