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LEGACY OFFSHORE, L.L.C. 401(K) PLAN 401k Plan overview

Plan NameLEGACY OFFSHORE, L.L.C. 401(K) PLAN
Plan identification number 001

LEGACY OFFSHORE, L.L.C. 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.
  • 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

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

Company Name:LEGACY OFFSHORE, LLC
Employer identification number (EIN):300450130
NAIC Classification:238900

Additional information about LEGACY OFFSHORE, LLC

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2008-08-18
Company Identification Number: 0801018553
Legal Registered Office Address: 1122 HIGHBORNE CAY CT

TEXAS CITY
United States of America (USA)
77590

More information about LEGACY OFFSHORE, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LEGACY OFFSHORE, L.L.C. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012018-01-01LOUIS SCHAEFER2018-08-06
0012017-01-01LOUIS SCHAEFER2018-08-06
0012016-01-01KAREN STRIPLING2017-10-11
0012015-01-01AMY SANFORD2016-10-19
0012014-01-01AMY SANFORD2015-10-13 CHARLES ZAMORA2015-10-13
0012013-01-01AMY SOLIS
0012012-01-01AMY SOLIS2013-10-14 AMY SOLIS2013-10-14
0012011-01-01AMY SANFORD
0012010-01-01JERRY LOWRIMORE

Plan Statistics for LEGACY OFFSHORE, L.L.C. 401(K) PLAN

401k plan membership statisitcs for LEGACY OFFSHORE, L.L.C. 401(K) PLAN

Measure Date Value
2013: LEGACY OFFSHORE, L.L.C. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0191
Total number of active participants reported on line 7a of the Form 55002013-01-01102
Number of retired or separated participants receiving benefits2013-01-011
Number of other retired or separated participants entitled to future benefits2013-01-017
Total of all active and inactive participants2013-01-01110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01110
Number of participants with account balances2013-01-0128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: LEGACY OFFSHORE, L.L.C. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0182
Total number of active participants reported on line 7a of the Form 55002012-01-0156
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-017
Total of all active and inactive participants2012-01-0163
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0163
Number of participants with account balances2012-01-0123
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: LEGACY OFFSHORE, L.L.C. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01104
Total number of active participants reported on line 7a of the Form 55002011-01-0180
Number of retired or separated participants receiving benefits2011-01-013
Number of other retired or separated participants entitled to future benefits2011-01-0112
Total of all active and inactive participants2011-01-0195
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0195
Number of participants with account balances2011-01-0128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: LEGACY OFFSHORE, L.L.C. 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01142
Total number of active participants reported on line 7a of the Form 55002010-01-0197
Number of other retired or separated participants entitled to future benefits2010-01-016
Total of all active and inactive participants2010-01-01103
Total participants2010-01-01103
Number of participants with account balances2010-01-0127
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-013

Financial Data on LEGACY OFFSHORE, L.L.C. 401(K) PLAN

Measure Date Value
2013 : LEGACY OFFSHORE, L.L.C. 401(K) PLAN 2013 401k financial data
Total income from all sources2013-12-31$170,736
Expenses. Total of all expenses incurred2013-12-31$24,046
Benefits paid (including direct rollovers)2013-12-31$23,034
Total plan assets at end of year2013-12-31$700,731
Total plan assets at beginning of year2013-12-31$554,041
Value of fidelity bond covering the plan2013-12-31$10,000
Total contributions received or receivable from participants2013-12-31$64,868
Other income received2013-12-31$105,868
Net income (gross income less expenses)2013-12-31$146,690
Net plan assets at end of year (total assets less liabilities)2013-12-31$700,731
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$554,041
Assets. Value of participant loans2013-12-31$17,388
Value of certain deemed distributions of participant loans2013-12-31$17
Value of corrective distributions2013-12-31$711
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$284
2012 : LEGACY OFFSHORE, L.L.C. 401(K) PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total income from all sources (including contributions)2012-12-31$108,379
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$119,101
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$118,628
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$35,013
Value of total assets at end of year2012-12-31$554,041
Value of total assets at beginning of year2012-12-31$564,763
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$473
Total interest from all sources2012-12-31$705
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$56,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$35,013
Participant contributions at end of year2012-12-31$24,025
Participant contributions at beginning of year2012-12-31$2,396
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$-10,722
Value of net assets at end of year (total assets less liabilities)2012-12-31$554,041
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$564,763
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$527,619
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$554,207
Interest on participant loans2012-12-31$705
Value of interest in common/collective trusts at end of year2012-12-31$0
Value of interest in common/collective trusts at beginning of year2012-12-31$8,160
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$2,397
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$72,661
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31Yes
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$118,628
Contract administrator fees2012-12-31$473
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-12-31No
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31THIBODAUX HEBERT DESHOTELS LEBLANC
Accountancy firm EIN2012-12-31208102502
2011 : LEGACY OFFSHORE, L.L.C. 401(K) PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total income from all sources (including contributions)2011-12-31$164,196
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$130,522
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$94,295
Expenses. Certain deemed distributions of participant loans2011-12-31$35,590
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$201,448
Value of total assets at end of year2011-12-31$564,763
Value of total assets at beginning of year2011-12-31$531,089
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$637
Total interest from all sources2011-12-31$73
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$10,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$104,897
Participant contributions at end of year2011-12-31$2,396
Participant contributions at beginning of year2011-12-31$37,581
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$96,551
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$33,674
Value of net assets at end of year (total assets less liabilities)2011-12-31$564,763
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$531,089
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Investment advisory and management fees2011-12-31$637
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$554,207
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$470,672
Interest on participant loans2011-12-31$73
Value of interest in common/collective trusts at end of year2011-12-31$8,160
Value of interest in common/collective trusts at beginning of year2011-12-31$22,836
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$-37,325
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31Yes
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$94,295
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31THIBODAUX HEBERT DESHOTELS LEBLANC
Accountancy firm EIN2011-12-31208102502
2010 : LEGACY OFFSHORE, L.L.C. 401(K) PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total income from all sources (including contributions)2010-12-31$307,855
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$24,802
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$24,469
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$257,663
Value of total assets at end of year2010-12-31$531,089
Value of total assets at beginning of year2010-12-31$248,036
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$333
Total interest from all sources2010-12-31$43
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Administrative expenses professional fees incurred2010-12-31$333
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$10,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$102,737
Participant contributions at end of year2010-12-31$37,581
Participant contributions at beginning of year2010-12-31$35,590
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$154,926
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$283,053
Value of net assets at end of year (total assets less liabilities)2010-12-31$531,089
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$248,036
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$470,672
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$197,186
Interest on participant loans2010-12-31$43
Value of interest in common/collective trusts at end of year2010-12-31$22,836
Value of interest in common/collective trusts at beginning of year2010-12-31$15,260
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$50,149
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31Yes
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$24,469
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31THIBODAUX HEBERT DESHOTELS LEBLANC
Accountancy firm EIN2010-12-31208102502

Form 5500 Responses for LEGACY OFFSHORE, L.L.C. 401(K) PLAN

2013: LEGACY OFFSHORE, L.L.C. 401(K) 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 – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: LEGACY OFFSHORE, L.L.C. 401(K) 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 – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: LEGACY OFFSHORE, L.L.C. 401(K) 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 – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: LEGACY OFFSHORE, L.L.C. 401(K) PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-809752
Policy instance 1
Insurance contract or identification numberGA-809752
Number of Individuals Covered0
Insurance policy start date2013-01-01
Insurance policy end date2013-07-31
Total amount of commissions paid to insurance brokerUSD $838
Total amount of fees paid to insurance companyUSD $134
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?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
Commission paid to Insurance BrokerUSD $838
Insurance broker organization code?3
Amount paid for insurance broker fees134
Additional information about fees paid to insurance brokerADMINISTRATIVE ALLOWANCE
Insurance broker nameACUFF & ASSOCIATES INC
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number810040
Policy instance 2
Insurance contract or identification number810040
Number of Individuals Covered28
Insurance policy start date2013-07-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $6,472
Total amount of fees paid to insurance companyUSD $1,326
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?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
Commission paid to Insurance BrokerUSD $6,472
Insurance broker organization code?3
Amount paid for insurance broker fees1326
Additional information about fees paid to insurance brokerTPA ALLIANCE PROGRAM
Insurance broker nameRETIREMENT STRATEGIES GROUP, LLC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-809752
Policy instance 1
Insurance contract or identification numberGA-809752
Number of Individuals Covered22
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,089
Total amount of fees paid to insurance companyUSD $282
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?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
Commission paid to Insurance BrokerUSD $1,089
Insurance broker organization code?3
Amount paid for insurance broker fees282
Additional information about fees paid to insurance brokerADMINISTRATIVE ALLOWANCE
Insurance broker nameACUFF & ASSOCIATES INC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-809752
Policy instance 1
Insurance contract or identification numberGA-809752
Number of Individuals Covered28
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $3,563
Total amount of fees paid to insurance companyUSD $270
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?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
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-809752
Policy instance 1
Insurance contract or identification numberGA-809752
Number of Individuals Covered27
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $2,360
Total amount of fees paid to insurance companyUSD $135
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?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

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