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CL SUPPORT SERVICES, 401(K) SAVINGS PLAN 401k Plan overview

Plan NameCL SUPPORT SERVICES, 401(K) SAVINGS PLAN
Plan identification number 001

CL SUPPORT SERVICES, 401(K) SAVINGS 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.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • 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.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

CL SUPPORT SERVICES, LLC has sponsored the creation of one or more 401k plans.

Company Name:CL SUPPORT SERVICES, LLC
Employer identification number (EIN):202586765
NAIC Classification:561110
NAIC Description:Office Administrative Services

Additional information about CL SUPPORT SERVICES, LLC

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 3938448

More information about CL SUPPORT SERVICES, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CL SUPPORT SERVICES, 401(K) SAVINGS 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
0012017-01-01
0012016-01-01

Plan Statistics for CL SUPPORT SERVICES, 401(K) SAVINGS PLAN

401k plan membership statisitcs for CL SUPPORT SERVICES, 401(K) SAVINGS PLAN

Measure Date Value
2022: CL SUPPORT SERVICES, 401(K) SAVINGS PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01314
Total number of active participants reported on line 7a of the Form 55002022-01-01262
Number of retired or separated participants receiving benefits2022-01-0110
Number of other retired or separated participants entitled to future benefits2022-01-0165
Total of all active and inactive participants2022-01-01337
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01337
Number of participants with account balances2022-01-01197
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-0113
2021: CL SUPPORT SERVICES, 401(K) SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01292
Total number of active participants reported on line 7a of the Form 55002021-01-01243
Number of retired or separated participants receiving benefits2021-01-014
Number of other retired or separated participants entitled to future benefits2021-01-0147
Total of all active and inactive participants2021-01-01294
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01294
Number of participants with account balances2021-01-01179
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-0112
2020: CL SUPPORT SERVICES, 401(K) SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01300
Total number of active participants reported on line 7a of the Form 55002020-01-01225
Number of retired or separated participants receiving benefits2020-01-014
Number of other retired or separated participants entitled to future benefits2020-01-0141
Total of all active and inactive participants2020-01-01270
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01270
Number of participants with account balances2020-01-01163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-0116
2019: CL SUPPORT SERVICES, 401(K) SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01314
Total number of active participants reported on line 7a of the Form 55002019-01-01230
Number of retired or separated participants receiving benefits2019-01-012
Number of other retired or separated participants entitled to future benefits2019-01-0127
Total of all active and inactive participants2019-01-01259
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01259
Number of participants with account balances2019-01-01152
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-016
2018: CL SUPPORT SERVICES, 401(K) SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01231
Total number of active participants reported on line 7a of the Form 55002018-01-01275
Number of retired or separated participants receiving benefits2018-01-012
Number of other retired or separated participants entitled to future benefits2018-01-0111
Total of all active and inactive participants2018-01-01288
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01288
Number of participants with account balances2018-01-01160
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-0112
2017: CL SUPPORT SERVICES, 401(K) SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01354
Total number of active participants reported on line 7a of the Form 55002017-01-01274
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0153
Total of all active and inactive participants2017-01-01327
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01327
Number of participants with account balances2017-01-01142
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: CL SUPPORT SERVICES, 401(K) SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01319
Total number of active participants reported on line 7a of the Form 55002016-01-01231
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0154
Total of all active and inactive participants2016-01-01285
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01285
Number of participants with account balances2016-01-01133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010

Financial Data on CL SUPPORT SERVICES, 401(K) SAVINGS PLAN

Measure Date Value
2022 : CL SUPPORT SERVICES, 401(K) SAVINGS PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$307
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$3,371
Total income from all sources (including contributions)2022-12-31$190,902
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$337,063
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$303,178
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$749,918
Value of total assets at end of year2022-12-31$3,592,051
Value of total assets at beginning of year2022-12-31$3,741,276
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$33,885
Total interest from all sources2022-12-31$5,485
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$164,869
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$164,869
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$325,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$594,354
Participant contributions at end of year2022-12-31$90,852
Participant contributions at beginning of year2022-12-31$106,547
Participant contributions at end of year2022-12-31$0
Participant contributions at beginning of year2022-12-31$34
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$307
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$3,371
Total non interest bearing cash at end of year2022-12-31$7,977
Total non interest bearing cash at beginning of year2022-12-31$11,182
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-146,161
Value of net assets at end of year (total assets less liabilities)2022-12-31$3,591,744
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$3,737,905
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$3,379,274
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$3,506,549
Interest on participant loans2022-12-31$5,485
Value of interest in common/collective trusts at end of year2022-12-31$0
Value of interest in common/collective trusts at beginning of year2022-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$113,948
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$116,964
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-729,370
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$155,564
Employer contributions (assets) at end of year2022-12-31$0
Employer contributions (assets) at beginning of year2022-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$303,178
Contract administrator fees2022-12-31$33,885
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31JAMES MILLER, CPA, PC
Accountancy firm EIN2022-12-31271127796
2021 : CL SUPPORT SERVICES, 401(K) SAVINGS PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$3,371
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$1,864
Total income from all sources (including contributions)2021-12-31$947,886
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$432,221
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$394,308
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$521,456
Value of total assets at end of year2021-12-31$3,741,276
Value of total assets at beginning of year2021-12-31$3,224,104
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$37,913
Total interest from all sources2021-12-31$5,477
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$153,390
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$153,390
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$325,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$406,379
Participant contributions at end of year2021-12-31$106,547
Participant contributions at beginning of year2021-12-31$111,448
Participant contributions at end of year2021-12-31$34
Participant contributions at beginning of year2021-12-31$8,855
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$6,058
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$3,371
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$1,864
Total non interest bearing cash at end of year2021-12-31$11,182
Total non interest bearing cash at beginning of year2021-12-31$7,878
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$515,665
Value of net assets at end of year (total assets less liabilities)2021-12-31$3,737,905
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$3,222,240
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$3,506,549
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$523,978
Interest on participant loans2021-12-31$5,477
Value of interest in common/collective trusts at end of year2021-12-31$0
Value of interest in common/collective trusts at beginning of year2021-12-31$2,466,977
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$116,964
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$102,283
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$267,563
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$109,019
Employer contributions (assets) at end of year2021-12-31$0
Employer contributions (assets) at beginning of year2021-12-31$2,685
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$394,308
Contract administrator fees2021-12-31$37,913
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31JAMES MILLER, CPA, PC
Accountancy firm EIN2021-12-31271127796
2020 : CL SUPPORT SERVICES, 401(K) SAVINGS PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$1,864
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$28
Total income from all sources (including contributions)2020-12-31$723,229
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$327,957
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$292,721
Value of total corrective distributions2020-12-31$12,974
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$382,434
Value of total assets at end of year2020-12-31$3,224,104
Value of total assets at beginning of year2020-12-31$2,826,996
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$22,262
Total interest from all sources2020-12-31$4,994
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$8,127
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$8,127
Administrative expenses professional fees incurred2020-12-31$22,262
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$325,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$306,874
Participant contributions at end of year2020-12-31$111,448
Participant contributions at beginning of year2020-12-31$0
Participant contributions at end of year2020-12-31$8,855
Participant contributions at beginning of year2020-12-31$20
Assets. Loans (other than to participants) at end of year2020-12-31$0
Assets. Loans (other than to participants) at beginning of year2020-12-31$94,488
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$1,864
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$28
Total non interest bearing cash at end of year2020-12-31$7,878
Total non interest bearing cash at beginning of year2020-12-31$7,797
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$395,272
Value of net assets at end of year (total assets less liabilities)2020-12-31$3,222,240
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$2,826,968
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$523,978
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$311,615
Interest on participant loans2020-12-31$4,994
Value of interest in common/collective trusts at end of year2020-12-31$2,466,977
Value of interest in common/collective trusts at beginning of year2020-12-31$2,338,233
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$102,283
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$74,843
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$40,845
Net investment gain or loss from common/collective trusts2020-12-31$286,829
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31Yes
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$75,560
Employer contributions (assets) at end of year2020-12-31$2,685
Employer contributions (assets) at beginning of year2020-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$292,721
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31JAMES MILLER, CPA, PC
Accountancy firm EIN2020-12-31271127796
2019 : CL SUPPORT SERVICES, 401(K) SAVINGS PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$28
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$740,747
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$255,609
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$225,516
Expenses. Certain deemed distributions of participant loans2019-12-31$9,765
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$340,535
Value of total assets at end of year2019-12-31$2,826,996
Value of total assets at beginning of year2019-12-31$2,341,830
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$20,328
Total interest from all sources2019-12-31$4,665
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$10,904
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$10,904
Administrative expenses professional fees incurred2019-12-31$20,328
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$325,000
If this is an individual account plan, was there a blackout period2019-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$279,888
Participant contributions at end of year2019-12-31$20
Participant contributions at beginning of year2019-12-31$827
Assets. Loans (other than to participants) at end of year2019-12-31$94,488
Assets. Loans (other than to participants) at beginning of year2019-12-31$96,548
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$28
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$0
Total non interest bearing cash at end of year2019-12-31$7,797
Total non interest bearing cash at beginning of year2019-12-31$7,832
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$485,138
Value of net assets at end of year (total assets less liabilities)2019-12-31$2,826,968
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$2,341,830
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$311,615
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$188,861
Interest on participant loans2019-12-31$4,665
Value of interest in common/collective trusts at end of year2019-12-31$2,338,233
Value of interest in common/collective trusts at beginning of year2019-12-31$1,942,036
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$74,843
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$105,417
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$37,583
Net investment gain or loss from common/collective trusts2019-12-31$347,060
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31Yes
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$60,647
Employer contributions (assets) at end of year2019-12-31$0
Employer contributions (assets) at beginning of year2019-12-31$309
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$225,516
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31JAMES MILLER, CPA, PC
Accountancy firm EIN2019-12-31271127796
2018 : CL SUPPORT SERVICES, 401(K) SAVINGS PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$225,702
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$191,283
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$149,523
Expenses. Certain deemed distributions of participant loans2018-12-31$19,969
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$286,052
Value of total assets at end of year2018-12-31$2,341,830
Value of total assets at beginning of year2018-12-31$2,307,411
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$21,791
Total interest from all sources2018-12-31$5,382
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$13,551
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$13,551
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$325,000
If this is an individual account plan, was there a blackout period2018-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$231,649
Participant contributions at end of year2018-12-31$827
Participant contributions at beginning of year2018-12-31$0
Assets. Loans (other than to participants) at end of year2018-12-31$96,548
Assets. Loans (other than to participants) at beginning of year2018-12-31$54,246
Total non interest bearing cash at end of year2018-12-31$7,832
Total non interest bearing cash at beginning of year2018-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$34,419
Value of net assets at end of year (total assets less liabilities)2018-12-31$2,341,830
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$2,307,411
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$188,861
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$2,253,165
Interest on participant loans2018-12-31$5,382
Value of interest in common/collective trusts at end of year2018-12-31$1,942,036
Value of interest in common/collective trusts at beginning of year2018-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$105,417
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-21,559
Net investment gain/loss from pooled separate accounts2018-12-31$75,098
Net investment gain or loss from common/collective trusts2018-12-31$-132,822
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$54,403
Employer contributions (assets) at end of year2018-12-31$309
Employer contributions (assets) at beginning of year2018-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$149,523
Contract administrator fees2018-12-31$21,791
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31Yes
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31JAMES MILLER, CPA, PC
Accountancy firm EIN2018-12-31271127796
2017 : CL SUPPORT SERVICES, 401(K) SAVINGS PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$304
Total income from all sources (including contributions)2017-12-31$461,096
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$178,921
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$167,372
Expenses. Certain deemed distributions of participant loans2017-12-31$9,388
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$176,167
Value of total assets at end of year2017-12-31$2,307,411
Value of total assets at beginning of year2017-12-31$2,025,540
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$2,161
Total interest from all sources2017-12-31$2,259
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$143,517
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$143,517
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$325,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$176,164
Participant contributions at end of year2017-12-31$54,246
Participant contributions at beginning of year2017-12-31$45,050
Participant contributions at end of year2017-12-31$0
Participant contributions at beginning of year2017-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$282,175
Value of net assets at end of year (total assets less liabilities)2017-12-31$2,307,411
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$2,025,236
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$2,253,165
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$1,980,490
Interest on participant loans2017-12-31$2,259
Net investment gain/loss from pooled separate accounts2017-12-31$139,153
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$3
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$167,372
Contract administrator fees2017-12-31$2,161
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
Liabilities. Value of benefit claims payable at end of year2017-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$304
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31JAMES MILLER, CPA, PC
Accountancy firm EIN2017-12-31271127796
2016 : CL SUPPORT SERVICES, 401(K) SAVINGS PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$304
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$304
Total income from all sources (including contributions)2016-12-31$221,022
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$281,220
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$256,685
Expenses. Certain deemed distributions of participant loans2016-12-31$23,436
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$117,807
Value of total assets at end of year2016-12-31$2,025,540
Value of total assets at beginning of year2016-12-31$2,085,738
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$1,099
Total interest from all sources2016-12-31$2,988
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$63,087
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$63,087
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$325,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$117,807
Participant contributions at end of year2016-12-31$45,050
Participant contributions at beginning of year2016-12-31$64,682
Participant contributions at end of year2016-12-31$0
Participant contributions at beginning of year2016-12-31$270
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$-60,198
Value of net assets at end of year (total assets less liabilities)2016-12-31$2,025,236
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$2,085,434
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in pooled separate accounts at end of year2016-12-31$1,980,490
Value of interest in pooled separate accounts at beginning of year2016-12-31$2,020,786
Interest on participant loans2016-12-31$2,988
Net investment gain/loss from pooled separate accounts2016-12-31$37,140
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$256,685
Contract administrator fees2016-12-31$1,099
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
Liabilities. Value of benefit claims payable at end of year2016-12-31$304
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$304
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31JAMES MILLER, CPA, PC
Accountancy firm EIN2016-12-31271127796

Form 5500 Responses for CL SUPPORT SERVICES, 401(K) SAVINGS PLAN

2022: CL SUPPORT SERVICES, 401(K) SAVINGS PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: CL SUPPORT SERVICES, 401(K) SAVINGS PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: CL SUPPORT SERVICES, 401(K) SAVINGS PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: CL SUPPORT SERVICES, 401(K) SAVINGS PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: CL SUPPORT SERVICES, 401(K) SAVINGS PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: CL SUPPORT SERVICES, 401(K) SAVINGS 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 – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: CL SUPPORT SERVICES, 401(K) SAVINGS 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 – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number503743-01
Policy instance 1
Insurance contract or identification number503743-01
Number of Individuals Covered14
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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?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
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number503743-01
Policy instance 1
Insurance contract or identification number503743-01
Number of Individuals Covered12
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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?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
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number503743-01
Policy instance 1
Insurance contract or identification number503743-01
Number of Individuals Covered15
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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?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
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number503743-01
Policy instance 1
Insurance contract or identification number503743-01
Number of Individuals Covered15
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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?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
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number503743-01
Policy instance 1
Insurance contract or identification number503743-01
Number of Individuals Covered12
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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?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-710429
Policy instance 1
Insurance contract or identification numberGA-710429
Number of Individuals Covered142
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $7,249
Total amount of fees paid to insurance companyUSD $0
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 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 $7,249
Insurance broker organization code?3
Insurance broker nameUBS FINANCIAL SERVICES

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