401k Plan data: NASDDDS 401K PLAN plan

NASDDDS 401K PLAN 401k Plan overview

Plan Name	NASDDDS 401K PLAN
Plan identification number	002

NASDDDS 401K PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Money purchase (other than target benefit)
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.
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

NATIONAL ASSOC. OF STATE DIRECTORS has sponsored the creation of one or more 401k plans.

Company Name: NATIONAL ASSOC. OF STATE DIRECTORS

Employer identification number (EIN): 237013310

NAIC Classification: 541990
NAIC Description: All Other Professional, Scientific, and Technical Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NASDDDS 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-07-01 KATHERINE KAROL SNYDER 2023-10-05 MARY SOWERS 2023-10-05
002 2021-07-01 KATHERINE KAROL SNYDER 2022-10-19 MARY P SOWERS 2022-10-19
002 2020-07-01 KATHERINE KAROL SNYDER 2021-10-13 MARY P. SOWERS 2021-10-13
002 2019-07-01 KATHERINE KAROL SNYDER 2020-12-01 MARY P SOWERS 2020-12-01
002 2018-07-01 KATHERINE KAROL SNYDER 2019-10-04 MARY SOWERS 2019-10-04
002 2017-07-01 KATHERINE KAROL SNYDER 2018-10-10 MARY LEE FAY 2018-10-10
002 2016-07-01 KATHERINE KAROL SNYDER 2017-11-01 MARY LEE FAY 2017-11-01
002 2015-07-01 KATHERINE KAROL SNYDER 2016-11-15 MARY LEE FAY 2016-11-15
002 2014-07-01 KATHERINE KAROL SNYDER MARY LEE FAY 2016-10-28
002 2014-07-01 KATHERINE KAROL SNYDER MARY LEE FAY 2016-01-07
002 2013-07-01 KATHERINE KAROL SNYDER
002 2012-07-01 KATHERINE KAROL SNYDER MARY LEE FAY 2016-06-15
002 2011-07-01 KATHERINE KAROL SNYDER NANCY THALER 2013-01-18
002 2010-09-01 KATHERINE KAROL SNYDER

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2022-07-01	KATHERINE KAROL SNYDER	2023-10-05	MARY SOWERS	2023-10-05
002	2021-07-01	KATHERINE KAROL SNYDER	2022-10-19	MARY P SOWERS	2022-10-19
002	2020-07-01	KATHERINE KAROL SNYDER	2021-10-13	MARY P. SOWERS	2021-10-13
002	2019-07-01	KATHERINE KAROL SNYDER	2020-12-01	MARY P SOWERS	2020-12-01
002	2018-07-01	KATHERINE KAROL SNYDER	2019-10-04	MARY SOWERS	2019-10-04
002	2017-07-01	KATHERINE KAROL SNYDER	2018-10-10	MARY LEE FAY	2018-10-10
002	2016-07-01	KATHERINE KAROL SNYDER	2017-11-01	MARY LEE FAY	2017-11-01
002	2015-07-01	KATHERINE KAROL SNYDER	2016-11-15	MARY LEE FAY	2016-11-15
002	2014-07-01	KATHERINE KAROL SNYDER		MARY LEE FAY	2016-10-28
002	2014-07-01	KATHERINE KAROL SNYDER		MARY LEE FAY	2016-01-07
002	2013-07-01	KATHERINE KAROL SNYDER
002	2012-07-01	KATHERINE KAROL SNYDER		MARY LEE FAY	2016-06-15
002	2011-07-01	KATHERINE KAROL SNYDER		NANCY THALER	2013-01-18
002	2010-09-01	KATHERINE KAROL SNYDER

Plan Statistics for NASDDDS 401K PLAN

401k plan membership statisitcs for NASDDDS 401K PLAN

Measure Date Value
2014: NASDDDS 401K PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 9
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 9
Number of retired or separated participants receiving benefits 2014-07-01 0
Number of other retired or separated participants entitled to future benefits 2014-07-01 1
Total of all active and inactive participants 2014-07-01 10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-07-01 1
Total participants 2014-07-01 11
Number of participants with account balances 2014-07-01 10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-07-01 0
2013: NASDDDS 401K PLAN 2013 401k membership
Total participants, beginning-of-year 2013-07-01 8
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 8
Number of retired or separated participants receiving benefits 2013-07-01 0
Number of other retired or separated participants entitled to future benefits 2013-07-01 0
Total of all active and inactive participants 2013-07-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-07-01 1
Total participants 2013-07-01 9
Number of participants with account balances 2013-07-01 9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-07-01 0
2012: NASDDDS 401K PLAN 2012 401k membership
Total participants, beginning-of-year 2012-07-01 8
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 8
Number of retired or separated participants receiving benefits 2012-07-01 0
Number of other retired or separated participants entitled to future benefits 2012-07-01 0
Total of all active and inactive participants 2012-07-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-07-01 1
Total participants 2012-07-01 9
Number of participants with account balances 2012-07-01 9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-07-01 1
2011: NASDDDS 401K PLAN 2011 401k membership
Total participants, beginning-of-year 2011-07-01 8
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 7
Number of retired or separated participants receiving benefits 2011-07-01 0
Number of other retired or separated participants entitled to future benefits 2011-07-01 1
Total of all active and inactive participants 2011-07-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-07-01 1
Total participants 2011-07-01 9
Number of participants with account balances 2011-07-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-07-01 1
2010: NASDDDS 401K PLAN 2010 401k membership
Total participants, beginning-of-year 2010-09-01 9
Total number of active participants reported on line 7a of the Form 5500 2010-09-01 7
Number of retired or separated participants receiving benefits 2010-09-01 0
Number of other retired or separated participants entitled to future benefits 2010-09-01 1
Total of all active and inactive participants 2010-09-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-09-01 0
Total participants 2010-09-01 8
Number of participants with account balances 2010-09-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-09-01 0

Measure	Date	Value
2014: NASDDDS 401K PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	9
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	9
Number of retired or separated participants receiving benefits	2014-07-01	0
Number of other retired or separated participants entitled to future benefits	2014-07-01	1
Total of all active and inactive participants	2014-07-01	10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-07-01	1
Total participants	2014-07-01	11
Number of participants with account balances	2014-07-01	10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-07-01	0
2013: NASDDDS 401K PLAN 2013 401k membership
Total participants, beginning-of-year	2013-07-01	8
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	8
Number of retired or separated participants receiving benefits	2013-07-01	0
Number of other retired or separated participants entitled to future benefits	2013-07-01	0
Total of all active and inactive participants	2013-07-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-07-01	1
Total participants	2013-07-01	9
Number of participants with account balances	2013-07-01	9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-07-01	0
2012: NASDDDS 401K PLAN 2012 401k membership
Total participants, beginning-of-year	2012-07-01	8
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	8
Number of retired or separated participants receiving benefits	2012-07-01	0
Number of other retired or separated participants entitled to future benefits	2012-07-01	0
Total of all active and inactive participants	2012-07-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-07-01	1
Total participants	2012-07-01	9
Number of participants with account balances	2012-07-01	9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-07-01	1
2011: NASDDDS 401K PLAN 2011 401k membership
Total participants, beginning-of-year	2011-07-01	8
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	7
Number of retired or separated participants receiving benefits	2011-07-01	0
Number of other retired or separated participants entitled to future benefits	2011-07-01	1
Total of all active and inactive participants	2011-07-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-07-01	1
Total participants	2011-07-01	9
Number of participants with account balances	2011-07-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-07-01	1
2010: NASDDDS 401K PLAN 2010 401k membership
Total participants, beginning-of-year	2010-09-01	9
Total number of active participants reported on line 7a of the Form 5500	2010-09-01	7
Number of retired or separated participants receiving benefits	2010-09-01	0
Number of other retired or separated participants entitled to future benefits	2010-09-01	1
Total of all active and inactive participants	2010-09-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-09-01	0
Total participants	2010-09-01	8
Number of participants with account balances	2010-09-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-09-01	0

Financial Data on NASDDDS 401K PLAN

Measure	Date	Value
2015 : NASDDDS 401K PLAN 2015 401k financial data
Transfers to/from the plan	2015-06-30	$0
Total income from all sources	2015-06-30	$117,516
Expenses. Total of all expenses incurred	2015-06-30	$13,012
Benefits paid (including direct rollovers)	2015-06-30	$0
Total plan assets at end of year	2015-06-30	$829,574
Total plan assets at beginning of year	2015-06-30	$725,070
Value of fidelity bond covering the plan	2015-06-30	$1,000,000
Total contributions received or receivable from participants	2015-06-30	$52,770
Expenses. Other expenses not covered elsewhere	2015-06-30	$13,012
Contributions received from other sources (not participants or employers)	2015-06-30	$0
Other income received	2015-06-30	$1,569
Net income (gross income less expenses)	2015-06-30	$104,504
Net plan assets at end of year (total assets less liabilities)	2015-06-30	$829,574
Net plan assets at beginning of year (total assets less liabilities)	2015-06-30	$725,070
Assets. Value of participant loans	2015-06-30	$0
Total contributions received or receivable from employer(s)	2015-06-30	$63,177
Value of certain deemed distributions of participant loans	2015-06-30	$0
Value of corrective distributions	2015-06-30	$0
Funding deficiency by the employer to the plan for this plan year	2015-06-30	$0
Minimum employer required contribution for this plan year	2015-06-30	$0
Amount contributed by the employer to the plan for this plan year	2015-06-30	$0
2014 : NASDDDS 401K PLAN 2014 401k financial data
Transfers to/from the plan	2014-06-30	$0
Total income from all sources	2014-06-30	$197,145
Expenses. Total of all expenses incurred	2014-06-30	$259,512
Benefits paid (including direct rollovers)	2014-06-30	$259,487
Total plan assets at end of year	2014-06-30	$725,070
Total plan assets at beginning of year	2014-06-30	$787,437
Value of fidelity bond covering the plan	2014-06-30	$1,000,000
Total contributions received or receivable from participants	2014-06-30	$41,808
Expenses. Other expenses not covered elsewhere	2014-06-30	$25
Contributions received from other sources (not participants or employers)	2014-06-30	$0
Other income received	2014-06-30	$96,811
Net income (gross income less expenses)	2014-06-30	$-62,367
Net plan assets at end of year (total assets less liabilities)	2014-06-30	$725,070
Net plan assets at beginning of year (total assets less liabilities)	2014-06-30	$787,437
Assets. Value of participant loans	2014-06-30	$0
Total contributions received or receivable from employer(s)	2014-06-30	$58,526
Value of certain deemed distributions of participant loans	2014-06-30	$0
Value of corrective distributions	2014-06-30	$0
Funding deficiency by the employer to the plan for this plan year	2014-06-30	$0
Minimum employer required contribution for this plan year	2014-06-30	$0
Amount contributed by the employer to the plan for this plan year	2014-06-30	$0
2013 : NASDDDS 401K PLAN 2013 401k financial data
Transfers to/from the plan	2013-06-30	$0
Total income from all sources	2013-06-30	$124,896
Expenses. Total of all expenses incurred	2013-06-30	$0
Benefits paid (including direct rollovers)	2013-06-30	$0
Total plan assets at end of year	2013-06-30	$787,436
Total plan assets at beginning of year	2013-06-30	$662,540
Value of fidelity bond covering the plan	2013-06-30	$1,000,000
Total contributions received or receivable from participants	2013-06-30	$32,433
Expenses. Other expenses not covered elsewhere	2013-06-30	$0
Contributions received from other sources (not participants or employers)	2013-06-30	$0
Other income received	2013-06-30	$44,528
Net income (gross income less expenses)	2013-06-30	$124,896
Net plan assets at end of year (total assets less liabilities)	2013-06-30	$787,436
Net plan assets at beginning of year (total assets less liabilities)	2013-06-30	$662,540
Assets. Value of participant loans	2013-06-30	$0
Total contributions received or receivable from employer(s)	2013-06-30	$47,935
Value of certain deemed distributions of participant loans	2013-06-30	$0
Value of corrective distributions	2013-06-30	$0
Funding deficiency by the employer to the plan for this plan year	2013-06-30	$0
Minimum employer required contribution for this plan year	2013-06-30	$0
Amount contributed by the employer to the plan for this plan year	2013-06-30	$0
2012 : NASDDDS 401K PLAN 2012 401k financial data
Transfers to/from the plan	2012-06-30	$0
Total income from all sources	2012-06-30	$71,711
Expenses. Total of all expenses incurred	2012-06-30	$0
Benefits paid (including direct rollovers)	2012-06-30	$0
Total plan assets at end of year	2012-06-30	$662,540
Total plan assets at beginning of year	2012-06-30	$590,829
Value of fidelity bond covering the plan	2012-06-30	$1,000,000
Total contributions received or receivable from participants	2012-06-30	$26,184
Expenses. Other expenses not covered elsewhere	2012-06-30	$0
Contributions received from other sources (not participants or employers)	2012-06-30	$0
Other income received	2012-06-30	$3,021
Net income (gross income less expenses)	2012-06-30	$71,711
Net plan assets at end of year (total assets less liabilities)	2012-06-30	$662,540
Net plan assets at beginning of year (total assets less liabilities)	2012-06-30	$590,829
Assets. Value of participant loans	2012-06-30	$0
Total contributions received or receivable from employer(s)	2012-06-30	$42,506
Value of certain deemed distributions of participant loans	2012-06-30	$0
Value of corrective distributions	2012-06-30	$0
Funding deficiency by the employer to the plan for this plan year	2012-06-30	$0
Minimum employer required contribution for this plan year	2012-06-30	$0
Amount contributed by the employer to the plan for this plan year	2012-06-30	$0
2011 : NASDDDS 401K PLAN 2011 401k financial data
Transfers to/from the plan	2011-06-30	$504,089
Total income from all sources	2011-06-30	$121,598
Expenses. Total of all expenses incurred	2011-06-30	$34,858
Benefits paid (including direct rollovers)	2011-06-30	$34,858
Total plan assets at end of year	2011-06-30	$590,829
Total plan assets at beginning of year	2011-06-30	$0
Value of fidelity bond covering the plan	2011-06-30	$100,000
Total contributions received or receivable from participants	2011-06-30	$41,796
Expenses. Other expenses not covered elsewhere	2011-06-30	$0
Contributions received from other sources (not participants or employers)	2011-06-30	$0
Other income received	2011-06-30	$41,794
Net income (gross income less expenses)	2011-06-30	$86,740
Net plan assets at end of year (total assets less liabilities)	2011-06-30	$590,829
Net plan assets at beginning of year (total assets less liabilities)	2011-06-30	$0
Assets. Value of participant loans	2011-06-30	$0
Total contributions received or receivable from employer(s)	2011-06-30	$38,008
Value of certain deemed distributions of participant loans	2011-06-30	$0
Value of corrective distributions	2011-06-30	$0
Funding deficiency by the employer to the plan for this plan year	2011-06-30	$0
Minimum employer required contribution for this plan year	2011-06-30	$0
Amount contributed by the employer to the plan for this plan year	2011-06-30	$0

Form 5500 Responses for NASDDDS 401K PLAN

2014: NASDDDS 401K PLAN 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	Submission has been amended	Yes
2014-07-01	This submission is the final filing	No
2014-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-07-01	Plan is a collectively bargained plan	No
2014-07-01	Plan funding arrangement – Insurance	Yes
2014-07-01	Plan funding arrangement – Trust	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes
2013: NASDDDS 401K PLAN 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
2013-07-01	Submission has been amended	No
2013-07-01	This submission is the final filing	No
2013-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-07-01	Plan is a collectively bargained plan	No
2013-07-01	Plan funding arrangement – Insurance	Yes
2013-07-01	Plan funding arrangement – Trust	Yes
2013-07-01	Plan benefit arrangement – Insurance	Yes
2012: NASDDDS 401K PLAN 2012 form 5500 responses
2012-07-01	Type of plan entity	Single employer plan
2012-07-01	Submission has been amended	Yes
2012-07-01	This submission is the final filing	No
2012-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-07-01	Plan is a collectively bargained plan	No
2012-07-01	Plan funding arrangement – Insurance	Yes
2012-07-01	Plan funding arrangement – Trust	Yes
2012-07-01	Plan benefit arrangement – Insurance	Yes
2011: NASDDDS 401K PLAN 2011 form 5500 responses
2011-07-01	Type of plan entity	Single employer plan
2011-07-01	Submission has been amended	No
2011-07-01	This submission is the final filing	No
2011-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-07-01	Plan is a collectively bargained plan	No
2011-07-01	Plan funding arrangement – Insurance	Yes
2011-07-01	Plan funding arrangement – Trust	Yes
2011-07-01	Plan benefit arrangement – Insurance	Yes
2010: NASDDDS 401K PLAN 2010 form 5500 responses
2010-09-01	Type of plan entity	Single employer plan
2010-09-01	First time form 5500 has been submitted	Yes
2010-09-01	Submission has been amended	No
2010-09-01	This submission is the final filing	No
2010-09-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2010-09-01	Plan is a collectively bargained plan	No
2010-09-01	Plan funding arrangement – Insurance	Yes
2010-09-01	Plan funding arrangement – Trust	Yes
2010-09-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-822859

Policy instance

Insurance contract or identification number	GA-822859
Number of Individuals Covered	10
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $2,342
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $2,342
Insurance broker organization code?	3
Insurance broker name	PNC INSURANCE SERVICES LLC

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-822859

Policy instance

Insurance contract or identification number	GA-822859
Number of Individuals Covered	9
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $2,412
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $2,412
Insurance broker organization code?	3
Insurance broker name	PNC INSURANCE SERVICES LLC

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-822859

Policy instance

Insurance contract or identification number	GA-822859
Number of Individuals Covered	9
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $2,005
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $2,005
Insurance broker organization code?	3
Insurance broker name	PNC INSURANCE SERVICES LLC

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-822859

Policy instance

Insurance contract or identification number	GA-822859
Number of Individuals Covered	8
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $1,720
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 number

GA-822859

Policy instance

Insurance contract or identification number	GA-822859
Number of Individuals Covered	8
Insurance policy start date	2010-09-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $5,036
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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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Company Name:	NATIONAL ASSOC. OF STATE DIRECTORS
Employer identification number (EIN):	237013310
NAIC Classification:	541990
NAIC Description:	All Other Professional, Scientific, and Technical Services