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MAX C. FELDMAN DEFINED BENEFIT PLAN 401k Plan overview

Plan NameMAX C. FELDMAN DEFINED BENEFIT PLAN
Plan identification number 002

MAX C. FELDMAN DEFINED BENEFIT PLAN Benefits

401k Plan TypeDefined Benefit Pension
Plan Features/Benefits
  • Benefits are primarily pay related
  • Plan covering Self-Employed individuals.

401k Sponsoring company profile

MAX C. FELDMAN, ATTORNEY AT LAW has sponsored the creation of one or more 401k plans.

Company Name:MAX C. FELDMAN, ATTORNEY AT LAW
Employer identification number (EIN):251699040
NAIC Classification:541110
NAIC Description:Offices of Lawyers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MAX C. FELDMAN DEFINED BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022017-01-01MAX FELDMAN
0022016-01-01MAX FELDMAN MAX FELDMAN2017-10-16
0022015-01-01REBECCA NEWMAN REBECCA NEWMAN2016-10-17
0022014-01-01REBECCA NEWMAN
0022013-01-01MAX C. FELDMAN
0022012-01-01MAX C. FELDMAN
0022011-01-01MAX C. FELDMAN
0022010-01-01MAX C. FELDMAN
0022009-01-01MAX C. FELDMAN
0022009-01-01MAX C. FELDMAN

Plan Statistics for MAX C. FELDMAN DEFINED BENEFIT PLAN

401k plan membership statisitcs for MAX C. FELDMAN DEFINED BENEFIT PLAN

Measure Date Value
2017: MAX C. FELDMAN DEFINED BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-018
Total number of active participants reported on line 7a of the Form 55002017-01-018
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-018
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-018
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: MAX C. FELDMAN DEFINED BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-018
Total number of active participants reported on line 7a of the Form 55002016-01-018
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 participants2016-01-018
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-018
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: MAX C. FELDMAN DEFINED BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-018
Total number of active participants reported on line 7a of the Form 55002015-01-010
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 participants2015-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: MAX C. FELDMAN DEFINED BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-017
Total number of active participants reported on line 7a of the Form 55002014-01-015
Number of retired or separated participants receiving benefits2014-01-011
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-016
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-016
2013: MAX C. FELDMAN DEFINED BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-017
Total number of active participants reported on line 7a of the Form 55002013-01-017
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-017
2012: MAX C. FELDMAN DEFINED BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-015
Total number of active participants reported on line 7a of the Form 55002012-01-016
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-016
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-016
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: MAX C. FELDMAN DEFINED BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-015
Total number of active participants reported on line 7a of the Form 55002011-01-015
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 participants2011-01-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-015
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: MAX C. FELDMAN DEFINED BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-012
Total number of active participants reported on line 7a of the Form 55002010-01-015
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-015
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: MAX C. FELDMAN DEFINED BENEFIT 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
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on MAX C. FELDMAN DEFINED BENEFIT PLAN

Measure Date Value
2016 : MAX C. FELDMAN DEFINED BENEFIT PLAN 2016 401k financial data
Transfers to/from the plan2016-12-31$0
Total plan liabilities at end of year2016-12-31$0
Total plan liabilities at beginning of year2016-12-31$0
Total income from all sources2016-12-31$294,175
Expenses. Total of all expenses incurred2016-12-31$0
Benefits paid (including direct rollovers)2016-12-31$0
Total plan assets at end of year2016-12-31$2,334,644
Total plan assets at beginning of year2016-12-31$2,040,469
Value of fidelity bond covering the plan2016-12-31$150,000
Total contributions received or receivable from participants2016-12-31$0
Expenses. Other expenses not covered elsewhere2016-12-31$0
Contributions received from other sources (not participants or employers)2016-12-31$0
Other income received2016-12-31$-25,487
Noncash contributions received2016-12-31$0
Net income (gross income less expenses)2016-12-31$294,175
Net plan assets at end of year (total assets less liabilities)2016-12-31$2,334,644
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$2,040,469
Total contributions received or receivable from employer(s)2016-12-31$319,662
Value of certain deemed distributions of participant loans2016-12-31$0
Value of corrective distributions2016-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : MAX C. FELDMAN DEFINED BENEFIT PLAN 2015 401k financial data
Total plan liabilities at end of year2015-12-31$0
Total plan liabilities at beginning of year2015-12-31$0
Total income from all sources2015-12-31$153,388
Expenses. Total of all expenses incurred2015-12-31$0
Benefits paid (including direct rollovers)2015-12-31$0
Total plan assets at end of year2015-12-31$2,040,469
Total plan assets at beginning of year2015-12-31$1,887,081
Value of fidelity bond covering the plan2015-12-31$150,000
Total contributions received or receivable from participants2015-12-31$0
Expenses. Other expenses not covered elsewhere2015-12-31$0
Contributions received from other sources (not participants or employers)2015-12-31$0
Other income received2015-12-31$-166,565
Noncash contributions received2015-12-31$0
Net income (gross income less expenses)2015-12-31$153,388
Net plan assets at end of year (total assets less liabilities)2015-12-31$2,040,469
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$1,887,081
Total contributions received or receivable from employer(s)2015-12-31$319,953
Value of certain deemed distributions of participant loans2015-12-31$0
Value of corrective distributions2015-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$0
2014 : MAX C. FELDMAN DEFINED BENEFIT PLAN 2014 401k financial data
Transfers to/from the plan2014-12-31$0
Total plan liabilities at end of year2014-12-31$0
Total plan liabilities at beginning of year2014-12-31$0
Total income from all sources2014-12-31$263,145
Expenses. Total of all expenses incurred2014-12-31$14,914
Benefits paid (including direct rollovers)2014-12-31$14,914
Total plan assets at end of year2014-12-31$1,887,081
Total plan assets at beginning of year2014-12-31$1,638,850
Value of fidelity bond covering the plan2014-12-31$150,000
Total contributions received or receivable from participants2014-12-31$0
Expenses. Other expenses not covered elsewhere2014-12-31$0
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$-64,016
Noncash contributions received2014-12-31$0
Net income (gross income less expenses)2014-12-31$248,231
Net plan assets at end of year (total assets less liabilities)2014-12-31$1,887,081
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$1,638,850
Total contributions received or receivable from employer(s)2014-12-31$327,161
Value of certain deemed distributions of participant loans2014-12-31$0
Value of corrective distributions2014-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : MAX C. FELDMAN DEFINED BENEFIT PLAN 2013 401k financial data
Total plan liabilities at end of year2013-12-31$0
Total plan liabilities at beginning of year2013-12-31$0
Total income from all sources2013-12-31$312,407
Expenses. Total of all expenses incurred2013-12-31$0
Benefits paid (including direct rollovers)2013-12-31$0
Total plan assets at end of year2013-12-31$1,638,850
Total plan assets at beginning of year2013-12-31$1,326,443
Value of fidelity bond covering the plan2013-12-31$150,000
Total contributions received or receivable from participants2013-12-31$0
Expenses. Other expenses not covered elsewhere2013-12-31$0
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$18,753
Noncash contributions received2013-12-31$0
Net income (gross income less expenses)2013-12-31$312,407
Net plan assets at end of year (total assets less liabilities)2013-12-31$1,638,850
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$1,326,443
Total contributions received or receivable from employer(s)2013-12-31$293,654
Value of certain deemed distributions of participant loans2013-12-31$0
Value of corrective distributions2013-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : MAX C. FELDMAN DEFINED BENEFIT PLAN 2012 401k financial data
Total plan liabilities at end of year2012-12-31$0
Total plan liabilities at beginning of year2012-12-31$0
Total income from all sources2012-12-31$104,564
Expenses. Total of all expenses incurred2012-12-31$0
Benefits paid (including direct rollovers)2012-12-31$0
Total plan assets at end of year2012-12-31$1,326,443
Total plan assets at beginning of year2012-12-31$1,221,879
Value of fidelity bond covering the plan2012-12-31$150,000
Total contributions received or receivable from participants2012-12-31$0
Expenses. Other expenses not covered elsewhere2012-12-31$0
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$-189,090
Noncash contributions received2012-12-31$0
Net income (gross income less expenses)2012-12-31$104,564
Net plan assets at end of year (total assets less liabilities)2012-12-31$1,326,443
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$1,221,879
Total contributions received or receivable from employer(s)2012-12-31$293,654
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : MAX C. FELDMAN DEFINED BENEFIT PLAN 2011 401k financial data
Total plan liabilities at end of year2011-12-31$0
Total plan liabilities at beginning of year2011-12-31$0
Total income from all sources2011-12-31$369,686
Expenses. Total of all expenses incurred2011-12-31$0
Benefits paid (including direct rollovers)2011-12-31$0
Total plan assets at end of year2011-12-31$1,221,879
Total plan assets at beginning of year2011-12-31$852,193
Value of fidelity bond covering the plan2011-12-31$150,000
Total contributions received or receivable from participants2011-12-31$0
Expenses. Other expenses not covered elsewhere2011-12-31$0
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$84,496
Noncash contributions received2011-12-31$0
Net income (gross income less expenses)2011-12-31$369,686
Net plan assets at end of year (total assets less liabilities)2011-12-31$1,221,879
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$852,193
Total contributions received or receivable from employer(s)2011-12-31$285,190
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : MAX C. FELDMAN DEFINED BENEFIT PLAN 2010 401k financial data
Total plan liabilities at end of year2010-12-31$0
Total plan liabilities at beginning of year2010-12-31$0
Total income from all sources2010-12-31$98,991
Expenses. Total of all expenses incurred2010-12-31$0
Benefits paid (including direct rollovers)2010-12-31$0
Total plan assets at end of year2010-12-31$852,193
Total plan assets at beginning of year2010-12-31$753,202
Value of fidelity bond covering the plan2010-12-31$100,000
Total contributions received or receivable from participants2010-12-31$0
Expenses. Other expenses not covered elsewhere2010-12-31$0
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$-65,865
Noncash contributions received2010-12-31$0
Net income (gross income less expenses)2010-12-31$98,991
Net plan assets at end of year (total assets less liabilities)2010-12-31$852,193
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$753,202
Total contributions received or receivable from employer(s)2010-12-31$164,856
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
2009 : MAX C. FELDMAN DEFINED BENEFIT PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for MAX C. FELDMAN DEFINED BENEFIT PLAN

2017: MAX C. FELDMAN DEFINED BENEFIT 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 – Section 412(e)(3) insurance ContractsYes
2017-01-01Plan benefit arrangement – Section 412(e)(3) insurance ContractsYes
2016: MAX C. FELDMAN DEFINED BENEFIT 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 – Section 412(e)(3) insurance ContractsYes
2016-01-01Plan benefit arrangement – Section 412(e)(3) insurance ContractsYes
2015: MAX C. FELDMAN DEFINED BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – Section 412(e)(3) insurance ContractsYes
2015-01-01Plan benefit arrangement – Section 412(e)(3) insurance ContractsYes
2014: MAX C. FELDMAN DEFINED BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – Section 412(e)(3) insurance ContractsYes
2014-01-01Plan benefit arrangement – Section 412(e)(3) insurance ContractsYes
2013: MAX C. FELDMAN DEFINED BENEFIT 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 – Section 412(e)(3) insurance ContractsYes
2013-01-01Plan benefit arrangement – Section 412(e)(3) insurance ContractsYes
2012: MAX C. FELDMAN DEFINED BENEFIT 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 – Section 412(e)(3) insurance ContractsYes
2012-01-01Plan benefit arrangement – Section 412(e)(3) insurance ContractsYes
2011: MAX C. FELDMAN DEFINED BENEFIT 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 – Section 412(e)(3) insurance ContractsYes
2011-01-01Plan benefit arrangement – Section 412(e)(3) insurance ContractsYes
2010: MAX C. FELDMAN DEFINED BENEFIT PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – Section 412(e)(3) insurance ContractsYes
2010-01-01Plan benefit arrangement – Section 412(e)(3) insurance ContractsYes
2009: MAX C. FELDMAN DEFINED BENEFIT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedYes
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 – Section 412(e)(3) insurance ContractsYes
2009-01-01Plan benefit arrangement – Section 412(e)(3) insurance ContractsYes

Insurance Providers Used on plan

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number7780777
Policy instance 2
Insurance contract or identification number7780777
Number of Individuals Covered8
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,926
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?1
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 $1,156
Insurance broker organization code?3
Insurance broker nameSCOTT C. IVOL
C.M. LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93432 )
Policy contract numberODY15321064
Policy instance 1
Insurance contract or identification numberODY15321064
Number of Individuals Covered1
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,478
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?1
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 $1,478
Insurance broker organization code?3
Insurance broker nameTBS AGENCY, INC.
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract numberODY15321064
Policy instance 1
Insurance contract or identification numberODY15321064
Number of Individuals Covered1
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,716
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $1,716
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameTBS AGENCY, INC.
ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )
Policy contract number71077518
Policy instance 1
Insurance contract or identification number71077518
Number of Individuals Covered6
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $15,516
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,930
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameCREATIVE MARKETING INT. GROUP
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number7780777
Policy instance 2
Insurance contract or identification number7780777
Number of Individuals Covered6
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $18,872
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Commission paid to Insurance BrokerUSD $6,302
Insurance broker organization code?3
Amount paid for insurance broker fees0
Insurance broker nameBROKERAGE RESOURCE OF AMERICA, LLC
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number32076565
Policy instance 1
Insurance contract or identification number32076565
Number of Individuals Covered7
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $18,442
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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 $9,221
Amount paid for insurance broker fees0
Additional information about fees paid to insurance broker0
Insurance broker organization code?3
Insurance broker nameSCOTT C. IVOL
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number32076565
Policy instance 1
Insurance contract or identification number32076565
Number of Individuals Covered1
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $280
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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?Yes
Commission paid to Insurance BrokerUSD $140
Amount paid for insurance broker fees0
Additional information about fees paid to insurance broker0
Insurance broker organization code?3
Insurance broker nameSCOTT C. IVOL
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number32076565
Policy instance 1
Insurance contract or identification number32076565
Number of Individuals Covered5
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $6,424
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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?Yes
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberWL4900565
Policy instance 2
Insurance contract or identification numberWL4900565
Number of Individuals Covered4
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $29,802
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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?Yes
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberWL4900565
Policy instance 2
Insurance contract or identification numberWL4900565
Number of Individuals Covered3
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $2,848
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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 $1,424
Insurance broker organization code?3
Insurance broker nameSCOTT C. IVOL
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number32076565
Policy instance 1
Insurance contract or identification number32076565
Number of Individuals Covered2
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $1,020
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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 $510
Insurance broker organization code?3
Insurance broker nameSCOTT C. IVOL

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