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GOOD SHEPHERD CENTER TSA 501(C)(3) 401k Plan overview

Plan NameGOOD SHEPHERD CENTER TSA 501(C)(3)
Plan identification number 001

GOOD SHEPHERD CENTER TSA 501(C)(3) Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.

401k Sponsoring company profile

GOOD SHEPHERD CENTER FOR EXCEPTIONAL CHILDREN has sponsored the creation of one or more 401k plans.

Company Name:GOOD SHEPHERD CENTER FOR EXCEPTIONAL CHILDREN
Employer identification number (EIN):362529613
NAIC Classification:611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GOOD SHEPHERD CENTER TSA 501(C)(3)

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01JAMES MOMMSEN
0012017-01-01PEGGY HOOGHEEM
0012017-01-01
0012016-01-01PEGGY HOOGHEEM
0012015-01-01PEGGY HOOGHEEM
0012014-01-01PEGGY HOOGHEEM
0012013-01-01PEGGY HOOGHEEM
0012012-01-01PEGGY HOOGHEEM PEGGY HOOGHEEM2013-10-04
0012011-01-01PEGGY HOOGHEEM
0012009-01-01PEGGY HOOGHEEM

Plan Statistics for GOOD SHEPHERD CENTER TSA 501(C)(3)

401k plan membership statisitcs for GOOD SHEPHERD CENTER TSA 501(C)(3)

Measure Date Value
2022: GOOD SHEPHERD CENTER TSA 501(C)(3) 2022 401k membership
Total participants, beginning-of-year2022-01-018
Total number of active participants reported on line 7a of the Form 55002022-01-010
Number of retired or separated participants receiving benefits2022-01-013
Number of other retired or separated participants entitled to future benefits2022-01-015
Total of all active and inactive participants2022-01-018
Total participants2022-01-018
Number of participants with account balances2022-01-018
2021: GOOD SHEPHERD CENTER TSA 501(C)(3) 2021 401k membership
Total participants, beginning-of-year2021-01-018
Total number of active participants reported on line 7a of the Form 55002021-01-013
Number of retired or separated participants receiving benefits2021-01-014
Number of other retired or separated participants entitled to future benefits2021-01-011
Total of all active and inactive participants2021-01-018
Total participants2021-01-018
Number of participants with account balances2021-01-018
2020: GOOD SHEPHERD CENTER TSA 501(C)(3) 2020 401k membership
Total participants, beginning-of-year2020-01-018
Total number of active participants reported on line 7a of the Form 55002020-01-011
Number of retired or separated participants receiving benefits2020-01-014
Number of other retired or separated participants entitled to future benefits2020-01-013
Total of all active and inactive participants2020-01-018
Total participants2020-01-018
Number of participants with account balances2020-01-018
2019: GOOD SHEPHERD CENTER TSA 501(C)(3) 2019 401k membership
Total participants, beginning-of-year2019-01-018
Total number of active participants reported on line 7a of the Form 55002019-01-011
Number of retired or separated participants receiving benefits2019-01-014
Number of other retired or separated participants entitled to future benefits2019-01-013
Total of all active and inactive participants2019-01-018
Total participants2019-01-018
Number of participants with account balances2019-01-018
2018: GOOD SHEPHERD CENTER TSA 501(C)(3) 2018 401k membership
Total participants, beginning-of-year2018-01-018
Total number of active participants reported on line 7a of the Form 55002018-01-011
Number of retired or separated participants receiving benefits2018-01-014
Number of other retired or separated participants entitled to future benefits2018-01-013
Total of all active and inactive participants2018-01-018
Total participants2018-01-018
2017: GOOD SHEPHERD CENTER TSA 501(C)(3) 2017 401k membership
Total participants, beginning-of-year2017-01-018
Total number of active participants reported on line 7a of the Form 55002017-01-011
Number of retired or separated participants receiving benefits2017-01-012
Number of other retired or separated participants entitled to future benefits2017-01-013
Total of all active and inactive participants2017-01-016
Total participants2017-01-016
2016: GOOD SHEPHERD CENTER TSA 501(C)(3) 2016 401k membership
Total participants, beginning-of-year2016-01-019
Total number of active participants reported on line 7a of the Form 55002016-01-011
Number of retired or separated participants receiving benefits2016-01-014
Number of other retired or separated participants entitled to future benefits2016-01-013
Total of all active and inactive participants2016-01-018
Total participants2016-01-018
2015: GOOD SHEPHERD CENTER TSA 501(C)(3) 2015 401k membership
Total participants, beginning-of-year2015-01-019
Total number of active participants reported on line 7a of the Form 55002015-01-012
Number of retired or separated participants receiving benefits2015-01-014
Number of other retired or separated participants entitled to future benefits2015-01-013
Total of all active and inactive participants2015-01-019
Total participants2015-01-019
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: GOOD SHEPHERD CENTER TSA 501(C)(3) 2014 401k membership
Total participants, beginning-of-year2014-01-019
Total number of active participants reported on line 7a of the Form 55002014-01-012
Number of retired or separated participants receiving benefits2014-01-014
Number of other retired or separated participants entitled to future benefits2014-01-013
Total of all active and inactive participants2014-01-019
Total participants2014-01-019
Number of participants with account balances2014-01-019
2013: GOOD SHEPHERD CENTER TSA 501(C)(3) 2013 401k membership
Total participants, beginning-of-year2013-01-019
Total number of active participants reported on line 7a of the Form 55002013-01-012
Number of retired or separated participants receiving benefits2013-01-013
Number of other retired or separated participants entitled to future benefits2013-01-014
Total of all active and inactive participants2013-01-019
Total participants2013-01-019
2012: GOOD SHEPHERD CENTER TSA 501(C)(3) 2012 401k membership
Total participants, beginning-of-year2012-01-019
Total number of active participants reported on line 7a of the Form 55002012-01-012
Number of retired or separated participants receiving benefits2012-01-013
Number of other retired or separated participants entitled to future benefits2012-01-014
Total of all active and inactive participants2012-01-019
Total participants2012-01-019
2011: GOOD SHEPHERD CENTER TSA 501(C)(3) 2011 401k membership
Total participants, beginning-of-year2011-01-0113
Total number of active participants reported on line 7a of the Form 55002011-01-013
Number of retired or separated participants receiving benefits2011-01-013
Number of other retired or separated participants entitled to future benefits2011-01-014
Total of all active and inactive participants2011-01-0110
Total participants2011-01-0110
Number of participants with account balances2011-01-0110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: GOOD SHEPHERD CENTER TSA 501(C)(3) 2009 401k membership
Total participants, beginning-of-year2009-01-0118
Total number of active participants reported on line 7a of the Form 55002009-01-013
Number of retired or separated participants receiving benefits2009-01-013
Number of other retired or separated participants entitled to future benefits2009-01-0111
Total of all active and inactive participants2009-01-0117
Total participants2009-01-0117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on GOOD SHEPHERD CENTER TSA 501(C)(3)

Measure Date Value
2022 : GOOD SHEPHERD CENTER TSA 501(C)(3) 2022 401k financial data
Total income from all sources2022-12-31$-98,947
Expenses. Total of all expenses incurred2022-12-31$47,196
Benefits paid (including direct rollovers)2022-12-31$47,076
Total plan assets at end of year2022-12-31$886,015
Total plan assets at beginning of year2022-12-31$1,032,158
Value of fidelity bond covering the plan2022-12-31$1,000,000
Other income received2022-12-31$-98,947
Net income (gross income less expenses)2022-12-31$-146,143
Net plan assets at end of year (total assets less liabilities)2022-12-31$886,015
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$1,032,158
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$120
2021 : GOOD SHEPHERD CENTER TSA 501(C)(3) 2021 401k financial data
Total income from all sources2021-12-31$81,490
Expenses. Total of all expenses incurred2021-12-31$30,197
Benefits paid (including direct rollovers)2021-12-31$25,335
Total plan assets at end of year2021-12-31$1,032,158
Total plan assets at beginning of year2021-12-31$980,865
Value of fidelity bond covering the plan2021-12-31$1,000,000
Total contributions received or receivable from participants2021-12-31$1,200
Other income received2021-12-31$80,290
Net income (gross income less expenses)2021-12-31$51,293
Net plan assets at end of year (total assets less liabilities)2021-12-31$1,032,158
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$980,865
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$4,862
2020 : GOOD SHEPHERD CENTER TSA 501(C)(3) 2020 401k financial data
Total income from all sources2020-12-31$81,425
Expenses. Total of all expenses incurred2020-12-31$4,212
Benefits paid (including direct rollovers)2020-12-31$0
Total plan assets at end of year2020-12-31$980,865
Total plan assets at beginning of year2020-12-31$903,652
Value of fidelity bond covering the plan2020-12-31$100,000
Total contributions received or receivable from participants2020-12-31$2,400
Other income received2020-12-31$79,025
Net income (gross income less expenses)2020-12-31$77,213
Net plan assets at end of year (total assets less liabilities)2020-12-31$980,865
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$903,652
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$4,212
2019 : GOOD SHEPHERD CENTER TSA 501(C)(3) 2019 401k financial data
Total income from all sources2019-12-31$123,134
Expenses. Total of all expenses incurred2019-12-31$27,901
Benefits paid (including direct rollovers)2019-12-31$22,027
Total plan assets at end of year2019-12-31$903,652
Total plan assets at beginning of year2019-12-31$808,419
Value of fidelity bond covering the plan2019-12-31$100,000
Total contributions received or receivable from participants2019-12-31$4,500
Other income received2019-12-31$118,634
Net income (gross income less expenses)2019-12-31$95,233
Net plan assets at end of year (total assets less liabilities)2019-12-31$903,652
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$808,419
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$5,874
2018 : GOOD SHEPHERD CENTER TSA 501(C)(3) 2018 401k financial data
Total income from all sources2018-12-31$15,000
Expenses. Total of all expenses incurred2018-12-31$34,623
Benefits paid (including direct rollovers)2018-12-31$21,933
Total plan assets at end of year2018-12-31$808,419
Total plan assets at beginning of year2018-12-31$828,042
Value of fidelity bond covering the plan2018-12-31$100,000
Total contributions received or receivable from participants2018-12-31$15,000
Expenses. Other expenses not covered elsewhere2018-12-31$8,130
Net income (gross income less expenses)2018-12-31$-19,623
Net plan assets at end of year (total assets less liabilities)2018-12-31$808,419
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$828,042
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$4,560
2017 : GOOD SHEPHERD CENTER TSA 501(C)(3) 2017 401k financial data
Total income from all sources2017-12-31$94,667
Expenses. Total of all expenses incurred2017-12-31$29,774
Benefits paid (including direct rollovers)2017-12-31$24,592
Total plan assets at end of year2017-12-31$828,042
Total plan assets at beginning of year2017-12-31$763,149
Value of fidelity bond covering the plan2017-12-31$100,000
Total contributions received or receivable from participants2017-12-31$16,250
Other income received2017-12-31$78,417
Net income (gross income less expenses)2017-12-31$64,893
Net plan assets at end of year (total assets less liabilities)2017-12-31$828,042
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$763,149
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$5,182
2016 : GOOD SHEPHERD CENTER TSA 501(C)(3) 2016 401k financial data
Total income from all sources2016-12-31$45,373
Expenses. Total of all expenses incurred2016-12-31$19,033
Benefits paid (including direct rollovers)2016-12-31$14,634
Total plan assets at end of year2016-12-31$763,149
Total plan assets at beginning of year2016-12-31$736,809
Value of fidelity bond covering the plan2016-12-31$1,000,000
Total contributions received or receivable from participants2016-12-31$13,750
Other income received2016-12-31$31,623
Net income (gross income less expenses)2016-12-31$26,340
Net plan assets at end of year (total assets less liabilities)2016-12-31$763,149
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$736,809
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$4,399
2015 : GOOD SHEPHERD CENTER TSA 501(C)(3) 2015 401k financial data
Total income from all sources2015-12-31$42,351
Expenses. Total of all expenses incurred2015-12-31$17,377
Benefits paid (including direct rollovers)2015-12-31$13,868
Total plan assets at end of year2015-12-31$736,809
Total plan assets at beginning of year2015-12-31$711,835
Value of fidelity bond covering the plan2015-12-31$1,000,000
Total contributions received or receivable from participants2015-12-31$25,443
Other income received2015-12-31$16,908
Net income (gross income less expenses)2015-12-31$24,974
Net plan assets at end of year (total assets less liabilities)2015-12-31$736,809
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$711,835
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$3,509
2014 : GOOD SHEPHERD CENTER TSA 501(C)(3) 2014 401k financial data
Total income from all sources2014-12-31$55,387
Expenses. Total of all expenses incurred2014-12-31$10,409
Benefits paid (including direct rollovers)2014-12-31$3,732
Total plan assets at end of year2014-12-31$711,835
Total plan assets at beginning of year2014-12-31$666,857
Value of fidelity bond covering the plan2014-12-31$1,000,000
Other income received2014-12-31$37,087
Net income (gross income less expenses)2014-12-31$44,978
Net plan assets at end of year (total assets less liabilities)2014-12-31$711,835
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$666,857
Total contributions received or receivable from employer(s)2014-12-31$18,300
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$6,677
2013 : GOOD SHEPHERD CENTER TSA 501(C)(3) 2013 401k financial data
Total income from all sources2013-12-31$94,372
Expenses. Total of all expenses incurred2013-12-31$9,655
Benefits paid (including direct rollovers)2013-12-31$4,012
Total plan assets at end of year2013-12-31$666,857
Total plan assets at beginning of year2013-12-31$582,140
Value of fidelity bond covering the plan2013-12-31$1,000,000
Total contributions received or receivable from participants2013-12-31$16,800
Other income received2013-12-31$77,572
Net income (gross income less expenses)2013-12-31$84,717
Net plan assets at end of year (total assets less liabilities)2013-12-31$666,857
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$582,140
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$5,643
2012 : GOOD SHEPHERD CENTER TSA 501(C)(3) 2012 401k financial data
Total income from all sources2012-12-31$52,413
Expenses. Total of all expenses incurred2012-12-31$8,096
Benefits paid (including direct rollovers)2012-12-31$3,950
Total plan assets at end of year2012-12-31$582,140
Total plan assets at beginning of year2012-12-31$537,823
Value of fidelity bond covering the plan2012-12-31$1,000,000
Total contributions received or receivable from participants2012-12-31$16,800
Other income received2012-12-31$35,613
Net income (gross income less expenses)2012-12-31$44,317
Net plan assets at end of year (total assets less liabilities)2012-12-31$582,140
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$537,823
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$4,146
2011 : GOOD SHEPHERD CENTER TSA 501(C)(3) 2011 401k financial data
Total income from all sources2011-12-31$24,062
Expenses. Total of all expenses incurred2011-12-31$175,228
Benefits paid (including direct rollovers)2011-12-31$171,151
Total plan assets at end of year2011-12-31$537,823
Total plan assets at beginning of year2011-12-31$688,989
Value of fidelity bond covering the plan2011-12-31$1,000,000
Total contributions received or receivable from participants2011-12-31$20,800
Other income received2011-12-31$3,262
Net income (gross income less expenses)2011-12-31$-151,166
Net plan assets at end of year (total assets less liabilities)2011-12-31$537,823
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$688,989
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$4,077
2010 : GOOD SHEPHERD CENTER TSA 501(C)(3) 2010 401k financial data
Total income from all sources2010-12-31$67,009
Expenses. Total of all expenses incurred2010-12-31$36,778
Benefits paid (including direct rollovers)2010-12-31$33,298
Total plan assets at end of year2010-12-31$688,989
Total plan assets at beginning of year2010-12-31$658,758
Value of fidelity bond covering the plan2010-12-31$1,000,000
Total contributions received or receivable from participants2010-12-31$21,960
Other income received2010-12-31$45,049
Net income (gross income less expenses)2010-12-31$30,231
Net plan assets at end of year (total assets less liabilities)2010-12-31$688,989
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$658,758
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$3,480

Form 5500 Responses for GOOD SHEPHERD CENTER TSA 501(C)(3)

2022: GOOD SHEPHERD CENTER TSA 501(C)(3) 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement - TrustYes
2021: GOOD SHEPHERD CENTER TSA 501(C)(3) 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement - TrustYes
2020: GOOD SHEPHERD CENTER TSA 501(C)(3) 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement - TrustYes
2019: GOOD SHEPHERD CENTER TSA 501(C)(3) 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement - TrustYes
2018: GOOD SHEPHERD CENTER TSA 501(C)(3) 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement - TrustYes
2017: GOOD SHEPHERD CENTER TSA 501(C)(3) 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement - TrustYes
2016: GOOD SHEPHERD CENTER TSA 501(C)(3) 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: GOOD SHEPHERD CENTER TSA 501(C)(3) 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2014: GOOD SHEPHERD CENTER TSA 501(C)(3) 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement - TrustYes
2013: GOOD SHEPHERD CENTER TSA 501(C)(3) 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement - TrustYes
2012: GOOD SHEPHERD CENTER TSA 501(C)(3) 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement - TrustYes
2011: GOOD SHEPHERD CENTER TSA 501(C)(3) 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement - TrustYes
2009: GOOD SHEPHERD CENTER TSA 501(C)(3) 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract number706996-0001
Policy instance 1
Insurance contract or identification number706996-0001
Number of Individuals Covered8
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $24
Total amount of fees paid to insurance companyUSD $4,838
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $24
Amount paid for insurance broker fees4847
Additional information about fees paid to insurance brokerADMINISTRATIVE AND INVESTMENT MANAGEMENT
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract number706996-0001
Policy instance 1
Insurance contract or identification number706996-0001
Number of Individuals Covered8
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $3,976
Total amount of fees paid to insurance companyUSD $90
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $4,093
Amount paid for insurance broker fees120
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract number706996-0001
Policy instance 1
Insurance contract or identification number706996-0001
Number of Individuals Covered8
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $5,661
Total amount of fees paid to insurance companyUSD $90
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,754
Amount paid for insurance broker fees120
Additional information about fees paid to insurance brokerADMINISTRATIVE AND INVESTMENT MANAGEMENT
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract number706996-0001
Policy instance 1
Insurance contract or identification number706996-0001
Number of Individuals Covered8
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $4,368
Total amount of fees paid to insurance companyUSD $90
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,440
Amount paid for insurance broker fees120
Additional information about fees paid to insurance brokerADMINISTRATIVE AND INVESTMENT MANAGEMENT
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract number706996-0001
Policy instance 1
Insurance contract or identification number706996-0001
Number of Individuals Covered6
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $4,952
Total amount of fees paid to insurance companyUSD $124
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,540
Amount paid for insurance broker fees154
Additional information about fees paid to insurance brokerADMINISTRATIVE AND INVESTMENT MANAGEMENT
Insurance broker nameE PETERSEN JR
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract number706996-0001
Policy instance 1
Insurance contract or identification number706996-0001
Number of Individuals Covered9
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of fees paid to insurance companyUSD $3,509
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees3509
Additional information about fees paid to insurance brokerADMINISTRATIVE AND INVESTMENT MANAGEMENT
Insurance broker nameAXA NETWORK LLC
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract number706996-0001
Policy instance 1
Insurance contract or identification number706996-0001
Number of Individuals Covered9
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $542
Total amount of fees paid to insurance companyUSD $6,210
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14
Amount paid for insurance broker fees0
Insurance broker nameE. PETERSON, JR
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract number706996-0001
Policy instance 1
Insurance contract or identification number706996-0001
Number of Individuals Covered9
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $533
Total amount of fees paid to insurance companyUSD $2,407
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $518
Insurance broker nameAXA NETWORK LLC
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract number706966
Policy instance 1
Insurance contract or identification number706966
Number of Individuals Covered9
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $497
Total amount of fees paid to insurance companyUSD $236
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $482
Insurance broker nameAXA NETWORK LLC
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract number706966
Policy instance 1
Insurance contract or identification number706966
Number of Individuals Covered9
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $617
Total amount of fees paid to insurance companyUSD $336
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract number706966
Policy instance 2
Insurance contract or identification number706966
Number of Individuals Covered14
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $3,217
Total amount of fees paid to insurance companyUSD $264
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,956
Amount paid for insurance broker fees264
Additional information about fees paid to insurance brokerADMINISTRATIVE
Insurance broker nameAXA NETWORK, LLC
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract numberG4258
Policy instance 1
Insurance contract or identification numberG4258
Number of Individuals Covered1
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker nameN/A

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