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RIIS BORG CONSTRUCTION 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan NameRIIS BORG CONSTRUCTION 401(K) PROFIT SHARING PLAN
Plan identification number 001

RIIS BORG CONSTRUCTION 401(K) PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

RIIS BORG CONSTRUCTION CO. has sponsored the creation of one or more 401k plans.

Company Name:RIIS BORG CONSTRUCTION CO.
Employer identification number (EIN):363446041
NAIC Classification:238900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan RIIS BORG CONSTRUCTION 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012015-05-01PATRICIA A. BORG PATRICIA A. BORG2016-01-05
0012015-05-01PATRICIA A. BORG PATRICIA A. BORG2016-01-05
0012015-05-01PATRICIA A. BORG PATRICIA A. BORG2016-02-22
0012014-05-01PATRICIA A.BORG PATRICIA A.BORG2015-11-30
0012013-05-01PATRICIA BORG PATRICIA BORG2014-11-26
0012012-05-01PAUL BORG
0012011-05-01PAUL BORG
0012009-05-01PAUL R. BORG, JR. PAUL R. BORG, JR.2010-11-23

Plan Statistics for RIIS BORG CONSTRUCTION 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for RIIS BORG CONSTRUCTION 401(K) PROFIT SHARING PLAN

Measure Date Value
2015: RIIS BORG CONSTRUCTION 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-05-012
Total number of active participants reported on line 7a of the Form 55002015-05-010
Number of retired or separated participants receiving benefits2015-05-010
Number of other retired or separated participants entitled to future benefits2015-05-010
Total of all active and inactive participants2015-05-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-05-010
Total participants2015-05-010
Number of participants with account balances2015-05-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-05-010
2014: RIIS BORG CONSTRUCTION 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-05-012
Total number of active participants reported on line 7a of the Form 55002014-05-012
Number of retired or separated participants receiving benefits2014-05-010
Number of other retired or separated participants entitled to future benefits2014-05-011
Total of all active and inactive participants2014-05-013
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-05-010
Total participants2014-05-013
Number of participants with account balances2014-05-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-05-010
2013: RIIS BORG CONSTRUCTION 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-05-0120
Total number of active participants reported on line 7a of the Form 55002013-05-0112
Number of retired or separated participants receiving benefits2013-05-010
Number of other retired or separated participants entitled to future benefits2013-05-0117
Total of all active and inactive participants2013-05-0129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-05-010
Total participants2013-05-0129
Number of participants with account balances2013-05-0125
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-05-010
2012: RIIS BORG CONSTRUCTION 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-05-0120
Total number of active participants reported on line 7a of the Form 55002012-05-0112
Number of retired or separated participants receiving benefits2012-05-010
Number of other retired or separated participants entitled to future benefits2012-05-0117
Total of all active and inactive participants2012-05-0129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-05-010
Total participants2012-05-0129
Number of participants with account balances2012-05-0112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-05-015
2011: RIIS BORG CONSTRUCTION 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-05-0123
Total number of active participants reported on line 7a of the Form 55002011-05-0113
Number of retired or separated participants receiving benefits2011-05-010
Number of other retired or separated participants entitled to future benefits2011-05-0113
Total of all active and inactive participants2011-05-0126
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-05-010
Total participants2011-05-0126
Number of participants with account balances2011-05-0126
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-05-010
2009: RIIS BORG CONSTRUCTION 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-05-0136
Total number of active participants reported on line 7a of the Form 55002009-05-0120
Number of retired or separated participants receiving benefits2009-05-010
Number of other retired or separated participants entitled to future benefits2009-05-018
Total of all active and inactive participants2009-05-0128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-05-010
Total participants2009-05-0128
Number of participants with account balances2009-05-0128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-05-010

Financial Data on RIIS BORG CONSTRUCTION 401(K) PROFIT SHARING PLAN

Measure Date Value
2015 : RIIS BORG CONSTRUCTION 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total plan liabilities at end of year2015-07-31$0
Total income from all sources2015-07-31$2,547
Expenses. Total of all expenses incurred2015-07-31$840,899
Benefits paid (including direct rollovers)2015-07-31$840,899
Total plan assets at end of year2015-07-31$0
Total plan assets at beginning of year2015-07-31$838,352
Value of fidelity bond covering the plan2015-07-31$100,000
Contributions received from other sources (not participants or employers)2015-07-31$0
Other income received2015-07-31$2,547
Net income (gross income less expenses)2015-07-31$-838,352
Net plan assets at end of year (total assets less liabilities)2015-07-31$0
Net plan assets at beginning of year (total assets less liabilities)2015-07-31$838,352
Total contributions received or receivable from employer(s)2015-07-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-07-31$0
Total income from all sources2015-04-30$105,141
Expenses. Total of all expenses incurred2015-04-30$67,796
Benefits paid (including direct rollovers)2015-04-30$67,796
Total plan assets at end of year2015-04-30$838,352
Total plan assets at beginning of year2015-04-30$801,007
Value of fidelity bond covering the plan2015-04-30$100,000
Total contributions received or receivable from participants2015-04-30$26,095
Contributions received from other sources (not participants or employers)2015-04-30$0
Other income received2015-04-30$79,046
Net income (gross income less expenses)2015-04-30$37,345
Net plan assets at end of year (total assets less liabilities)2015-04-30$838,352
Net plan assets at beginning of year (total assets less liabilities)2015-04-30$801,007
Assets. Value of participant loans2015-04-30$2,257
Total contributions received or receivable from employer(s)2015-04-30$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-04-30$0
2014 : RIIS BORG CONSTRUCTION 401(K) PROFIT SHARING PLAN 2014 401k financial data
Transfers to/from the plan2014-04-30$0
Total income from all sources2014-04-30$163,466
Expenses. Total of all expenses incurred2014-04-30$678,357
Benefits paid (including direct rollovers)2014-04-30$678,217
Total plan assets at end of year2014-04-30$801,007
Total plan assets at beginning of year2014-04-30$1,315,898
Value of fidelity bond covering the plan2014-04-30$100,000
Total contributions received or receivable from participants2014-04-30$36,332
Expenses. Other expenses not covered elsewhere2014-04-30$140
Contributions received from other sources (not participants or employers)2014-04-30$0
Other income received2014-04-30$127,134
Net income (gross income less expenses)2014-04-30$-514,891
Net plan assets at end of year (total assets less liabilities)2014-04-30$801,007
Net plan assets at beginning of year (total assets less liabilities)2014-04-30$1,315,898
Assets. Value of participant loans2014-04-30$18,310
Total contributions received or receivable from employer(s)2014-04-30$0
Value of certain deemed distributions of participant loans2014-04-30$0
Value of corrective distributions2014-04-30$0
Funding deficiency by the employer to the plan for this plan year2014-04-30$0
Minimum employer required contribution for this plan year2014-04-30$0
Amount contributed by the employer to the plan for this plan year2014-04-30$0
2013 : RIIS BORG CONSTRUCTION 401(K) PROFIT SHARING PLAN 2013 401k financial data
Transfers to/from the plan2013-04-30$0
Total income from all sources2013-04-30$130,395
Expenses. Total of all expenses incurred2013-04-30$27,515
Benefits paid (including direct rollovers)2013-04-30$27,445
Total plan assets at end of year2013-04-30$1,315,898
Total plan assets at beginning of year2013-04-30$1,213,018
Value of fidelity bond covering the plan2013-04-30$100,000
Total contributions received or receivable from participants2013-04-30$35,884
Expenses. Other expenses not covered elsewhere2013-04-30$70
Contributions received from other sources (not participants or employers)2013-04-30$0
Other income received2013-04-30$94,511
Net income (gross income less expenses)2013-04-30$102,880
Net plan assets at end of year (total assets less liabilities)2013-04-30$1,315,898
Net plan assets at beginning of year (total assets less liabilities)2013-04-30$1,213,018
Assets. Value of participant loans2013-04-30$12,268
Total contributions received or receivable from employer(s)2013-04-30$0
Value of certain deemed distributions of participant loans2013-04-30$0
Value of corrective distributions2013-04-30$0
Funding deficiency by the employer to the plan for this plan year2013-04-30$0
Minimum employer required contribution for this plan year2013-04-30$0
Amount contributed by the employer to the plan for this plan year2013-04-30$0
2012 : RIIS BORG CONSTRUCTION 401(K) PROFIT SHARING PLAN 2012 401k financial data
Transfers to/from the plan2012-04-30$0
Total income from all sources2012-04-30$22,593
Expenses. Total of all expenses incurred2012-04-30$0
Benefits paid (including direct rollovers)2012-04-30$0
Total plan assets at end of year2012-04-30$1,213,018
Total plan assets at beginning of year2012-04-30$1,190,425
Total contributions received or receivable from participants2012-04-30$39,129
Expenses. Other expenses not covered elsewhere2012-04-30$0
Contributions received from other sources (not participants or employers)2012-04-30$0
Other income received2012-04-30$-16,536
Net income (gross income less expenses)2012-04-30$22,593
Net plan assets at end of year (total assets less liabilities)2012-04-30$1,213,018
Net plan assets at beginning of year (total assets less liabilities)2012-04-30$1,190,425
Assets. Value of participant loans2012-04-30$6,082
Total contributions received or receivable from employer(s)2012-04-30$0
Value of certain deemed distributions of participant loans2012-04-30$0
Value of corrective distributions2012-04-30$0
2011 : RIIS BORG CONSTRUCTION 401(K) PROFIT SHARING PLAN 2011 401k financial data
Transfers to/from the plan2011-04-30$0
Total income from all sources2011-04-30$191,114
Expenses. Total of all expenses incurred2011-04-30$18,113
Benefits paid (including direct rollovers)2011-04-30$18,043
Total plan assets at end of year2011-04-30$1,190,425
Total plan assets at beginning of year2011-04-30$1,017,424
Value of fidelity bond covering the plan2011-04-30$100,000
Total contributions received or receivable from participants2011-04-30$41,655
Expenses. Other expenses not covered elsewhere2011-04-30$70
Contributions received from other sources (not participants or employers)2011-04-30$0
Other income received2011-04-30$149,459
Net income (gross income less expenses)2011-04-30$173,001
Net plan assets at end of year (total assets less liabilities)2011-04-30$1,190,425
Net plan assets at beginning of year (total assets less liabilities)2011-04-30$1,017,424
Assets. Value of participant loans2011-04-30$7,807
Total contributions received or receivable from employer(s)2011-04-30$0
Value of certain deemed distributions of participant loans2011-04-30$0
Value of corrective distributions2011-04-30$0
Funding deficiency by the employer to the plan for this plan year2011-04-30$0
Minimum employer required contribution for this plan year2011-04-30$0
Amount contributed by the employer to the plan for this plan year2011-04-30$0
2010 : RIIS BORG CONSTRUCTION 401(K) PROFIT SHARING PLAN 2010 401k financial data
Funding deficiency by the employer to the plan for this plan year2010-04-30$0
Minimum employer required contribution for this plan year2010-04-30$0
Amount contributed by the employer to the plan for this plan year2010-04-30$0

Form 5500 Responses for RIIS BORG CONSTRUCTION 401(K) PROFIT SHARING PLAN

2015: RIIS BORG CONSTRUCTION 401(K) PROFIT SHARING PLAN 2015 form 5500 responses
2015-05-01Type of plan entitySingle employer plan
2015-05-01Submission has been amendedNo
2015-05-01This submission is the final filingYes
2015-05-01This return/report is a short plan year return/report (less than 12 months)Yes
2015-05-01Plan is a collectively bargained planNo
2015-05-01Plan funding arrangement – InsuranceYes
2015-05-01Plan funding arrangement – TrustYes
2015-05-01Plan benefit arrangement – InsuranceYes
2014: RIIS BORG CONSTRUCTION 401(K) PROFIT SHARING PLAN 2014 form 5500 responses
2014-05-01Type of plan entitySingle employer plan
2014-05-01Submission has been amendedNo
2014-05-01This submission is the final filingNo
2014-05-01This return/report is a short plan year return/report (less than 12 months)No
2014-05-01Plan is a collectively bargained planNo
2014-05-01Plan funding arrangement – InsuranceYes
2014-05-01Plan funding arrangement – TrustYes
2014-05-01Plan benefit arrangement – InsuranceYes
2013: RIIS BORG CONSTRUCTION 401(K) PROFIT SHARING PLAN 2013 form 5500 responses
2013-05-01Type of plan entitySingle employer plan
2013-05-01Submission has been amendedNo
2013-05-01This submission is the final filingNo
2013-05-01This return/report is a short plan year return/report (less than 12 months)No
2013-05-01Plan is a collectively bargained planNo
2013-05-01Plan funding arrangement – InsuranceYes
2013-05-01Plan funding arrangement – TrustYes
2013-05-01Plan benefit arrangement – InsuranceYes
2012: RIIS BORG CONSTRUCTION 401(K) PROFIT SHARING PLAN 2012 form 5500 responses
2012-05-01Type of plan entitySingle employer plan
2012-05-01Submission has been amendedNo
2012-05-01This submission is the final filingNo
2012-05-01This return/report is a short plan year return/report (less than 12 months)No
2012-05-01Plan is a collectively bargained planNo
2012-05-01Plan funding arrangement – InsuranceYes
2012-05-01Plan funding arrangement – TrustYes
2012-05-01Plan benefit arrangement – InsuranceYes
2011: RIIS BORG CONSTRUCTION 401(K) PROFIT SHARING PLAN 2011 form 5500 responses
2011-05-01Type of plan entitySingle employer plan
2011-05-01Submission has been amendedNo
2011-05-01This submission is the final filingNo
2011-05-01This return/report is a short plan year return/report (less than 12 months)No
2011-05-01Plan is a collectively bargained planNo
2011-05-01Plan funding arrangement – InsuranceYes
2011-05-01Plan funding arrangement – TrustYes
2011-05-01Plan benefit arrangement – InsuranceYes
2009: RIIS BORG CONSTRUCTION 401(K) PROFIT SHARING PLAN 2009 form 5500 responses
2009-05-01Type of plan entitySingle employer plan
2009-05-01Submission has been amendedNo
2009-05-01This submission is the final filingNo
2009-05-01This return/report is a short plan year return/report (less than 12 months)No
2009-05-01Plan is a collectively bargained planNo
2009-05-01Plan funding arrangement – InsuranceYes
2009-05-01Plan funding arrangement – TrustYes
2009-05-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-026574
Policy instance 1
Insurance contract or identification numberGA-026574
Number of Individuals Covered0
Insurance policy start date2015-05-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $629
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $629
Insurance broker organization code?3
Insurance broker nameEDWARD D JONES & CO
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-026574
Policy instance 1
Insurance contract or identification numberGA-026574
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $2,510
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,510
Insurance broker organization code?3
Insurance broker nameEDWARD D JONES & CO
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-026574
Policy instance 1
Insurance contract or identification numberGA-026574
Number of Individuals Covered25
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $4,138
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,138
Insurance broker organization code?3
Insurance broker nameEDWARD D JONES & CO
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-026574
Policy instance 1
Insurance contract or identification numberGA-026574
Number of Individuals Covered12
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $3,658
Total amount of fees paid to insurance companyUSD $599
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,658
Insurance broker organization code?3
Amount paid for insurance broker fees599
Additional information about fees paid to insurance brokerSALES/MARKETING
Insurance broker nameEDWARD D JONES & CO
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-026574
Policy instance 1
Insurance contract or identification numberGA-026574
Number of Individuals Covered26
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $3,356
Total amount of fees paid to insurance companyUSD $1,123
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-026574
Policy instance 1
Insurance contract or identification numberGA-026574
Number of Individuals Covered26
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $3,091
Total amount of fees paid to insurance companyUSD $827
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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