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THE ANIMAL CLINIC 401(K) PLAN 401k Plan overview

Plan NameTHE ANIMAL CLINIC 401(K) PLAN
Plan identification number 001

THE ANIMAL CLINIC 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • 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

THE ANIMAL CLINIC has sponsored the creation of one or more 401k plans.

Company Name:THE ANIMAL CLINIC
Employer identification number (EIN):201985018
NAIC Classification:541940
NAIC Description:Veterinary Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE ANIMAL CLINIC 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012016-01-01WILLIAM SHANNON2017-04-25
0012015-01-01KIM SMITH2016-06-13 W. G. SHANNON2016-06-13
0012015-01-01W. G. SHANNON2016-06-13
0012014-01-01WILLIAM G. SHANNON
0012013-01-01WILLIAM SHANNON WILLIAM SHANNON2014-06-02
0012012-01-01WILLIAM SHANNON WILLIAM SHANNON2013-05-30
0012011-01-01WILLIAM SHANNON
0012010-01-01WILLIAM SHANNON
0012009-01-01WILLIAM SHANNON WILLIAM SHANNON2010-10-13
0012008-01-01WILLIAM SHANNON

Plan Statistics for THE ANIMAL CLINIC 401(K) PLAN

401k plan membership statisitcs for THE ANIMAL CLINIC 401(K) PLAN

Measure Date Value
2014: THE ANIMAL CLINIC 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0125
Total number of active participants reported on line 7a of the Form 55002014-01-0118
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-016
Total of all active and inactive participants2014-01-0124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0124
Number of participants with account balances2014-01-0124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-011
2013: THE ANIMAL CLINIC 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0126
Total number of active participants reported on line 7a of the Form 55002013-01-0120
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-015
Total of all active and inactive participants2013-01-0125
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0125
Number of participants with account balances2013-01-0124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-011
2012: THE ANIMAL CLINIC 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0125
Total number of active participants reported on line 7a of the Form 55002012-01-0119
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-015
Total of all active and inactive participants2012-01-0124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0124
Number of participants with account balances2012-01-0119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: THE ANIMAL CLINIC 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0121
Total number of active participants reported on line 7a of the Form 55002011-01-0116
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-016
Total of all active and inactive participants2011-01-0122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0122
Number of participants with account balances2011-01-0122
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: THE ANIMAL CLINIC 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0122
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
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0123
Number of participants with account balances2010-01-0123
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: THE ANIMAL CLINIC 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0116
Total number of active participants reported on line 7a of the Form 55002009-01-0116
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-016
Total of all active and inactive participants2009-01-0122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0122
Number of participants with account balances2009-01-0121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010
2008: THE ANIMAL CLINIC 401(K) PLAN 2008 401k membership
Total participants, beginning-of-year2008-01-0115
Total number of active participants reported on line 7a of the Form 55002008-01-0111
Number of retired or separated participants receiving benefits2008-01-010
Number of other retired or separated participants entitled to future benefits2008-01-015
Total of all active and inactive participants2008-01-0116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2008-01-010
Total participants2008-01-0116
Number of participants with account balances2008-01-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2008-01-013

Financial Data on THE ANIMAL CLINIC 401(K) PLAN

Measure Date Value
2014 : THE ANIMAL CLINIC 401(K) PLAN 2014 401k financial data
Transfers to/from the plan2014-12-31$0
Total income from all sources2014-12-31$88,351
Expenses. Total of all expenses incurred2014-12-31$492,121
Benefits paid (including direct rollovers)2014-12-31$491,258
Total plan assets at end of year2014-12-31$219,460
Total plan assets at beginning of year2014-12-31$623,230
Value of fidelity bond covering the plan2014-12-31$75,000
Total contributions received or receivable from participants2014-12-31$38,186
Expenses. Other expenses not covered elsewhere2014-12-31$863
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$23,489
Net income (gross income less expenses)2014-12-31$-403,770
Net plan assets at end of year (total assets less liabilities)2014-12-31$219,460
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$623,230
Assets. Value of participant loans2014-12-31$0
Total contributions received or receivable from employer(s)2014-12-31$26,676
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 : THE ANIMAL CLINIC 401(K) PLAN 2013 401k financial data
Transfers to/from the plan2013-12-31$38
Total income from all sources2013-12-31$190,017
Expenses. Total of all expenses incurred2013-12-31$42,664
Benefits paid (including direct rollovers)2013-12-31$41,809
Total plan assets at end of year2013-12-31$623,230
Total plan assets at beginning of year2013-12-31$475,839
Value of fidelity bond covering the plan2013-12-31$75,000
Total contributions received or receivable from participants2013-12-31$36,654
Expenses. Other expenses not covered elsewhere2013-12-31$855
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$127,031
Net income (gross income less expenses)2013-12-31$147,353
Net plan assets at end of year (total assets less liabilities)2013-12-31$623,230
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$475,839
Assets. Value of participant loans2013-12-31$0
Total contributions received or receivable from employer(s)2013-12-31$26,332
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 : THE ANIMAL CLINIC 401(K) PLAN 2012 401k financial data
Transfers to/from the plan2012-12-31$0
Total income from all sources2012-12-31$128,136
Expenses. Total of all expenses incurred2012-12-31$6,748
Benefits paid (including direct rollovers)2012-12-31$5,442
Total plan assets at end of year2012-12-31$475,839
Total plan assets at beginning of year2012-12-31$354,451
Value of fidelity bond covering the plan2012-12-31$75,000
Total contributions received or receivable from participants2012-12-31$40,340
Expenses. Other expenses not covered elsewhere2012-12-31$832
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$61,587
Net income (gross income less expenses)2012-12-31$121,388
Net plan assets at end of year (total assets less liabilities)2012-12-31$475,839
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$354,451
Assets. Value of participant loans2012-12-31$0
Total contributions received or receivable from employer(s)2012-12-31$26,209
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$474
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 : THE ANIMAL CLINIC 401(K) PLAN 2011 401k financial data
Transfers to/from the plan2011-12-31$0
Total income from all sources2011-12-31$53,671
Expenses. Total of all expenses incurred2011-12-31$7,460
Benefits paid (including direct rollovers)2011-12-31$5,805
Total plan assets at end of year2011-12-31$354,451
Total plan assets at beginning of year2011-12-31$308,240
Value of fidelity bond covering the plan2011-12-31$75,000
Total contributions received or receivable from participants2011-12-31$47,344
Expenses. Other expenses not covered elsewhere2011-12-31$825
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-23,820
Net income (gross income less expenses)2011-12-31$46,211
Net plan assets at end of year (total assets less liabilities)2011-12-31$354,451
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$308,240
Assets. Value of participant loans2011-12-31$0
Total contributions received or receivable from employer(s)2011-12-31$30,147
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$830
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 : THE ANIMAL CLINIC 401(K) PLAN 2010 401k financial data
Transfers to/from the plan2010-12-31$0
Total income from all sources2010-12-31$108,408
Expenses. Total of all expenses incurred2010-12-31$812
Benefits paid (including direct rollovers)2010-12-31$0
Total plan assets at end of year2010-12-31$308,240
Total plan assets at beginning of year2010-12-31$200,644
Value of fidelity bond covering the plan2010-12-31$75,000
Total contributions received or receivable from participants2010-12-31$47,716
Expenses. Other expenses not covered elsewhere2010-12-31$812
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$30,463
Net income (gross income less expenses)2010-12-31$107,596
Net plan assets at end of year (total assets less liabilities)2010-12-31$308,240
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$200,644
Assets. Value of participant loans2010-12-31$0
Total contributions received or receivable from employer(s)2010-12-31$30,229
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$0
2009 : THE ANIMAL CLINIC 401(K) PLAN 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
2008 : THE ANIMAL CLINIC 401(K) PLAN 2008 401k financial data
Transfers to/from the plan2008-12-31$0
Total income from all sources2008-12-31$29,084
Expenses. Total of all expenses incurred2008-12-31$650
Benefits paid (including direct rollovers)2008-12-31$0
Total plan assets at end of year2008-12-31$83,602
Total plan assets at beginning of year2008-12-31$55,168
Value of fidelity bond covering the plan2008-12-31$75,000
Total contributions received or receivable from participants2008-12-31$45,974
Expenses. Other expenses not covered elsewhere2008-12-31$650
Contributions received from other sources (not participants or employers)2008-12-31$0
Other income received2008-12-31$-41,191
Net income (gross income less expenses)2008-12-31$28,434
Net plan assets at end of year (total assets less liabilities)2008-12-31$83,602
Net plan assets at beginning of year (total assets less liabilities)2008-12-31$55,168
Total contributions received or receivable from employer(s)2008-12-31$24,301
Value of certain deemed distributions of participant loans2008-12-31$0
Value of corrective distributions2008-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2008-12-31$0

Form 5500 Responses for THE ANIMAL CLINIC 401(K) PLAN

2014: THE ANIMAL CLINIC 401(K) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: THE ANIMAL CLINIC 401(K) PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedYes
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: THE ANIMAL CLINIC 401(K) PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: THE ANIMAL CLINIC 401(K) PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: THE ANIMAL CLINIC 401(K) 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 – InsuranceYes
2009: THE ANIMAL CLINIC 401(K) PLAN 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 – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2008: THE ANIMAL CLINIC 401(K) PLAN 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

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-804984
Policy instance 1
Insurance contract or identification numberGA-804984
Number of Individuals Covered24
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $3,273
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 $3,273
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-804984
Policy instance 1
Insurance contract or identification numberGA-804984
Number of Individuals Covered24
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2,595
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 $2,595
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-804984
Policy instance 1
Insurance contract or identification numberGA-804984
Number of Individuals Covered19
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,950
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 $1,950
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-804984
Policy instance 1
Insurance contract or identification numberGA-804984
Number of Individuals Covered22
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $1,629
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-804984
Policy instance 1
Insurance contract or identification numberGA-804984
Number of Individuals Covered23
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $1,100
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 $1,100
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-804984
Policy instance 1
Insurance contract or identification numberGA-804984
Number of Individuals Covered16
Insurance policy start date2008-01-01
Insurance policy end date2008-12-31
Total amount of commissions paid to insurance brokerUSD $357
Total amount of fees paid to insurance companyUSD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $357
Insurance broker organization code?3
Insurance broker nameLINSCO PRIVATE LEDGER CORP

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