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HOWELLS GLASS COMPANY 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan NameHOWELLS GLASS COMPANY 401(K) PROFIT SHARING PLAN
Plan identification number 001

HOWELLS GLASS COMPANY 401(K) PROFIT SHARING 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

HOWELLS GLASS COMPANY, INC. has sponsored the creation of one or more 401k plans.

Company Name:HOWELLS GLASS COMPANY, INC.
Employer identification number (EIN):231712303
NAIC Classification:238100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HOWELLS GLASS COMPANY 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-06-01ROBERT HOWELLS2023-12-20
0012021-06-01ROBERT HOWELLS2023-02-02
0012020-06-01KELLEE KRESS2022-01-18 KELLEE KRESS2022-01-18
0012020-06-01ROBERT HOWELLS2022-05-31
0012020-01-01
0012019-06-01ROBERT HOWELLS2020-11-19
0012018-06-01ROBERT HOWELLS2020-03-10 ROBERT HOWELLS2020-03-10
0012016-06-01BOB HOWELLS2017-10-04
0012015-06-01LAUREN ROTH2016-11-01
0012014-06-01ROBERT HOWELLS
0012013-06-01ROBERT HOWELLS ROBERT HOWELLS2014-10-28
0012012-06-01MABEL MERK ROBERT HOWELLS2013-10-01
0012011-06-01ROBERT HOWELLS ROBERT HOWELLS2014-05-09
0012010-06-01ROBERT HOWELLS
0012009-06-01MABEL MERK MABEL MERK2010-12-28

Plan Statistics for HOWELLS GLASS COMPANY 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for HOWELLS GLASS COMPANY 401(K) PROFIT SHARING PLAN

Measure Date Value
2020: HOWELLS GLASS COMPANY 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0113
Total number of active participants reported on line 7a of the Form 55002020-01-0113
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-0113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-0113
Number of participants with account balances2020-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
Number of employers contributing to the scheme2020-01-0113
2014: HOWELLS GLASS COMPANY 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-06-0115
Total number of active participants reported on line 7a of the Form 55002014-06-0115
Number of retired or separated participants receiving benefits2014-06-010
Number of other retired or separated participants entitled to future benefits2014-06-011
Total of all active and inactive participants2014-06-0116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-06-010
Total participants2014-06-0116
Number of participants with account balances2014-06-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-06-010
2013: HOWELLS GLASS COMPANY 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-06-0115
Total number of active participants reported on line 7a of the Form 55002013-06-0115
Number of retired or separated participants receiving benefits2013-06-010
Number of other retired or separated participants entitled to future benefits2013-06-010
Total of all active and inactive participants2013-06-0115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-06-010
Total participants2013-06-0115
Number of participants with account balances2013-06-0115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-06-011
2012: HOWELLS GLASS COMPANY 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-06-0115
Total number of active participants reported on line 7a of the Form 55002012-06-0115
Number of retired or separated participants receiving benefits2012-06-010
Number of other retired or separated participants entitled to future benefits2012-06-011
Total of all active and inactive participants2012-06-0116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-06-010
Total participants2012-06-0116
Number of participants with account balances2012-06-0115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-06-012
2011: HOWELLS GLASS COMPANY 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-06-0116
Total number of active participants reported on line 7a of the Form 55002011-06-0115
Number of retired or separated participants receiving benefits2011-06-010
Number of other retired or separated participants entitled to future benefits2011-06-012
Total of all active and inactive participants2011-06-0117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-06-010
Total participants2011-06-0117
Number of participants with account balances2011-06-0115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-06-011
2010: HOWELLS GLASS COMPANY 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year2010-06-0114
Total number of active participants reported on line 7a of the Form 55002010-06-0114
Number of retired or separated participants receiving benefits2010-06-010
Number of other retired or separated participants entitled to future benefits2010-06-012
Total of all active and inactive participants2010-06-0116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-06-010
Total participants2010-06-0116
Number of participants with account balances2010-06-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-06-010
2009: HOWELLS GLASS COMPANY 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-06-0115
Total number of active participants reported on line 7a of the Form 55002009-06-0114
Number of retired or separated participants receiving benefits2009-06-010
Number of other retired or separated participants entitled to future benefits2009-06-011
Total of all active and inactive participants2009-06-0115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-06-010
Total participants2009-06-0115
Number of participants with account balances2009-06-0115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-06-010

Financial Data on HOWELLS GLASS COMPANY 401(K) PROFIT SHARING PLAN

Measure Date Value
2015 : HOWELLS GLASS COMPANY 401(K) PROFIT SHARING PLAN 2015 401k financial data
Transfers to/from the plan2015-05-31$0
Total income from all sources2015-05-31$132,172
Expenses. Total of all expenses incurred2015-05-31$2,364
Benefits paid (including direct rollovers)2015-05-31$2,364
Total plan assets at end of year2015-05-31$1,599,856
Total plan assets at beginning of year2015-05-31$1,470,048
Value of fidelity bond covering the plan2015-05-31$1,000,000
Total contributions received or receivable from participants2015-05-31$29,844
Expenses. Other expenses not covered elsewhere2015-05-31$0
Contributions received from other sources (not participants or employers)2015-05-31$0
Other income received2015-05-31$66,400
Net income (gross income less expenses)2015-05-31$129,808
Net plan assets at end of year (total assets less liabilities)2015-05-31$1,599,856
Net plan assets at beginning of year (total assets less liabilities)2015-05-31$1,470,048
Assets. Value of participant loans2015-05-31$0
Total contributions received or receivable from employer(s)2015-05-31$35,928
Value of certain deemed distributions of participant loans2015-05-31$0
Value of corrective distributions2015-05-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-05-31$0
2014 : HOWELLS GLASS COMPANY 401(K) PROFIT SHARING PLAN 2014 401k financial data
Transfers to/from the plan2014-05-31$59
Total income from all sources2014-05-31$197,260
Expenses. Total of all expenses incurred2014-05-31$5,666
Benefits paid (including direct rollovers)2014-05-31$5,641
Total plan assets at end of year2014-05-31$1,470,048
Total plan assets at beginning of year2014-05-31$1,278,395
Value of fidelity bond covering the plan2014-05-31$1,000,000
Total contributions received or receivable from participants2014-05-31$24,975
Expenses. Other expenses not covered elsewhere2014-05-31$25
Contributions received from other sources (not participants or employers)2014-05-31$0
Other income received2014-05-31$140,122
Net income (gross income less expenses)2014-05-31$191,594
Net plan assets at end of year (total assets less liabilities)2014-05-31$1,470,048
Net plan assets at beginning of year (total assets less liabilities)2014-05-31$1,278,395
Assets. Value of participant loans2014-05-31$0
Total contributions received or receivable from employer(s)2014-05-31$32,163
Value of certain deemed distributions of participant loans2014-05-31$0
Value of corrective distributions2014-05-31$0
Funding deficiency by the employer to the plan for this plan year2014-05-31$0
Minimum employer required contribution for this plan year2014-05-31$0
Amount contributed by the employer to the plan for this plan year2014-05-31$0
2013 : HOWELLS GLASS COMPANY 401(K) PROFIT SHARING PLAN 2013 401k financial data
Transfers to/from the plan2013-05-31$0
Total income from all sources2013-05-31$210,338
Expenses. Total of all expenses incurred2013-05-31$14,787
Benefits paid (including direct rollovers)2013-05-31$14,737
Total plan assets at end of year2013-05-31$1,278,395
Total plan assets at beginning of year2013-05-31$1,082,844
Value of fidelity bond covering the plan2013-05-31$1,000,000
Total contributions received or receivable from participants2013-05-31$19,955
Expenses. Other expenses not covered elsewhere2013-05-31$50
Contributions received from other sources (not participants or employers)2013-05-31$0
Other income received2013-05-31$159,367
Net income (gross income less expenses)2013-05-31$195,551
Net plan assets at end of year (total assets less liabilities)2013-05-31$1,278,395
Net plan assets at beginning of year (total assets less liabilities)2013-05-31$1,082,844
Assets. Value of participant loans2013-05-31$0
Total contributions received or receivable from employer(s)2013-05-31$31,016
Value of certain deemed distributions of participant loans2013-05-31$0
Value of corrective distributions2013-05-31$0
Funding deficiency by the employer to the plan for this plan year2013-05-31$0
Minimum employer required contribution for this plan year2013-05-31$0
Amount contributed by the employer to the plan for this plan year2013-05-31$0
2012 : HOWELLS GLASS COMPANY 401(K) PROFIT SHARING PLAN 2012 401k financial data
Transfers to/from the plan2012-05-31$0
Total income from all sources2012-05-31$6,790
Expenses. Total of all expenses incurred2012-05-31$135,771
Benefits paid (including direct rollovers)2012-05-31$135,721
Total plan assets at end of year2012-05-31$1,082,844
Total plan assets at beginning of year2012-05-31$1,211,825
Value of fidelity bond covering the plan2012-05-31$1,000,000
Total contributions received or receivable from participants2012-05-31$18,466
Expenses. Other expenses not covered elsewhere2012-05-31$50
Contributions received from other sources (not participants or employers)2012-05-31$-217
Other income received2012-05-31$-47,016
Net income (gross income less expenses)2012-05-31$-128,981
Net plan assets at end of year (total assets less liabilities)2012-05-31$1,082,844
Net plan assets at beginning of year (total assets less liabilities)2012-05-31$1,211,825
Assets. Value of participant loans2012-05-31$0
Total contributions received or receivable from employer(s)2012-05-31$35,557
Value of certain deemed distributions of participant loans2012-05-31$0
Value of corrective distributions2012-05-31$0
Funding deficiency by the employer to the plan for this plan year2012-05-31$0
Minimum employer required contribution for this plan year2012-05-31$0
Amount contributed by the employer to the plan for this plan year2012-05-31$0
2011 : HOWELLS GLASS COMPANY 401(K) PROFIT SHARING PLAN 2011 401k financial data
Transfers to/from the plan2011-05-31$0
Total income from all sources2011-05-31$241,356
Expenses. Total of all expenses incurred2011-05-31$1,516
Benefits paid (including direct rollovers)2011-05-31$1,491
Total plan assets at end of year2011-05-31$1,211,825
Total plan assets at beginning of year2011-05-31$971,985
Value of fidelity bond covering the plan2011-05-31$1,000,000
Total contributions received or receivable from participants2011-05-31$17,387
Expenses. Other expenses not covered elsewhere2011-05-31$25
Contributions received from other sources (not participants or employers)2011-05-31$217
Other income received2011-05-31$194,542
Net income (gross income less expenses)2011-05-31$239,840
Net plan assets at end of year (total assets less liabilities)2011-05-31$1,211,825
Net plan assets at beginning of year (total assets less liabilities)2011-05-31$971,985
Assets. Value of participant loans2011-05-31$0
Total contributions received or receivable from employer(s)2011-05-31$29,210
Value of certain deemed distributions of participant loans2011-05-31$0
Value of corrective distributions2011-05-31$0
Funding deficiency by the employer to the plan for this plan year2011-05-31$0
Minimum employer required contribution for this plan year2011-05-31$0
Amount contributed by the employer to the plan for this plan year2011-05-31$0
2010 : HOWELLS GLASS COMPANY 401(K) PROFIT SHARING PLAN 2010 401k financial data
Funding deficiency by the employer to the plan for this plan year2010-05-31$0
Minimum employer required contribution for this plan year2010-05-31$0
Amount contributed by the employer to the plan for this plan year2010-05-31$0

Form 5500 Responses for HOWELLS GLASS COMPANY 401(K) PROFIT SHARING PLAN

2020: HOWELLS GLASS COMPANY 401(K) PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01First time form 5500 has been submittedYes
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 – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: HOWELLS GLASS COMPANY 401(K) PROFIT SHARING PLAN 2014 form 5500 responses
2014-06-01Type of plan entitySingle employer plan
2014-06-01Submission has been amendedNo
2014-06-01This submission is the final filingNo
2014-06-01This return/report is a short plan year return/report (less than 12 months)No
2014-06-01Plan is a collectively bargained planNo
2014-06-01Plan funding arrangement – InsuranceYes
2014-06-01Plan funding arrangement – TrustYes
2014-06-01Plan benefit arrangement – InsuranceYes
2013: HOWELLS GLASS COMPANY 401(K) PROFIT SHARING PLAN 2013 form 5500 responses
2013-06-01Type of plan entitySingle employer plan
2013-06-01Submission has been amendedNo
2013-06-01This submission is the final filingNo
2013-06-01This return/report is a short plan year return/report (less than 12 months)No
2013-06-01Plan is a collectively bargained planNo
2013-06-01Plan funding arrangement – InsuranceYes
2013-06-01Plan funding arrangement – TrustYes
2013-06-01Plan benefit arrangement – InsuranceYes
2012: HOWELLS GLASS COMPANY 401(K) PROFIT SHARING PLAN 2012 form 5500 responses
2012-06-01Type of plan entitySingle employer plan
2012-06-01Submission has been amendedNo
2012-06-01This submission is the final filingNo
2012-06-01This return/report is a short plan year return/report (less than 12 months)No
2012-06-01Plan is a collectively bargained planNo
2012-06-01Plan funding arrangement – InsuranceYes
2012-06-01Plan funding arrangement – TrustYes
2012-06-01Plan benefit arrangement – InsuranceYes
2011: HOWELLS GLASS COMPANY 401(K) PROFIT SHARING PLAN 2011 form 5500 responses
2011-06-01Type of plan entitySingle employer plan
2011-06-01Submission has been amendedNo
2011-06-01This submission is the final filingNo
2011-06-01This return/report is a short plan year return/report (less than 12 months)No
2011-06-01Plan is a collectively bargained planNo
2011-06-01Plan funding arrangement – InsuranceYes
2011-06-01Plan funding arrangement – TrustYes
2011-06-01Plan benefit arrangement – InsuranceYes
2010: HOWELLS GLASS COMPANY 401(K) PROFIT SHARING PLAN 2010 form 5500 responses
2010-06-01Type of plan entitySingle employer plan
2010-06-01Submission has been amendedNo
2010-06-01This submission is the final filingNo
2010-06-01This return/report is a short plan year return/report (less than 12 months)No
2010-06-01Plan is a collectively bargained planNo
2010-06-01Plan funding arrangement – InsuranceYes
2010-06-01Plan funding arrangement – TrustYes
2010-06-01Plan benefit arrangement – InsuranceYes
2009: HOWELLS GLASS COMPANY 401(K) PROFIT SHARING PLAN 2009 form 5500 responses
2009-06-01Type of plan entitySingle employer plan
2009-06-01Submission has been amendedNo
2009-06-01This submission is the final filingNo
2009-06-01This return/report is a short plan year return/report (less than 12 months)No
2009-06-01Plan is a collectively bargained planNo
2009-06-01Plan funding arrangement – InsuranceYes
2009-06-01Plan funding arrangement – TrustYes
2009-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-711582
Policy instance 1
Insurance contract or identification numberGA-711582
Number of Individuals Covered16
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $3,859
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 $3,859
Insurance broker organization code?3
Insurance broker nameWOODBURY FIN SVCS INC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-711582
Policy instance 1
Insurance contract or identification numberGA-711582
Number of Individuals Covered15
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $3,422
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 $3,422
Insurance broker organization code?3
Insurance broker nameWOODBURY FIN SVCS INC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-711582
Policy instance 1
Insurance contract or identification numberGA-711582
Number of Individuals Covered15
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $2,963
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 $2,963
Insurance broker organization code?3
Insurance broker nameWOODBURY FINANCIAL SVCS INC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-711582
Policy instance 1
Insurance contract or identification numberGA-711582
Number of Individuals Covered15
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $2,768
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-711582
Policy instance 1
Insurance contract or identification numberGA-711582
Number of Individuals Covered16
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Total amount of commissions paid to insurance brokerUSD $2,686
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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