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SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN 401k Plan overview

Plan NameSNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN
Plan identification number 001

SNOW CREEK WEALTH MANAGEMENT LLC 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.

401k Sponsoring company profile

SNOW CREEK WEALTH MANAGEMENT, LLC has sponsored the creation of one or more 401k plans.

Company Name:SNOW CREEK WEALTH MANAGEMENT, LLC
Employer identification number (EIN):208775713
NAIC Classification:523900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012019-01-01
0012018-01-01LIZ CLAY
0012017-01-01LIZ CLAY
0012016-01-01LIZ CLAY
0012015-01-01LIZ CLAY
0012014-01-01LIZ CLAY
0012014-01-01LIZ CLAY
0012013-01-01LIZ CLAY
0012012-01-01LIZ CLAY
0012011-01-01LIZ CLAY
0012009-01-01DAVID GOLDBERG DAVID GOLDBERG2010-10-13

Plan Statistics for SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN

401k plan membership statisitcs for SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN

Measure Date Value
2019: SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-015
Total number of active participants reported on line 7a of the Form 55002019-01-010
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-010
Number of participants with account balances2019-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-014
Total number of active participants reported on line 7a of the Form 55002018-01-014
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-011
Total of all active and inactive participants2018-01-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-015
Number of participants with account balances2018-01-015
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-014
Total number of active participants reported on line 7a of the Form 55002017-01-013
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-011
Total of all active and inactive participants2017-01-014
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-014
Number of participants with account balances2017-01-014
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-011
2016: SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-013
Total number of active participants reported on line 7a of the Form 55002016-01-014
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-014
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-014
Number of participants with account balances2016-01-014
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-013
Total number of active participants reported on line 7a of the Form 55002015-01-013
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-013
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-013
Number of participants with account balances2015-01-013
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-013
Total number of active participants reported on line 7a of the Form 55002014-01-013
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-013
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-013
Number of participants with account balances2014-01-013
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-012
Total number of active participants reported on line 7a of the Form 55002013-01-011
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 participants2013-01-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-012
Number of participants with account balances2013-01-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-013
Total number of active participants reported on line 7a of the Form 55002012-01-012
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-011
Total of all active and inactive participants2012-01-013
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-013
Number of participants with account balances2012-01-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-012
Total number of active participants reported on line 7a of the Form 55002011-01-012
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 participants2011-01-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-012
Number of participants with account balances2011-01-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-012
Total number of active participants reported on line 7a of the Form 55002009-01-012
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-012
Number of participants with account balances2009-01-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN

Measure Date Value
2019 : SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN 2019 401k financial data
Total income from all sources2019-12-31$369,878
Expenses. Total of all expenses incurred2019-12-31$1,433,931
Benefits paid (including direct rollovers)2019-12-31$1,433,931
Total plan assets at end of year2019-12-31$0
Total plan assets at beginning of year2019-12-31$1,064,053
Value of fidelity bond covering the plan2019-12-31$65,000
Total contributions received or receivable from participants2019-12-31$62,850
Other income received2019-12-31$175,262
Net income (gross income less expenses)2019-12-31$-1,064,053
Net plan assets at end of year (total assets less liabilities)2019-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$1,064,053
Total contributions received or receivable from employer(s)2019-12-31$131,766
2018 : SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN 2018 401k financial data
Total income from all sources2018-12-31$236,099
Total plan assets at end of year2018-12-31$1,064,053
Total plan assets at beginning of year2018-12-31$827,954
Value of fidelity bond covering the plan2018-12-31$65,000
Total contributions received or receivable from participants2018-12-31$59,143
Contributions received from other sources (not participants or employers)2018-12-31$123,288
Other income received2018-12-31$-55,908
Net income (gross income less expenses)2018-12-31$236,099
Net plan assets at end of year (total assets less liabilities)2018-12-31$1,064,053
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$827,954
Total contributions received or receivable from employer(s)2018-12-31$109,576
2017 : SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN 2017 401k financial data
Total income from all sources2017-12-31$213,605
Total plan assets at end of year2017-12-31$827,954
Total plan assets at beginning of year2017-12-31$614,349
Value of fidelity bond covering the plan2017-12-31$65,000
Total contributions received or receivable from participants2017-12-31$55,276
Other income received2017-12-31$122,329
Net income (gross income less expenses)2017-12-31$213,605
Net plan assets at end of year (total assets less liabilities)2017-12-31$827,954
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$614,349
Total contributions received or receivable from employer(s)2017-12-31$36,000
2016 : SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN 2016 401k financial data
Total income from all sources2016-12-31$184,915
Total plan assets at end of year2016-12-31$614,349
Total plan assets at beginning of year2016-12-31$429,434
Value of fidelity bond covering the plan2016-12-31$65,000
Total contributions received or receivable from participants2016-12-31$33,415
Contributions received from other sources (not participants or employers)2016-12-31$9,937
Other income received2016-12-31$52,679
Net income (gross income less expenses)2016-12-31$184,915
Net plan assets at end of year (total assets less liabilities)2016-12-31$614,349
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$429,434
Total contributions received or receivable from employer(s)2016-12-31$88,884
2015 : SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN 2015 401k financial data
Total income from all sources2015-12-31$102,826
Total plan assets at end of year2015-12-31$429,434
Total plan assets at beginning of year2015-12-31$326,608
Value of fidelity bond covering the plan2015-12-31$25,000
Total contributions received or receivable from participants2015-12-31$29,200
Other income received2015-12-31$30
Net income (gross income less expenses)2015-12-31$102,826
Net plan assets at end of year (total assets less liabilities)2015-12-31$429,434
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$326,608
Total contributions received or receivable from employer(s)2015-12-31$73,596
2014 : SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN 2014 401k financial data
Total income from all sources2014-12-31$1,041,242
Expenses. Total of all expenses incurred2014-12-31$3,552
Benefits paid (including direct rollovers)2014-12-31$3,552
Total plan assets at end of year2014-12-31$1,094,280
Total plan assets at beginning of year2014-12-31$53,038
Value of fidelity bond covering the plan2014-12-31$25,000
Total contributions received or receivable from participants2014-12-31$27,875
Contributions received from other sources (not participants or employers)2014-12-31$873,143
Other income received2014-12-31$67,629
Net income (gross income less expenses)2014-12-31$1,041,242
Net plan assets at end of year (total assets less liabilities)2014-12-31$1,094,280
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$53,038
Total contributions received or receivable from employer(s)2014-12-31$72,595
2013 : SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN 2013 401k financial data
Transfers to/from the plan2013-12-31$939
Total income from all sources2013-12-31$52,210
Expenses. Total of all expenses incurred2013-12-31$43,296
Benefits paid (including direct rollovers)2013-12-31$43,240
Total plan assets at end of year2013-12-31$53,038
Total plan assets at beginning of year2013-12-31$43,185
Value of fidelity bond covering the plan2013-12-31$25,000
Total contributions received or receivable from participants2013-12-31$20,000
Expenses. Other expenses not covered elsewhere2013-12-31$56
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$9,170
Net income (gross income less expenses)2013-12-31$8,914
Net plan assets at end of year (total assets less liabilities)2013-12-31$53,038
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$43,185
Assets. Value of participant loans2013-12-31$0
Total contributions received or receivable from employer(s)2013-12-31$23,040
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 : SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN 2012 401k financial data
Transfers to/from the plan2012-12-31$0
Total income from all sources2012-12-31$46,041
Expenses. Total of all expenses incurred2012-12-31$49,297
Benefits paid (including direct rollovers)2012-12-31$49,228
Total plan assets at end of year2012-12-31$43,185
Total plan assets at beginning of year2012-12-31$46,441
Value of fidelity bond covering the plan2012-12-31$25,000
Total contributions received or receivable from participants2012-12-31$34,418
Expenses. Other expenses not covered elsewhere2012-12-31$69
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$5,468
Net income (gross income less expenses)2012-12-31$-3,256
Net plan assets at end of year (total assets less liabilities)2012-12-31$43,185
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$46,441
Assets. Value of participant loans2012-12-31$0
Total contributions received or receivable from employer(s)2012-12-31$6,155
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 : SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN 2011 401k financial data
Transfers to/from the plan2011-12-31$0
Total income from all sources2011-12-31$32,598
Expenses. Total of all expenses incurred2011-12-31$30,050
Benefits paid (including direct rollovers)2011-12-31$30,000
Total plan assets at end of year2011-12-31$46,441
Total plan assets at beginning of year2011-12-31$43,893
Value of fidelity bond covering the plan2011-12-31$25,000
Total contributions received or receivable from participants2011-12-31$25,750
Expenses. Other expenses not covered elsewhere2011-12-31$50
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-1,152
Net income (gross income less expenses)2011-12-31$2,548
Net plan assets at end of year (total assets less liabilities)2011-12-31$46,441
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$43,893
Assets. Value of participant loans2011-12-31$0
Total contributions received or receivable from employer(s)2011-12-31$8,000
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 : SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN 2010 401k financial data
Transfers to/from the plan2010-12-31$0
Total income from all sources2010-12-31$62,642
Expenses. Total of all expenses incurred2010-12-31$100,050
Benefits paid (including direct rollovers)2010-12-31$100,000
Total plan assets at end of year2010-12-31$43,893
Total plan assets at beginning of year2010-12-31$81,301
Value of fidelity bond covering the plan2010-12-31$25,000
Total contributions received or receivable from participants2010-12-31$26,200
Expenses. Other expenses not covered elsewhere2010-12-31$50
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$11,689
Net income (gross income less expenses)2010-12-31$-37,408
Net plan assets at end of year (total assets less liabilities)2010-12-31$43,893
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$81,301
Assets. Value of participant loans2010-12-31$0
Total contributions received or receivable from employer(s)2010-12-31$24,753
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$0
Funding deficiency by the employer to the plan for this plan year2010-12-31$0
Minimum employer required contribution for this plan year2010-12-31$0
Amount contributed by the employer to the plan for this plan year2010-12-31$0

Form 5500 Responses for SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN

2019: SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01This submission is the final filingYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement - TrustYes
2018: SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement - TrustYes
2017: SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement - TrustYes
2016: SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2014: SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement - TrustYes
2013: SNOW CREEK WEALTH MANAGEMENT LLC 401(K) PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: SNOW CREEK WEALTH MANAGEMENT LLC 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: SNOW CREEK WEALTH MANAGEMENT LLC 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
2009: SNOW CREEK WEALTH MANAGEMENT LLC 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

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-809504
Policy instance 1
Insurance contract or identification numberGA-809504
Number of Individuals Covered2
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $566
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 $566
Insurance broker organization code?3
Insurance broker nameTBS AGENCY INC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-809504
Policy instance 1
Insurance contract or identification numberGA-809504
Number of Individuals Covered2
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $514
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 $335
Insurance broker organization code?3
Insurance broker nameTBS AGENCY INC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-809504
Policy instance 1
Insurance contract or identification numberGA-809504
Number of Individuals Covered2
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $465
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-809504
Policy instance 1
Insurance contract or identification numberGA-809504
Number of Individuals Covered2
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $747
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

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