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VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN 401k Plan overview

Plan NameVALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN
Plan identification number 001

VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

D & A MARKETING, INC. DBA VALPAK OF TAMPA BAY has sponsored the creation of one or more 401k plans.

Company Name:D & A MARKETING, INC. DBA VALPAK OF TAMPA BAY
Employer identification number (EIN):271134369
NAIC Classification:541800

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012019-01-01ADELE HARLACHER2022-05-12
0012018-01-01
0012017-01-01
0012016-01-01
0012015-01-01
0012014-01-01DANIEL F. HARLACHER
0012013-01-01ADELE HARLACHER
0012012-01-01ADELE HARLACHER
0012011-01-01ADELE HARLACHER
0012010-06-01ADELE HARLACHER ADELE HARLACHER2011-10-16

Plan Statistics for VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN

401k plan membership statisitcs for VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN

Measure Date Value
2019: VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0111
Total number of active participants reported on line 7a of the Form 55002019-01-010
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-010
Number of participants with account balances2019-01-010
2018: VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0112
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 balances2018-01-019
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0112
Total number of active participants reported on line 7a of the Form 55002017-01-0111
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 participants2017-01-0112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0112
Number of participants with account balances2017-01-019
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0114
Total number of active participants reported on line 7a of the Form 55002016-01-0111
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 participants2016-01-0112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0112
Number of participants with account balances2016-01-019
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0113
Total number of active participants reported on line 7a of the Form 55002015-01-0111
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-011
Total of all active and inactive participants2015-01-0112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0112
Number of participants with account balances2015-01-018
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0113
Total number of active participants reported on line 7a of the Form 55002014-01-0113
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-0113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0113
Number of participants with account balances2014-01-018
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0115
Total number of active participants reported on line 7a of the Form 55002013-01-0113
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 participants2013-01-0113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0113
Number of participants with account balances2013-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0112
Total number of active participants reported on line 7a of the Form 55002012-01-0113
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 participants2012-01-0113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0113
Number of participants with account balances2012-01-018
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0114
Total number of active participants reported on line 7a of the Form 55002011-01-0112
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 participants2011-01-0112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0112
Number of participants with account balances2011-01-018
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year2010-06-010
Total number of active participants reported on line 7a of the Form 55002010-06-0114
Number of retired or separated participants receiving benefits2010-06-010
Number of other retired or separated participants entitled to future benefits2010-06-010
Total of all active and inactive participants2010-06-0114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-06-010
Total participants2010-06-0114
Number of participants with account balances2010-06-019
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-06-010

Financial Data on VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN

Measure Date Value
2019 : VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN 2019 401k financial data
Total income from all sources2019-12-31$49,464
Expenses. Total of all expenses incurred2019-12-31$537,391
Benefits paid (including direct rollovers)2019-12-31$535,891
Total plan assets at end of year2019-12-31$0
Total plan assets at beginning of year2019-12-31$487,927
Value of fidelity bond covering the plan2019-12-31$75,000
Total contributions received or receivable from participants2019-12-31$2,319
Other income received2019-12-31$47,145
Net income (gross income less expenses)2019-12-31$-487,927
Net plan assets at end of year (total assets less liabilities)2019-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$487,927
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$1,500
2018 : VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN 2018 401k financial data
Total income from all sources2018-12-31$-432
Expenses. Total of all expenses incurred2018-12-31$5,280
Total plan assets at end of year2018-12-31$487,927
Total plan assets at beginning of year2018-12-31$493,639
Value of fidelity bond covering the plan2018-12-31$75,000
Total contributions received or receivable from participants2018-12-31$32,736
Other income received2018-12-31$-33,168
Net income (gross income less expenses)2018-12-31$-5,712
Net plan assets at end of year (total assets less liabilities)2018-12-31$487,927
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$493,639
Assets. Value of participant loans2018-12-31$611
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$5,280
2017 : VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN 2017 401k financial data
Total income from all sources2017-12-31$110,621
Expenses. Total of all expenses incurred2017-12-31$6,099
Total plan assets at end of year2017-12-31$493,639
Total plan assets at beginning of year2017-12-31$389,117
Value of fidelity bond covering the plan2017-12-31$75,000
Total contributions received or receivable from participants2017-12-31$35,513
Expenses. Other expenses not covered elsewhere2017-12-31$366
Other income received2017-12-31$75,108
Net income (gross income less expenses)2017-12-31$104,522
Net plan assets at end of year (total assets less liabilities)2017-12-31$493,639
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$389,117
Assets. Value of participant loans2017-12-31$944
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$5,733
2016 : VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN 2016 401k financial data
Total income from all sources2016-12-31$62,460
Expenses. Total of all expenses incurred2016-12-31$4,933
Total plan assets at end of year2016-12-31$389,117
Total plan assets at beginning of year2016-12-31$331,590
Value of fidelity bond covering the plan2016-12-31$75,000
Total contributions received or receivable from participants2016-12-31$39,325
Expenses. Other expenses not covered elsewhere2016-12-31$380
Other income received2016-12-31$23,135
Net income (gross income less expenses)2016-12-31$57,527
Net plan assets at end of year (total assets less liabilities)2016-12-31$389,117
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$331,590
Assets. Value of participant loans2016-12-31$1,263
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$4,553
2015 : VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN 2015 401k financial data
Total income from all sources2015-12-31$113,318
Expenses. Total of all expenses incurred2015-12-31$4,535
Total plan assets at end of year2015-12-31$331,590
Total plan assets at beginning of year2015-12-31$222,807
Value of fidelity bond covering the plan2015-12-31$50,000
Total contributions received or receivable from participants2015-12-31$32,920
Contributions received from other sources (not participants or employers)2015-12-31$83,408
Other income received2015-12-31$-3,010
Net income (gross income less expenses)2015-12-31$108,783
Net plan assets at end of year (total assets less liabilities)2015-12-31$331,590
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$222,807
Assets. Value of participant loans2015-12-31$1,580
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$4,535
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN 2014 401k financial data
Total income from all sources2014-12-31$39,007
Expenses. Total of all expenses incurred2014-12-31$279,065
Benefits paid (including direct rollovers)2014-12-31$278,885
Total plan assets at end of year2014-12-31$222,807
Total plan assets at beginning of year2014-12-31$462,865
Value of fidelity bond covering the plan2014-12-31$50,000
Total contributions received or receivable from participants2014-12-31$13,014
Other income received2014-12-31$25,993
Net income (gross income less expenses)2014-12-31$-240,058
Net plan assets at end of year (total assets less liabilities)2014-12-31$222,807
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$462,865
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$180
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN 2013 401k financial data
Total income from all sources2013-12-31$45,558
Expenses. Total of all expenses incurred2013-12-31$23,185
Benefits paid (including direct rollovers)2013-12-31$21,654
Total plan assets at end of year2013-12-31$462,865
Total plan assets at beginning of year2013-12-31$440,492
Value of fidelity bond covering the plan2013-12-31$50,000
Total contributions received or receivable from participants2013-12-31$28,133
Other income received2013-12-31$17,425
Net income (gross income less expenses)2013-12-31$22,373
Net plan assets at end of year (total assets less liabilities)2013-12-31$462,865
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$440,492
Assets. Value of participant loans2013-12-31$0
Value of certain deemed distributions of participant loans2013-12-31$1,423
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$108
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN 2012 401k financial data
Total income from all sources2012-12-31$50,975
Expenses. Total of all expenses incurred2012-12-31$81
Total plan assets at end of year2012-12-31$440,492
Total plan assets at beginning of year2012-12-31$389,598
Value of fidelity bond covering the plan2012-12-31$50,000
Total contributions received or receivable from participants2012-12-31$28,653
Other income received2012-12-31$22,322
Net income (gross income less expenses)2012-12-31$50,894
Net plan assets at end of year (total assets less liabilities)2012-12-31$440,492
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$389,598
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$81
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN 2011 401k financial data
Total income from all sources2011-12-31$38,982
Expenses. Total of all expenses incurred2011-12-31$3,124
Benefits paid (including direct rollovers)2011-12-31$3,034
Total plan assets at end of year2011-12-31$389,598
Total plan assets at beginning of year2011-12-31$353,740
Value of fidelity bond covering the plan2011-12-31$50,000
Total contributions received or receivable from participants2011-12-31$37,573
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$1,409
Noncash contributions received2011-12-31$0
Net income (gross income less expenses)2011-12-31$35,858
Net plan assets at end of year (total assets less liabilities)2011-12-31$389,598
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$353,740
Total contributions received or receivable from employer(s)2011-12-31$0
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$90
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN 2010 401k financial data
Total income from all sources2010-12-31$353,740
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$353,740
Total plan assets at beginning of year2010-12-31$0
Value of fidelity bond covering the plan2010-12-31$50,000
Total contributions received or receivable from participants2010-12-31$57,748
Expenses. Other expenses not covered elsewhere2010-12-31$0
Contributions received from other sources (not participants or employers)2010-12-31$289,780
Other income received2010-12-31$6,212
Noncash contributions received2010-12-31$0
Net income (gross income less expenses)2010-12-31$353,740
Net plan assets at end of year (total assets less liabilities)2010-12-31$353,740
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$0
Total contributions received or receivable from employer(s)2010-12-31$0
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

Form 5500 Responses for VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN

2019: VALPAK OF TAMPA BAY 401(K) RETIREMENT 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 filingYes
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 – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement - TrustYes
2018: VALPAK OF TAMPA BAY 401(K) RETIREMENT 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 – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement - TrustYes
2017: VALPAK OF TAMPA BAY 401(K) RETIREMENT 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 – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement - TrustYes
2016: VALPAK OF TAMPA BAY 401(K) RETIREMENT 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 – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: VALPAK OF TAMPA BAY 401(K) RETIREMENT 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 – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2014: VALPAK OF TAMPA BAY 401(K) RETIREMENT 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 – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement - TrustYes
2013: VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement - TrustYes
2012: VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement - TrustYes
2011: VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement - TrustYes
2010: VALPAK OF TAMPA BAY 401(K) RETIREMENT PLAN 2010 form 5500 responses
2010-06-01Type of plan entitySingle employer plan
2010-06-01First time form 5500 has been submittedYes
2010-06-01Submission has been amendedNo
2010-06-01This submission is the final filingNo
2010-06-01This return/report is a short plan year return/report (less than 12 months)Yes
2010-06-01Plan is a collectively bargained planNo
2010-06-01Plan funding arrangement – InsuranceYes
2010-06-01Plan funding arrangement – TrustYes
2010-06-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number805312-000
Policy instance 1
Insurance contract or identification number805312-000
Number of Individuals Covered9
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $701
Total amount of fees paid to insurance companyUSD $60
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $701
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number805312-000
Policy instance 1
Insurance contract or identification number805312-000
Number of Individuals Covered9
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $2,185
Total amount of fees paid to insurance companyUSD $220
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,185
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameAMERICAN PENSION SERVICES, LLC

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