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MDG SUBS, INC. 401(K) PROFIT SHARING PLAN & TRUST 401k Plan overview

Plan NameMDG SUBS, INC. 401(K) PROFIT SHARING PLAN & TRUST
Plan identification number 001

MDG SUBS, 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.
  • Prototype plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion or notification letter; and under which a seperate funding medium (for example, a seperate trust or custodial account) is established for the use of each adopting employer.

401k Sponsoring company profile

MDG SUBS, INC. has sponsored the creation of one or more 401k plans.

Company Name:MDG SUBS, INC.
Employer identification number (EIN):201819838
NAIC Classification:722513
NAIC Description:Limited-Service Restaurants

Additional information about MDG SUBS, INC.

Jurisdiction of Incorporation: New York Department of State
Incorporation Date: 2004-11-01
Company Identification Number: 3120540
Legal Registered Office Address: PO BOX 107
SARATOGA
CLIFTON PARK
United States of America (USA)
12065

More information about MDG SUBS, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MDG SUBS, INC. 401(K) PROFIT SHARING PLAN & TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012018-01-01MITCH GELMAN2018-11-26
0012017-01-01MITCH GELMAN2018-07-23
0012016-01-01MITCH GELMAN2017-07-13
0012015-01-01MITCHELL GELMAN2016-07-29 MITCHELL GELMAN2016-07-29
0012014-01-01MITCH GELMAN
0012013-01-01MITCH GELMAN
0012012-01-01MITCH GELMAN MITCH GELMAN2013-07-22
0012011-01-01MITCH GELMAN
0012009-01-01MITCH GELMAN
0012008-01-01MITCH GELMAN
0012007-01-01MITCH GELMAN

Plan Statistics for MDG SUBS, INC. 401(K) PROFIT SHARING PLAN & TRUST

401k plan membership statisitcs for MDG SUBS, INC. 401(K) PROFIT SHARING PLAN & TRUST

Measure Date Value
2014: MDG SUBS, INC. 401(K) PROFIT SHARING PLAN & TRUST 2014 401k membership
Total participants, beginning-of-year2014-01-018
Total number of active participants reported on line 7a of the Form 55002014-01-014
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-011
Total of all active and inactive participants2014-01-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-015
Number of participants with account balances2014-01-015
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: MDG SUBS, INC. 401(K) PROFIT SHARING PLAN & TRUST 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 benefits2013-01-011
Total of all active and inactive participants2013-01-018
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-018
Number of participants with account balances2013-01-018
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: MDG SUBS, INC. 401(K) PROFIT SHARING PLAN & TRUST 2012 401k membership
Total participants, beginning-of-year2012-01-014
Total number of active participants reported on line 7a of the Form 55002012-01-019
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 participants2012-01-019
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 balances2012-01-019
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: MDG SUBS, INC. 401(K) PROFIT SHARING PLAN & TRUST 2011 401k membership
Total participants, beginning-of-year2011-01-013
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 balances2011-01-013
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: MDG SUBS, INC. 401(K) PROFIT SHARING PLAN & TRUST 2009 401k membership
Total participants, beginning-of-year2009-01-017
Total number of active participants reported on line 7a of the Form 55002009-01-015
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-011
Total of all active and inactive participants2009-01-016
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-016
Number of participants with account balances2009-01-013
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010
2008: MDG SUBS, INC. 401(K) PROFIT SHARING PLAN & TRUST 2008 401k membership
Total participants, beginning-of-year2008-01-017
Total number of active participants reported on line 7a of the Form 55002008-01-015
Number of retired or separated participants receiving benefits2008-01-010
Number of other retired or separated participants entitled to future benefits2008-01-010
Total of all active and inactive participants2008-01-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2008-01-010
Total participants2008-01-015
Number of participants with account balances2008-01-014
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2008-01-010
2007: MDG SUBS, INC. 401(K) PROFIT SHARING PLAN & TRUST 2007 401k membership
Total participants, beginning-of-year2007-01-017
Total number of active participants reported on line 7a of the Form 55002007-01-017
Number of retired or separated participants receiving benefits2007-01-010
Number of other retired or separated participants entitled to future benefits2007-01-010
Total of all active and inactive participants2007-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2007-01-010
Total participants2007-01-017
Number of participants with account balances2007-01-014
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2007-01-010

Financial Data on MDG SUBS, INC. 401(K) PROFIT SHARING PLAN & TRUST

Measure Date Value
2014 : MDG SUBS, 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$21,138
Expenses. Total of all expenses incurred2014-12-31$3,948
Benefits paid (including direct rollovers)2014-12-31$3,747
Total plan assets at end of year2014-12-31$75,043
Total plan assets at beginning of year2014-12-31$57,853
Total contributions received or receivable from participants2014-12-31$10,671
Expenses. Other expenses not covered elsewhere2014-12-31$201
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$1,930
Net income (gross income less expenses)2014-12-31$17,190
Net plan assets at end of year (total assets less liabilities)2014-12-31$75,043
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$57,853
Assets. Value of participant loans2014-12-31$18,095
Total contributions received or receivable from employer(s)2014-12-31$8,537
Value of certain deemed distributions of participant loans2014-12-31$0
Value of corrective distributions2014-12-31$0
Funding deficiency by the employer to the plan for this plan year2014-12-31$0
Minimum employer required contribution for this plan year2014-12-31$0
Amount contributed by the employer to the plan for this plan year2014-12-31$0
2013 : MDG SUBS, 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$25,060
Expenses. Total of all expenses incurred2013-12-31$121,760
Benefits paid (including direct rollovers)2013-12-31$121,498
Total plan assets at end of year2013-12-31$57,853
Total plan assets at beginning of year2013-12-31$154,553
Total contributions received or receivable from participants2013-12-31$11,506
Expenses. Other expenses not covered elsewhere2013-12-31$262
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$4,353
Net income (gross income less expenses)2013-12-31$-96,700
Net plan assets at end of year (total assets less liabilities)2013-12-31$57,853
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$154,553
Assets. Value of participant loans2013-12-31$27,146
Total contributions received or receivable from employer(s)2013-12-31$9,201
Value of certain deemed distributions of participant loans2013-12-31$0
Value of corrective distributions2013-12-31$0
Funding deficiency by the employer to the plan for this plan year2013-12-31$0
Minimum employer required contribution for this plan year2013-12-31$0
Amount contributed by the employer to the plan for this plan year2013-12-31$0
2012 : MDG SUBS, 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$67,508
Expenses. Total of all expenses incurred2012-12-31$250,264
Benefits paid (including direct rollovers)2012-12-31$250,000
Total plan assets at end of year2012-12-31$154,553
Total plan assets at beginning of year2012-12-31$337,309
Total contributions received or receivable from participants2012-12-31$52,380
Expenses. Other expenses not covered elsewhere2012-12-31$264
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$5,896
Net income (gross income less expenses)2012-12-31$-182,756
Net plan assets at end of year (total assets less liabilities)2012-12-31$154,553
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$337,309
Assets. Value of participant loans2012-12-31$54,339
Total contributions received or receivable from employer(s)2012-12-31$9,232
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 : MDG SUBS, 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$61,285
Expenses. Total of all expenses incurred2011-12-31$14,864
Benefits paid (including direct rollovers)2011-12-31$14,386
Total plan assets at end of year2011-12-31$337,309
Total plan assets at beginning of year2011-12-31$290,888
Total contributions received or receivable from participants2011-12-31$47,776
Expenses. Other expenses not covered elsewhere2011-12-31$478
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$10,052
Net income (gross income less expenses)2011-12-31$46,421
Net plan assets at end of year (total assets less liabilities)2011-12-31$337,309
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$290,888
Assets. Value of participant loans2011-12-31$80,533
Total contributions received or receivable from employer(s)2011-12-31$3,457
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 : MDG SUBS, INC. 401(K) PROFIT SHARING PLAN & TRUST 2010 401k financial data
Transfers to/from the plan2010-12-31$0
Total income from all sources2010-12-31$53,175
Expenses. Total of all expenses incurred2010-12-31$107
Benefits paid (including direct rollovers)2010-12-31$0
Total plan assets at end of year2010-12-31$290,888
Total plan assets at beginning of year2010-12-31$237,820
Total contributions received or receivable from participants2010-12-31$42,119
Expenses. Other expenses not covered elsewhere2010-12-31$107
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$8,320
Net income (gross income less expenses)2010-12-31$53,068
Net plan assets at end of year (total assets less liabilities)2010-12-31$290,888
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$237,820
Assets. Value of participant loans2010-12-31$55,584
Total contributions received or receivable from employer(s)2010-12-31$2,736
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$0
2009 : MDG SUBS, INC. 401(K) PROFIT SHARING PLAN & TRUST 2009 401k financial data
Funding deficiency by the employer to the plan for this plan year2009-12-31$0
Minimum employer required contribution for this plan year2009-12-31$0
Amount contributed by the employer to the plan for this plan year2009-12-31$0

Form 5500 Responses for MDG SUBS, INC. 401(K) PROFIT SHARING PLAN & TRUST

2014: MDG SUBS, 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: MDG SUBS, 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: MDG SUBS, 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: MDG SUBS, 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: MDG SUBS, INC. 401(K) PROFIT SHARING PLAN & TRUST 2009 form 5500 responses
2009-01-01Type of plan entityMulitple 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 – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2008: MDG SUBS, INC. 401(K) PROFIT SHARING PLAN & TRUST 2008 form 5500 responses
2008-01-01Type of plan entitySingle employer plan
2008-01-01Submission has been amendedNo
2008-01-01This submission is the final filingNo
2008-01-01This return/report is a short plan year return/report (less than 12 months)No
2008-01-01Plan is a collectively bargained planNo
2008-01-01Plan funding arrangement – InsuranceYes
2008-01-01Plan funding arrangement – TrustYes
2008-01-01Plan benefit arrangement – InsuranceYes
2007: MDG SUBS, INC. 401(K) PROFIT SHARING PLAN & TRUST 2007 form 5500 responses
2007-01-01Type of plan entitySingle employer plan
2007-01-01Submission has been amendedNo
2007-01-01This submission is the final filingNo
2007-01-01This return/report is a short plan year return/report (less than 12 months)No
2007-01-01Plan is a collectively bargained planNo
2007-01-01Plan funding arrangement – InsuranceYes
2007-01-01Plan funding arrangement – TrustYes
2007-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-805292
Policy instance 1
Insurance contract or identification numberGA-805292
Number of Individuals Covered5
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $110
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 $110
Insurance broker organization code?3
Insurance broker nameLPL FINANCIAL CORPORATION
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-805292
Policy instance 1
Insurance contract or identification numberGA-805292
Number of Individuals Covered8
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $259
Total amount of fees paid to insurance companyUSD $54
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 $259
Insurance broker organization code?3
Amount paid for insurance broker fees54
Additional information about fees paid to insurance brokerSALES/MARKETING
Insurance broker nameLPL FINANCIAL LLC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-805292
Policy instance 1
Insurance contract or identification numberGA-805292
Number of Individuals Covered9
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $420
Total amount of fees paid to insurance companyUSD $74
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 $420
Insurance broker organization code?3
Amount paid for insurance broker fees74
Additional information about fees paid to insurance brokerSALES/MARKETING
Insurance broker nameLPL FINANCIAL LLC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-805292
Policy instance 1
Insurance contract or identification numberGA-805292
Number of Individuals Covered3
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $640
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-805292
Policy instance 1
Insurance contract or identification numberGA-805292
Number of Individuals Covered3
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $467
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 $257
Insurance broker organization code?3
Insurance broker nameUVEST INS AGENCY OF MA INC

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