GENESIS HEALTHCARE SYSTEM has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GENESIS HEALTHCARE SYSTEM TDA THRIFT PLAN
Measure | Date | Value |
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2022 : GENESIS HEALTHCARE SYSTEM TDA THRIFT PLAN 2022 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2022-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $0 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $0 |
Total income from all sources (including contributions) | 2022-12-31 | $-5,507,619 |
Total loss/gain on sale of assets | 2022-12-31 | $0 |
Total of all expenses incurred | 2022-12-31 | $13,259,470 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-12-31 | $12,589,049 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-12-31 | $12,801,439 |
Value of total assets at end of year | 2022-12-31 | $153,874,907 |
Value of total assets at beginning of year | 2022-12-31 | $172,641,996 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-12-31 | $670,421 |
Total interest from all sources | 2022-12-31 | $2,844,019 |
Total dividends received (eg from common stock, registered investment company shares) | 2022-12-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-12-31 | No |
Was this plan covered by a fidelity bond | 2022-12-31 | Yes |
Value of fidelity bond cover | 2022-12-31 | $2,000,000 |
If this is an individual account plan, was there a blackout period | 2022-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2022-12-31 | No |
Contributions received from participants | 2022-12-31 | $10,007,639 |
Participant contributions at end of year | 2022-12-31 | $1,737,420 |
Participant contributions at beginning of year | 2022-12-31 | $1,530,655 |
Participant contributions at end of year | 2022-12-31 | $380,523 |
Participant contributions at beginning of year | 2022-12-31 | $368,564 |
Income. Received or receivable in cash from other sources (including rollovers) | 2022-12-31 | $483,374 |
Administrative expenses (other) incurred | 2022-12-31 | $670,421 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
Value of net income/loss | 2022-12-31 | $-18,767,089 |
Value of net assets at end of year (total assets less liabilities) | 2022-12-31 | $153,874,907 |
Value of net assets at beginning of year (total assets less liabilities) | 2022-12-31 | $172,641,996 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2022-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2022-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2022-12-31 | $74,738,302 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2022-12-31 | $87,887,685 |
Value of interest in pooled separate accounts at end of year | 2022-12-31 | $11,125,246 |
Value of interest in pooled separate accounts at beginning of year | 2022-12-31 | $13,332,490 |
Interest on participant loans | 2022-12-31 | $72,999 |
Interest earned on other investments | 2022-12-31 | $2,771,020 |
Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2022-12-31 | $65,804,915 |
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2022-12-31 | $69,439,946 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2022-12-31 | $-21,153,077 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2022-12-31 | Yes |
Has the plan failed to provide any benefit when due under the plan | 2022-12-31 | No |
Contributions received in cash from employer | 2022-12-31 | $2,310,426 |
Employer contributions (assets) at end of year | 2022-12-31 | $88,501 |
Employer contributions (assets) at beginning of year | 2022-12-31 | $82,656 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-12-31 | $12,589,049 |
Did the plan have assets held for investment | 2022-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2022-12-31 | Disclaimer |
Accountancy firm name | 2022-12-31 | REA & ASSOCIATES |
Accountancy firm EIN | 2022-12-31 | 341310124 |
2021 : GENESIS HEALTHCARE SYSTEM TDA THRIFT PLAN 2021 401k financial data |
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Unrealized appreciation/depreciation of other (non real estate) assets | 2021-12-31 | $1,631,383 |
Total unrealized appreciation/depreciation of assets | 2021-12-31 | $1,631,383 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $0 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $0 |
Total income from all sources (including contributions) | 2021-12-31 | $29,805,988 |
Total loss/gain on sale of assets | 2021-12-31 | $0 |
Total of all expenses incurred | 2021-12-31 | $9,925,425 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-12-31 | $9,258,489 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-12-31 | $13,200,349 |
Value of total assets at end of year | 2021-12-31 | $172,641,996 |
Value of total assets at beginning of year | 2021-12-31 | $152,761,433 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-12-31 | $666,936 |
Total interest from all sources | 2021-12-31 | $2,747,553 |
Total dividends received (eg from common stock, registered investment company shares) | 2021-12-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-12-31 | No |
Was this plan covered by a fidelity bond | 2021-12-31 | Yes |
Value of fidelity bond cover | 2021-12-31 | $2,000,000 |
If this is an individual account plan, was there a blackout period | 2021-12-31 | No |
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2021-12-31 | $0 |
Were there any nonexempt tranactions with any party-in-interest | 2021-12-31 | No |
Contributions received from participants | 2021-12-31 | $9,355,068 |
Participant contributions at end of year | 2021-12-31 | $1,530,655 |
Participant contributions at beginning of year | 2021-12-31 | $1,396,290 |
Participant contributions at end of year | 2021-12-31 | $368,564 |
Participant contributions at beginning of year | 2021-12-31 | $330,546 |
Income. Received or receivable in cash from other sources (including rollovers) | 2021-12-31 | $1,673,118 |
Administrative expenses (other) incurred | 2021-12-31 | $666,936 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
Value of net income/loss | 2021-12-31 | $19,880,563 |
Value of net assets at end of year (total assets less liabilities) | 2021-12-31 | $172,641,996 |
Value of net assets at beginning of year (total assets less liabilities) | 2021-12-31 | $152,761,433 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2021-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2021-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2021-12-31 | $87,887,685 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2021-12-31 | $75,030,378 |
Value of interest in pooled separate accounts at end of year | 2021-12-31 | $13,332,490 |
Value of interest in pooled separate accounts at beginning of year | 2021-12-31 | $11,838,178 |
Interest on participant loans | 2021-12-31 | $71,584 |
Interest earned on other investments | 2021-12-31 | $2,675,969 |
Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2021-12-31 | $69,439,946 |
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2021-12-31 | $64,087,684 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2021-12-31 | $12,226,703 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2021-12-31 | Yes |
Has the plan failed to provide any benefit when due under the plan | 2021-12-31 | No |
Contributions received in cash from employer | 2021-12-31 | $2,172,163 |
Employer contributions (assets) at end of year | 2021-12-31 | $82,656 |
Employer contributions (assets) at beginning of year | 2021-12-31 | $78,357 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2021-12-31 | $9,258,489 |
Did the plan have assets held for investment | 2021-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2021-12-31 | Disclaimer |
Accountancy firm name | 2021-12-31 | REA & ASSOCIATES |
Accountancy firm EIN | 2021-12-31 | 341310124 |
2020 : GENESIS HEALTHCARE SYSTEM TDA THRIFT PLAN 2020 401k financial data |
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Unrealized appreciation/depreciation of other (non real estate) assets | 2020-12-31 | $1,642,538 |
Total unrealized appreciation/depreciation of assets | 2020-12-31 | $1,642,538 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $0 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $0 |
Total income from all sources (including contributions) | 2020-12-31 | $29,562,014 |
Total loss/gain on sale of assets | 2020-12-31 | $0 |
Total of all expenses incurred | 2020-12-31 | $11,426,967 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-12-31 | $10,851,889 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-12-31 | $10,639,661 |
Value of total assets at end of year | 2020-12-31 | $152,761,433 |
Value of total assets at beginning of year | 2020-12-31 | $134,626,386 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-12-31 | $575,078 |
Total interest from all sources | 2020-12-31 | $2,463,002 |
Total dividends received (eg from common stock, registered investment company shares) | 2020-12-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-12-31 | No |
Was this plan covered by a fidelity bond | 2020-12-31 | Yes |
Value of fidelity bond cover | 2020-12-31 | $2,000,000 |
If this is an individual account plan, was there a blackout period | 2020-12-31 | No |
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2020-12-31 | $0 |
Were there any nonexempt tranactions with any party-in-interest | 2020-12-31 | No |
Contributions received from participants | 2020-12-31 | $8,031,337 |
Participant contributions at end of year | 2020-12-31 | $1,396,290 |
Participant contributions at beginning of year | 2020-12-31 | $1,497,794 |
Participant contributions at end of year | 2020-12-31 | $330,546 |
Participant contributions at beginning of year | 2020-12-31 | $286,738 |
Assets. Other investments not covered elsewhere at end of year | 2020-12-31 | $0 |
Assets. Other investments not covered elsewhere at beginning of year | 2020-12-31 | $75,339 |
Income. Received or receivable in cash from other sources (including rollovers) | 2020-12-31 | $531,251 |
Administrative expenses (other) incurred | 2020-12-31 | $575,078 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
Value of net income/loss | 2020-12-31 | $18,135,047 |
Value of net assets at end of year (total assets less liabilities) | 2020-12-31 | $152,761,433 |
Value of net assets at beginning of year (total assets less liabilities) | 2020-12-31 | $134,626,386 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2020-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2020-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2020-12-31 | $75,030,378 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2020-12-31 | $63,718,828 |
Value of interest in pooled separate accounts at end of year | 2020-12-31 | $11,838,178 |
Value of interest in pooled separate accounts at beginning of year | 2020-12-31 | $11,206,224 |
Interest on participant loans | 2020-12-31 | $75,680 |
Interest earned on other investments | 2020-12-31 | $2,387,322 |
Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2020-12-31 | $64,087,684 |
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2020-12-31 | $57,775,556 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2020-12-31 | $14,816,813 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2020-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2020-12-31 | No |
Contributions received in cash from employer | 2020-12-31 | $2,077,073 |
Employer contributions (assets) at end of year | 2020-12-31 | $78,357 |
Employer contributions (assets) at beginning of year | 2020-12-31 | $65,907 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-12-31 | $10,851,889 |
Did the plan have assets held for investment | 2020-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2020-12-31 | Unqualified |
Accountancy firm name | 2020-12-31 | REA & ASSOCIATES |
Accountancy firm EIN | 2020-12-31 | 341310124 |
2019 : GENESIS HEALTHCARE SYSTEM TDA THRIFT PLAN 2019 401k financial data |
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Unrealized appreciation/depreciation of other (non real estate) assets | 2019-12-31 | $2,132,485 |
Unrealized appreciation/depreciation of other (non real estate) assets | 2019-12-31 | $2,132,485 |
Total unrealized appreciation/depreciation of assets | 2019-12-31 | $2,132,485 |
Total unrealized appreciation/depreciation of assets | 2019-12-31 | $2,132,485 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $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 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 | $28,214,161 |
Total income from all sources (including contributions) | 2019-12-31 | $28,214,161 |
Total loss/gain on sale of assets | 2019-12-31 | $0 |
Total loss/gain on sale of assets | 2019-12-31 | $0 |
Total of all expenses incurred | 2019-12-31 | $10,654,968 |
Total of all expenses incurred | 2019-12-31 | $10,654,968 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $10,148,751 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $10,148,751 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-12-31 | $10,634,212 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-12-31 | $10,634,212 |
Value of total assets at end of year | 2019-12-31 | $134,626,386 |
Value of total assets at end of year | 2019-12-31 | $134,626,386 |
Value of total assets at beginning of year | 2019-12-31 | $117,067,193 |
Value of total assets at beginning of year | 2019-12-31 | $117,067,193 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $506,217 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $506,217 |
Total interest from all sources | 2019-12-31 | $2,320,701 |
Total interest from all sources | 2019-12-31 | $2,320,701 |
Total dividends received (eg from common stock, registered investment company shares) | 2019-12-31 | $0 |
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 year | 2019-12-31 | No |
Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
Value of fidelity bond cover | 2019-12-31 | $2,000,000 |
Value of fidelity bond cover | 2019-12-31 | $2,000,000 |
If this is an individual account plan, was there a blackout period | 2019-12-31 | No |
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2019-12-31 | $0 |
Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
Contributions received from participants | 2019-12-31 | $7,558,412 |
Contributions received from participants | 2019-12-31 | $7,558,412 |
Participant contributions at end of year | 2019-12-31 | $1,497,794 |
Participant contributions at end of year | 2019-12-31 | $1,497,794 |
Participant contributions at beginning of year | 2019-12-31 | $1,303,288 |
Participant contributions at beginning of year | 2019-12-31 | $1,303,288 |
Participant contributions at end of year | 2019-12-31 | $286,738 |
Participant contributions at end of year | 2019-12-31 | $286,738 |
Participant contributions at beginning of year | 2019-12-31 | $267,073 |
Participant contributions at beginning of year | 2019-12-31 | $267,073 |
Assets. Other investments not covered elsewhere at end of year | 2019-12-31 | $75,339 |
Assets. Other investments not covered elsewhere at end of year | 2019-12-31 | $75,339 |
Assets. Other investments not covered elsewhere at beginning of year | 2019-12-31 | $94,468 |
Assets. Other investments not covered elsewhere at beginning of year | 2019-12-31 | $94,468 |
Income. Received or receivable in cash from other sources (including rollovers) | 2019-12-31 | $1,280,154 |
Income. Received or receivable in cash from other sources (including rollovers) | 2019-12-31 | $1,280,154 |
Administrative expenses (other) incurred | 2019-12-31 | $506,217 |
Administrative expenses (other) incurred | 2019-12-31 | $506,217 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
Value of net income/loss | 2019-12-31 | $17,559,193 |
Value of net income/loss | 2019-12-31 | $17,559,193 |
Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $134,626,386 |
Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $134,626,386 |
Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $117,067,193 |
Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $117,067,193 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2019-12-31 | $63,718,828 |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2019-12-31 | $63,718,828 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2019-12-31 | $51,821,230 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2019-12-31 | $51,821,230 |
Value of interest in pooled separate accounts at end of year | 2019-12-31 | $11,206,224 |
Value of interest in pooled separate accounts at end of year | 2019-12-31 | $11,206,224 |
Value of interest in pooled separate accounts at beginning of year | 2019-12-31 | $10,126,543 |
Value of interest in pooled separate accounts at beginning of year | 2019-12-31 | $10,126,543 |
Interest on participant loans | 2019-12-31 | $72,059 |
Interest on participant loans | 2019-12-31 | $72,059 |
Interest earned on other investments | 2019-12-31 | $2,248,642 |
Interest earned on other investments | 2019-12-31 | $2,248,642 |
Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2019-12-31 | $57,775,556 |
Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2019-12-31 | $57,775,556 |
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2019-12-31 | $53,390,939 |
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2019-12-31 | $53,390,939 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2019-12-31 | $13,126,763 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2019-12-31 | $13,126,763 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | No |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
Contributions received in cash from employer | 2019-12-31 | $1,795,646 |
Contributions received in cash from employer | 2019-12-31 | $1,795,646 |
Employer contributions (assets) at end of year | 2019-12-31 | $65,907 |
Employer contributions (assets) at end of year | 2019-12-31 | $65,907 |
Employer contributions (assets) at beginning of year | 2019-12-31 | $63,652 |
Employer contributions (assets) at beginning of year | 2019-12-31 | $63,652 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-12-31 | $10,148,751 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-12-31 | $10,148,751 |
Did the plan have assets held for investment | 2019-12-31 | Yes |
Did the plan have assets held for investment | 2019-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | Yes |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Disclaimer |
Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Disclaimer |
Accountancy firm name | 2019-12-31 | REA & ASSOCIATES |
Accountancy firm name | 2019-12-31 | REA & ASSOCIATES |
Accountancy firm EIN | 2019-12-31 | 341310124 |
Accountancy firm EIN | 2019-12-31 | 341310124 |
2018 : GENESIS HEALTHCARE SYSTEM TDA THRIFT PLAN 2018 401k financial data |
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Unrealized appreciation/depreciation of other (non real estate) assets | 2018-12-31 | $-732,381 |
Total unrealized appreciation/depreciation of assets | 2018-12-31 | $-732,381 |
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 | $5,008,410 |
Total loss/gain on sale of assets | 2018-12-31 | $0 |
Total of all expenses incurred | 2018-12-31 | $9,253,137 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-12-31 | $9,201,751 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-12-31 | $8,990,958 |
Value of total assets at end of year | 2018-12-31 | $117,067,193 |
Value of total assets at beginning of year | 2018-12-31 | $121,311,920 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-12-31 | $51,386 |
Total interest from all sources | 2018-12-31 | $2,103,280 |
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 year | 2018-12-31 | No |
Was this plan covered by a fidelity bond | 2018-12-31 | Yes |
Value of fidelity bond cover | 2018-12-31 | $2,000,000 |
If this is an individual account plan, was there a blackout period | 2018-12-31 | No |
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2018-12-31 | $0 |
Were there any nonexempt tranactions with any party-in-interest | 2018-12-31 | No |
Contributions received from participants | 2018-12-31 | $6,856,053 |
Participant contributions at end of year | 2018-12-31 | $1,303,288 |
Participant contributions at beginning of year | 2018-12-31 | $1,395,466 |
Participant contributions at end of year | 2018-12-31 | $267,073 |
Participant contributions at beginning of year | 2018-12-31 | $246,812 |
Assets. Other investments not covered elsewhere at end of year | 2018-12-31 | $94,468 |
Assets. Other investments not covered elsewhere at beginning of year | 2018-12-31 | $300,132 |
Income. Received or receivable in cash from other sources (including rollovers) | 2018-12-31 | $448,561 |
Administrative expenses (other) incurred | 2018-12-31 | $51,386 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
Value of net income/loss | 2018-12-31 | $-4,244,727 |
Value of net assets at end of year (total assets less liabilities) | 2018-12-31 | $117,067,193 |
Value of net assets at beginning of year (total assets less liabilities) | 2018-12-31 | $121,311,920 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2018-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2018-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2018-12-31 | $51,821,230 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2018-12-31 | $54,720,206 |
Value of interest in pooled separate accounts at end of year | 2018-12-31 | $10,126,543 |
Value of interest in pooled separate accounts at beginning of year | 2018-12-31 | $12,219,708 |
Interest on participant loans | 2018-12-31 | $65,519 |
Interest earned on other investments | 2018-12-31 | $2,037,761 |
Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2018-12-31 | $53,390,939 |
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2018-12-31 | $52,365,456 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2018-12-31 | $-5,353,447 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2018-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2018-12-31 | No |
Contributions received in cash from employer | 2018-12-31 | $1,686,344 |
Employer contributions (assets) at end of year | 2018-12-31 | $63,652 |
Employer contributions (assets) at beginning of year | 2018-12-31 | $64,140 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-12-31 | $9,201,751 |
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2018-12-31 | No |
Did the plan have assets held for investment | 2018-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-12-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2018-12-31 | Disclaimer |
Accountancy firm name | 2018-12-31 | REA & ASSOCIATES |
Accountancy firm EIN | 2018-12-31 | 341310124 |
2017 : GENESIS HEALTHCARE SYSTEM TDA THRIFT PLAN 2017 401k financial data |
---|
Unrealized appreciation/depreciation of other (non real estate) assets | 2017-12-31 | $511,223 |
Total unrealized appreciation/depreciation of assets | 2017-12-31 | $511,223 |
Total income from all sources (including contributions) | 2017-12-31 | $21,443,996 |
Total of all expenses incurred | 2017-12-31 | $8,007,069 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-12-31 | $7,960,552 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-12-31 | $8,363,157 |
Value of total assets at end of year | 2017-12-31 | $121,311,920 |
Value of total assets at beginning of year | 2017-12-31 | $107,874,993 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-12-31 | $46,517 |
Total interest from all sources | 2017-12-31 | $1,515,380 |
Total dividends received (eg from common stock, registered investment company shares) | 2017-12-31 | $441,670 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2017-12-31 | $441,670 |
Was this plan covered by a fidelity bond | 2017-12-31 | Yes |
Value of fidelity bond cover | 2017-12-31 | $2,000,000 |
If this is an individual account plan, was there a blackout period | 2017-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2017-12-31 | No |
Contributions received from participants | 2017-12-31 | $6,298,695 |
Participant contributions at end of year | 2017-12-31 | $1,395,466 |
Participant contributions at beginning of year | 2017-12-31 | $1,365,680 |
Participant contributions at end of year | 2017-12-31 | $246,812 |
Participant contributions at beginning of year | 2017-12-31 | $230,485 |
Assets. Other investments not covered elsewhere at end of year | 2017-12-31 | $300,132 |
Assets. Other investments not covered elsewhere at beginning of year | 2017-12-31 | $403,246 |
Income. Received or receivable in cash from other sources (including rollovers) | 2017-12-31 | $602,419 |
Administrative expenses (other) incurred | 2017-12-31 | $46,517 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
Value of net income/loss | 2017-12-31 | $13,436,927 |
Value of net assets at end of year (total assets less liabilities) | 2017-12-31 | $121,311,920 |
Value of net assets at beginning of year (total assets less liabilities) | 2017-12-31 | $107,874,993 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2017-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2017-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2017-12-31 | $55,214,452 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2017-12-31 | $47,540,658 |
Value of interest in pooled separate accounts at end of year | 2017-12-31 | $8,195,601 |
Value of interest in pooled separate accounts at beginning of year | 2017-12-31 | $7,476,627 |
Interest on participant loans | 2017-12-31 | $54,975 |
Interest earned on other investments | 2017-12-31 | $1,460,405 |
Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2017-12-31 | $55,895,317 |
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2017-12-31 | $50,803,585 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2017-12-31 | $9,354,484 |
Net investment gain/loss from pooled separate accounts | 2017-12-31 | $1,258,082 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-12-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2017-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2017-12-31 | No |
Contributions received in cash from employer | 2017-12-31 | $1,462,043 |
Employer contributions (assets) at end of year | 2017-12-31 | $64,140 |
Employer contributions (assets) at beginning of year | 2017-12-31 | $54,712 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-12-31 | $7,960,552 |
Did the plan have assets held for investment | 2017-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-12-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2017-12-31 | Disclaimer |
Accountancy firm name | 2017-12-31 | MCLAIN, HILL, RUGG & ASSOCIATES,INC |
Accountancy firm EIN | 2017-12-31 | 311038077 |
2016 : GENESIS HEALTHCARE SYSTEM TDA THRIFT PLAN 2016 401k financial data |
---|
Unrealized appreciation/depreciation of other (non real estate) assets | 2016-12-31 | $199,888 |
Total unrealized appreciation/depreciation of assets | 2016-12-31 | $199,888 |
Total income from all sources (including contributions) | 2016-12-31 | $14,213,848 |
Total of all expenses incurred | 2016-12-31 | $6,756,869 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-12-31 | $6,716,157 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-12-31 | $8,035,726 |
Value of total assets at end of year | 2016-12-31 | $107,874,993 |
Value of total assets at beginning of year | 2016-12-31 | $100,418,014 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-12-31 | $40,712 |
Total interest from all sources | 2016-12-31 | $1,370,816 |
Total dividends received (eg from common stock, registered investment company shares) | 2016-12-31 | $362,922 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2016-12-31 | $362,922 |
Was this plan covered by a fidelity bond | 2016-12-31 | Yes |
Value of fidelity bond cover | 2016-12-31 | $2,000,000 |
If this is an individual account plan, was there a blackout period | 2016-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2016-12-31 | No |
Contributions received from participants | 2016-12-31 | $5,925,768 |
Participant contributions at end of year | 2016-12-31 | $1,365,680 |
Participant contributions at beginning of year | 2016-12-31 | $1,238,251 |
Participant contributions at end of year | 2016-12-31 | $230,485 |
Participant contributions at beginning of year | 2016-12-31 | $203,813 |
Assets. Other investments not covered elsewhere at end of year | 2016-12-31 | $403,246 |
Assets. Other investments not covered elsewhere at beginning of year | 2016-12-31 | $368,113 |
Income. Received or receivable in cash from other sources (including rollovers) | 2016-12-31 | $541,228 |
Administrative expenses (other) incurred | 2016-12-31 | $40,712 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
Value of net income/loss | 2016-12-31 | $7,456,979 |
Value of net assets at end of year (total assets less liabilities) | 2016-12-31 | $107,874,993 |
Value of net assets at beginning of year (total assets less liabilities) | 2016-12-31 | $100,418,014 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2016-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2016-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2016-12-31 | $47,540,658 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2016-12-31 | $43,687,316 |
Value of interest in pooled separate accounts at end of year | 2016-12-31 | $7,476,627 |
Value of interest in pooled separate accounts at beginning of year | 2016-12-31 | $7,608,371 |
Interest on participant loans | 2016-12-31 | $48,966 |
Interest earned on other investments | 2016-12-31 | $1,321,850 |
Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2016-12-31 | $50,803,585 |
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2016-12-31 | $47,257,993 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2016-12-31 | $3,767,984 |
Net investment gain/loss from pooled separate accounts | 2016-12-31 | $476,512 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2016-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2016-12-31 | No |
Contributions received in cash from employer | 2016-12-31 | $1,568,730 |
Employer contributions (assets) at end of year | 2016-12-31 | $54,712 |
Employer contributions (assets) at beginning of year | 2016-12-31 | $54,157 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-12-31 | $6,716,157 |
Did the plan have assets held for investment | 2016-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-12-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2016-12-31 | Disclaimer |
Accountancy firm name | 2016-12-31 | MCLAIN, HILL, RUGG & ASSOCIATES,INC |
Accountancy firm EIN | 2016-12-31 | 311038077 |
2015 : GENESIS HEALTHCARE SYSTEM TDA THRIFT PLAN 2015 401k financial data |
---|
Unrealized appreciation/depreciation of other (non real estate) assets | 2015-12-31 | $-22,985 |
Total unrealized appreciation/depreciation of assets | 2015-12-31 | $-22,985 |
Total income from all sources (including contributions) | 2015-12-31 | $10,854,599 |
Total of all expenses incurred | 2015-12-31 | $9,768,447 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-12-31 | $9,752,546 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-12-31 | $8,789,315 |
Value of total assets at end of year | 2015-12-31 | $100,418,014 |
Value of total assets at beginning of year | 2015-12-31 | $99,331,862 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-12-31 | $15,901 |
Total interest from all sources | 2015-12-31 | $1,305,837 |
Total dividends received (eg from common stock, registered investment company shares) | 2015-12-31 | $381,936 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2015-12-31 | $381,936 |
Was this plan covered by a fidelity bond | 2015-12-31 | Yes |
Value of fidelity bond cover | 2015-12-31 | $2,000,000 |
If this is an individual account plan, was there a blackout period | 2015-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2015-12-31 | No |
Contributions received from participants | 2015-12-31 | $5,823,676 |
Participant contributions at end of year | 2015-12-31 | $1,238,251 |
Participant contributions at beginning of year | 2015-12-31 | $1,283,969 |
Participant contributions at end of year | 2015-12-31 | $203,813 |
Participant contributions at beginning of year | 2015-12-31 | $372 |
Assets. Other investments not covered elsewhere at end of year | 2015-12-31 | $368,113 |
Assets. Other investments not covered elsewhere at beginning of year | 2015-12-31 | $366,868 |
Income. Received or receivable in cash from other sources (including rollovers) | 2015-12-31 | $1,383,261 |
Administrative expenses (other) incurred | 2015-12-31 | $15,901 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
Value of net income/loss | 2015-12-31 | $1,086,152 |
Value of net assets at end of year (total assets less liabilities) | 2015-12-31 | $100,418,014 |
Value of net assets at beginning of year (total assets less liabilities) | 2015-12-31 | $99,331,862 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2015-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2015-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2015-12-31 | $43,687,316 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2015-12-31 | $42,375,215 |
Value of interest in pooled separate accounts at end of year | 2015-12-31 | $7,608,371 |
Value of interest in pooled separate accounts at beginning of year | 2015-12-31 | $8,475,631 |
Interest on participant loans | 2015-12-31 | $45,219 |
Interest earned on other investments | 2015-12-31 | $1,260,618 |
Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2015-12-31 | $47,257,993 |
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2015-12-31 | $46,829,701 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2015-12-31 | $493,166 |
Net investment gain/loss from pooled separate accounts | 2015-12-31 | $-92,670 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-12-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2015-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2015-12-31 | No |
Contributions received in cash from employer | 2015-12-31 | $1,582,378 |
Employer contributions (assets) at end of year | 2015-12-31 | $54,157 |
Employer contributions (assets) at beginning of year | 2015-12-31 | $106 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-12-31 | $9,752,546 |
Did the plan have assets held for investment | 2015-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-12-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2015-12-31 | Disclaimer |
Accountancy firm name | 2015-12-31 | MCLAIN, HILL, RUGG & ASSOCIATES,INC |
Accountancy firm EIN | 2015-12-31 | 311038077 |
2014 : GENESIS HEALTHCARE SYSTEM TDA THRIFT PLAN 2014 401k financial data |
---|
Unrealized appreciation/depreciation of other (non real estate) assets | 2014-12-31 | $187,312 |
Total unrealized appreciation/depreciation of assets | 2014-12-31 | $187,312 |
Total income from all sources (including contributions) | 2014-12-31 | $12,102,457 |
Total of all expenses incurred | 2014-12-31 | $6,890,289 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-12-31 | $6,873,555 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-12-31 | $7,615,311 |
Value of total assets at end of year | 2014-12-31 | $99,331,862 |
Value of total assets at beginning of year | 2014-12-31 | $94,119,694 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-12-31 | $16,734 |
Total interest from all sources | 2014-12-31 | $1,251,560 |
Total dividends received (eg from common stock, registered investment company shares) | 2014-12-31 | $335,737 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2014-12-31 | $335,737 |
Was this plan covered by a fidelity bond | 2014-12-31 | Yes |
Value of fidelity bond cover | 2014-12-31 | $2,000,000 |
If this is an individual account plan, was there a blackout period | 2014-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2014-12-31 | No |
Contributions received from participants | 2014-12-31 | $5,239,402 |
Participant contributions at end of year | 2014-12-31 | $1,283,969 |
Participant contributions at beginning of year | 2014-12-31 | $1,186,526 |
Participant contributions at end of year | 2014-12-31 | $372 |
Participant contributions at beginning of year | 2014-12-31 | $744 |
Assets. Other investments not covered elsewhere at end of year | 2014-12-31 | $366,868 |
Assets. Other investments not covered elsewhere at beginning of year | 2014-12-31 | $325,319 |
Income. Received or receivable in cash from other sources (including rollovers) | 2014-12-31 | $891,203 |
Administrative expenses (other) incurred | 2014-12-31 | $16,734 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
Value of net income/loss | 2014-12-31 | $5,212,168 |
Value of net assets at end of year (total assets less liabilities) | 2014-12-31 | $99,331,862 |
Value of net assets at beginning of year (total assets less liabilities) | 2014-12-31 | $94,119,694 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2014-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2014-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2014-12-31 | $42,375,215 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2014-12-31 | $39,460,110 |
Value of interest in pooled separate accounts at end of year | 2014-12-31 | $8,475,631 |
Value of interest in pooled separate accounts at beginning of year | 2014-12-31 | $8,619,492 |
Interest on participant loans | 2014-12-31 | $42,669 |
Interest earned on other investments | 2014-12-31 | $1,208,891 |
Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2014-12-31 | $46,829,701 |
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2014-12-31 | $44,527,289 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2014-12-31 | $2,149,977 |
Net investment gain/loss from pooled separate accounts | 2014-12-31 | $562,560 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2014-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2014-12-31 | No |
Contributions received in cash from employer | 2014-12-31 | $1,484,706 |
Employer contributions (assets) at end of year | 2014-12-31 | $106 |
Employer contributions (assets) at beginning of year | 2014-12-31 | $214 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-12-31 | $6,873,555 |
Did the plan have assets held for investment | 2014-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-12-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2014-12-31 | Disclaimer |
Accountancy firm name | 2014-12-31 | MCLAIN, HILL, RUGG & ASSOCIATES,INC |
Accountancy firm EIN | 2014-12-31 | 311038077 |
2013 : GENESIS HEALTHCARE SYSTEM TDA THRIFT PLAN 2013 401k financial data |
---|
Unrealized appreciation/depreciation of other (non real estate) assets | 2013-12-31 | $433,715 |
Total unrealized appreciation/depreciation of assets | 2013-12-31 | $433,715 |
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 | $21,012,364 |
Total loss/gain on sale of assets | 2013-12-31 | $0 |
Total of all expenses incurred | 2013-12-31 | $5,078,668 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-12-31 | $5,049,105 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-12-31 | $6,939,165 |
Value of total assets at end of year | 2013-12-31 | $96,707,733 |
Value of total assets at beginning of year | 2013-12-31 | $80,774,037 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-12-31 | $29,563 |
Total interest from all sources | 2013-12-31 | $1,161,465 |
Total dividends received (eg from common stock, registered investment company shares) | 2013-12-31 | $250,634 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2013-12-31 | $250,634 |
Was this plan covered by a fidelity bond | 2013-12-31 | Yes |
Value of fidelity bond cover | 2013-12-31 | $2,000,000 |
If this is an individual account plan, was there a blackout period | 2013-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2013-12-31 | No |
Contributions received from participants | 2013-12-31 | $4,888,567 |
Participant contributions at end of year | 2013-12-31 | $1,033,380 |
Participant contributions at beginning of year | 2013-12-31 | $866,615 |
Participant contributions at end of year | 2013-12-31 | $744 |
Participant contributions at beginning of year | 2013-12-31 | $376 |
Assets. Other investments not covered elsewhere at end of year | 2013-12-31 | $325,319 |
Assets. Other investments not covered elsewhere at beginning of year | 2013-12-31 | $289,486 |
Income. Received or receivable in cash from other sources (including rollovers) | 2013-12-31 | $562,019 |
Administrative expenses (other) incurred | 2013-12-31 | $29,563 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
Value of net income/loss | 2013-12-31 | $15,933,696 |
Value of net assets at end of year (total assets less liabilities) | 2013-12-31 | $96,707,733 |
Value of net assets at beginning of year (total assets less liabilities) | 2013-12-31 | $80,774,037 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2013-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2013-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2013-12-31 | $41,962,518 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2013-12-31 | $27,129,590 |
Value of interest in pooled separate accounts at end of year | 2013-12-31 | $8,463,406 |
Value of interest in pooled separate accounts at beginning of year | 2013-12-31 | $12,141,097 |
Interest on participant loans | 2013-12-31 | $38,638 |
Interest earned on other investments | 2013-12-31 | $1,122,827 |
Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2013-12-31 | $44,922,152 |
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2013-12-31 | $40,346,776 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2013-12-31 | $9,548,187 |
Net investment gain/loss from pooled separate accounts | 2013-12-31 | $2,679,198 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2013-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2013-12-31 | No |
Contributions received in cash from employer | 2013-12-31 | $1,488,579 |
Employer contributions (assets) at end of year | 2013-12-31 | $214 |
Employer contributions (assets) at beginning of year | 2013-12-31 | $97 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-12-31 | $5,049,105 |
Did the plan have assets held for investment | 2013-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-12-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2013-12-31 | Disclaimer |
Accountancy firm name | 2013-12-31 | MCLAIN, HILL, RUGG & ASSOCIATES,INC |
Accountancy firm EIN | 2013-12-31 | 311038077 |
2012 : GENESIS HEALTHCARE SYSTEM TDA THRIFT PLAN 2012 401k financial data |
---|
Unrealized appreciation/depreciation of other (non real estate) assets | 2012-12-31 | $524,191 |
Total unrealized appreciation/depreciation of assets | 2012-12-31 | $524,191 |
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 | $3,590 |
Total income from all sources (including contributions) | 2012-12-31 | $12,750,018 |
Total loss/gain on sale of assets | 2012-12-31 | $0 |
Total of all expenses incurred | 2012-12-31 | $4,729,549 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-12-31 | $4,713,362 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-12-31 | $6,800,575 |
Value of total assets at end of year | 2012-12-31 | $80,774,037 |
Value of total assets at beginning of year | 2012-12-31 | $72,757,158 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-12-31 | $16,187 |
Total interest from all sources | 2012-12-31 | $1,049,289 |
Total dividends received (eg from common stock, registered investment company shares) | 2012-12-31 | $234,991 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2012-12-31 | $234,991 |
Was this plan covered by a fidelity bond | 2012-12-31 | Yes |
Value of fidelity bond cover | 2012-12-31 | $2,000,000 |
If this is an individual account plan, was there a blackout period | 2012-12-31 | No |
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2012-12-31 | $0 |
Were there any nonexempt tranactions with any party-in-interest | 2012-12-31 | No |
Contributions received from participants | 2012-12-31 | $4,456,796 |
Participant contributions at end of year | 2012-12-31 | $866,615 |
Participant contributions at beginning of year | 2012-12-31 | $716,805 |
Participant contributions at end of year | 2012-12-31 | $376 |
Participant contributions at beginning of year | 2012-12-31 | $561 |
Assets. Other investments not covered elsewhere at end of year | 2012-12-31 | $289,486 |
Assets. Other investments not covered elsewhere at beginning of year | 2012-12-31 | $240,131 |
Income. Received or receivable in cash from other sources (including rollovers) | 2012-12-31 | $964,548 |
Administrative expenses (other) incurred | 2012-12-31 | $16,187 |
Liabilities. Value of operating payables at end of year | 2012-12-31 | $0 |
Liabilities. Value of operating payables at beginning of year | 2012-12-31 | $3,590 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
Value of net income/loss | 2012-12-31 | $8,020,469 |
Value of net assets at end of year (total assets less liabilities) | 2012-12-31 | $80,774,037 |
Value of net assets at beginning of year (total assets less liabilities) | 2012-12-31 | $72,753,568 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2012-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2012-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2012-12-31 | $27,129,590 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2012-12-31 | $22,809,158 |
Value of interest in pooled separate accounts at end of year | 2012-12-31 | $12,141,097 |
Value of interest in pooled separate accounts at beginning of year | 2012-12-31 | $12,388,220 |
Interest on participant loans | 2012-12-31 | $37,465 |
Interest earned on other investments | 2012-12-31 | $1,011,824 |
Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2012-12-31 | $40,346,776 |
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2012-12-31 | $36,602,101 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2012-12-31 | $2,645,235 |
Net investment gain/loss from pooled separate accounts | 2012-12-31 | $1,495,737 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2012-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2012-12-31 | No |
Contributions received in cash from employer | 2012-12-31 | $1,379,231 |
Employer contributions (assets) at end of year | 2012-12-31 | $97 |
Employer contributions (assets) at beginning of year | 2012-12-31 | $182 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-12-31 | $4,713,362 |
Did the plan have assets held for investment | 2012-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-12-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2012-12-31 | Disclaimer |
Accountancy firm name | 2012-12-31 | MCLAIN, HILL, RUGG & ASSOCIATES,INC |
Accountancy firm EIN | 2012-12-31 | 311038077 |
2011 : GENESIS HEALTHCARE SYSTEM TDA THRIFT PLAN 2011 401k financial data |
---|
Unrealized appreciation/depreciation of other (non real estate) assets | 2011-12-31 | $-84,410 |
Total unrealized appreciation/depreciation of assets | 2011-12-31 | $-84,410 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $3,590 |
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 | $7,006,601 |
Total loss/gain on sale of assets | 2011-12-31 | $0 |
Total of all expenses incurred | 2011-12-31 | $3,125,625 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-12-31 | $3,105,841 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-12-31 | $7,205,258 |
Value of total assets at end of year | 2011-12-31 | $72,757,158 |
Value of total assets at beginning of year | 2011-12-31 | $68,872,592 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-12-31 | $19,784 |
Total interest from all sources | 2011-12-31 | $944,563 |
Total dividends received (eg from common stock, registered investment company shares) | 2011-12-31 | $190,866 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2011-12-31 | $190,866 |
Was this plan covered by a fidelity bond | 2011-12-31 | Yes |
Value of fidelity bond cover | 2011-12-31 | $2,000,000 |
If this is an individual account plan, was there a blackout period | 2011-12-31 | No |
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2011-12-31 | $0 |
Were there any nonexempt tranactions with any party-in-interest | 2011-12-31 | No |
Contributions received from participants | 2011-12-31 | $3,932,191 |
Participant contributions at end of year | 2011-12-31 | $716,805 |
Participant contributions at beginning of year | 2011-12-31 | $655,774 |
Participant contributions at end of year | 2011-12-31 | $561 |
Assets. Other investments not covered elsewhere at end of year | 2011-12-31 | $240,131 |
Assets. Other investments not covered elsewhere at beginning of year | 2011-12-31 | $248,004 |
Income. Received or receivable in cash from other sources (including rollovers) | 2011-12-31 | $1,982,594 |
Administrative expenses (other) incurred | 2011-12-31 | $19,784 |
Liabilities. Value of operating payables at end of year | 2011-12-31 | $3,590 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
Value of net income/loss | 2011-12-31 | $3,880,976 |
Value of net assets at end of year (total assets less liabilities) | 2011-12-31 | $72,753,568 |
Value of net assets at beginning of year (total assets less liabilities) | 2011-12-31 | $68,872,592 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2011-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2011-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2011-12-31 | $22,809,158 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2011-12-31 | $21,021,703 |
Value of interest in pooled separate accounts at end of year | 2011-12-31 | $12,388,220 |
Value of interest in pooled separate accounts at beginning of year | 2011-12-31 | $13,219,999 |
Interest on participant loans | 2011-12-31 | $28,268 |
Interest earned on other investments | 2011-12-31 | $916,295 |
Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2011-12-31 | $36,602,101 |
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2011-12-31 | $33,727,112 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2011-12-31 | $-624,508 |
Net investment gain/loss from pooled separate accounts | 2011-12-31 | $-625,168 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2011-12-31 | Yes |
Has the plan failed to provide any benefit when due under the plan | 2011-12-31 | No |
Contributions received in cash from employer | 2011-12-31 | $1,290,473 |
Employer contributions (assets) at end of year | 2011-12-31 | $182 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-12-31 | $3,105,841 |
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2011-12-31 | No |
Did the plan have assets held for investment | 2011-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-12-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2011-12-31 | Disclaimer |
Accountancy firm name | 2011-12-31 | MCLAIN, HILL, RUGG & ASSOCIATES,INC |
Accountancy firm EIN | 2011-12-31 | 311038077 |
2010 : GENESIS HEALTHCARE SYSTEM TDA THRIFT PLAN 2010 401k financial data |
---|
Total unrealized appreciation/depreciation of assets | 2010-12-31 | $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 | $11,954,302 |
Total loss/gain on sale of assets | 2010-12-31 | $104,456 |
Total of all expenses incurred | 2010-12-31 | $5,171,424 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2010-12-31 | $5,157,372 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2010-12-31 | $6,674,746 |
Value of total assets at end of year | 2010-12-31 | $68,872,592 |
Value of total assets at beginning of year | 2010-12-31 | $62,089,714 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2010-12-31 | $14,052 |
Total interest from all sources | 2010-12-31 | $887,905 |
Total dividends received (eg from common stock, registered investment company shares) | 2010-12-31 | $146,934 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2010-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2010-12-31 | $146,934 |
Was this plan covered by a fidelity bond | 2010-12-31 | Yes |
Value of fidelity bond cover | 2010-12-31 | $2,000,000 |
If this is an individual account plan, was there a blackout period | 2010-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2010-12-31 | No |
Contributions received from participants | 2010-12-31 | $3,813,703 |
Participant contributions at end of year | 2010-12-31 | $655,774 |
Participant contributions at beginning of year | 2010-12-31 | $433,010 |
Participant contributions at beginning of year | 2010-12-31 | $144,663 |
Assets. Other investments not covered elsewhere at end of year | 2010-12-31 | $248,004 |
Assets. Other investments not covered elsewhere at beginning of year | 2010-12-31 | $197,489 |
Income. Received or receivable in cash from other sources (including rollovers) | 2010-12-31 | $1,594,670 |
Other income not declared elsewhere | 2010-12-31 | $42,893 |
Administrative expenses (other) incurred | 2010-12-31 | $14,052 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
Value of net income/loss | 2010-12-31 | $6,782,878 |
Value of net assets at end of year (total assets less liabilities) | 2010-12-31 | $68,872,592 |
Value of net assets at beginning of year (total assets less liabilities) | 2010-12-31 | $62,089,714 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2010-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2010-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2010-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2010-12-31 | $21,021,703 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2010-12-31 | $17,201,601 |
Value of interest in pooled separate accounts at end of year | 2010-12-31 | $13,219,999 |
Value of interest in pooled separate accounts at beginning of year | 2010-12-31 | $13,112,406 |
Interest on participant loans | 2010-12-31 | $25,541 |
Interest earned on other investments | 2010-12-31 | $862,364 |
Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2010-12-31 | $33,727,112 |
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2010-12-31 | $30,951,962 |
Net investment gain/loss from pooled separate accounts | 2010-12-31 | $4,097,368 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2010-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2010-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2010-12-31 | No |
Contributions received in cash from employer | 2010-12-31 | $1,266,373 |
Employer contributions (assets) at beginning of year | 2010-12-31 | $48,583 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2010-12-31 | $5,157,372 |
Did the plan have assets held for investment | 2010-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2010-12-31 | No |
Aggregate proceeds on sale of assets | 2010-12-31 | $104,456 |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2010-12-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2010-12-31 | Disclaimer |
Accountancy firm name | 2010-12-31 | MCLAIN HILL RUGG & ASSOCIATES, INC. |
Accountancy firm EIN | 2010-12-31 | 311038077 |
RIVERSOURCE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65005 ) |
Policy contract number | 16033117 |
Policy instance | 6 |
Insurance contract or identification number | 16033117 | Number of Individuals Covered | 32 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $17,401 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 1 | 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 $13,386 | Insurance broker organization code? | 3 |
|
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) |
Policy contract number | B01413 |
Policy instance | 5 |
Insurance contract or identification number | B01413 | Number of Individuals Covered | 3 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | 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 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 |
|
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 ) |
Policy contract number | 005389 |
Policy instance | 4 |
Insurance contract or identification number | 005389 | Number of Individuals Covered | 4186 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | 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 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 |
|
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
Policy contract number | COPE0101CC37 |
Policy instance | 3 |
Insurance contract or identification number | COPE0101CC37 | Number of Individuals Covered | 17 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | 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 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 |
|
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 ) |
Policy contract number | 919734 |
Policy instance | 2 |
Insurance contract or identification number | 919734 | Number of Individuals Covered | 119 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | 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 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 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G05580 |
Policy instance | 1 |
Insurance contract or identification number | G05580 | Number of Individuals Covered | 99 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | 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 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 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G05580 |
Policy instance | 1 |
Insurance contract or identification number | G05580 | Number of Individuals Covered | 103 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | 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 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 |
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METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 ) |
Policy contract number | 919734 |
Policy instance | 2 |
Insurance contract or identification number | 919734 | Number of Individuals Covered | 123 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | 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 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 |
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NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
Policy contract number | COPE0101CC37 |
Policy instance | 3 |
Insurance contract or identification number | COPE0101CC37 | Number of Individuals Covered | 19 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | 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 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 |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 005389 |
Policy instance | 4 |
Insurance contract or identification number | 005389 | Number of Individuals Covered | 4005 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | 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 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 |
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AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) |
Policy contract number | B01413 |
Policy instance | 5 |
Insurance contract or identification number | B01413 | Number of Individuals Covered | 3 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | 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 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 |
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RIVERSOURCE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65005 ) |
Policy contract number | 16033117 |
Policy instance | 6 |
Insurance contract or identification number | 16033117 | Number of Individuals Covered | 33 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $19,149 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 1 | 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 $14,362 | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G05580 |
Policy instance | 1 |
Insurance contract or identification number | G05580 | Number of Individuals Covered | 108 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | 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 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 |
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METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 ) |
Policy contract number | 919734 |
Policy instance | 2 |
Insurance contract or identification number | 919734 | Number of Individuals Covered | 134 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | 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 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 |
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NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
Policy contract number | COPE0101CC37 |
Policy instance | 3 |
Insurance contract or identification number | COPE0101CC37 | Number of Individuals Covered | 19 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | 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 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 |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 005389 |
Policy instance | 4 |
Insurance contract or identification number | 005389 | Number of Individuals Covered | 3754 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | 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 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 |
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AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) |
Policy contract number | B01413 |
Policy instance | 5 |
Insurance contract or identification number | B01413 | Number of Individuals Covered | 3 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | 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 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 |
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RIVERSOURCE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65005 ) |
Policy contract number | 16033117 |
Policy instance | 6 |
Insurance contract or identification number | 16033117 | Number of Individuals Covered | 36 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $17,583 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 1 | 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 $12,621 | Insurance broker organization code? | 3 |
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AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) |
Policy contract number | B01413 |
Policy instance | 6 |
Insurance contract or identification number | B01413 | Number of Individuals Covered | 3 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | 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 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 |
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METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 ) |
Policy contract number | 1014314-01 |
Policy instance | 5 |
Insurance contract or identification number | 1014314-01 | Number of Individuals Covered | 0 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | 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 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 |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 005389 |
Policy instance | 4 |
Insurance contract or identification number | 005389 | Number of Individuals Covered | 3538 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | 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 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 |
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METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 ) |
Policy contract number | 919734 |
Policy instance | 2 |
Insurance contract or identification number | 919734 | Number of Individuals Covered | 144 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | 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 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 |
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NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
Policy contract number | COPE0101CC37 |
Policy instance | 3 |
Insurance contract or identification number | COPE0101CC37 | Number of Individuals Covered | 20 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | 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 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 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G05580 |
Policy instance | 1 |
Insurance contract or identification number | G05580 | Number of Individuals Covered | 117 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | 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 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 |
|
RIVERSOURCE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65005 ) |
Policy contract number | 16033117 |
Policy instance | 7 |
Insurance contract or identification number | 16033117 | Number of Individuals Covered | 40 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $21,592 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 1 | 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 $12,379 | Insurance broker organization code? | 3 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G05580 |
Policy instance | 1 |
Insurance contract or identification number | G05580 | Number of Individuals Covered | 124 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | 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 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 |
|
RIVERSOURCE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65005 ) |
Policy contract number | 16033117 |
Policy instance | 7 |
Insurance contract or identification number | 16033117 | Number of Individuals Covered | 42 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $25,347 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 1 | 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 $12,643 | Insurance broker organization code? | 3 |
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AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) |
Policy contract number | B01413 |
Policy instance | 6 |
Insurance contract or identification number | B01413 | Number of Individuals Covered | 4 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | 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 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 |
|
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 ) |
Policy contract number | 1014314-01 |
Policy instance | 5 |
Insurance contract or identification number | 1014314-01 | Number of Individuals Covered | 5 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | 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 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 |
|
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 005389 |
Policy instance | 4 |
Insurance contract or identification number | 005389 | Number of Individuals Covered | 3199 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | 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 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 |
|
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
Policy contract number | COPE0101CC37 |
Policy instance | 3 |
Insurance contract or identification number | COPE0101CC37 | Number of Individuals Covered | 30 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | 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 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 |
|
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 ) |
Policy contract number | 919734 |
Policy instance | 2 |
Insurance contract or identification number | 919734 | Number of Individuals Covered | 153 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $97 | Total amount of fees paid to insurance company | USD $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 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 $97 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | ASSET ALLOCATION ADVICE REBALANCING SERVICES | Insurance broker organization code? | 3 |
|
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 ) |
Policy contract number | 919734 |
Policy instance | 2 |
Insurance contract or identification number | 919734 | Number of Individuals Covered | 161 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $7,026 | 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 $7,026 | Additional information about fees paid to insurance broker | ASSET ALLOCATION ADVICE REBALANCING SERVICES | Insurance broker organization code? | 3 | Insurance broker name | BRIGHTHOUSE SECURITIES, LLC |
|
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
Policy contract number | COPE0101CC37 |
Policy instance | 3 |
Insurance contract or identification number | COPE0101CC37 | Number of Individuals Covered | 34 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | 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 |
|
RIVERSOURCE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65005 ) |
Policy contract number | 16033117 |
Policy instance | 4 |
Insurance contract or identification number | 16033117 | Number of Individuals Covered | 44 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $24,823 | Are there contracts with allocated funds for individual policies? | 1 | 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 $12,222 | Insurance broker organization code? | 3 | Insurance broker name | ANDREW BRATE |
|
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 005389 |
Policy instance | 5 |
Insurance contract or identification number | 005389 | Number of Individuals Covered | 3079 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | 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 | Additional information about fees paid to insurance broker | SERVICES TO INSURER OR PLAN | Insurance broker name | UBS FINANCIAL SRVCS INS AGENCY INC |
|
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 ) |
Policy contract number | 1014314-01 |
Policy instance | 6 |
Insurance contract or identification number | 1014314-01 | Number of Individuals Covered | 4 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | 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 |
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HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
Policy contract number | 080168 |
Policy instance | 7 |
Insurance contract or identification number | 080168 | Number of Individuals Covered | 1 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | 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 |
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AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) |
Policy contract number | B01413 |
Policy instance | 8 |
Insurance contract or identification number | B01413 | Number of Individuals Covered | 4 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | 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 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G05580 |
Policy instance | 1 |
Insurance contract or identification number | G05580 | Number of Individuals Covered | 131 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | 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 |
|
METLIFE INVESTORS (National Association of Insurance Commissioners NAIC id number: 80950 ) |
Policy contract number | 919734 |
Policy instance | 2 |
Insurance contract or identification number | 919734 | Number of Individuals Covered | 187 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of fees paid to insurance company | USD $20,503 | 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 | Amount paid for insurance broker fees | 20503 | Additional information about fees paid to insurance broker | ASSET ALLOCATION ADVICE AND REBALANCING SERVICES FOR PLAN PARTI | Insurance broker organization code? | 3 | Insurance broker name | METLIFE SECURITIES, INC. |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G05580 |
Policy instance | 1 |
Insurance contract or identification number | G05580 | Number of Individuals Covered | 149 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | 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 |
|
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
Policy contract number | COPE0101CC37 |
Policy instance | 3 |
Insurance contract or identification number | COPE0101CC37 | Number of Individuals Covered | 47 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | 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 |
|
RIVERSOURCE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65005 ) |
Policy contract number | 16033117 |
Policy instance | 4 |
Insurance contract or identification number | 16033117 | Number of Individuals Covered | 54 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $26,106 | Are there contracts with allocated funds for individual policies? | 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 $13,430 | Insurance broker organization code? | 3 | Insurance broker name | ANDY OGILIVIE |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 005389 |
Policy instance | 5 |
Insurance contract or identification number | 005389 | Number of Individuals Covered | 2850 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of fees paid to insurance company | USD $81,671 | 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 | Amount paid for insurance broker fees | 81671 | Additional information about fees paid to insurance broker | SERVICES TO INSURER OR PLAN | Insurance broker name | UBS FINANCIAL SRVCS INS AGENCY INC |
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METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 ) |
Policy contract number | 1014314-01 |
Policy instance | 6 |
Insurance contract or identification number | 1014314-01 | Number of Individuals Covered | 3 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | 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 |
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HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
Policy contract number | 080168 |
Policy instance | 7 |
Insurance contract or identification number | 080168 | Number of Individuals Covered | 2 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | 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 |
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PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 ) |
Policy contract number | 005389 |
Policy instance | 8 |
Insurance contract or identification number | 005389 | Number of Individuals Covered | 2850 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of fees paid to insurance company | USD $1,134 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1134 | Additional information about fees paid to insurance broker | SERVICES TO INSURER OR PLAN | Insurance broker organization code? | 3 | Insurance broker name | UBS FINANCIAL SRVCS INS AGENCY INC |
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AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) |
Policy contract number | B01413 |
Policy instance | 9 |
Insurance contract or identification number | B01413 | Number of Individuals Covered | 7 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | 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 |
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RIVERSOURCE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65005 ) |
Policy contract number | 16033117 |
Policy instance | 4 |
Insurance contract or identification number | 16033117 | Number of Individuals Covered | 56 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $25,154 | Are there contracts with allocated funds for individual policies? | 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 $12,556 | Insurance broker organization code? | 3 | Insurance broker name | ANDY OGILIVIE |
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METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 ) |
Policy contract number | 919734 |
Policy instance | 2 |
Insurance contract or identification number | 919734 | Number of Individuals Covered | 74 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of fees paid to insurance company | USD $21,277 | 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 | Amount paid for insurance broker fees | 21277 | Additional information about fees paid to insurance broker | ASSET ALLOCATION ADVICE AND REBALANCING SERVICES FOR PLAN PARTI | Insurance broker organization code? | 3 | Insurance broker name | METLIFE SECURITIES, INC. |
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NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
Policy contract number | COPE0101CC37 |
Policy instance | 3 |
Insurance contract or identification number | COPE0101CC37 | Number of Individuals Covered | 50 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | 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 |
|
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 005389 |
Policy instance | 5 |
Insurance contract or identification number | 005389 | Number of Individuals Covered | 2687 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of fees paid to insurance company | USD $78,258 | 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 | Amount paid for insurance broker fees | 78258 | Additional information about fees paid to insurance broker | SERVICES TO INSURER OR PLAN | Insurance broker name | UBS FINANCIAL SRVCS INS AGENCY INC |
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METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 ) |
Policy contract number | 1014314-01 |
Policy instance | 6 |
Insurance contract or identification number | 1014314-01 | Number of Individuals Covered | 3 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | 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 |
|
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
Policy contract number | 080168,080118 |
Policy instance | 7 |
Insurance contract or identification number | 080168,080118 | Number of Individuals Covered | 1 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | 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 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G05580 |
Policy instance | 1 |
Insurance contract or identification number | G05580 | Number of Individuals Covered | 163 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | 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 |
|
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 ) |
Policy contract number | 919734 |
Policy instance | 2 |
Insurance contract or identification number | 919734 | Number of Individuals Covered | 79 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $21,033 | 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 | Amount paid for insurance broker fees | 21033 | Additional information about fees paid to insurance broker | ASSET ALLOCATION ADVICE AND REBALANCING SERVICES FOR PLAN PARTI | Insurance broker organization code? | 3 | Insurance broker name | METLIFE SECURITIES, INC. |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 1014314-01 |
Policy instance | 6 |
Insurance contract or identification number | 1014314-01 | Number of Individuals Covered | 3 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | 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 |
|
RIVERSOURCE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65005 ) |
Policy contract number | 16033117 |
Policy instance | 4 |
Insurance contract or identification number | 16033117 | Number of Individuals Covered | 59 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $23,545 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | Yes | 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? | No | 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 $12,781 | Insurance broker organization code? | 3 | Insurance broker name | DEBORAH LINSCOTT-WINDAU |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 005389 |
Policy instance | 5 |
Insurance contract or identification number | 005389 | Number of Individuals Covered | 2468 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $71,849 | 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 | Amount paid for insurance broker fees | 71849 | Additional information about fees paid to insurance broker | SERVICES TO INSURER OR PLAN | Insurance broker name | UBS FINANCIAL SRVCS INS AGENCY INC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G05580 |
Policy instance | 1 |
Insurance contract or identification number | G05580 | Number of Individuals Covered | 173 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | 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 |
|
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
Policy contract number | COPE0101CC37 |
Policy instance | 3 |
Insurance contract or identification number | COPE0101CC37 | Number of Individuals Covered | 51 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | 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 |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 1014314-01 |
Policy instance | 1 |
Insurance contract or identification number | 1014314-01 | Number of Individuals Covered | 3 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | 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 |
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NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
Policy contract number | COPE0101CC37 |
Policy instance | 6 |
Insurance contract or identification number | COPE0101CC37 | Number of Individuals Covered | 56 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | 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 |
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RIVERSOURCE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65005 ) |
Policy contract number | 16033117-9 |
Policy instance | 4 |
Insurance contract or identification number | 16033117-9 | Number of Individuals Covered | 155 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $9,043 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | Yes | 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? | No | 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 $7,212 | Insurance broker organization code? | 3 | Insurance broker name | DAVID WHITESMITH |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G05580 |
Policy instance | 3 |
Insurance contract or identification number | G05580 | Number of Individuals Covered | 182 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | 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 |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 005389 |
Policy instance | 2 |
Insurance contract or identification number | 005389 | Number of Individuals Covered | 2331 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $64,066 | 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 | Amount paid for insurance broker fees | 64066 | Additional information about fees paid to insurance broker | SERVICES TO INSURERE OR PLAN | Insurance broker organization code? | 0 | Insurance broker name | UBS FINANCIAL SRVCS INS AGENCY INC |
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METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 ) |
Policy contract number | 919734 |
Policy instance | 5 |
Insurance contract or identification number | 919734 | Number of Individuals Covered | 84 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $20,496 | 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 | Amount paid for insurance broker fees | 20496 | Additional information about fees paid to insurance broker | ASSET ALLOCATION ADVICE AND REBALANCING SERVICES FOR PLAN PARTICIPANTS WHO ELECTED TO RECEIVE THEM | Insurance broker organization code? | 3 | Insurance broker name | METLIFE SECURITIES, INC. |
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NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
Policy contract number | COPE0101CC37 |
Policy instance | 6 |
Insurance contract or identification number | COPE0101CC37 | Number of Individuals Covered | 60 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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 |
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METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 ) |
Policy contract number | 919734 |
Policy instance | 5 |
Insurance contract or identification number | 919734 | Number of Individuals Covered | 237 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $22,205 | 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 |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 005389 |
Policy instance | 4 |
Insurance contract or identification number | 005389 | Number of Individuals Covered | 2043 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $57,928 | 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 |
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RIVERSOURCE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65005 ) |
Policy contract number | 16033117-9 |
Policy instance | 3 |
Insurance contract or identification number | 16033117-9 | Number of Individuals Covered | 155 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $8,981 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | Yes | 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? | No | 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 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 1014314-01 |
Policy instance | 2 |
Insurance contract or identification number | 1014314-01 | Number of Individuals Covered | 3 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G05580 |
Policy instance | 1 |
Insurance contract or identification number | G05580 | Number of Individuals Covered | 195 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 1014314-01 |
Policy instance | 3 |
Insurance contract or identification number | 1014314-01 | Number of Individuals Covered | 3 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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 |
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METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 ) |
Policy contract number | 919734 |
Policy instance | 1 |
Insurance contract or identification number | 919734 | Number of Individuals Covered | 253 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $25,119 | 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 |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 005389 |
Policy instance | 4 |
Insurance contract or identification number | 005389 | Number of Individuals Covered | 1712 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $52,251 | 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 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G05580 |
Policy instance | 5 |
Insurance contract or identification number | G05580 | Number of Individuals Covered | 207 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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 |
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RIVERSOURCE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65005 ) |
Policy contract number | 16033117-9 |
Policy instance | 6 |
Insurance contract or identification number | 16033117-9 | Number of Individuals Covered | 155 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $7,953 | 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? | No | 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 |
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NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
Policy contract number | COPE0101CC37 |
Policy instance | 2 |
Insurance contract or identification number | COPE0101CC37 | Number of Individuals Covered | 69 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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 |
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