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PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS PLAN 401k Plan overview

Plan NamePROVIDIEN, LLC 401(K) RETIREMENT SAVINGS PLAN
Plan identification number 001

PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • 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.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

PROVIDIEN, LLC has sponsored the creation of one or more 401k plans.

Company Name:PROVIDIEN, LLC
Employer identification number (EIN):273557593
NAIC Classification:326100

Additional information about PROVIDIEN, LLC

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 4839536

More information about PROVIDIEN, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012020-01-01
0012019-01-01
0012018-01-01
0012017-01-01MARIA MENDEZ MARIA MENDEZ2018-10-15
0012017-01-01MARIA MENDEZ MARIA MENDEZ2018-10-15
0012016-01-01MARIA MENDEZ MARIA MENDEZ2017-10-16
0012016-01-01 MARIA MENDEZ2017-10-13
0012015-01-01MARIA MENDEZ
0012014-01-01MARIA MENDEZ
0012013-01-01MARIA MENDEZ MARIA MENDEZ2015-01-23
0012012-01-01MARIA MENDEZ2013-07-29

Plan Statistics for PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS PLAN

401k plan membership statisitcs for PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS PLAN

Measure Date Value
2020: PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01448
Total number of active participants reported on line 7a of the Form 55002020-01-01302
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 participants2020-01-01302
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01302
Number of participants with account balances2020-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-013
2019: PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01382
Total number of active participants reported on line 7a of the Form 55002019-01-01262
Number of retired or separated participants receiving benefits2019-01-011
Number of other retired or separated participants entitled to future benefits2019-01-01172
Total of all active and inactive participants2019-01-01435
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01435
Number of participants with account balances2019-01-01417
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-0149
2018: PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01342
Total number of active participants reported on line 7a of the Form 55002018-01-01250
Number of retired or separated participants receiving benefits2018-01-011
Number of other retired or separated participants entitled to future benefits2018-01-01121
Total of all active and inactive participants2018-01-01372
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01372
Number of participants with account balances2018-01-01357
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-0130
2017: PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01334
Total number of active participants reported on line 7a of the Form 55002017-01-01244
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-01101
Total of all active and inactive participants2017-01-01345
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01345
Number of participants with account balances2017-01-01326
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-0126
2016: PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01353
Total number of active participants reported on line 7a of the Form 55002016-01-01246
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0187
Total of all active and inactive participants2016-01-01333
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01333
Number of participants with account balances2016-01-01312
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-0126
2015: PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01332
Total number of active participants reported on line 7a of the Form 55002015-01-01262
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0187
Total of all active and inactive participants2015-01-01349
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01349
Number of participants with account balances2015-01-01323
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-0136
2014: PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01286
Total number of active participants reported on line 7a of the Form 55002014-01-01236
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0191
Total of all active and inactive participants2014-01-01327
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01327
Number of participants with account balances2014-01-01295
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-0130
2013: PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01233
Total number of active participants reported on line 7a of the Form 55002013-01-01180
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0142
Total of all active and inactive participants2013-01-01222
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01222
Number of participants with account balances2013-01-01174
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-0135

Financial Data on PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS PLAN

Measure Date Value
2020 : PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-05-29$0
Total transfer of assets from this plan2020-05-29$11,864,777
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-05-29$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-05-29$0
Total income from all sources (including contributions)2020-05-29$-70,536
Total loss/gain on sale of assets2020-05-29$0
Total of all expenses incurred2020-05-29$1,204,866
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-05-29$1,185,377
Expenses. Certain deemed distributions of participant loans2020-05-29$5,463
Value of total corrective distributions2020-05-29$3,256
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-05-29$425,926
Value of total assets at end of year2020-05-29$0
Value of total assets at beginning of year2020-05-29$13,140,179
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-05-29$10,770
Total interest from all sources2020-05-29$24,601
Total dividends received (eg from common stock, registered investment company shares)2020-05-29$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-05-29Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2020-05-29$0
Was this plan covered by a fidelity bond2020-05-29Yes
Value of fidelity bond cover2020-05-29$1,000,000
If this is an individual account plan, was there a blackout period2020-05-29Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-05-29$0
Were there any nonexempt tranactions with any party-in-interest2020-05-29No
Contributions received from participants2020-05-29$300,892
Participant contributions at end of year2020-05-29$0
Participant contributions at beginning of year2020-05-29$334,212
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-05-29No
Value of net income/loss2020-05-29$-1,275,402
Value of net assets at end of year (total assets less liabilities)2020-05-29$0
Value of net assets at beginning of year (total assets less liabilities)2020-05-29$13,140,179
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-05-29No
Were any loans by the plan or fixed income obligations due to the plan in default2020-05-29No
Were any leases to which the plan was party in default or uncollectible2020-05-29No
Value of interest in pooled separate accounts at end of year2020-05-29$0
Value of interest in pooled separate accounts at beginning of year2020-05-29$10,405,154
Interest on participant loans2020-05-29$7,438
Interest earned on other investments2020-05-29$17,163
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-05-29$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-05-29$2,400,813
Net investment gain/loss from pooled separate accounts2020-05-29$-521,063
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-05-29No
Was there a failure to transmit to the plan any participant contributions2020-05-29No
Has the plan failed to provide any benefit when due under the plan2020-05-29No
Contributions received in cash from employer2020-05-29$125,034
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-05-29$1,185,377
Contract administrator fees2020-05-29$10,770
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-05-29Yes
Did the plan have assets held for investment2020-05-29No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-05-29No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-05-29Yes
Opinion of an independent qualified public accountant for this plan2020-05-29Disclaimer
Accountancy firm name2020-05-29DIXON HUGES GOODMAN LLP
Accountancy firm EIN2020-05-29560747981
2019 : PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$3,863,462
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$1,173,168
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$1,148,934
Expenses. Certain deemed distributions of participant loans2019-12-31$12,935
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$1,729,206
Value of total assets at end of year2019-12-31$13,140,179
Value of total assets at beginning of year2019-12-31$10,449,885
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$11,299
Total interest from all sources2019-12-31$60,332
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Administrative expenses professional fees incurred2019-12-31$11,299
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$1,000,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$1,214,226
Participant contributions at end of year2019-12-31$334,212
Participant contributions at beginning of year2019-12-31$409,266
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$22,749
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$2,690,294
Value of net assets at end of year (total assets less liabilities)2019-12-31$13,140,179
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$10,449,885
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in pooled separate accounts at end of year2019-12-31$10,405,154
Value of interest in pooled separate accounts at beginning of year2019-12-31$7,783,263
Interest on participant loans2019-12-31$21,842
Interest earned on other investments2019-12-31$38,490
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$2,400,813
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$2,257,356
Net investment gain/loss from pooled separate accounts2019-12-31$2,073,924
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$492,231
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$1,148,934
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31DIXON HUGHES GOODMAN LLP
Accountancy firm EIN2019-12-31560747981
2018 : PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$1,159,195
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$397,014
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$353,523
Expenses. Certain deemed distributions of participant loans2018-12-31$34,684
Value of total corrective distributions2018-12-31$225
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$1,711,838
Value of total assets at end of year2018-12-31$10,449,885
Value of total assets at beginning of year2018-12-31$9,687,704
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$8,582
Total interest from all sources2018-12-31$50,223
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Administrative expenses professional fees incurred2018-12-31$0
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$1,000,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$1,088,150
Participant contributions at end of year2018-12-31$409,266
Participant contributions at beginning of year2018-12-31$277,196
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$181,863
Other income not declared elsewhere2018-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$762,181
Value of net assets at end of year (total assets less liabilities)2018-12-31$10,449,885
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$9,687,704
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in pooled separate accounts at end of year2018-12-31$7,783,263
Value of interest in pooled separate accounts at beginning of year2018-12-31$7,661,912
Interest on participant loans2018-12-31$20,964
Interest earned on other investments2018-12-31$29,259
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$2,257,356
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$1,748,596
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$0
Net investment gain/loss from pooled separate accounts2018-12-31$-602,866
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$441,825
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$353,523
Contract administrator fees2018-12-31$8,582
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31DIXON HUGHES GOODMAN LLP
Accountancy firm EIN2018-12-31560747981
2017 : PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$2,695,680
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$1,261,878
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$1,249,863
Expenses. Certain deemed distributions of participant loans2017-12-31$1,777
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$1,423,568
Value of total assets at end of year2017-12-31$9,687,704
Value of total assets at beginning of year2017-12-31$8,253,902
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$10,238
Total interest from all sources2017-12-31$39,858
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$1,000,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$1,006,011
Participant contributions at end of year2017-12-31$277,196
Participant contributions at beginning of year2017-12-31$306,927
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$1,433,802
Value of net assets at end of year (total assets less liabilities)2017-12-31$9,687,704
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$8,253,902
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in pooled separate accounts at end of year2017-12-31$7,661,912
Value of interest in pooled separate accounts at beginning of year2017-12-31$5,845,980
Interest on participant loans2017-12-31$12,936
Interest earned on other investments2017-12-31$26,922
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$1,748,596
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$2,100,995
Net investment gain/loss from pooled separate accounts2017-12-31$1,232,254
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31Yes
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$417,557
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$1,249,863
Contract administrator fees2017-12-31$10,238
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31DIXON HUGHES GOODMAN LLP
Accountancy firm EIN2017-12-31560747981
2016 : PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total income from all sources (including contributions)2016-12-31$2,010,941
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$669,704
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$658,778
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$1,554,069
Value of total assets at end of year2016-12-31$8,253,902
Value of total assets at beginning of year2016-12-31$6,912,665
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$10,926
Total interest from all sources2016-12-31$41,590
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$1,000,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$1,084,955
Participant contributions at end of year2016-12-31$306,927
Participant contributions at beginning of year2016-12-31$321,834
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$13,002
Other income not declared elsewhere2016-12-31$1,159
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$1,341,237
Value of net assets at end of year (total assets less liabilities)2016-12-31$8,253,902
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$6,912,665
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in pooled separate accounts at end of year2016-12-31$5,845,980
Value of interest in pooled separate accounts at beginning of year2016-12-31$4,953,871
Interest on participant loans2016-12-31$14,716
Interest earned on other investments2016-12-31$26,874
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$2,100,995
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$1,636,960
Net investment gain/loss from pooled separate accounts2016-12-31$414,123
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$456,112
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$658,778
Contract administrator fees2016-12-31$10,926
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31DIXON HUGHES GOODMAN LLP
Accountancy firm EIN2016-12-31560747981
2015 : PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$1,657,028
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$354,909
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$345,136
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$1,685,656
Value of total assets at end of year2015-12-31$6,912,665
Value of total assets at beginning of year2015-12-31$5,610,546
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$9,773
Total interest from all sources2015-12-31$32,580
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$1,000,000
If this is an individual account plan, was there a blackout period2015-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$918,856
Participant contributions at end of year2015-12-31$321,834
Participant contributions at beginning of year2015-12-31$254,090
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$391,468
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$1,302,119
Value of net assets at end of year (total assets less liabilities)2015-12-31$6,912,665
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$5,610,546
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in pooled separate accounts at end of year2015-12-31$4,953,871
Value of interest in pooled separate accounts at beginning of year2015-12-31$3,977,923
Interest on participant loans2015-12-31$11,078
Interest earned on other investments2015-12-31$21,502
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$1,636,960
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$1,378,533
Net investment gain/loss from pooled separate accounts2015-12-31$-61,208
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$375,332
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$345,136
Contract administrator fees2015-12-31$9,773
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-12-31Yes
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31DIXON, HUGHES, GOODMAN LLP
Accountancy firm EIN2015-12-31560747981
2014 : PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total transfer of assets to this plan2014-12-31$2,072,725
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$1,491,264
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$1,395,282
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$1,384,520
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$1,221,083
Value of total assets at end of year2014-12-31$5,610,546
Value of total assets at beginning of year2014-12-31$3,441,839
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$10,762
Total interest from all sources2014-12-31$32,232
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$1,000,000
If this is an individual account plan, was there a blackout period2014-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$804,368
Participant contributions at end of year2014-12-31$254,090
Participant contributions at beginning of year2014-12-31$134,463
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$36,845
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$95,982
Value of net assets at end of year (total assets less liabilities)2014-12-31$5,610,546
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$3,441,839
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in pooled separate accounts at end of year2014-12-31$3,977,923
Value of interest in pooled separate accounts at beginning of year2014-12-31$2,456,810
Interest on participant loans2014-12-31$12,704
Interest earned on other investments2014-12-31$19,528
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$1,378,533
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$850,566
Net investment gain/loss from pooled separate accounts2014-12-31$237,949
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$379,870
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$1,384,520
Contract administrator fees2014-12-31$10,762
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-12-31Yes
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31DIXON, HUGHES, GOODMAN LLP
Accountancy firm EIN2014-12-31560747981
2013 : PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total transfer of assets to this plan2013-12-31$747,924
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total income from all sources (including contributions)2013-12-31$1,349,261
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$208,779
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$205,036
Value of total corrective distributions2013-12-31$2,240
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$905,981
Value of total assets at end of year2013-12-31$3,441,839
Value of total assets at beginning of year2013-12-31$1,553,433
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$1,503
Total interest from all sources2013-12-31$17,212
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$1,000,000
If this is an individual account plan, was there a blackout period2013-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$659,607
Participant contributions at end of year2013-12-31$134,463
Participant contributions at beginning of year2013-12-31$80,563
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$399
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$1,140,482
Value of net assets at end of year (total assets less liabilities)2013-12-31$3,441,839
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$1,553,433
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in pooled separate accounts at end of year2013-12-31$2,456,810
Value of interest in pooled separate accounts at beginning of year2013-12-31$850,073
Interest on participant loans2013-12-31$4,225
Interest earned on other investments2013-12-31$12,987
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$850,566
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$622,797
Net investment gain/loss from pooled separate accounts2013-12-31$426,068
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$245,975
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$205,036
Contract administrator fees2013-12-31$1,503
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-12-31Yes
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31DIXON, HUGHES, GOODMAN LLP
Accountancy firm EIN2013-12-31560747981

Form 5500 Responses for PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS PLAN

2020: PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS 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 – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS 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 – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS 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 – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS 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 – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedYes
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 – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS 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 – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS 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 – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: PROVIDIEN, LLC 401(K) RETIREMENT SAVINGS PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedYes
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 – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number67193
Policy instance 1
Insurance contract or identification number67193
Number of Individuals Covered302
Insurance policy start date2020-01-01
Insurance policy end date2020-05-29
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number67193
Policy instance 1
Insurance contract or identification number67193
Number of Individuals Covered435
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number67193
Policy instance 1
Insurance contract or identification number67193
Number of Individuals Covered372
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number67193
Policy instance 1
Insurance contract or identification number67193
Number of Individuals Covered345
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number67193
Policy instance 1
Insurance contract or identification number67193
Number of Individuals Covered349
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $15,289
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,289
Insurance broker organization code?3
Insurance broker nameNFP ADVISORY SERVICES
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number67193
Policy instance 1
Insurance contract or identification number67193
Number of Individuals Covered327
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $25,084
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,084
Insurance broker organization code?3
Insurance broker nameNFP ADVISORY SERVICES
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number67193
Policy instance 1
Insurance contract or identification number67193
Number of Individuals Covered222
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $14,299
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,299
Insurance broker organization code?3
Insurance broker nameFINANCIAL TELESIS INC

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