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SEIKOH GIKEN USA INC 401(K) PROFIT SHARING PLAN & TRUST 401k Plan overview

Plan NameSEIKOH GIKEN USA INC 401(K) PROFIT SHARING PLAN & TRUST
Plan identification number 001

SEIKOH GIKEN USA INC 401(K) PROFIT SHARING PLAN & TRUST 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.
  • 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

SEIKOH GIKEN USA INC. has sponsored the creation of one or more 401k plans.

Company Name:SEIKOH GIKEN USA INC.
Employer identification number (EIN):134134994
NAIC Classification:339900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SEIKOH GIKEN USA INC 401(K) PROFIT SHARING PLAN & TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01TAKAHIRO YANAGIYA2023-04-17
0012021-01-01TAKAHIRO YANAGIYA2022-04-26
0012020-01-01TAKAHIRO YANAGIYA2021-04-09
0012019-01-01
0012018-01-01BRAD WEIS2019-07-11
0012017-01-01EDWARD ROJAS2018-04-25
0012017-01-01EDWARD ROJAS2018-05-09
0012016-01-01EDWARD ROJAS2017-06-23
0012015-01-01EDWARD ROJAS
0012014-01-01SONI MEKSVANH
0012013-01-01SONI MEKSVANH
0012012-01-01SONI MEKSVANH
0012011-01-01SONI MEKSVANH
0012009-01-01TAKAYUKI HONAMI

Plan Statistics for SEIKOH GIKEN USA INC 401(K) PROFIT SHARING PLAN & TRUST

401k plan membership statisitcs for SEIKOH GIKEN USA INC 401(K) PROFIT SHARING PLAN & TRUST

Measure Date Value
2015: SEIKOH GIKEN USA INC 401(K) PROFIT SHARING PLAN & TRUST 2015 401k membership
Total participants, beginning-of-year2015-01-0114
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 benefits2015-01-015
Total of all active and inactive participants2015-01-0117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0117
Number of participants with account balances2015-01-0112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-011
2014: SEIKOH GIKEN USA INC 401(K) PROFIT SHARING PLAN & TRUST 2014 401k membership
Total participants, beginning-of-year2014-01-0112
Total number of active participants reported on line 7a of the Form 55002014-01-019
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-013
Total of all active and inactive participants2014-01-0112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0112
Number of participants with account balances2014-01-0110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-015
2013: SEIKOH GIKEN USA INC 401(K) PROFIT SHARING PLAN & TRUST 2013 401k membership
Total participants, beginning-of-year2013-01-0110
Total number of active participants reported on line 7a of the Form 55002013-01-019
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-013
Total of all active and inactive participants2013-01-0112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0112
Number of participants with account balances2013-01-019
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-015
2012: SEIKOH GIKEN USA INC 401(K) PROFIT SHARING PLAN & TRUST 2012 401k membership
Total participants, beginning-of-year2012-01-0110
Total number of active participants reported on line 7a of the Form 55002012-01-016
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-013
Total of all active and inactive participants2012-01-019
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-019
Number of participants with account balances2012-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-013
2011: SEIKOH GIKEN USA INC 401(K) PROFIT SHARING PLAN & TRUST 2011 401k membership
Total participants, beginning-of-year2011-01-0110
Total number of active participants reported on line 7a of the Form 55002011-01-016
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 participants2011-01-016
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-016
Number of participants with account balances2011-01-018
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: SEIKOH GIKEN USA INC 401(K) PROFIT SHARING PLAN & TRUST 2009 401k membership
Total participants, beginning-of-year2009-01-0111
Total number of active participants reported on line 7a of the Form 55002009-01-018
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-012
Total of all active and inactive participants2009-01-0110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0110
Number of participants with account balances2009-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-011

Financial Data on SEIKOH GIKEN USA INC 401(K) PROFIT SHARING PLAN & TRUST

Measure Date Value
2015 : SEIKOH GIKEN USA INC 401(K) PROFIT SHARING PLAN & TRUST 2015 401k financial data
Transfers to/from the plan2015-12-31$0
Total plan liabilities at end of year2015-12-31$0
Total plan liabilities at beginning of year2015-12-31$0
Total income from all sources2015-12-31$62,651
Expenses. Total of all expenses incurred2015-12-31$161,413
Benefits paid (including direct rollovers)2015-12-31$159,000
Total plan assets at end of year2015-12-31$452,077
Total plan assets at beginning of year2015-12-31$550,839
Value of fidelity bond covering the plan2015-12-31$37,996
Total contributions received or receivable from participants2015-12-31$36,807
Expenses. Other expenses not covered elsewhere2015-12-31$71
Contributions received from other sources (not participants or employers)2015-12-31$0
Other income received2015-12-31$13,869
Net income (gross income less expenses)2015-12-31$-98,762
Net plan assets at end of year (total assets less liabilities)2015-12-31$452,077
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$550,839
Assets. Value of participant loans2015-12-31$2,110
Total contributions received or receivable from employer(s)2015-12-31$11,975
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$2,342
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Funding deficiency by the employer to the plan for this plan year2015-12-31$0
Minimum employer required contribution for this plan year2015-12-31$0
Amount contributed by the employer to the plan for this plan year2015-12-31$0
2014 : SEIKOH GIKEN USA INC 401(K) PROFIT SHARING PLAN & TRUST 2014 401k financial data
Transfers to/from the plan2014-12-31$0
Total income from all sources2014-12-31$40,615
Expenses. Total of all expenses incurred2014-12-31$24
Benefits paid (including direct rollovers)2014-12-31$0
Total plan assets at end of year2014-12-31$550,839
Total plan assets at beginning of year2014-12-31$510,248
Total contributions received or receivable from participants2014-12-31$14,933
Expenses. Other expenses not covered elsewhere2014-12-31$24
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$18,175
Net income (gross income less expenses)2014-12-31$40,591
Net plan assets at end of year (total assets less liabilities)2014-12-31$550,839
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$510,248
Assets. Value of participant loans2014-12-31$4,812
Total contributions received or receivable from employer(s)2014-12-31$7,507
Value of certain deemed distributions of participant loans2014-12-31$0
Value of corrective distributions2014-12-31$0
2013 : SEIKOH GIKEN USA INC 401(K) PROFIT SHARING PLAN & TRUST 2013 401k financial data
Transfers to/from the plan2013-12-31$0
Total income from all sources2013-12-31$90,525
Expenses. Total of all expenses incurred2013-12-31$24
Benefits paid (including direct rollovers)2013-12-31$0
Total plan assets at end of year2013-12-31$510,248
Total plan assets at beginning of year2013-12-31$419,747
Total contributions received or receivable from participants2013-12-31$7,298
Expenses. Other expenses not covered elsewhere2013-12-31$24
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$79,578
Net income (gross income less expenses)2013-12-31$90,501
Net plan assets at end of year (total assets less liabilities)2013-12-31$510,248
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$419,747
Assets. Value of participant loans2013-12-31$7,806
Total contributions received or receivable from employer(s)2013-12-31$3,649
Value of certain deemed distributions of participant loans2013-12-31$0
Value of corrective distributions2013-12-31$0
2012 : SEIKOH GIKEN USA INC 401(K) PROFIT SHARING PLAN & TRUST 2012 401k financial data
Transfers to/from the plan2012-12-31$0
Total income from all sources2012-12-31$54,636
Expenses. Total of all expenses incurred2012-12-31$1,598
Benefits paid (including direct rollovers)2012-12-31$1,505
Total plan assets at end of year2012-12-31$419,747
Total plan assets at beginning of year2012-12-31$366,709
Value of fidelity bond covering the plan2012-12-31$26,000
Total contributions received or receivable from participants2012-12-31$7,233
Expenses. Other expenses not covered elsewhere2012-12-31$93
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$43,446
Net income (gross income less expenses)2012-12-31$53,038
Net plan assets at end of year (total assets less liabilities)2012-12-31$419,747
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$366,709
Assets. Value of participant loans2012-12-31$10,704
Total contributions received or receivable from employer(s)2012-12-31$3,957
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$0
Funding deficiency by the employer to the plan for this plan year2012-12-31$0
Minimum employer required contribution for this plan year2012-12-31$0
Amount contributed by the employer to the plan for this plan year2012-12-31$0
2011 : SEIKOH GIKEN USA INC 401(K) PROFIT SHARING PLAN & TRUST 2011 401k financial data
Transfers to/from the plan2011-12-31$0
Total income from all sources2011-12-31$-5,657
Expenses. Total of all expenses incurred2011-12-31$13,477
Benefits paid (including direct rollovers)2011-12-31$13,427
Total plan assets at end of year2011-12-31$366,709
Total plan assets at beginning of year2011-12-31$385,843
Value of fidelity bond covering the plan2011-12-31$26,000
Total contributions received or receivable from participants2011-12-31$6,446
Expenses. Other expenses not covered elsewhere2011-12-31$50
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-15,473
Net income (gross income less expenses)2011-12-31$-19,134
Net plan assets at end of year (total assets less liabilities)2011-12-31$366,709
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$385,843
Assets. Value of participant loans2011-12-31$0
Total contributions received or receivable from employer(s)2011-12-31$3,370
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$0
Funding deficiency by the employer to the plan for this plan year2011-12-31$0
Minimum employer required contribution for this plan year2011-12-31$0
Amount contributed by the employer to the plan for this plan year2011-12-31$0
2010 : SEIKOH GIKEN USA INC 401(K) PROFIT SHARING PLAN & TRUST 2010 401k financial data
Total income from all sources2010-12-31$36,372
Expenses. Total of all expenses incurred2010-12-31$0
Benefits paid (including direct rollovers)2010-12-31$0
Total plan assets at end of year2010-12-31$385,843
Total plan assets at beginning of year2010-12-31$349,471
Value of fidelity bond covering the plan2010-12-31$26,000
Total contributions received or receivable from participants2010-12-31$5,954
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$27,441
Net income (gross income less expenses)2010-12-31$36,372
Net plan assets at end of year (total assets less liabilities)2010-12-31$385,843
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$349,471
Assets. Value of participant loans2010-12-31$0
Total contributions received or receivable from employer(s)2010-12-31$2,977
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$0
2009 : SEIKOH GIKEN USA INC 401(K) PROFIT SHARING PLAN & TRUST 2009 401k financial data
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 SEIKOH GIKEN USA INC 401(K) PROFIT SHARING PLAN & TRUST

2015: SEIKOH GIKEN USA INC 401(K) PROFIT SHARING PLAN & TRUST 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: SEIKOH GIKEN USA INC 401(K) PROFIT SHARING PLAN & TRUST 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
2013: SEIKOH GIKEN USA INC 401(K) PROFIT SHARING PLAN & TRUST 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
2012: SEIKOH GIKEN USA INC 401(K) PROFIT SHARING PLAN & TRUST 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
2011: SEIKOH GIKEN USA INC 401(K) PROFIT SHARING PLAN & TRUST 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
2009: SEIKOH GIKEN USA INC 401(K) PROFIT SHARING PLAN & TRUST 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
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 – TrustYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-820760
Policy instance 1
Insurance contract or identification numberGA-820760
Number of Individuals Covered10
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,014
Total amount of fees paid to insurance companyUSD $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 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?Yes
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 $1,014
Insurance broker organization code?3
Insurance broker nameRBC CAPITAL MARKETS LLC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-820760
Policy instance 1
Insurance contract or identification numberGA-820760
Number of Individuals Covered9
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $857
Total amount of fees paid to insurance companyUSD $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 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?Yes
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 $857
Insurance broker organization code?3
Insurance broker nameRBC CAPITAL MARKETS CORP
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-820760
Policy instance 1
Insurance contract or identification numberGA-820760
Number of Individuals Covered6
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $765
Total amount of fees paid to insurance companyUSD $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 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?Yes
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 $765
Insurance broker organization code?3
Insurance broker nameRBC CAPITAL MARKETS CORP
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-820760
Policy instance 1
Insurance contract or identification numberGA-820760
Number of Individuals Covered8
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $598
Total amount of fees paid to insurance companyUSD $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 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?Yes
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
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-820760
Policy instance 1
Insurance contract or identification numberGA-820760
Number of Individuals Covered8
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $5,367
Total amount of fees paid to insurance companyUSD $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 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?Yes
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 $5,367
Insurance broker organization code?3
Insurance broker nameRBC CAPITAL MARKETS CORP

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