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GREEN & GROSS PC 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan NameGREEN & GROSS PC 401(K) PROFIT SHARING PLAN
Plan identification number 002

GREEN & GROSS PC 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.
  • 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.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • 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

GREEN & GROSS PC has sponsored the creation of one or more 401k plans.

Company Name:GREEN & GROSS PC
Employer identification number (EIN):061328298
NAIC Classification:541110
NAIC Description:Offices of Lawyers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GREEN & GROSS PC 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022023-01-01ARLENE KOROLYSHUN2024-05-22 ARLENE KOROLYSHUN2024-05-22
0022022-01-01ARLENE KOROLYSHUN2023-05-23
0022021-01-01ARLENE KOROLYSHUN2022-05-20
0022020-01-01ERIC M GROSS2021-05-26 ARLENE KOROLYSHUN2021-05-26
0022019-01-01ARLENE KOROLYSHUN2020-05-28
0022018-01-01ARLENE KOROLYSHUN2019-04-23
0022017-01-01ARLENE KOROLYSHUN2018-05-08
0022016-01-01ARLENE KOROLYSHUN2017-06-26
0022015-01-01ARLENE KOROLYSHUN
0022014-01-01PATRICIA ROSS ERIC M. GROSS2015-07-08
0022013-01-01PATRICIA ROSS ERIC M. GROSS2016-09-28
0022012-01-01PATRICIA ROSS ERIC GROSS2016-09-27
0022011-01-01PATRICIA ROSS
0022010-01-01PATRICIA ROSS
0022009-01-01PATRICIA ROSS ERIC GROSS2016-09-28
0022009-01-012010-09-17
0022009-01-01ERIC M GROSS ERIC M GROSS2010-09-17

Plan Statistics for GREEN & GROSS PC 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for GREEN & GROSS PC 401(K) PROFIT SHARING PLAN

Measure Date Value
2015: GREEN & GROSS PC 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0113
Total number of active participants reported on line 7a of the Form 55002015-01-0112
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-011
Total of all active and inactive participants2015-01-0113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0113
Number of participants with account balances2015-01-0113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: GREEN & GROSS PC 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0114
Total number of active participants reported on line 7a of the Form 55002014-01-0112
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-011
Total of all active and inactive participants2014-01-0113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0113
Number of participants with account balances2014-01-0113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: GREEN & GROSS PC 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0114
Total number of active participants reported on line 7a of the Form 55002013-01-0112
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-012
Total of all active and inactive participants2013-01-0114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0114
Number of participants with account balances2013-01-0113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: GREEN & GROSS PC 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0115
Total number of active participants reported on line 7a of the Form 55002012-01-0110
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-012
Total of all active and inactive participants2012-01-0112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0112
Number of participants with account balances2012-01-0112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: GREEN & GROSS PC 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0115
Total number of active participants reported on line 7a of the Form 55002011-01-0110
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-015
Total of all active and inactive participants2011-01-0115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0115
Number of participants with account balances2011-01-0115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: GREEN & GROSS PC 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0116
Total number of active participants reported on line 7a of the Form 55002010-01-0111
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-014
Total of all active and inactive participants2010-01-0115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0115
Number of participants with account balances2010-01-0115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: GREEN & GROSS PC 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0116
Total number of active participants reported on line 7a of the Form 55002009-01-0111
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-015
Total of all active and inactive participants2009-01-0116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0116
Number of participants with account balances2009-01-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on GREEN & GROSS PC 401(K) PROFIT SHARING PLAN

Measure Date Value
2015 : GREEN & GROSS PC 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources2015-12-31$40,036
Expenses. Total of all expenses incurred2015-12-31$63,240
Benefits paid (including direct rollovers)2015-12-31$47,700
Total plan assets at end of year2015-12-31$5,596,387
Total plan assets at beginning of year2015-12-31$5,619,591
Value of fidelity bond covering the plan2015-12-31$500,000
Total contributions received or receivable from participants2015-12-31$153,063
Expenses. Other expenses not covered elsewhere2015-12-31$14,830
Contributions received from other sources (not participants or employers)2015-12-31$10,709
Other income received2015-12-31$-167,510
Net income (gross income less expenses)2015-12-31$-23,204
Net plan assets at end of year (total assets less liabilities)2015-12-31$5,596,387
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$5,619,591
Assets. Value of participant loans2015-12-31$28,048
Assets. Value of real-estate (other than employer real property)2015-12-31$362,100
Total contributions received or receivable from employer(s)2015-12-31$43,774
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$710
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : GREEN & GROSS PC 401(K) PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources2014-12-31$453,833
Expenses. Total of all expenses incurred2014-12-31$95,423
Benefits paid (including direct rollovers)2014-12-31$95,303
Total plan assets at end of year2014-12-31$5,619,591
Total plan assets at beginning of year2014-12-31$5,261,181
Value of fidelity bond covering the plan2014-12-31$500,000
Total contributions received or receivable from participants2014-12-31$163,563
Other income received2014-12-31$253,438
Net income (gross income less expenses)2014-12-31$358,410
Net plan assets at end of year (total assets less liabilities)2014-12-31$5,619,591
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$5,261,181
Assets. Value of participant loans2014-12-31$7,766
Assets. Value of real-estate (other than employer real property)2014-12-31$682,500
Total contributions received or receivable from employer(s)2014-12-31$36,832
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$120
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : GREEN & GROSS PC 401(K) PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources2013-12-31$896,069
Expenses. Total of all expenses incurred2013-12-31$26,536
Benefits paid (including direct rollovers)2013-12-31$26,326
Total plan assets at end of year2013-12-31$5,261,181
Total plan assets at beginning of year2013-12-31$4,391,648
Value of fidelity bond covering the plan2013-12-31$500,000
Total contributions received or receivable from participants2013-12-31$142,177
Contributions received from other sources (not participants or employers)2013-12-31$14,212
Other income received2013-12-31$705,479
Net income (gross income less expenses)2013-12-31$869,533
Net plan assets at end of year (total assets less liabilities)2013-12-31$5,261,181
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$4,391,648
Assets. Value of participant loans2013-12-31$9,783
Assets. Value of employer real property2013-12-31$654,625
Total contributions received or receivable from employer(s)2013-12-31$34,201
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$210
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : GREEN & GROSS PC 401(K) PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources2012-12-31$554,912
Expenses. Total of all expenses incurred2012-12-31$40,496
Benefits paid (including direct rollovers)2012-12-31$40,316
Total plan assets at end of year2012-12-31$4,391,648
Total plan assets at beginning of year2012-12-31$3,877,232
Value of fidelity bond covering the plan2012-12-31$500,000
Total contributions received or receivable from participants2012-12-31$129,040
Contributions received from other sources (not participants or employers)2012-12-31$19,500
Other income received2012-12-31$373,034
Net income (gross income less expenses)2012-12-31$514,416
Net plan assets at end of year (total assets less liabilities)2012-12-31$4,391,648
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$3,877,232
Assets. Value of participant loans2012-12-31$3,581
Assets. Value of employer real property2012-12-31$629,625
Total contributions received or receivable from employer(s)2012-12-31$33,338
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$180
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : GREEN & GROSS PC 401(K) PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources2011-12-31$75,568
Expenses. Total of all expenses incurred2011-12-31$30,010
Benefits paid (including direct rollovers)2011-12-31$29,860
Total plan assets at end of year2011-12-31$3,877,232
Total plan assets at beginning of year2011-12-31$3,831,674
Value of fidelity bond covering the plan2011-12-31$350,000
Total contributions received or receivable from participants2011-12-31$126,266
Other income received2011-12-31$-103,915
Net income (gross income less expenses)2011-12-31$45,558
Net plan assets at end of year (total assets less liabilities)2011-12-31$3,877,232
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$3,831,674
Assets. Value of participant loans2011-12-31$5,366
Assets. Value of employer real property2011-12-31$605,000
Total contributions received or receivable from employer(s)2011-12-31$53,217
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$150
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : GREEN & GROSS PC 401(K) PROFIT SHARING PLAN 2010 401k financial data
Total income from all sources2010-12-31$377,603
Expenses. Total of all expenses incurred2010-12-31$289,299
Benefits paid (including direct rollovers)2010-12-31$278,019
Total plan assets at end of year2010-12-31$3,831,674
Total plan assets at beginning of year2010-12-31$3,743,370
Value of fidelity bond covering the plan2010-12-31$350,000
Total contributions received or receivable from participants2010-12-31$125,208
Other income received2010-12-31$219,395
Net income (gross income less expenses)2010-12-31$88,304
Net plan assets at end of year (total assets less liabilities)2010-12-31$3,831,674
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$3,743,370
Assets. Value of participant loans2010-12-31$0
Total contributions received or receivable from employer(s)2010-12-31$33,000
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$11,280
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
2009 : GREEN & GROSS PC 401(K) PROFIT SHARING PLAN 2009 401k financial data
Total income from all sources2009-12-31$739,198
Expenses. Total of all expenses incurred2009-12-31$15,717
Benefits paid (including direct rollovers)2009-12-31$15,592
Total plan assets at end of year2009-12-31$3,743,370
Total plan assets at beginning of year2009-12-31$3,019,889
Value of fidelity bond covering the plan2009-12-31$350,000
Total contributions received or receivable from participants2009-12-31$123,600
Other income received2009-12-31$563,598
Net income (gross income less expenses)2009-12-31$723,481
Net plan assets at end of year (total assets less liabilities)2009-12-31$3,743,370
Net plan assets at beginning of year (total assets less liabilities)2009-12-31$3,019,889
Assets. Value of participant loans2009-12-31$848
Assets. Value of real-estate (other than employer real property)2009-12-31$673,750
Total contributions received or receivable from employer(s)2009-12-31$52,000
Expenses. Administrative service providers (salaries,fees and commissions)2009-12-31$125
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for GREEN & GROSS PC 401(K) PROFIT SHARING PLAN

2015: GREEN & GROSS PC 401(K) PROFIT SHARING 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 – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2014: GREEN & GROSS PC 401(K) PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: GREEN & GROSS PC 401(K) PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedYes
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: GREEN & GROSS PC 401(K) PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedYes
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: GREEN & GROSS PC 401(K) PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: GREEN & GROSS PC 401(K) PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: GREEN & GROSS PC 401(K) PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedYes
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

VALLEY FORGE LIFE INSURANCE CO./REASSURE AMERICA LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 70211 )
Policy contract number82060206
Policy instance 3
Insurance contract or identification number82060206
Number of Individuals Covered1
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GENWORTH LIFE AND ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65536 )
Policy contract number2765038
Policy instance 2
Insurance contract or identification number2765038
Number of Individuals Covered1
Insurance policy start date2014-03-11
Insurance policy end date2015-03-11
Total amount of commissions paid to insurance brokerUSD $69
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $69
Insurance broker organization code?3
Insurance broker nameCRUMP LIFE INS SERVICES, INC
WAHINGTON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65900 )
Policy contract number1OUL050564
Policy instance 1
Insurance contract or identification number1OUL050564
Number of Individuals Covered1
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VALLEY FORGE LIFE INSURANCE CO./REASSURE AMERICA LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 70211 )
Policy contract number82060206
Policy instance 3
Insurance contract or identification number82060206
Number of Individuals Covered1
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $45
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $45
Insurance broker organization code?3
Insurance broker nameMAX FILTELSON & SON INC
WAHINGTON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65900 )
Policy contract number1OUL050564
Policy instance 1
Insurance contract or identification number1OUL050564
Number of Individuals Covered3
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
GENWORTH LIFE AND ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65536 )
Policy contract number2765038
Policy instance 2
Insurance contract or identification number2765038
Number of Individuals Covered1
Insurance policy start date2013-03-11
Insurance policy end date2014-03-11
Total amount of commissions paid to insurance brokerUSD $69
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $69
Insurance broker organization code?3
Insurance broker nameCRUMP LIFE INS SERVICES, INC
WAHINGTON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65900 )
Policy contract numberINDIV POL
Policy instance 1
Insurance contract or identification numberINDIV POL
Number of Individuals Covered3
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $165
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $105
Insurance broker organization code?3
Insurance broker nameCIP,INC
VALLEY FORGE LIFE INSURANCE CO./REASSURE AMERICA LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 70211 )
Policy contract number82060206
Policy instance 3
Insurance contract or identification number82060206
Number of Individuals Covered1
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $0
Insurance broker nameMAX FITELSON & SON INC
GENWORTH LIFE AND ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65536 )
Policy contract number2765038
Policy instance 2
Insurance contract or identification number2765038
Number of Individuals Covered1
Insurance policy start date2011-03-11
Insurance policy end date2012-03-11
Total amount of commissions paid to insurance brokerUSD $69
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $69
Insurance broker organization code?3
Insurance broker nameCRUMP LIFE INS SERVICES, INC
GENWORTH LIFE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 63401 )
Policy contract number
Policy instance 2
Insurance policy start date2010-03-11
Insurance policy end date2011-03-11
Total amount of commissions paid to insurance brokerUSD $69
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
WAHINGTON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65900 )
Policy contract numberINDIV POL
Policy instance 1
Insurance contract or identification numberINDIV POL
Number of Individuals Covered3
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $165
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
REASSURE AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70211 )
Policy contract number82060206
Policy instance 3
Insurance contract or identification number82060206
Number of Individuals Covered1
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $61
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
WAHINGTON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65900 )
Policy contract numberINDIV POL
Policy instance 1
Insurance contract or identification numberINDIV POL
Number of Individuals Covered3
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $165
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
GENWORTH LIFE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 63401 )
Policy contract number
Policy instance 2
Number of Individuals Covered1
Insurance policy start date2010-03-11
Insurance policy end date2011-03-11
Total amount of commissions paid to insurance brokerUSD $69
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
REASSURE AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70211 )
Policy contract number82060206
Policy instance 3
Insurance contract or identification number82060206
Number of Individuals Covered1
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
VALLEY FORGE LIFE INSURANCE CO./REASSURE AMERICA LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 70211 )
Policy contract number82060206
Policy instance 3
Insurance contract or identification number82060206
Number of Individuals Covered1
Insurance policy start date2009-01-01
Insurance policy end date2009-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
GENWORTH LIFE AND ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65536 )
Policy contract number2765038
Policy instance 2
Insurance contract or identification number2765038
Number of Individuals Covered1
Insurance policy start date2009-01-01
Insurance policy end date2009-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
WAHINGTON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65900 )
Policy contract numberINDIV POL
Policy instance 1
Insurance contract or identification numberINDIV POL
Number of Individuals Covered3
Insurance policy start date2009-01-01
Insurance policy end date2009-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No

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