401k Plan data: HOME STREET SA 401(K) PLAN plan

HOME STREET SA 401(K) PLAN 401k Plan overview

Plan Name	HOME STREET SA 401(K) PLAN
Plan identification number	001

HOME STREET SA 401(K) PLAN Benefits

401k Plan Type

Defined 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

AMERICAN HEARTLAND, INC. has sponsored the creation of one or more 401k plans.

Company Name: AMERICAN HEARTLAND, INC.

Employer identification number (EIN): 311293226

NAIC Classification: 721310
NAIC Description: Rooming and Boarding Houses

Additional information about AMERICAN HEARTLAND, INC.

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division

Incorporation Date: 1990-01-12

Company Identification Number: 764578

Legal Registered Office Address: 7700 CLOISTER DRIVE
-
COLUMBUS
United States of America (USA)
43235

More information about AMERICAN HEARTLAND, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HOME STREET SA 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 MITCHELL SMITH 2023-10-06 MITCHELL SMITH 2023-10-06
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 GARY SMITH
001 2016-01-01 GARY SMITH
001 2015-01-01 GARY SMITH
001 2014-01-01 GARY SMITH
001 2013-01-01 GARY SMITH
001 2012-01-01 GARY SMITH
001 2011-01-01 GARY SMITH
001 2009-01-01 GARY SMITH GARY SMITH 2010-07-29
001 2009-01-01 GARY SMITH GARY SMITH 2010-07-29
001 2009-01-01 GARY P. SMITH GARY P. SMITH 2010-07-26
001 2009-01-01 GARY SMITH GARY SMITH 2010-08-11
001 2009-01-01 GARY SMITH GARY SMITH 2010-08-11
001 2009-01-01 GARY P. SMITH
001 2009-01-01 GARY P. SMITH GARY P. SMITH 2010-07-26
001 2009-01-01 GARY SMITH GARY SMITH 2010-08-11
001 2009-01-01 GARY P. SMITH GARY P. SMITH 2010-07-26
001 2009-01-01 GARY SMITH GARY SMITH 2010-09-27

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01	MITCHELL SMITH	2023-10-06	MITCHELL SMITH	2023-10-06
001	2021-01-01
001	2020-01-01
001	2019-01-01
001	2018-01-01
001	2017-01-01	GARY SMITH
001	2016-01-01	GARY SMITH
001	2015-01-01	GARY SMITH
001	2014-01-01	GARY SMITH
001	2013-01-01	GARY SMITH
001	2012-01-01	GARY SMITH
001	2011-01-01	GARY SMITH
001	2009-01-01	GARY SMITH		GARY SMITH	2010-07-29
001	2009-01-01	GARY SMITH		GARY SMITH	2010-07-29
001	2009-01-01	GARY P. SMITH		GARY P. SMITH	2010-07-26
001	2009-01-01	GARY SMITH		GARY SMITH	2010-08-11
001	2009-01-01	GARY SMITH		GARY SMITH	2010-08-11
001	2009-01-01	GARY P. SMITH
001	2009-01-01	GARY P. SMITH		GARY P. SMITH	2010-07-26
001	2009-01-01	GARY SMITH		GARY SMITH	2010-08-11
001	2009-01-01	GARY P. SMITH		GARY P. SMITH	2010-07-26
001	2009-01-01	GARY SMITH		GARY SMITH	2010-09-27

Plan Statistics for HOME STREET SA 401(K) PLAN

401k plan membership statisitcs for HOME STREET SA 401(K) PLAN

Measure Date Value
2021: HOME STREET SA 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 26
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 18
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 5
Total of all active and inactive participants 2021-01-01 23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 23
Number of participants with account balances 2021-01-01 23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: HOME STREET SA 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 17
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 23
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 3
Total of all active and inactive participants 2020-01-01 26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 26
Number of participants with account balances 2020-01-01 25
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: HOME STREET SA 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 19
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 14
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 3
Total of all active and inactive participants 2019-01-01 17
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 17
Number of participants with account balances 2019-01-01 16
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: HOME STREET SA 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 20
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 16
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 3
Total of all active and inactive participants 2018-01-01 19
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 19
Number of participants with account balances 2018-01-01 19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: HOME STREET SA 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 21
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 17
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 3
Total of all active and inactive participants 2017-01-01 20
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 20
Number of participants with account balances 2017-01-01 20
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: HOME STREET SA 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 25
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 18
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 3
Total of all active and inactive participants 2016-01-01 21
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 21
Number of participants with account balances 2016-01-01 19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: HOME STREET SA 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 14
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 21
Number of other retired or separated participants entitled to future benefits 2015-01-01 4
Total of all active and inactive participants 2015-01-01 25
Total participants 2015-01-01 25
Number of participants with account balances 2015-01-01 17
2014: HOME STREET SA 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 17
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 10
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 4
Total of all active and inactive participants 2014-01-01 14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 14
Number of participants with account balances 2014-01-01 14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: HOME STREET SA 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 11
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 13
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 4
Total of all active and inactive participants 2013-01-01 17
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 17
Number of participants with account balances 2013-01-01 11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: HOME STREET SA 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 0
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 8
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 3
Total of all active and inactive participants 2012-01-01 11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 11
Number of participants with account balances 2012-01-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: HOME STREET SA 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 5
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 3
Total of all active and inactive participants 2011-01-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 8
Number of participants with account balances 2011-01-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: HOME STREET SA 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 6
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 2
Total of all active and inactive participants 2009-01-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 8
Number of participants with account balances 2009-01-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 2

Measure	Date	Value
2021: HOME STREET SA 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	26
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	18
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	5
Total of all active and inactive participants	2021-01-01	23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	23
Number of participants with account balances	2021-01-01	23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: HOME STREET SA 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	17
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	23
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	3
Total of all active and inactive participants	2020-01-01	26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	26
Number of participants with account balances	2020-01-01	25
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: HOME STREET SA 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	19
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	14
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	3
Total of all active and inactive participants	2019-01-01	17
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	17
Number of participants with account balances	2019-01-01	16
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: HOME STREET SA 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	20
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	16
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	3
Total of all active and inactive participants	2018-01-01	19
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	19
Number of participants with account balances	2018-01-01	19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: HOME STREET SA 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	21
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	17
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	3
Total of all active and inactive participants	2017-01-01	20
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	20
Number of participants with account balances	2017-01-01	20
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: HOME STREET SA 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	25
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	18
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	3
Total of all active and inactive participants	2016-01-01	21
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	21
Number of participants with account balances	2016-01-01	19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: HOME STREET SA 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	14
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	21
Number of other retired or separated participants entitled to future benefits	2015-01-01	4
Total of all active and inactive participants	2015-01-01	25
Total participants	2015-01-01	25
Number of participants with account balances	2015-01-01	17
2014: HOME STREET SA 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	17
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	10
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	4
Total of all active and inactive participants	2014-01-01	14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	14
Number of participants with account balances	2014-01-01	14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: HOME STREET SA 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	11
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	13
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	4
Total of all active and inactive participants	2013-01-01	17
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	17
Number of participants with account balances	2013-01-01	11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: HOME STREET SA 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	0
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	8
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	3
Total of all active and inactive participants	2012-01-01	11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	11
Number of participants with account balances	2012-01-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: HOME STREET SA 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	5
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	3
Total of all active and inactive participants	2011-01-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	8
Number of participants with account balances	2011-01-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: HOME STREET SA 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	6
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	2
Total of all active and inactive participants	2009-01-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	8
Number of participants with account balances	2009-01-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	2

Financial Data on HOME STREET SA 401(K) PLAN

Measure	Date	Value
2021 : HOME STREET SA 401(K) PLAN 2021 401k financial data
Transfers to/from the plan	2021-12-31	$0
Total plan liabilities at end of year	2021-12-31	$0
Total plan liabilities at beginning of year	2021-12-31	$0
Total income from all sources	2021-12-31	$513,338
Expenses. Total of all expenses incurred	2021-12-31	$22,644
Benefits paid (including direct rollovers)	2021-12-31	$17,832
Total plan assets at end of year	2021-12-31	$1,191,904
Total plan assets at beginning of year	2021-12-31	$701,210
Value of fidelity bond covering the plan	2021-12-31	$100,000
Assets. Value of tangible personal property	2021-12-31	$0
Total contributions received or receivable from participants	2021-12-31	$63,133
Assets. Value of loans (other than to participants)	2021-12-31	$0
Expenses. Other expenses not covered elsewhere	2021-12-31	$0
Contributions received from other sources (not participants or employers)	2021-12-31	$267,706
Other income received	2021-12-31	$150,344
Noncash contributions received	2021-12-31	$0
Net income (gross income less expenses)	2021-12-31	$490,694
Net plan assets at end of year (total assets less liabilities)	2021-12-31	$1,191,904
Net plan assets at beginning of year (total assets less liabilities)	2021-12-31	$701,210
Assets. Value of participant loans	2021-12-31	$0
Assets. Value of assets in partnership/joint-venture interests	2021-12-31	$0
Assets. Value of real-estate (other than employer real property)	2021-12-31	$0
Assets. Value of employer securities	2021-12-31	$0
Assets. Value of employer real property	2021-12-31	$0
Total contributions received or receivable from employer(s)	2021-12-31	$32,155
Value of certain deemed distributions of participant loans	2021-12-31	$0
Value of corrective distributions	2021-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2021-12-31	$4,812
2020 : HOME STREET SA 401(K) PLAN 2020 401k financial data
Transfers to/from the plan	2020-12-31	$0
Total plan liabilities at end of year	2020-12-31	$0
Total plan liabilities at beginning of year	2020-12-31	$0
Total income from all sources	2020-12-31	$187,578
Expenses. Total of all expenses incurred	2020-12-31	$43,021
Benefits paid (including direct rollovers)	2020-12-31	$40,266
Total plan assets at end of year	2020-12-31	$701,210
Total plan assets at beginning of year	2020-12-31	$556,653
Value of fidelity bond covering the plan	2020-12-31	$100,000
Total contributions received or receivable from participants	2020-12-31	$54,144
Expenses. Other expenses not covered elsewhere	2020-12-31	$0
Contributions received from other sources (not participants or employers)	2020-12-31	$0
Other income received	2020-12-31	$111,736
Noncash contributions received	2020-12-31	$0
Net income (gross income less expenses)	2020-12-31	$144,557
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$701,210
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$556,653
Total contributions received or receivable from employer(s)	2020-12-31	$21,698
Value of certain deemed distributions of participant loans	2020-12-31	$0
Value of corrective distributions	2020-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2020-12-31	$2,755
2019 : HOME STREET SA 401(K) PLAN 2019 401k financial data
Transfers to/from the plan	2019-12-31	$0
Total plan liabilities at end of year	2019-12-31	$0
Total plan liabilities at beginning of year	2019-12-31	$0
Total income from all sources	2019-12-31	$229,421
Expenses. Total of all expenses incurred	2019-12-31	$143,913
Benefits paid (including direct rollovers)	2019-12-31	$141,914
Total plan assets at end of year	2019-12-31	$556,653
Total plan assets at beginning of year	2019-12-31	$471,145
Value of fidelity bond covering the plan	2019-12-31	$100,000
Total contributions received or receivable from participants	2019-12-31	$83,421
Expenses. Other expenses not covered elsewhere	2019-12-31	$0
Contributions received from other sources (not participants or employers)	2019-12-31	$0
Other income received	2019-12-31	$125,430
Noncash contributions received	2019-12-31	$0
Net income (gross income less expenses)	2019-12-31	$85,508
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$556,653
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$471,145
Total contributions received or receivable from employer(s)	2019-12-31	$20,570
Value of certain deemed distributions of participant loans	2019-12-31	$0
Value of corrective distributions	2019-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2019-12-31	$1,999
2018 : HOME STREET SA 401(K) PLAN 2018 401k financial data
Transfers to/from the plan	2018-12-31	$0
Total plan liabilities at end of year	2018-12-31	$0
Total plan liabilities at beginning of year	2018-12-31	$0
Total income from all sources	2018-12-31	$57,085
Expenses. Total of all expenses incurred	2018-12-31	$21,040
Benefits paid (including direct rollovers)	2018-12-31	$18,577
Total plan assets at end of year	2018-12-31	$471,145
Total plan assets at beginning of year	2018-12-31	$435,100
Value of fidelity bond covering the plan	2018-12-31	$100,000
Total contributions received or receivable from participants	2018-12-31	$80,987
Expenses. Other expenses not covered elsewhere	2018-12-31	$0
Contributions received from other sources (not participants or employers)	2018-12-31	$0
Other income received	2018-12-31	$-51,327
Noncash contributions received	2018-12-31	$0
Net income (gross income less expenses)	2018-12-31	$36,045
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$471,145
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$435,100
Total contributions received or receivable from employer(s)	2018-12-31	$27,425
Value of certain deemed distributions of participant loans	2018-12-31	$0
Value of corrective distributions	2018-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$2,463
2017 : HOME STREET SA 401(K) PLAN 2017 401k financial data
Transfers to/from the plan	2017-12-31	$0
Total plan liabilities at end of year	2017-12-31	$0
Total plan liabilities at beginning of year	2017-12-31	$0
Total income from all sources	2017-12-31	$264,397
Expenses. Total of all expenses incurred	2017-12-31	$1,622,538
Benefits paid (including direct rollovers)	2017-12-31	$1,618,060
Total plan assets at end of year	2017-12-31	$435,100
Total plan assets at beginning of year	2017-12-31	$1,793,241
Value of fidelity bond covering the plan	2017-12-31	$100,000
Assets. Value of tangible personal property	2017-12-31	$0
Total contributions received or receivable from participants	2017-12-31	$81,499
Assets. Value of loans (other than to participants)	2017-12-31	$0
Expenses. Other expenses not covered elsewhere	2017-12-31	$0
Contributions received from other sources (not participants or employers)	2017-12-31	$0
Other income received	2017-12-31	$151,142
Noncash contributions received	2017-12-31	$0
Net income (gross income less expenses)	2017-12-31	$-1,358,141
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$435,100
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$1,793,241
Assets. Value of participant loans	2017-12-31	$0
Assets. Value of assets in partnership/joint-venture interests	2017-12-31	$0
Assets. Value of real-estate (other than employer real property)	2017-12-31	$0
Assets. Value of employer securities	2017-12-31	$0
Assets. Value of employer real property	2017-12-31	$0
Total contributions received or receivable from employer(s)	2017-12-31	$31,756
Value of certain deemed distributions of participant loans	2017-12-31	$0
Value of corrective distributions	2017-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$4,478
2016 : HOME STREET SA 401(K) PLAN 2016 401k financial data
Transfers to/from the plan	2016-12-31	$0
Total plan liabilities at end of year	2016-12-31	$0
Total plan liabilities at beginning of year	2016-12-31	$0
Total income from all sources	2016-12-31	$245,737
Expenses. Total of all expenses incurred	2016-12-31	$80,311
Benefits paid (including direct rollovers)	2016-12-31	$71,622
Total plan assets at end of year	2016-12-31	$1,793,241
Total plan assets at beginning of year	2016-12-31	$1,627,815
Value of fidelity bond covering the plan	2016-12-31	$100,000
Total contributions received or receivable from participants	2016-12-31	$76,980
Expenses. Other expenses not covered elsewhere	2016-12-31	$0
Contributions received from other sources (not participants or employers)	2016-12-31	$55,570
Other income received	2016-12-31	$88,965
Noncash contributions received	2016-12-31	$0
Net income (gross income less expenses)	2016-12-31	$165,426
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$1,793,241
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$1,627,815
Total contributions received or receivable from employer(s)	2016-12-31	$24,222
Value of certain deemed distributions of participant loans	2016-12-31	$0
Value of corrective distributions	2016-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$8,689
2015 : HOME STREET SA 401(K) PLAN 2015 401k financial data
Transfers to/from the plan	2015-12-31	$0
Total plan liabilities at end of year	2015-12-31	$0
Total plan liabilities at beginning of year	2015-12-31	$0
Total income from all sources	2015-12-31	$68,977
Expenses. Total of all expenses incurred	2015-12-31	$11,980
Benefits paid (including direct rollovers)	2015-12-31	$3,581
Total plan assets at end of year	2015-12-31	$1,627,815
Total plan assets at beginning of year	2015-12-31	$1,570,818
Value of fidelity bond covering the plan	2015-12-31	$100,000
Total contributions received or receivable from participants	2015-12-31	$71,614
Expenses. Other expenses not covered elsewhere	2015-12-31	$0
Contributions received from other sources (not participants or employers)	2015-12-31	$0
Other income received	2015-12-31	$-22,663
Noncash contributions received	2015-12-31	$0
Net income (gross income less expenses)	2015-12-31	$56,997
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$1,627,815
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$1,570,818
Total contributions received or receivable from employer(s)	2015-12-31	$20,026
Value of certain deemed distributions of participant loans	2015-12-31	$0
Value of corrective distributions	2015-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$8,399
2014 : HOME STREET SA 401(K) PLAN 2014 401k financial data
Transfers to/from the plan	2014-12-31	$0
Total plan liabilities at end of year	2014-12-31	$0
Total plan liabilities at beginning of year	2014-12-31	$0
Total income from all sources	2014-12-31	$206,330
Expenses. Total of all expenses incurred	2014-12-31	$11,361
Benefits paid (including direct rollovers)	2014-12-31	$3,246
Total plan assets at end of year	2014-12-31	$1,570,818
Total plan assets at beginning of year	2014-12-31	$1,375,849
Value of fidelity bond covering the plan	2014-12-31	$100,000
Total contributions received or receivable from participants	2014-12-31	$65,058
Expenses. Other expenses not covered elsewhere	2014-12-31	$0
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$122,038
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$194,969
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$1,570,818
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$1,375,849
Total contributions received or receivable from employer(s)	2014-12-31	$19,234
Value of certain deemed distributions of participant loans	2014-12-31	$0
Value of corrective distributions	2014-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$8,115
2013 : HOME STREET SA 401(K) PLAN 2013 401k financial data
Transfers to/from the plan	2013-12-31	$0
Total plan liabilities at end of year	2013-12-31	$0
Total plan liabilities at beginning of year	2013-12-31	$0
Total income from all sources	2013-12-31	$323,357
Expenses. Total of all expenses incurred	2013-12-31	$14,501
Benefits paid (including direct rollovers)	2013-12-31	$9,751
Total plan assets at end of year	2013-12-31	$1,375,849
Total plan assets at beginning of year	2013-12-31	$1,066,993
Value of fidelity bond covering the plan	2013-12-31	$100,000
Total contributions received or receivable from participants	2013-12-31	$67,174
Expenses. Other expenses not covered elsewhere	2013-12-31	$0
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$237,795
Noncash contributions received	2013-12-31	$0
Net income (gross income less expenses)	2013-12-31	$308,856
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$1,375,849
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$1,066,993
Total contributions received or receivable from employer(s)	2013-12-31	$18,388
Value of certain deemed distributions of participant loans	2013-12-31	$0
Value of corrective distributions	2013-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$4,750
2012 : HOME STREET SA 401(K) PLAN 2012 401k financial data
Transfers to/from the plan	2012-12-31	$0
Total income from all sources	2012-12-31	$194,510
Expenses. Total of all expenses incurred	2012-12-31	$0
Benefits paid (including direct rollovers)	2012-12-31	$0
Total plan assets at end of year	2012-12-31	$1,066,993
Total plan assets at beginning of year	2012-12-31	$872,483
Value of fidelity bond covering the plan	2012-12-31	$100,000
Total contributions received or receivable from participants	2012-12-31	$68,331
Expenses. Other expenses not covered elsewhere	2012-12-31	$0
Contributions received from other sources (not participants or employers)	2012-12-31	$0
Other income received	2012-12-31	$110,769
Net income (gross income less expenses)	2012-12-31	$194,510
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$1,066,993
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$872,483
Assets. Value of participant loans	2012-12-31	$0
Total contributions received or receivable from employer(s)	2012-12-31	$15,410
Value of certain deemed distributions of participant loans	2012-12-31	$0
Value of corrective distributions	2012-12-31	$0
2011 : HOME STREET SA 401(K) PLAN 2011 401k financial data
Transfers to/from the plan	2011-12-31	$0
Total income from all sources	2011-12-31	$-61,905
Expenses. Total of all expenses incurred	2011-12-31	$5,134
Benefits paid (including direct rollovers)	2011-12-31	$5,134
Total plan assets at end of year	2011-12-31	$872,483
Total plan assets at beginning of year	2011-12-31	$939,522
Total contributions received or receivable from participants	2011-12-31	$51,672
Expenses. Other expenses not covered elsewhere	2011-12-31	$0
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$-123,997
Net income (gross income less expenses)	2011-12-31	$-67,039
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$872,483
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$939,522
Assets. Value of participant loans	2011-12-31	$0
Total contributions received or receivable from employer(s)	2011-12-31	$10,420
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2011-12-31	$0
Minimum employer required contribution for this plan year	2011-12-31	$0
Amount contributed by the employer to the plan for this plan year	2011-12-31	$0
2010 : HOME STREET SA 401(K) PLAN 2010 401k financial data
Transfers to/from the plan	2010-12-31	$0
Total income from all sources	2010-12-31	$209,528
Expenses. Total of all expenses incurred	2010-12-31	$1,993
Benefits paid (including direct rollovers)	2010-12-31	$1,993
Total plan assets at end of year	2010-12-31	$939,522
Total plan assets at beginning of year	2010-12-31	$731,987
Value of fidelity bond covering the plan	2010-12-31	$2,000,000
Total contributions received or receivable from participants	2010-12-31	$51,356
Expenses. Other expenses not covered elsewhere	2010-12-31	$0
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$149,258
Net income (gross income less expenses)	2010-12-31	$207,535
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$939,522
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$731,987
Assets. Value of participant loans	2010-12-31	$0
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2010-12-31	$284
Total contributions received or receivable from employer(s)	2010-12-31	$8,914
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2010-12-31	$0
Minimum employer required contribution for this plan year	2010-12-31	$0
Amount contributed by the employer to the plan for this plan year	2010-12-31	$0
2008 : HOME STREET SA 401(K) PLAN 2008 401k financial data
Total income from all sources	2008-12-31	$-429,324
Expenses. Total of all expenses incurred	2008-12-31	$40,577
Benefits paid (including direct rollovers)	2008-12-31	$40,542
Total plan assets at end of year	2008-12-31	$451,936
Total plan assets at beginning of year	2008-12-31	$921,837
Value of fidelity bond covering the plan	2008-12-31	$1,000,000
Total contributions received or receivable from participants	2008-12-31	$52,493
Expenses. Other expenses not covered elsewhere	2008-12-31	$35
Other income received	2008-12-31	$-497,821
Net income (gross income less expenses)	2008-12-31	$-469,901
Net plan assets at end of year (total assets less liabilities)	2008-12-31	$451,936
Net plan assets at beginning of year (total assets less liabilities)	2008-12-31	$921,837
Total contributions received or receivable from employer(s)	2008-12-31	$16,004

Form 5500 Responses for HOME STREET SA 401(K) PLAN

2021: HOME STREET SA 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	This submission is the final filing	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: HOME STREET SA 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: HOME STREET SA 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: HOME STREET SA 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: HOME STREET SA 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: HOME STREET SA 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: HOME STREET SA 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: HOME STREET SA 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: HOME STREET SA 401(K) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: HOME STREET SA 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: HOME STREET SA 401(K) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: HOME STREET SA 401(K) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-811883

Policy instance

Insurance contract or identification number	GA-811883
Insurance policy start date	2013-01-01
Insurance policy end date	2013-02-28
Total amount of commissions paid to insurance broker	USD $1,040
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $1,040
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	CES INSURANCE AGENCY

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-811883

Policy instance

Insurance contract or identification number	GA-811883
Number of Individuals Covered	8
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $3,796
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $3,796
Insurance broker organization code?	3
Insurance broker name	CES INSURANCE AGENCY INC

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-811883

Policy instance

Insurance contract or identification number	GA-811883
Number of Individuals Covered	8
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $3,785
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 number

GA-811883

Policy instance

Insurance contract or identification number	GA-811883
Number of Individuals Covered	8
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $2,314
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $2,314
Insurance broker organization code?	3
Insurance broker name	CES INSURANCE AGENCY INC

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

455244

Policy instance

Insurance contract or identification number	455244
Number of Individuals Covered	8
Insurance policy start date	2008-02-01
Insurance policy end date	2008-12-31
Total amount of commissions paid to insurance broker	USD $2,714
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,714
Insurance broker organization code?	3
Insurance broker name	MICHAEL J SHOTT

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

427474

Policy instance

Insurance contract or identification number	427474
Number of Individuals Covered	0
Insurance policy start date	2008-01-01
Insurance policy end date	2008-02-06
Total amount of commissions paid to insurance broker	USD $483
Total amount of fees paid to insurance company	USD $922
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $483
Amount paid for insurance broker fees	922
Additional information about fees paid to insurance broker	REFERRAL/SERVICE FEE
Insurance broker organization code?	3
Insurance broker name	INTEGRATED BENEFITS AGENCY INC

Was this data useful?

If you found the data here useful, PLEASE HELP US. We are a start-up and believe in making information freely available. By linking to us, posting on twitter, facebook and linkedin about us and generally spreading the word, you'll help us to grow. Our vision is to provide high quality data about the activities of all the companies in the world and where possible make it free to use and view. Finding and integrating data from thousands of data sources is time consuming and needs lots of effort. By simply spreading the word about us, you will help us. Please use the share buttons. It will only take a few seconds of your time. Thanks for helping

Information Disclaimer

The information provided on this website is not advice, endorsement or recommendation
The information published is supplied by third parties so we make no warranty on the accuracy, completeness etc. This information is provided "as-is". The information is subject to change as we obtain updates and corrections from the primary information sources.
You are free to use the information for your own personal research on the understanding to do so is at your own risk.

See full terms and conditions

Company Name:	AMERICAN HEARTLAND, INC.
Employer identification number (EIN):	311293226
NAIC Classification:	721310
NAIC Description:	Rooming and Boarding Houses

Jurisdiction of Incorporation:	Ohio Secretary of State Business Services Division
Incorporation Date:	1990-01-12
Company Identification Number:	764578
Legal Registered Office Address:	7700 CLOISTER DRIVE - COLUMBUS United States of America (USA) 43235