ANJOST CORPORATION has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan ZARO'S BREAD BASKET 401(K) PLAN
| Measure | Date | Value |
|---|
| 2014: ZARO'S BREAD BASKET 401(K) PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 38 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 23 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 10 |
| Total of all active and inactive participants | 2014-01-01 | 35 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-01-01 | 0 |
| Total participants | 2014-01-01 | 35 |
| Number of participants with account balances | 2014-01-01 | 28 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2014-01-01 | 3 |
| 2013: ZARO'S BREAD BASKET 401(K) PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 36 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 25 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 10 |
| Total of all active and inactive participants | 2013-01-01 | 37 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-01-01 | 0 |
| Total participants | 2013-01-01 | 37 |
| Number of participants with account balances | 2013-01-01 | 30 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-01-01 | 1 |
| 2012: ZARO'S BREAD BASKET 401(K) PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 37 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 28 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 10 |
| Total of all active and inactive participants | 2012-01-01 | 38 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-01-01 | 0 |
| Total participants | 2012-01-01 | 38 |
| Number of participants with account balances | 2012-01-01 | 28 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-01-01 | 1 |
| 2011: ZARO'S BREAD BASKET 401(K) PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 35 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 29 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 1 |
| Total of all active and inactive participants | 2011-01-01 | 30 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-01-01 | 0 |
| Total participants | 2011-01-01 | 30 |
| Number of participants with account balances | 2011-01-01 | 30 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2011-01-01 | 0 |
| 2010: ZARO'S BREAD BASKET 401(K) PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 35 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 27 |
| Number of retired or separated participants receiving benefits | 2010-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2010-01-01 | 2 |
| Total of all active and inactive participants | 2010-01-01 | 29 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2010-01-01 | 0 |
| Total participants | 2010-01-01 | 29 |
| Number of participants with account balances | 2010-01-01 | 29 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2010-01-01 | 0 |
| 2009: ZARO'S BREAD BASKET 401(K) PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 37 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 28 |
| 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 | 8 |
| Total of all active and inactive participants | 2009-01-01 | 36 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-01-01 | 0 |
| Total participants | 2009-01-01 | 36 |
| Number of participants with account balances | 2009-01-01 | 28 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-01-01 | 0 |
| Measure | Date | Value |
|---|
| 2014 : ZARO'S BREAD BASKET 401(K) PLAN 2014 401k financial data |
|---|
| Transfers to/from the plan | 2014-12-31 | $0 |
| Total income from all sources | 2014-12-31 | $165,320 |
| Expenses. Total of all expenses incurred | 2014-12-31 | $28,055 |
| Benefits paid (including direct rollovers) | 2014-12-31 | $27,303 |
| Total plan assets at end of year | 2014-12-31 | $1,146,073 |
| Total plan assets at beginning of year | 2014-12-31 | $1,008,808 |
| Value of fidelity bond covering the plan | 2014-12-31 | $500,000 |
| Total contributions received or receivable from participants | 2014-12-31 | $93,056 |
| Expenses. Other expenses not covered elsewhere | 2014-12-31 | $752 |
| Contributions received from other sources (not participants or employers) | 2014-12-31 | $0 |
| Other income received | 2014-12-31 | $61,621 |
| Net income (gross income less expenses) | 2014-12-31 | $137,265 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $1,146,073 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $1,008,808 |
| Assets. Value of participant loans | 2014-12-31 | $3,701 |
| Total contributions received or receivable from employer(s) | 2014-12-31 | $10,643 |
| 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 : ZARO'S BREAD BASKET 401(K) PLAN 2013 401k financial data |
|---|
| Transfers to/from the plan | 2013-12-31 | $0 |
| Total income from all sources | 2013-12-31 | $269,738 |
| Expenses. Total of all expenses incurred | 2013-12-31 | $163,344 |
| Benefits paid (including direct rollovers) | 2013-12-31 | $162,518 |
| Total plan assets at end of year | 2013-12-31 | $1,008,808 |
| Total plan assets at beginning of year | 2013-12-31 | $902,414 |
| Value of fidelity bond covering the plan | 2013-12-31 | $500,000 |
| Total contributions received or receivable from participants | 2013-12-31 | $115,456 |
| Expenses. Other expenses not covered elsewhere | 2013-12-31 | $826 |
| Contributions received from other sources (not participants or employers) | 2013-12-31 | $0 |
| Other income received | 2013-12-31 | $154,282 |
| Net income (gross income less expenses) | 2013-12-31 | $106,394 |
| Net plan assets at end of year (total assets less liabilities) | 2013-12-31 | $1,008,808 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-12-31 | $902,414 |
| Assets. Value of participant loans | 2013-12-31 | $3,706 |
| 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 : ZARO'S BREAD BASKET 401(K) PLAN 2012 401k financial data |
|---|
| Transfers to/from the plan | 2012-12-31 | $0 |
| Total income from all sources | 2012-12-31 | $210,584 |
| Expenses. Total of all expenses incurred | 2012-12-31 | $19,135 |
| Benefits paid (including direct rollovers) | 2012-12-31 | $18,360 |
| Total plan assets at end of year | 2012-12-31 | $902,414 |
| Total plan assets at beginning of year | 2012-12-31 | $710,965 |
| Value of fidelity bond covering the plan | 2012-12-31 | $500,000 |
| Total contributions received or receivable from participants | 2012-12-31 | $124,941 |
| Expenses. Other expenses not covered elsewhere | 2012-12-31 | $775 |
| Contributions received from other sources (not participants or employers) | 2012-12-31 | $0 |
| Other income received | 2012-12-31 | $85,643 |
| Net income (gross income less expenses) | 2012-12-31 | $191,449 |
| Net plan assets at end of year (total assets less liabilities) | 2012-12-31 | $902,414 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-12-31 | $710,965 |
| Assets. Value of participant loans | 2012-12-31 | $824 |
| 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 : ZARO'S BREAD BASKET 401(K) PLAN 2011 401k financial data |
|---|
| Transfers to/from the plan | 2011-12-31 | $0 |
| Total income from all sources | 2011-12-31 | $80,480 |
| Expenses. Total of all expenses incurred | 2011-12-31 | $164,997 |
| Benefits paid (including direct rollovers) | 2011-12-31 | $163,768 |
| Total plan assets at end of year | 2011-12-31 | $710,965 |
| Total plan assets at beginning of year | 2011-12-31 | $795,482 |
| Value of fidelity bond covering the plan | 2011-12-31 | $500,000 |
| Total contributions received or receivable from participants | 2011-12-31 | $103,757 |
| Expenses. Other expenses not covered elsewhere | 2011-12-31 | $814 |
| Contributions received from other sources (not participants or employers) | 2011-12-31 | $0 |
| Other income received | 2011-12-31 | $-23,277 |
| Net income (gross income less expenses) | 2011-12-31 | $-84,517 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-31 | $710,965 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-31 | $795,482 |
| Assets. Value of participant loans | 2011-12-31 | $2,120 |
| Total contributions received or receivable from employer(s) | 2011-12-31 | $0 |
| Value of certain deemed distributions of participant loans | 2011-12-31 | $0 |
| Value of corrective distributions | 2011-12-31 | $415 |
| 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 : ZARO'S BREAD BASKET 401(K) PLAN 2010 401k financial data |
|---|
| Transfers to/from the plan | 2010-12-31 | $0 |
| Total income from all sources | 2010-12-31 | $172,681 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $21,266 |
| Benefits paid (including direct rollovers) | 2010-12-31 | $20,535 |
| Total plan assets at end of year | 2010-12-31 | $795,482 |
| Total plan assets at beginning of year | 2010-12-31 | $644,067 |
| Value of fidelity bond covering the plan | 2010-12-31 | $500,000 |
| Total contributions received or receivable from participants | 2010-12-31 | $110,088 |
| Expenses. Other expenses not covered elsewhere | 2010-12-31 | $731 |
| Contributions received from other sources (not participants or employers) | 2010-12-31 | $0 |
| Other income received | 2010-12-31 | $62,593 |
| Net income (gross income less expenses) | 2010-12-31 | $151,415 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $795,482 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $644,067 |
| Assets. Value of participant loans | 2010-12-31 | $1,655 |
| Total contributions received or receivable from employer(s) | 2010-12-31 | $0 |
| Value of certain deemed distributions of participant loans | 2010-12-31 | $0 |
| Value of corrective distributions | 2010-12-31 | $0 |
| 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 : ZARO'S BREAD BASKET 401(K) 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 |
| 2014: ZARO'S BREAD BASKET 401(K) 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: ZARO'S BREAD BASKET 401(K) 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: ZARO'S BREAD BASKET 401(K) 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: ZARO'S BREAD BASKET 401(K) 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: ZARO'S BREAD BASKET 401(K) 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: ZARO'S BREAD BASKET 401(K) 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-006836 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-006836 | | Number of Individuals Covered | 28 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $4,039 | | 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 $4,039 | | Insurance broker organization code? | 3 | | Insurance broker name | PLANNED PROTECTION CONSULT LTD |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-006836 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-006836 | | Number of Individuals Covered | 30 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $3,659 | | 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 $3,659 | | Insurance broker organization code? | 3 | | Insurance broker name | PLANNED PROTECTION |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-006836 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-006836 | | Number of Individuals Covered | 28 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $3,243 | | 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 $3,243 | | Insurance broker organization code? | 3 | | Insurance broker name | PLANNED PROTECTION |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-006836 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-006836 | | Number of Individuals Covered | 30 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $3,318 | | 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-006836 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-006836 | | Number of Individuals Covered | 29 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $2,800 | | 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 $2,800 | | Insurance broker organization code? | 3 | | Insurance broker name | PLANNED PROTECTION |
|
