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SHAKER PEDIATRICS, P.C. PROFIT SHARING PLAN 401k Plan overview

Plan NameSHAKER PEDIATRICS, P.C. PROFIT SHARING PLAN
Plan identification number 001

SHAKER PEDIATRICS, P.C. 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.
  • 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.
  • Life insurance

401k Sponsoring company profile

SHAKER PEDIATRICS, P.C. has sponsored the creation of one or more 401k plans.

Company Name:SHAKER PEDIATRICS, P.C.
Employer identification number (EIN):141551900
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Additional information about SHAKER PEDIATRICS, P.C.

Jurisdiction of Incorporation: New York Department of State
Incorporation Date: 1973-05-01
Company Identification Number: 260198
Legal Registered Office Address: 10 CENTURY HILL DRIVE
Albany
LATHAM
United States of America (USA)
12110

More information about SHAKER PEDIATRICS, P.C.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SHAKER PEDIATRICS, P.C. PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01
0012017-01-01HENRY M. NEILLEY, MD
0012016-01-01HENRY M. NEILLEY, MD
0012015-01-01HENRY M. NEILLEY, MD
0012014-01-01HENRY M. NEILLEY, MD
0012013-01-01HENRY M. NEILLEY, MD
0012012-01-01HENRY M. NEILLEY, MD
0012011-01-01HENRY M. NEILLEY, MD
0012010-01-01HENRY M. NEILLEY, MD
0012009-01-01HENRY M. NEILLEY, MD
0012009-01-01HENRY M. NEILLEY, MD

Plan Statistics for SHAKER PEDIATRICS, P.C. PROFIT SHARING PLAN

401k plan membership statisitcs for SHAKER PEDIATRICS, P.C. PROFIT SHARING PLAN

Measure Date Value
2017: SHAKER PEDIATRICS, P.C. PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0121
Total number of active participants reported on line 7a of the Form 55002017-01-0118
Number of retired or separated participants receiving benefits2017-01-011
Number of other retired or separated participants entitled to future benefits2017-01-012
Total of all active and inactive participants2017-01-0121
Total participants2017-01-0121
Number of participants with account balances2017-01-0121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: SHAKER PEDIATRICS, P.C. PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0121
Total number of active participants reported on line 7a of the Form 55002016-01-0118
Number of retired or separated participants receiving benefits2016-01-011
Number of other retired or separated participants entitled to future benefits2016-01-011
Total of all active and inactive participants2016-01-0120
Total participants2016-01-0120
Number of participants with account balances2016-01-0120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: SHAKER PEDIATRICS, P.C. PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0120
Total number of active participants reported on line 7a of the Form 55002015-01-0119
Number of retired or separated participants receiving benefits2015-01-011
Number of other retired or separated participants entitled to future benefits2015-01-011
Total of all active and inactive participants2015-01-0121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0121
Number of participants with account balances2015-01-0121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: SHAKER PEDIATRICS, P.C. PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0120
Total number of active participants reported on line 7a of the Form 55002014-01-0118
Number of retired or separated participants receiving benefits2014-01-011
Number of other retired or separated participants entitled to future benefits2014-01-011
Total of all active and inactive participants2014-01-0120
Total participants2014-01-0120
Number of participants with account balances2014-01-0120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: SHAKER PEDIATRICS, P.C. PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0121
Total number of active participants reported on line 7a of the Form 55002013-01-0118
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 participants2013-01-0120
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0120
Number of participants with account balances2013-01-0120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: SHAKER PEDIATRICS, P.C. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0123
Total number of active participants reported on line 7a of the Form 55002012-01-0120
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 participants2012-01-0123
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0123
Number of participants with account balances2012-01-0121
2011: SHAKER PEDIATRICS, P.C. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0123
Total number of active participants reported on line 7a of the Form 55002011-01-0120
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-013
Total of all active and inactive participants2011-01-0123
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0123
Number of participants with account balances2011-01-0121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: SHAKER PEDIATRICS, P.C. PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0123
Total number of active participants reported on line 7a of the Form 55002010-01-0119
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 participants2010-01-0123
Total participants2010-01-0123
Number of participants with account balances2010-01-0122
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: SHAKER PEDIATRICS, P.C. PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0122
Total number of active participants reported on line 7a of the Form 55002009-01-0119
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-014
Total of all active and inactive participants2009-01-0123
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0123
Number of participants with account balances2009-01-0122
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on SHAKER PEDIATRICS, P.C. PROFIT SHARING PLAN

Measure Date Value
2017 : SHAKER PEDIATRICS, P.C. PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources2017-12-31$1,571,421
Expenses. Total of all expenses incurred2017-12-31$260,464
Benefits paid (including direct rollovers)2017-12-31$197,047
Total plan assets at end of year2017-12-31$9,531,930
Total plan assets at beginning of year2017-12-31$8,220,973
Value of fidelity bond covering the plan2017-12-31$500,000
Total contributions received or receivable from participants2017-12-31$127,108
Contributions received from other sources (not participants or employers)2017-12-31$43,380
Other income received2017-12-31$1,250,933
Net income (gross income less expenses)2017-12-31$1,310,957
Net plan assets at end of year (total assets less liabilities)2017-12-31$9,531,930
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$8,220,973
Assets. Value of participant loans2017-12-31$23,108
Total contributions received or receivable from employer(s)2017-12-31$150,000
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$63,417
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : SHAKER PEDIATRICS, P.C. PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources2016-12-31$803,299
Expenses. Total of all expenses incurred2016-12-31$1,052,982
Benefits paid (including direct rollovers)2016-12-31$1,052,982
Total plan assets at end of year2016-12-31$8,220,973
Total plan assets at beginning of year2016-12-31$8,470,656
Value of fidelity bond covering the plan2016-12-31$500,000
Total contributions received or receivable from participants2016-12-31$126,765
Other income received2016-12-31$526,534
Net income (gross income less expenses)2016-12-31$-249,683
Net plan assets at end of year (total assets less liabilities)2016-12-31$8,220,973
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$8,470,656
Assets. Value of participant loans2016-12-31$33,032
Total contributions received or receivable from employer(s)2016-12-31$150,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : SHAKER PEDIATRICS, P.C. PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources2015-12-31$364,369
Expenses. Total of all expenses incurred2015-12-31$214,750
Benefits paid (including direct rollovers)2015-12-31$214,750
Total plan assets at end of year2015-12-31$8,470,656
Total plan assets at beginning of year2015-12-31$8,321,037
Value of fidelity bond covering the plan2015-12-31$500,000
Total contributions received or receivable from participants2015-12-31$143,560
Contributions received from other sources (not participants or employers)2015-12-31$0
Other income received2015-12-31$70,809
Net income (gross income less expenses)2015-12-31$149,619
Net plan assets at end of year (total assets less liabilities)2015-12-31$8,470,656
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$8,321,037
Total contributions received or receivable from employer(s)2015-12-31$150,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : SHAKER PEDIATRICS, P.C. PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources2014-12-31$803,584
Expenses. Total of all expenses incurred2014-12-31$476,802
Benefits paid (including direct rollovers)2014-12-31$476,802
Total plan assets at end of year2014-12-31$8,321,037
Total plan assets at beginning of year2014-12-31$7,994,255
Value of fidelity bond covering the plan2014-12-31$500,000
Total contributions received or receivable from participants2014-12-31$116,513
Other income received2014-12-31$537,071
Net income (gross income less expenses)2014-12-31$326,782
Net plan assets at end of year (total assets less liabilities)2014-12-31$8,321,037
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$7,994,255
Total contributions received or receivable from employer(s)2014-12-31$150,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : SHAKER PEDIATRICS, P.C. PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources2013-12-31$1,465,443
Expenses. Total of all expenses incurred2013-12-31$241,448
Benefits paid (including direct rollovers)2013-12-31$241,448
Total plan assets at end of year2013-12-31$7,994,255
Total plan assets at beginning of year2013-12-31$6,770,260
Value of fidelity bond covering the plan2013-12-31$500,000
Total contributions received or receivable from participants2013-12-31$114,710
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$1,200,733
Noncash contributions received2013-12-31$0
Net income (gross income less expenses)2013-12-31$1,223,995
Net plan assets at end of year (total assets less liabilities)2013-12-31$7,994,255
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$6,770,260
Total contributions received or receivable from employer(s)2013-12-31$150,000
Value of certain deemed distributions of participant loans2013-12-31$0
Value of corrective distributions2013-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : SHAKER PEDIATRICS, P.C. PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources2012-12-31$881,938
Expenses. Total of all expenses incurred2012-12-31$187,108
Benefits paid (including direct rollovers)2012-12-31$187,108
Total plan assets at end of year2012-12-31$6,770,260
Total plan assets at beginning of year2012-12-31$6,075,430
Value of fidelity bond covering the plan2012-12-31$500,000
Total contributions received or receivable from participants2012-12-31$121,605
Other income received2012-12-31$630,333
Net income (gross income less expenses)2012-12-31$694,830
Net plan assets at end of year (total assets less liabilities)2012-12-31$6,770,260
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$6,075,430
Total contributions received or receivable from employer(s)2012-12-31$130,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : SHAKER PEDIATRICS, P.C. PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources2011-12-31$393,891
Expenses. Total of all expenses incurred2011-12-31$176,141
Benefits paid (including direct rollovers)2011-12-31$176,141
Total plan assets at end of year2011-12-31$6,075,430
Total plan assets at beginning of year2011-12-31$5,857,680
Value of fidelity bond covering the plan2011-12-31$500,000
Total contributions received or receivable from participants2011-12-31$122,726
Other income received2011-12-31$141,165
Net income (gross income less expenses)2011-12-31$217,750
Net plan assets at end of year (total assets less liabilities)2011-12-31$6,075,430
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$5,857,680
Assets. Value of participant loans2011-12-31$686
Total contributions received or receivable from employer(s)2011-12-31$130,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : SHAKER PEDIATRICS, P.C. PROFIT SHARING PLAN 2010 401k financial data
Total income from all sources2010-12-31$831,014
Expenses. Total of all expenses incurred2010-12-31$167,232
Benefits paid (including direct rollovers)2010-12-31$167,232
Total plan assets at end of year2010-12-31$5,857,680
Total plan assets at beginning of year2010-12-31$5,193,898
Value of fidelity bond covering the plan2010-12-31$500,000
Total contributions received or receivable from participants2010-12-31$117,848
Other income received2010-12-31$583,166
Net income (gross income less expenses)2010-12-31$663,782
Net plan assets at end of year (total assets less liabilities)2010-12-31$5,857,680
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$5,193,898
Assets. Value of participant loans2010-12-31$2,263
Total contributions received or receivable from employer(s)2010-12-31$130,000
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 SHAKER PEDIATRICS, P.C. PROFIT SHARING PLAN

2017: SHAKER PEDIATRICS, P.C. PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement - TrustYes
2016: SHAKER PEDIATRICS, P.C. 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 filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
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 - TrustYes
2015: SHAKER PEDIATRICS, P.C. 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 – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2014: SHAKER PEDIATRICS, P.C. 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 - TrustYes
2013: SHAKER PEDIATRICS, P.C. 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 - TrustYes
2012: SHAKER PEDIATRICS, P.C. 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 - TrustYes
2011: SHAKER PEDIATRICS, P.C. 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 - TrustYes
2010: SHAKER PEDIATRICS, P.C. 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 - TrustYes
2009: SHAKER PEDIATRICS, P.C. 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 - TrustYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberOUO4146/OUO4144
Policy instance 1
Insurance contract or identification numberOUO4146/OUO4144
Number of Individuals Covered0
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
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 BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $0
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 numberOUO4146/OUO4144
Policy instance 1
Insurance contract or identification numberOUO4146/OUO4144
Number of Individuals Covered2
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $14,361
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 numberOUO4146/OUO4144
Policy instance 1
Insurance contract or identification numberOUO4146/OUO4144
Number of Individuals Covered2
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $9,574
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 numberOUO4146/OUO4144
Policy instance 1
Insurance contract or identification numberOUO4146/OUO4144
Number of Individuals Covered2
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $9,574
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 numberOUO4146/OUO4144
Policy instance 1
Insurance contract or identification numberOUO4146/OUO4144
Number of Individuals Covered2
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $9,574
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 numberOUO4146/OUO4144
Policy instance 1
Insurance contract or identification numberOUO4146/OUO4144
Number of Individuals Covered2
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $9,574
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 numberOUO4146/OUO4144
Policy instance 1
Insurance contract or identification numberOUO4146/OUO4144
Number of Individuals Covered2
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $9,574
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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