KTC, INC. DBA KINGSBURY CLUB & has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan KINGSBURY CLUB 401(K) SAVINGS PLAN
| Measure | Date | Value |
|---|
| 2014: KINGSBURY CLUB 401(K) SAVINGS PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 68 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 44 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 11 |
| Total of all active and inactive participants | 2014-01-01 | 56 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-01-01 | 0 |
| Total participants | 2014-01-01 | 56 |
| Number of participants with account balances | 2014-01-01 | 29 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2014-01-01 | 0 |
| 2013: KINGSBURY CLUB 401(K) SAVINGS PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 95 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 86 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 11 |
| Total of all active and inactive participants | 2013-01-01 | 98 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-01-01 | 0 |
| Total participants | 2013-01-01 | 98 |
| Number of participants with account balances | 2013-01-01 | 31 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-01-01 | 0 |
| 2012: KINGSBURY CLUB 401(K) SAVINGS PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 97 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 82 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 11 |
| Total of all active and inactive participants | 2012-01-01 | 94 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-01-01 | 0 |
| Total participants | 2012-01-01 | 94 |
| Number of participants with account balances | 2012-01-01 | 83 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-01-01 | 13 |
| 2011: KINGSBURY CLUB 401(K) SAVINGS PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 116 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 99 |
| 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 | 0 |
| Total of all active and inactive participants | 2011-01-01 | 99 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-01-01 | 0 |
| Total participants | 2011-01-01 | 99 |
| Number of participants with account balances | 2011-01-01 | 33 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2011-01-01 | 0 |
| 2010: KINGSBURY CLUB 401(K) SAVINGS PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 116 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 104 |
| 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 | 0 |
| Total of all active and inactive participants | 2010-01-01 | 104 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2010-01-01 | 0 |
| Total participants | 2010-01-01 | 104 |
| Number of participants with account balances | 2010-01-01 | 35 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2010-01-01 | 0 |
| 2009: KINGSBURY CLUB 401(K) SAVINGS PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 96 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 85 |
| 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 | 12 |
| Total of all active and inactive participants | 2009-01-01 | 97 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-01-01 | 0 |
| Total participants | 2009-01-01 | 97 |
| Number of participants with account balances | 2009-01-01 | 34 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-01-01 | 2 |
| Measure | Date | Value |
|---|
| 2014 : KINGSBURY CLUB 401(K) SAVINGS PLAN 2014 401k financial data |
|---|
| Transfers to/from the plan | 2014-12-31 | $0 |
| Total income from all sources | 2014-12-31 | $113,894 |
| Expenses. Total of all expenses incurred | 2014-12-31 | $120,076 |
| Benefits paid (including direct rollovers) | 2014-12-31 | $119,910 |
| Total plan assets at end of year | 2014-12-31 | $1,143,124 |
| Total plan assets at beginning of year | 2014-12-31 | $1,149,306 |
| Value of fidelity bond covering the plan | 2014-12-31 | $50,000 |
| Total contributions received or receivable from participants | 2014-12-31 | $77,481 |
| Expenses. Other expenses not covered elsewhere | 2014-12-31 | $166 |
| Contributions received from other sources (not participants or employers) | 2014-12-31 | $0 |
| Other income received | 2014-12-31 | $36,413 |
| Net income (gross income less expenses) | 2014-12-31 | $-6,182 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $1,143,124 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $1,149,306 |
| Assets. Value of participant loans | 2014-12-31 | $43,529 |
| 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 |
| Funding deficiency by the employer to the plan for this plan year | 2014-12-31 | $0 |
| Minimum employer required contribution for this plan year | 2014-12-31 | $0 |
| Amount contributed by the employer to the plan for this plan year | 2014-12-31 | $0 |
| 2013 : KINGSBURY CLUB 401(K) SAVINGS PLAN 2013 401k financial data |
|---|
| Transfers to/from the plan | 2013-12-31 | $0 |
| Total income from all sources | 2013-12-31 | $225,280 |
| Expenses. Total of all expenses incurred | 2013-12-31 | $17,932 |
| Benefits paid (including direct rollovers) | 2013-12-31 | $17,820 |
| Total plan assets at end of year | 2013-12-31 | $1,149,306 |
| Total plan assets at beginning of year | 2013-12-31 | $941,958 |
| Value of fidelity bond covering the plan | 2013-12-31 | $50,000 |
| Total contributions received or receivable from participants | 2013-12-31 | $87,220 |
| Expenses. Other expenses not covered elsewhere | 2013-12-31 | $112 |
| Contributions received from other sources (not participants or employers) | 2013-12-31 | $0 |
| Other income received | 2013-12-31 | $138,060 |
| Net income (gross income less expenses) | 2013-12-31 | $207,348 |
| Net plan assets at end of year (total assets less liabilities) | 2013-12-31 | $1,149,306 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-12-31 | $941,958 |
| Assets. Value of participant loans | 2013-12-31 | $51,910 |
| Total contributions received or receivable from employer(s) | 2013-12-31 | $0 |
| Value of certain deemed distributions of participant loans | 2013-12-31 | $0 |
| Value of corrective distributions | 2013-12-31 | $0 |
| Funding deficiency by the employer to the plan for this plan year | 2013-12-31 | $0 |
| Minimum employer required contribution for this plan year | 2013-12-31 | $0 |
| Amount contributed by the employer to the plan for this plan year | 2013-12-31 | $0 |
| 2012 : KINGSBURY CLUB 401(K) SAVINGS PLAN 2012 401k financial data |
|---|
| Transfers to/from the plan | 2012-12-31 | $-619 |
| Total income from all sources | 2012-12-31 | $186,703 |
| Expenses. Total of all expenses incurred | 2012-12-31 | $23,521 |
| Benefits paid (including direct rollovers) | 2012-12-31 | $23,317 |
| Total plan assets at end of year | 2012-12-31 | $941,958 |
| Total plan assets at beginning of year | 2012-12-31 | $779,395 |
| Value of fidelity bond covering the plan | 2012-12-31 | $50,000 |
| Total contributions received or receivable from participants | 2012-12-31 | $89,744 |
| Expenses. Other expenses not covered elsewhere | 2012-12-31 | $204 |
| Contributions received from other sources (not participants or employers) | 2012-12-31 | $3,814 |
| Other income received | 2012-12-31 | $93,145 |
| Net income (gross income less expenses) | 2012-12-31 | $163,182 |
| Net plan assets at end of year (total assets less liabilities) | 2012-12-31 | $941,958 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-12-31 | $779,395 |
| Assets. Value of participant loans | 2012-12-31 | $66,130 |
| Total contributions received or receivable from employer(s) | 2012-12-31 | $0 |
| Value of certain deemed distributions of participant loans | 2012-12-31 | $0 |
| Value of corrective distributions | 2012-12-31 | $0 |
| Funding deficiency by the employer to the plan for this plan year | 2012-12-31 | $0 |
| Minimum employer required contribution for this plan year | 2012-12-31 | $0 |
| Amount contributed by the employer to the plan for this plan year | 2012-12-31 | $0 |
| 2011 : KINGSBURY CLUB 401(K) SAVINGS PLAN 2011 401k financial data |
|---|
| Transfers to/from the plan | 2011-12-31 | $0 |
| Total income from all sources | 2011-12-31 | $67,541 |
| Expenses. Total of all expenses incurred | 2011-12-31 | $118,227 |
| Benefits paid (including direct rollovers) | 2011-12-31 | $118,065 |
| Total plan assets at end of year | 2011-12-31 | $779,395 |
| Total plan assets at beginning of year | 2011-12-31 | $830,081 |
| Value of fidelity bond covering the plan | 2011-12-31 | $50,000 |
| Total contributions received or receivable from participants | 2011-12-31 | $77,563 |
| Expenses. Other expenses not covered elsewhere | 2011-12-31 | $162 |
| Contributions received from other sources (not participants or employers) | 2011-12-31 | $25,709 |
| Other income received | 2011-12-31 | $-35,731 |
| Net income (gross income less expenses) | 2011-12-31 | $-50,686 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-31 | $779,395 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-31 | $830,081 |
| Assets. Value of participant loans | 2011-12-31 | $38,682 |
| Funding deficiency by the employer to the plan for this plan year | 2011-12-31 | $0 |
| Minimum employer required contribution for this plan year | 2011-12-31 | $0 |
| Amount contributed by the employer to the plan for this plan year | 2011-12-31 | $0 |
| 2010 : KINGSBURY CLUB 401(K) SAVINGS PLAN 2010 401k financial data |
|---|
| Total income from all sources | 2010-12-31 | $158,479 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $3,370 |
| Benefits paid (including direct rollovers) | 2010-12-31 | $3,174 |
| Total plan assets at end of year | 2010-12-31 | $830,081 |
| Total plan assets at beginning of year | 2010-12-31 | $674,972 |
| Value of fidelity bond covering the plan | 2010-12-31 | $50,000 |
| Total contributions received or receivable from participants | 2010-12-31 | $75,486 |
| Expenses. Other expenses not covered elsewhere | 2010-12-31 | $196 |
| Other income received | 2010-12-31 | $82,993 |
| Net income (gross income less expenses) | 2010-12-31 | $155,109 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $830,081 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $674,972 |
| Assets. Value of participant loans | 2010-12-31 | $57,875 |
| Funding deficiency by the employer to the plan for this plan year | 2010-12-31 | $0 |
| Minimum employer required contribution for this plan year | 2010-12-31 | $0 |
| Amount contributed by the employer to the plan for this plan year | 2010-12-31 | $0 |
| 2009 : KINGSBURY CLUB 401(K) SAVINGS PLAN 2009 401k financial data |
|---|
| Funding deficiency by the employer to the plan for this plan year | 2009-12-31 | $0 |
| Minimum employer required contribution for this plan year | 2009-12-31 | $0 |
| Amount contributed by the employer to the plan for this plan year | 2009-12-31 | $0 |
| 2008 : KINGSBURY CLUB 401(K) SAVINGS PLAN 2008 401k financial data |
|---|
| Transfers to/from the plan | 2008-12-31 | $0 |
| Total income from all sources | 2008-12-31 | $-138,580 |
| Expenses. Total of all expenses incurred | 2008-12-31 | $65,300 |
| Benefits paid (including direct rollovers) | 2008-12-31 | $65,052 |
| Total plan assets at end of year | 2008-12-31 | $498,529 |
| Total plan assets at beginning of year | 2008-12-31 | $702,409 |
| Value of fidelity bond covering the plan | 2008-12-31 | $50,000 |
| Total contributions received or receivable from participants | 2008-12-31 | $77,863 |
| Expenses. Other expenses not covered elsewhere | 2008-12-31 | $248 |
| Contributions received from other sources (not participants or employers) | 2008-12-31 | $0 |
| Other income received | 2008-12-31 | $-229,165 |
| Net income (gross income less expenses) | 2008-12-31 | $-203,880 |
| Net plan assets at end of year (total assets less liabilities) | 2008-12-31 | $498,529 |
| Net plan assets at beginning of year (total assets less liabilities) | 2008-12-31 | $702,409 |
| Assets. Value of participant loans | 2008-12-31 | $37,970 |
| Total contributions received or receivable from employer(s) | 2008-12-31 | $12,722 |
| Value of certain deemed distributions of participant loans | 2008-12-31 | $0 |
| Value of corrective distributions | 2008-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2008-12-31 | $0 |
| 2014: KINGSBURY CLUB 401(K) SAVINGS 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 – Insurance | Yes |
| 2013: KINGSBURY CLUB 401(K) SAVINGS 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 – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – Trust | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: KINGSBURY CLUB 401(K) SAVINGS 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 – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – Trust | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: KINGSBURY CLUB 401(K) SAVINGS 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 – Insurance | Yes |
| 2011-01-01 | Plan funding arrangement – Trust | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: KINGSBURY CLUB 401(K) SAVINGS 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 – Insurance | Yes |
| 2010-01-01 | Plan funding arrangement – Trust | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: KINGSBURY CLUB 401(K) SAVINGS 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 – Insurance | Yes |
| 2009-01-01 | Plan funding arrangement – Trust | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-029624 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-029624 | | Number of Individuals Covered | 29 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $3,946 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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? | Yes | | 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 $3,946 | | Insurance broker organization code? | 3 | | Insurance broker name | NEW ENGLAND SECURITIES CORP |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-029624 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-029624 | | Number of Individuals Covered | 31 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $3,277 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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? | Yes | | 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 $3,277 | | Insurance broker organization code? | 3 | | Insurance broker name | NEW ENGLAND SEC CORP |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-029624 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-029624 | | Number of Individuals Covered | 83 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $2,829 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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? | Yes | | 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 $2,829 | | Insurance broker organization code? | 3 | | Insurance broker name | NEW ENGLAND SEC CORP |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-029624 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-029624 | | Number of Individuals Covered | 33 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $2,737 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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? | Yes | | 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 |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-029624 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-029624 | | Number of Individuals Covered | 35 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $2,327 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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? | Yes | | 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 $2,327 | | Insurance broker organization code? | 3 | | Insurance broker name | ENTERPRISE GENERAL INS AGCY |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-029624 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-029624 | | Number of Individuals Covered | 34 | | Insurance policy start date | 2008-01-01 | | Insurance policy end date | 2008-12-31 | | Total amount of commissions paid to insurance broker | USD $2,288 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $228 | | Insurance broker organization code? | 3 | | Insurance broker name | ENTERPRISE GENERAL INS AGCY |
|
