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BURT CRANE & RIGGING 401(K) PLAN 401k Plan overview

Plan NameBURT CRANE & RIGGING 401(K) PLAN
Plan identification number 001

BURT CRANE & RIGGING 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • 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

BURT CRANE & RIGGING has sponsored the creation of one or more 401k plans.

Company Name:BURT CRANE & RIGGING
Employer identification number (EIN):030241299
NAIC Classification:238290
NAIC Description:Other Building Equipment Contractors

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BURT CRANE & RIGGING 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012023-01-01BRIDGET HUBAL2024-10-11
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01
0012017-01-01RON ZIELINSKI
0012016-01-01JEFFREY AYOTTE
0012015-01-01JEFFREY AYOTTE
0012014-01-01
0012013-01-01
0012012-01-01THOMAS J. CUNNINGHAM2013-04-18 THOMAS J. CUNNINGHAM2013-04-18
0012011-01-01THOMAS J. CUNNINGHAM2012-07-18 THOMAS J. CUNNINGHAM2012-07-18
0012010-01-01THOMAS J. CUNNINGHAM2011-06-21 THOMAS J. CUNNINGHAM2011-06-21

Plan Statistics for BURT CRANE & RIGGING 401(K) PLAN

401k plan membership statisitcs for BURT CRANE & RIGGING 401(K) PLAN

Measure Date Value
2022: BURT CRANE & RIGGING 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0126
Total number of active participants reported on line 7a of the Form 55002022-01-0119
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-015
Total of all active and inactive participants2022-01-0124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-0124
Number of participants with account balances2022-01-0124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-011
2021: BURT CRANE & RIGGING 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0124
Total number of active participants reported on line 7a of the Form 55002021-01-0119
Number of retired or separated participants receiving benefits2021-01-011
Number of other retired or separated participants entitled to future benefits2021-01-016
Total of all active and inactive participants2021-01-0126
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-0126
Number of participants with account balances2021-01-0126
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-011
2020: BURT CRANE & RIGGING 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0125
Total number of active participants reported on line 7a of the Form 55002020-01-0117
Number of retired or separated participants receiving benefits2020-01-011
Number of other retired or separated participants entitled to future benefits2020-01-016
Total of all active and inactive participants2020-01-0124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-0124
Number of participants with account balances2020-01-0124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-011
2019: BURT CRANE & RIGGING 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0123
Total number of active participants reported on line 7a of the Form 55002019-01-0120
Number of retired or separated participants receiving benefits2019-01-011
Number of other retired or separated participants entitled to future benefits2019-01-014
Total of all active and inactive participants2019-01-0125
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0125
Number of participants with account balances2019-01-0124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: BURT CRANE & RIGGING 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0127
Total number of active participants reported on line 7a of the Form 55002018-01-0121
Number of retired or separated participants receiving benefits2018-01-011
Number of other retired or separated participants entitled to future benefits2018-01-011
Total of all active and inactive participants2018-01-0123
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0123
Number of participants with account balances2018-01-0122
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-012
2017: BURT CRANE & RIGGING 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0132
Total number of active participants reported on line 7a of the Form 55002017-01-0123
Number of retired or separated participants receiving benefits2017-01-011
Number of other retired or separated participants entitled to future benefits2017-01-013
Total of all active and inactive participants2017-01-0127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0127
Number of participants with account balances2017-01-0126
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-012
2016: BURT CRANE & RIGGING 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0128
Total number of active participants reported on line 7a of the Form 55002016-01-0130
Number of retired or separated participants receiving benefits2016-01-011
Number of other retired or separated participants entitled to future benefits2016-01-011
Total of all active and inactive participants2016-01-0132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0132
Number of participants with account balances2016-01-0127
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-012
2015: BURT CRANE & RIGGING 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0125
Total number of active participants reported on line 7a of the Form 55002015-01-0126
Number of retired or separated participants receiving benefits2015-01-011
Number of other retired or separated participants entitled to future benefits2015-01-011
Total of all active and inactive participants2015-01-0128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0128
Number of participants with account balances2015-01-0126
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-011

Financial Data on BURT CRANE & RIGGING 401(K) PLAN

Measure Date Value
2022 : BURT CRANE & RIGGING 401(K) PLAN 2022 401k financial data
Transfers to/from the plan2022-12-31$0
Total plan liabilities at end of year2022-12-31$0
Total plan liabilities at beginning of year2022-12-31$0
Total income from all sources2022-12-31$-425,604
Expenses. Total of all expenses incurred2022-12-31$152,821
Benefits paid (including direct rollovers)2022-12-31$142,156
Total plan assets at end of year2022-12-31$3,754,102
Total plan assets at beginning of year2022-12-31$4,332,527
Value of fidelity bond covering the plan2022-12-31$4,500,000
Assets. Value of tangible personal property2022-12-31$0
Total contributions received or receivable from participants2022-12-31$153,853
Assets. Value of loans (other than to participants)2022-12-31$0
Expenses. Other expenses not covered elsewhere2022-12-31$0
Contributions received from other sources (not participants or employers)2022-12-31$0
Other income received2022-12-31$-635,474
Noncash contributions received2022-12-31$0
Net income (gross income less expenses)2022-12-31$-578,425
Net plan assets at end of year (total assets less liabilities)2022-12-31$3,754,102
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$4,332,527
Assets. Value of participant loans2022-12-31$24,203
Assets. Value of assets in partnership/joint-venture interests2022-12-31$0
Assets. Value of real-estate (other than employer real property)2022-12-31$0
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-1022022-12-31$0
Assets. Value of employer securities2022-12-31$0
Assets. Value of employer real property2022-12-31$0
Total contributions received or receivable from employer(s)2022-12-31$56,017
Value of certain deemed distributions of participant loans2022-12-31$3,241
Value of corrective distributions2022-12-31$7,355
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$69
2021 : BURT CRANE & RIGGING 401(K) PLAN 2021 401k financial data
Transfers to/from the plan2021-12-31$0
Total plan liabilities at end of year2021-12-31$0
Total plan liabilities at beginning of year2021-12-31$0
Total income from all sources2021-12-31$693,670
Expenses. Total of all expenses incurred2021-12-31$579,820
Benefits paid (including direct rollovers)2021-12-31$564,919
Total plan assets at end of year2021-12-31$4,332,527
Total plan assets at beginning of year2021-12-31$4,218,677
Value of fidelity bond covering the plan2021-12-31$4,500,000
Assets. Value of tangible personal property2021-12-31$0
Total contributions received or receivable from participants2021-12-31$159,965
Assets. Value of loans (other than to participants)2021-12-31$0
Expenses. Other expenses not covered elsewhere2021-12-31$0
Contributions received from other sources (not participants or employers)2021-12-31$0
Other income received2021-12-31$486,506
Noncash contributions received2021-12-31$0
Net income (gross income less expenses)2021-12-31$113,850
Net plan assets at end of year (total assets less liabilities)2021-12-31$4,332,527
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$4,218,677
Assets. Value of participant loans2021-12-31$33,683
Assets. Value of assets in partnership/joint-venture interests2021-12-31$0
Assets. Value of real-estate (other than employer real property)2021-12-31$0
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-1022021-12-31$0
Assets. Value of employer securities2021-12-31$0
Assets. Value of employer real property2021-12-31$0
Total contributions received or receivable from employer(s)2021-12-31$47,199
Value of certain deemed distributions of participant loans2021-12-31$8,136
Value of corrective distributions2021-12-31$6,540
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$225
2020 : BURT CRANE & RIGGING 401(K) PLAN 2020 401k financial data
Transfers to/from the plan2020-12-31$0
Total plan liabilities at end of year2020-12-31$0
Total plan liabilities at beginning of year2020-12-31$0
Total income from all sources2020-12-31$742,695
Expenses. Total of all expenses incurred2020-12-31$257,202
Benefits paid (including direct rollovers)2020-12-31$257,021
Total plan assets at end of year2020-12-31$4,218,677
Total plan assets at beginning of year2020-12-31$3,733,184
Value of fidelity bond covering the plan2020-12-31$400,000
Assets. Value of tangible personal property2020-12-31$0
Total contributions received or receivable from participants2020-12-31$174,479
Assets. Value of loans (other than to participants)2020-12-31$0
Expenses. Other expenses not covered elsewhere2020-12-31$0
Contributions received from other sources (not participants or employers)2020-12-31$0
Other income received2020-12-31$513,429
Noncash contributions received2020-12-31$0
Net income (gross income less expenses)2020-12-31$485,493
Net plan assets at end of year (total assets less liabilities)2020-12-31$4,218,677
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$3,733,184
Assets. Value of participant loans2020-12-31$9,166
Assets. Value of assets in partnership/joint-venture interests2020-12-31$0
Assets. Value of real-estate (other than employer real property)2020-12-31$0
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-1022020-12-31$0
Assets. Value of employer securities2020-12-31$0
Assets. Value of employer real property2020-12-31$0
Total contributions received or receivable from employer(s)2020-12-31$54,787
Value of certain deemed distributions of participant loans2020-12-31$0
Value of corrective distributions2020-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$181
2019 : BURT CRANE & RIGGING 401(K) PLAN 2019 401k financial data
Transfers to/from the plan2019-12-31$0
Total plan liabilities at end of year2019-12-31$0
Total plan liabilities at beginning of year2019-12-31$0
Total income from all sources2019-12-31$832,660
Expenses. Total of all expenses incurred2019-12-31$81,160
Benefits paid (including direct rollovers)2019-12-31$77,122
Total plan assets at end of year2019-12-31$3,733,184
Total plan assets at beginning of year2019-12-31$2,981,684
Value of fidelity bond covering the plan2019-12-31$400,000
Total contributions received or receivable from participants2019-12-31$182,164
Expenses. Other expenses not covered elsewhere2019-12-31$0
Contributions received from other sources (not participants or employers)2019-12-31$0
Other income received2019-12-31$563,456
Noncash contributions received2019-12-31$0
Net income (gross income less expenses)2019-12-31$751,500
Net plan assets at end of year (total assets less liabilities)2019-12-31$3,733,184
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$2,981,684
Assets. Value of participant loans2019-12-31$49,083
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-1022019-12-31$0
Total contributions received or receivable from employer(s)2019-12-31$87,040
Value of certain deemed distributions of participant loans2019-12-31$0
Value of corrective distributions2019-12-31$3,688
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$350
2018 : BURT CRANE & RIGGING 401(K) PLAN 2018 401k financial data
Transfers to/from the plan2018-12-31$0
Total plan liabilities at end of year2018-12-31$0
Total plan liabilities at beginning of year2018-12-31$0
Total income from all sources2018-12-31$-5,965
Expenses. Total of all expenses incurred2018-12-31$134,947
Benefits paid (including direct rollovers)2018-12-31$118,475
Total plan assets at end of year2018-12-31$2,981,684
Total plan assets at beginning of year2018-12-31$3,122,596
Value of fidelity bond covering the plan2018-12-31$250,000
Total contributions received or receivable from participants2018-12-31$115,811
Expenses. Other expenses not covered elsewhere2018-12-31$0
Contributions received from other sources (not participants or employers)2018-12-31$0
Other income received2018-12-31$-159,932
Noncash contributions received2018-12-31$0
Net income (gross income less expenses)2018-12-31$-140,912
Net plan assets at end of year (total assets less liabilities)2018-12-31$2,981,684
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$3,122,596
Assets. Value of participant loans2018-12-31$37,417
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-1022018-12-31$0
Total contributions received or receivable from employer(s)2018-12-31$38,156
Value of certain deemed distributions of participant loans2018-12-31$0
Value of corrective distributions2018-12-31$16,291
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$181
2017 : BURT CRANE & RIGGING 401(K) PLAN 2017 401k financial data
Transfers to/from the plan2017-12-31$0
Total plan liabilities at end of year2017-12-31$0
Total plan liabilities at beginning of year2017-12-31$0
Total income from all sources2017-12-31$540,452
Expenses. Total of all expenses incurred2017-12-31$73,198
Benefits paid (including direct rollovers)2017-12-31$72,264
Total plan assets at end of year2017-12-31$3,122,596
Total plan assets at beginning of year2017-12-31$2,655,342
Value of fidelity bond covering the plan2017-12-31$212,000
Assets. Value of tangible personal property2017-12-31$0
Total contributions received or receivable from participants2017-12-31$146,778
Assets. Value of loans (other than to participants)2017-12-31$0
Expenses. Other expenses not covered elsewhere2017-12-31$0
Contributions received from other sources (not participants or employers)2017-12-31$0
Other income received2017-12-31$363,680
Noncash contributions received2017-12-31$0
Net income (gross income less expenses)2017-12-31$467,254
Net plan assets at end of year (total assets less liabilities)2017-12-31$3,122,596
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$2,655,342
Assets. Value of participant loans2017-12-31$48,554
Assets. Value of assets in partnership/joint-venture interests2017-12-31$0
Assets. Value of real-estate (other than employer real property)2017-12-31$0
Assets. Value of employer securities2017-12-31$0
Assets. Value of employer real property2017-12-31$0
Total contributions received or receivable from employer(s)2017-12-31$29,994
Value of certain deemed distributions of participant loans2017-12-31$0
Value of corrective distributions2017-12-31$584
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$350
2016 : BURT CRANE & RIGGING 401(K) PLAN 2016 401k financial data
Transfers to/from the plan2016-12-31$0
Total plan liabilities at end of year2016-12-31$0
Total plan liabilities at beginning of year2016-12-31$0
Total income from all sources2016-12-31$258,185
Expenses. Total of all expenses incurred2016-12-31$46,409
Benefits paid (including direct rollovers)2016-12-31$24,856
Total plan assets at end of year2016-12-31$2,655,342
Total plan assets at beginning of year2016-12-31$2,443,566
Value of fidelity bond covering the plan2016-12-31$212,000
Total contributions received or receivable from participants2016-12-31$85,847
Expenses. Other expenses not covered elsewhere2016-12-31$0
Contributions received from other sources (not participants or employers)2016-12-31$0
Other income received2016-12-31$134,557
Noncash contributions received2016-12-31$0
Net income (gross income less expenses)2016-12-31$211,776
Net plan assets at end of year (total assets less liabilities)2016-12-31$2,655,342
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$2,443,566
Assets. Value of participant loans2016-12-31$35,946
Total contributions received or receivable from employer(s)2016-12-31$37,781
Value of certain deemed distributions of participant loans2016-12-31$0
Value of corrective distributions2016-12-31$21,053
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$500
2015 : BURT CRANE & RIGGING 401(K) PLAN 2015 401k financial data
Transfers to/from the plan2015-12-31$0
Total plan liabilities at end of year2015-12-31$0
Total plan liabilities at beginning of year2015-12-31$0
Total income from all sources2015-12-31$184,955
Expenses. Total of all expenses incurred2015-12-31$23,341
Benefits paid (including direct rollovers)2015-12-31$23,241
Total plan assets at end of year2015-12-31$2,443,566
Total plan assets at beginning of year2015-12-31$2,281,952
Value of fidelity bond covering the plan2015-12-31$212,000
Total contributions received or receivable from participants2015-12-31$123,403
Expenses. Other expenses not covered elsewhere2015-12-31$0
Contributions received from other sources (not participants or employers)2015-12-31$0
Other income received2015-12-31$10,813
Noncash contributions received2015-12-31$0
Net income (gross income less expenses)2015-12-31$161,614
Net plan assets at end of year (total assets less liabilities)2015-12-31$2,443,566
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$2,281,952
Assets. Value of participant loans2015-12-31$9,399
Total contributions received or receivable from employer(s)2015-12-31$50,739
Value of certain deemed distributions of participant loans2015-12-31$0
Value of corrective distributions2015-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$100

Form 5500 Responses for BURT CRANE & RIGGING 401(K) PLAN

2022: BURT CRANE & RIGGING 401(K) 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 – TrustYes
2022-01-01Plan benefit arrangement - TrustYes
2021: BURT CRANE & RIGGING 401(K) 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 – TrustYes
2021-01-01Plan benefit arrangement - TrustYes
2020: BURT CRANE & RIGGING 401(K) 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 – TrustYes
2020-01-01Plan benefit arrangement - TrustYes
2019: BURT CRANE & RIGGING 401(K) 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 – TrustYes
2019-01-01Plan benefit arrangement - TrustYes
2018: BURT CRANE & RIGGING 401(K) 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 – TrustYes
2018-01-01Plan benefit arrangement - TrustYes
2017: BURT CRANE & RIGGING 401(K) 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
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement - TrustYes
2016: BURT CRANE & RIGGING 401(K) 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
2015: BURT CRANE & RIGGING 401(K) PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number324-80084
Policy instance 1
Insurance contract or identification number324-80084
Number of Individuals Covered0
Insurance policy start date2015-01-01
Insurance policy end date2015-02-28
Total amount of commissions paid to insurance brokerUSD $336
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?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 $336
Amount paid for insurance broker fees0
Insurance broker nameUBS FINANCIAL SERVICES INC

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