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METROPOLITAN PAIN CONSULTANTS 401(K) PLAN 401k Plan overview

Plan NameMETROPOLITAN PAIN CONSULTANTS 401(K) PLAN
Plan identification number 001

METROPOLITAN PAIN CONSULTANTS 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Plan covering Self-Employed individuals.
  • 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

METROPOLITAN PAIN CONSULTANTS has sponsored the creation of one or more 401k plans.

Company Name:METROPOLITAN PAIN CONSULTANTS
Employer identification number (EIN):260140273
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan METROPOLITAN PAIN CONSULTANTS 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012020-01-01
0012019-01-01
0012018-01-01RICHARD KANG
0012017-01-01RICHARD KANG
0012016-01-01RICHARD KANG
0012015-01-01RICHARD KANG
0012014-01-01RICHARD KANG

Plan Statistics for METROPOLITAN PAIN CONSULTANTS 401(K) PLAN

401k plan membership statisitcs for METROPOLITAN PAIN CONSULTANTS 401(K) PLAN

Measure Date Value
2020: METROPOLITAN PAIN CONSULTANTS 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0115
Total number of active participants reported on line 7a of the Form 55002020-01-010
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 participants2020-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-010
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
2019: METROPOLITAN PAIN CONSULTANTS 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0112
Total number of active participants reported on line 7a of the Form 55002019-01-0110
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-014
Total of all active and inactive participants2019-01-0114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0114
Number of participants with account balances2019-01-0114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-013
2018: METROPOLITAN PAIN CONSULTANTS 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0111
Total number of active participants reported on line 7a of the Form 55002018-01-0110
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-011
Total of all active and inactive participants2018-01-0111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0111
Number of participants with account balances2018-01-0111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-011
2017: METROPOLITAN PAIN CONSULTANTS 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0110
Total number of active participants reported on line 7a of the Form 55002017-01-0110
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-011
Total of all active and inactive participants2017-01-0111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0111
Number of participants with account balances2017-01-0111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-011
2016: METROPOLITAN PAIN CONSULTANTS 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-017
Total number of active participants reported on line 7a of the Form 55002016-01-017
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-011
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
Number of participants with account balances2016-01-018
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: METROPOLITAN PAIN CONSULTANTS 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0112
Total number of active participants reported on line 7a of the Form 55002015-01-014
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-013
Total of all active and inactive participants2015-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-017
Number of participants with account balances2015-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-012
2014: METROPOLITAN PAIN CONSULTANTS 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0112
Total number of active participants reported on line 7a of the Form 55002014-01-015
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-017
Total of all active and inactive participants2014-01-0112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0112
Number of participants with account balances2014-01-0112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-017

Financial Data on METROPOLITAN PAIN CONSULTANTS 401(K) PLAN

Measure Date Value
2020 : METROPOLITAN PAIN CONSULTANTS 401(K) PLAN 2020 401k financial data
Transfers to/from the plan2020-12-24$0
Total plan liabilities at beginning of year2020-12-24$0
Total income from all sources2020-12-24$75,804
Expenses. Total of all expenses incurred2020-12-24$983,942
Benefits paid (including direct rollovers)2020-12-24$977,674
Total plan assets at end of year2020-12-24$0
Total plan assets at beginning of year2020-12-24$908,138
Total contributions received or receivable from participants2020-12-24$18,600
Expenses. Other expenses not covered elsewhere2020-12-24$0
Contributions received from other sources (not participants or employers)2020-12-24$8,000
Other income received2020-12-24$49,204
Noncash contributions received2020-12-24$0
Net income (gross income less expenses)2020-12-24$-908,138
Net plan assets at end of year (total assets less liabilities)2020-12-24$0
Net plan assets at beginning of year (total assets less liabilities)2020-12-24$908,138
Total contributions received or receivable from employer(s)2020-12-24$0
Value of certain deemed distributions of participant loans2020-12-24$0
Value of corrective distributions2020-12-24$0
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-24$6,268
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-24$0
2019 : METROPOLITAN PAIN CONSULTANTS 401(K) PLAN 2019 401k financial data
Transfers to/from the plan2019-12-31$0
Total plan liabilities at end of year2019-12-31$0
Total plan liabilities at beginning of year2019-12-31$0
Total income from all sources2019-12-31$318,912
Expenses. Total of all expenses incurred2019-12-31$91,238
Benefits paid (including direct rollovers)2019-12-31$83,407
Total plan assets at end of year2019-12-31$908,138
Total plan assets at beginning of year2019-12-31$680,464
Total contributions received or receivable from participants2019-12-31$52,292
Expenses. Other expenses not covered elsewhere2019-12-31$0
Contributions received from other sources (not participants or employers)2019-12-31$2,682
Other income received2019-12-31$165,117
Noncash contributions received2019-12-31$0
Net income (gross income less expenses)2019-12-31$227,674
Net plan assets at end of year (total assets less liabilities)2019-12-31$908,138
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$680,464
Total contributions received or receivable from employer(s)2019-12-31$98,821
Value of certain deemed distributions of participant loans2019-12-31$0
Value of corrective distributions2019-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$7,831
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
2018 : METROPOLITAN PAIN CONSULTANTS 401(K) PLAN 2018 401k financial data
Transfers to/from the plan2018-12-31$0
Total plan liabilities at end of year2018-12-31$0
Total plan liabilities at beginning of year2018-12-31$0
Total income from all sources2018-12-31$112,750
Expenses. Total of all expenses incurred2018-12-31$2,487
Benefits paid (including direct rollovers)2018-12-31$246
Total plan assets at end of year2018-12-31$680,464
Total plan assets at beginning of year2018-12-31$570,201
Total contributions received or receivable from participants2018-12-31$67,408
Expenses. Other expenses not covered elsewhere2018-12-31$0
Contributions received from other sources (not participants or employers)2018-12-31$0
Other income received2018-12-31$-59,604
Noncash contributions received2018-12-31$0
Net income (gross income less expenses)2018-12-31$110,263
Net plan assets at end of year (total assets less liabilities)2018-12-31$680,464
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$570,201
Total contributions received or receivable from employer(s)2018-12-31$104,946
Value of certain deemed distributions of participant loans2018-12-31$0
Value of corrective distributions2018-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$2,241
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
2017 : METROPOLITAN PAIN CONSULTANTS 401(K) PLAN 2017 401k financial data
Transfers to/from the plan2017-12-31$0
Total plan liabilities at end of year2017-12-31$0
Total plan liabilities at beginning of year2017-12-31$0
Total income from all sources2017-12-31$229,301
Expenses. Total of all expenses incurred2017-12-31$6,084
Benefits paid (including direct rollovers)2017-12-31$3,571
Total plan assets at end of year2017-12-31$570,201
Total plan assets at beginning of year2017-12-31$346,984
Total contributions received or receivable from participants2017-12-31$62,708
Expenses. Other expenses not covered elsewhere2017-12-31$0
Contributions received from other sources (not participants or employers)2017-12-31$29,362
Other income received2017-12-31$64,526
Noncash contributions received2017-12-31$0
Net income (gross income less expenses)2017-12-31$223,217
Net plan assets at end of year (total assets less liabilities)2017-12-31$570,201
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$346,984
Total contributions received or receivable from employer(s)2017-12-31$72,705
Value of certain deemed distributions of participant loans2017-12-31$0
Value of corrective distributions2017-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$2,513
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : METROPOLITAN PAIN CONSULTANTS 401(K) 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$133,289
Expenses. Total of all expenses incurred2016-12-31$1,936
Benefits paid (including direct rollovers)2016-12-31$759
Total plan assets at end of year2016-12-31$346,984
Total plan assets at beginning of year2016-12-31$215,631
Total contributions received or receivable from participants2016-12-31$36,000
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$16,956
Noncash contributions received2016-12-31$0
Net income (gross income less expenses)2016-12-31$131,353
Net plan assets at end of year (total assets less liabilities)2016-12-31$346,984
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$215,631
Total contributions received or receivable from employer(s)2016-12-31$80,333
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$1,177
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : METROPOLITAN PAIN CONSULTANTS 401(K) 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$103,372
Expenses. Total of all expenses incurred2015-12-31$1,688
Benefits paid (including direct rollovers)2015-12-31$1,157
Total plan assets at end of year2015-12-31$215,631
Total plan assets at beginning of year2015-12-31$113,947
Total contributions received or receivable from participants2015-12-31$36,000
Expenses. Other expenses not covered elsewhere2015-12-31$0
Contributions received from other sources (not participants or employers)2015-12-31$0
Other income received2015-12-31$-6,737
Noncash contributions received2015-12-31$0
Net income (gross income less expenses)2015-12-31$101,684
Net plan assets at end of year (total assets less liabilities)2015-12-31$215,631
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$113,947
Total contributions received or receivable from employer(s)2015-12-31$74,109
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$531
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : METROPOLITAN PAIN CONSULTANTS 401(K) 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$113,947
Expenses. Total of all expenses incurred2014-12-31$0
Benefits paid (including direct rollovers)2014-12-31$0
Total plan assets at end of year2014-12-31$113,947
Total plan assets at beginning of year2014-12-31$0
Total contributions received or receivable from participants2014-12-31$35,000
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$628
Noncash contributions received2014-12-31$0
Net income (gross income less expenses)2014-12-31$113,947
Net plan assets at end of year (total assets less liabilities)2014-12-31$113,947
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$0
Total contributions received or receivable from employer(s)2014-12-31$78,319
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

Form 5500 Responses for METROPOLITAN PAIN CONSULTANTS 401(K) PLAN

2020: METROPOLITAN PAIN CONSULTANTS 401(K) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingYes
2020-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement - TrustYes
2019: METROPOLITAN PAIN CONSULTANTS 401(K) PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement - TrustYes
2018: METROPOLITAN PAIN CONSULTANTS 401(K) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement - TrustYes
2017: METROPOLITAN PAIN CONSULTANTS 401(K) 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 – TrustYes
2017-01-01Plan benefit arrangement - TrustYes
2016: METROPOLITAN PAIN CONSULTANTS 401(K) 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 – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: METROPOLITAN PAIN CONSULTANTS 401(K) 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 – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2014: METROPOLITAN PAIN CONSULTANTS 401(K) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01First time form 5500 has been submittedYes
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 – TrustYes
2014-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number715193
Policy instance 1
Insurance contract or identification number715193
Number of Individuals Covered0
Insurance policy start date2020-01-01
Insurance policy end date2020-12-24
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $121
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees121
Additional information about fees paid to insurance brokerREFERRAL/SERVICE FEE
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number715193
Policy instance 1
Insurance contract or identification number715193
Number of Individuals Covered9
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $54
Total amount of fees paid to insurance companyUSD $111
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees111
Additional information about fees paid to insurance brokerREFERRAL/SERVICE FEE
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number715193
Policy instance 1
Insurance contract or identification number715193
Number of Individuals Covered10
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $866
Total amount of fees paid to insurance companyUSD $195
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $866
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerREFERRAL/SERVICE FEE
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number715193
Policy instance 1
Insurance contract or identification number715193
Number of Individuals Covered11
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $411
Total amount of fees paid to insurance companyUSD $92
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $411
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerREFERRAL/SERVICE FEE
Insurance broker nameMERRILL LYNCH PIERCE FENNER & SMITH

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