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FORGER-KUNKEL PLUMBING & HEATING, LLC PROFIT SHARING PLAN 401k Plan overview

Plan NameFORGER-KUNKEL PLUMBING & HEATING, LLC PROFIT SHARING PLAN
Plan identification number 001

FORGER-KUNKEL PLUMBING & HEATING, LLC PROFIT SHARING 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 covering Self-Employed individuals.
  • 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

FORGER-KUNKEL PLUMBING & HEATING, LLC has sponsored the creation of one or more 401k plans.

Company Name:FORGER-KUNKEL PLUMBING & HEATING, LLC
Employer identification number (EIN):061610887
NAIC Classification:238220
NAIC Description:Plumbing, Heating, and Air-Conditioning Contractors

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FORGER-KUNKEL PLUMBING & HEATING, LLC PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012016-01-01JARED KUNKEL
0012015-01-01JARED KUNKEL
0012015-01-01JARED KUNKEL
0012014-01-01JARED KUNKEL
0012013-01-01JARED KUNKEL
0012012-01-01JARED KUNKEL
0012011-01-01JARED KUNKEL
0012010-01-01JARED KUNKEL

Plan Statistics for FORGER-KUNKEL PLUMBING & HEATING, LLC PROFIT SHARING PLAN

401k plan membership statisitcs for FORGER-KUNKEL PLUMBING & HEATING, LLC PROFIT SHARING PLAN

Measure Date Value
2016: FORGER-KUNKEL PLUMBING & HEATING, LLC PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-017
Total number of active participants reported on line 7a of the Form 55002016-01-010
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-010
Number of participants with account balances2016-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: FORGER-KUNKEL PLUMBING & HEATING, LLC PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-017
Total number of active participants reported on line 7a of the Form 55002015-01-017
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-017
2014: FORGER-KUNKEL PLUMBING & HEATING, LLC PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-017
Total number of active participants reported on line 7a of the Form 55002014-01-017
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-017
Number of participants with account balances2014-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: FORGER-KUNKEL PLUMBING & HEATING, LLC PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-017
Total number of active participants reported on line 7a of the Form 55002013-01-017
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-017
Number of participants with account balances2013-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: FORGER-KUNKEL PLUMBING & HEATING, LLC PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-018
Total number of active participants reported on line 7a of the Form 55002012-01-017
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-017
Number of participants with account balances2012-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: FORGER-KUNKEL PLUMBING & HEATING, LLC PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-018
Total number of active participants reported on line 7a of the Form 55002011-01-018
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-018
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-018
Number of participants with account balances2011-01-018
2010: FORGER-KUNKEL PLUMBING & HEATING, LLC PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-018
Total number of active participants reported on line 7a of the Form 55002010-01-018
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-018
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-018
Number of participants with account balances2010-01-018
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010

Financial Data on FORGER-KUNKEL PLUMBING & HEATING, LLC PROFIT SHARING PLAN

Measure Date Value
2016 : FORGER-KUNKEL PLUMBING & HEATING, LLC PROFIT SHARING PLAN 2016 401k financial data
Total plan liabilities at end of year2016-10-31$0
Total plan liabilities at beginning of year2016-10-31$0
Total income from all sources2016-10-31$49,153
Expenses. Total of all expenses incurred2016-10-31$1,270,042
Benefits paid (including direct rollovers)2016-10-31$1,267,253
Total plan assets at end of year2016-10-31$0
Total plan assets at beginning of year2016-10-31$1,220,889
Value of fidelity bond covering the plan2016-10-31$500,000
Total contributions received or receivable from participants2016-10-31$238
Contributions received from other sources (not participants or employers)2016-10-31$23,897
Other income received2016-10-31$25,018
Noncash contributions received2016-10-31$0
Net income (gross income less expenses)2016-10-31$-1,220,889
Net plan assets at end of year (total assets less liabilities)2016-10-31$0
Net plan assets at beginning of year (total assets less liabilities)2016-10-31$1,220,889
Total contributions received or receivable from employer(s)2016-10-31$0
Value of certain deemed distributions of participant loans2016-10-31$0
Value of corrective distributions2016-10-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2016-10-31$2,789
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-10-31$0
2015 : FORGER-KUNKEL PLUMBING & HEATING, LLC PROFIT SHARING PLAN 2015 401k financial data
Total plan liabilities at beginning of year2015-12-31$0
Total income from all sources2015-12-31$-5,841
Expenses. Total of all expenses incurred2015-12-31$34,506
Benefits paid (including direct rollovers)2015-12-31$21,382
Total plan assets at end of year2015-12-31$1,220,889
Total plan assets at beginning of year2015-12-31$1,261,236
Value of fidelity bond covering the plan2015-12-31$500,000
Total contributions received or receivable from participants2015-12-31$13,614
Expenses. Other expenses not covered elsewhere2015-12-31$8,361
Contributions received from other sources (not participants or employers)2015-12-31$0
Other income received2015-12-31$-29,497
Noncash contributions received2015-12-31$0
Net income (gross income less expenses)2015-12-31$-40,347
Net plan assets at end of year (total assets less liabilities)2015-12-31$1,220,889
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$1,261,236
Total contributions received or receivable from employer(s)2015-12-31$10,042
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$4,763
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : FORGER-KUNKEL PLUMBING & HEATING, LLC PROFIT SHARING PLAN 2014 401k financial data
Total plan liabilities at end of year2014-12-31$0
Total plan liabilities at beginning of year2014-12-31$0
Total income from all sources2014-12-31$64,594
Expenses. Total of all expenses incurred2014-12-31$4,677
Benefits paid (including direct rollovers)2014-12-31$0
Total plan assets at end of year2014-12-31$1,261,236
Total plan assets at beginning of year2014-12-31$1,201,319
Value of fidelity bond covering the plan2014-12-31$500,000
Total contributions received or receivable from participants2014-12-31$12,756
Expenses. Other expenses not covered elsewhere2014-12-31$0
Other income received2014-12-31$35,956
Noncash contributions received2014-12-31$0
Net income (gross income less expenses)2014-12-31$59,917
Net plan assets at end of year (total assets less liabilities)2014-12-31$1,261,236
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$1,201,319
Total contributions received or receivable from employer(s)2014-12-31$15,882
Value of certain deemed distributions of participant loans2014-12-31$0
Value of corrective distributions2014-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$4,677
2013 : FORGER-KUNKEL PLUMBING & HEATING, LLC PROFIT SHARING PLAN 2013 401k financial data
Total plan liabilities at end of year2013-12-31$0
Total plan liabilities at beginning of year2013-12-31$0
Total income from all sources2013-12-31$105,462
Expenses. Total of all expenses incurred2013-12-31$4,419
Benefits paid (including direct rollovers)2013-12-31$0
Total plan assets at end of year2013-12-31$1,201,319
Total plan assets at beginning of year2013-12-31$1,100,276
Value of fidelity bond covering the plan2013-12-31$500,000
Total contributions received or receivable from participants2013-12-31$10,489
Expenses. Other expenses not covered elsewhere2013-12-31$0
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$86,202
Noncash contributions received2013-12-31$0
Net income (gross income less expenses)2013-12-31$101,043
Net plan assets at end of year (total assets less liabilities)2013-12-31$1,201,319
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$1,100,276
Total contributions received or receivable from employer(s)2013-12-31$8,771
Value of certain deemed distributions of participant loans2013-12-31$0
Value of corrective distributions2013-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$4,419
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : FORGER-KUNKEL PLUMBING & HEATING, LLC PROFIT SHARING PLAN 2012 401k financial data
Total plan liabilities at end of year2012-12-31$0
Total plan liabilities at beginning of year2012-12-31$0
Total income from all sources2012-12-31$105,380
Expenses. Total of all expenses incurred2012-12-31$34,406
Benefits paid (including direct rollovers)2012-12-31$30,233
Total plan assets at end of year2012-12-31$1,100,276
Total plan assets at beginning of year2012-12-31$1,029,302
Value of fidelity bond covering the plan2012-12-31$500,000
Total contributions received or receivable from participants2012-12-31$5,821
Expenses. Other expenses not covered elsewhere2012-12-31$0
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$81,987
Noncash contributions received2012-12-31$0
Net income (gross income less expenses)2012-12-31$70,974
Net plan assets at end of year (total assets less liabilities)2012-12-31$1,100,276
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$1,029,302
Total contributions received or receivable from employer(s)2012-12-31$17,572
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$4,173
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : FORGER-KUNKEL PLUMBING & HEATING, LLC PROFIT SHARING PLAN 2011 401k financial data
Total plan liabilities at end of year2011-12-31$0
Total plan liabilities at beginning of year2011-12-31$0
Total income from all sources2011-12-31$-5,153
Expenses. Total of all expenses incurred2011-12-31$4,056
Benefits paid (including direct rollovers)2011-12-31$0
Total plan assets at end of year2011-12-31$1,029,302
Total plan assets at beginning of year2011-12-31$1,038,511
Value of fidelity bond covering the plan2011-12-31$500,000
Total contributions received or receivable from participants2011-12-31$5,484
Expenses. Other expenses not covered elsewhere2011-12-31$0
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-28,133
Noncash contributions received2011-12-31$0
Net income (gross income less expenses)2011-12-31$-9,209
Net plan assets at end of year (total assets less liabilities)2011-12-31$1,029,302
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$1,038,511
Total contributions received or receivable from employer(s)2011-12-31$17,496
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$4,056
2010 : FORGER-KUNKEL PLUMBING & HEATING, LLC PROFIT SHARING PLAN 2010 401k financial data
Total plan liabilities at end of year2010-12-31$0
Total plan liabilities at beginning of year2010-12-31$0
Total income from all sources2010-12-31$55,998
Expenses. Total of all expenses incurred2010-12-31$251,457
Benefits paid (including direct rollovers)2010-12-31$250,000
Total plan assets at end of year2010-12-31$1,038,511
Total plan assets at beginning of year2010-12-31$1,233,970
Value of fidelity bond covering the plan2010-12-31$500,000
Total contributions received or receivable from participants2010-12-31$2,105
Expenses. Other expenses not covered elsewhere2010-12-31$0
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$37,581
Noncash contributions received2010-12-31$0
Net income (gross income less expenses)2010-12-31$-195,459
Net plan assets at end of year (total assets less liabilities)2010-12-31$1,038,511
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$1,233,970
Total contributions received or receivable from employer(s)2010-12-31$16,312
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$1,457
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0

Form 5500 Responses for FORGER-KUNKEL PLUMBING & HEATING, LLC PROFIT SHARING PLAN

2016: FORGER-KUNKEL PLUMBING & HEATING, LLC PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingYes
2016-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: FORGER-KUNKEL PLUMBING & HEATING, LLC PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedYes
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
2014: FORGER-KUNKEL PLUMBING & HEATING, LLC 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: FORGER-KUNKEL PLUMBING & HEATING, LLC PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
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: FORGER-KUNKEL PLUMBING & HEATING, LLC PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
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: FORGER-KUNKEL PLUMBING & HEATING, LLC 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: FORGER-KUNKEL PLUMBING & HEATING, LLC PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedYes
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

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number5432683
Policy instance 1
Insurance contract or identification number5432683
Number of Individuals Covered0
Insurance policy start date2016-01-01
Insurance policy end date2016-10-31
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?Yes
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number5432683
Policy instance 1
Insurance contract or identification number5432683
Number of Individuals Covered7
Insurance policy start date2015-01-01
Insurance policy end date2015-12-01
Total amount of commissions paid to insurance brokerUSD $2,395
Total amount of fees paid to insurance companyUSD $219
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?Yes
Commission paid to Insurance BrokerUSD $2,198
Insurance broker organization code?3
Amount paid for insurance broker fees219
Additional information about fees paid to insurance brokerMARKETING ALLOWANCE
Insurance broker nameSWBC ADVISORY SERVICES LLC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number5432683
Policy instance 1
Insurance contract or identification number5432683
Number of Individuals Covered1
Insurance policy start date2014-01-01
Insurance policy end date2014-12-01
Total amount of commissions paid to insurance brokerUSD $2,178
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?Yes
Commission paid to Insurance BrokerUSD $2,178
Insurance broker organization code?3
Insurance broker nameBRIAN KEEGAN
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number5432683
Policy instance 1
Insurance contract or identification number5432683
Number of Individuals Covered7
Insurance policy start date2013-01-01
Insurance policy end date2013-12-01
Total amount of commissions paid to insurance brokerUSD $2,066
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?Yes
Commission paid to Insurance BrokerUSD $2,066
Insurance broker organization code?3
Insurance broker nameBRIAN KEEGAN
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number5432683
Policy instance 1
Insurance contract or identification number5432683
Number of Individuals Covered7
Insurance policy start date2012-01-01
Insurance policy end date2012-12-01
Total amount of commissions paid to insurance brokerUSD $1,925
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?Yes
Commission paid to Insurance BrokerUSD $1,925
Insurance broker organization code?3
Insurance broker nameBRIAN KEEGAN
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number5432683
Policy instance 1
Insurance contract or identification number5432683
Number of Individuals Covered7
Insurance policy start date2011-01-01
Insurance policy end date2011-12-01
Total amount of commissions paid to insurance brokerUSD $1,989
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?Yes
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number5432683
Policy instance 1
Insurance contract or identification number5432683
Number of Individuals Covered7
Insurance policy start date2010-01-01
Insurance policy end date2010-12-01
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?Yes

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