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JACK BROWN PRODUCE, INC. EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan NameJACK BROWN PRODUCE, INC. EMPLOYEE BENEFIT PLAN
Plan identification number 001

JACK BROWN PRODUCE, INC. EMPLOYEE BENEFIT 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

JACK BROWN PRODUCE, INC. has sponsored the creation of one or more 401k plans.

Company Name:JACK BROWN PRODUCE, INC.
Employer identification number (EIN):381641251
NAIC Classification:115110

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JACK BROWN PRODUCE, INC. EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012021-07-01SHANE CURTIS2023-04-13
0012020-07-01JOHN A SCHAEFER JR2022-01-23 JOHN A SCHAEFER JR2022-01-23
0012019-07-01JOHN A SCHAEFER JR2020-12-08 JOHN A SCHAEFER JR2020-12-08
0012018-07-01JOHN A SCHAEFER JR2019-12-18 JOHN A SCHAEFER JR2019-12-18
0012017-07-01JOHN A SCHAEFER JR2018-11-26 JOHN A SCHAEFER JR2018-11-26
0012016-07-01JOHN A SCHAEFER JR2017-11-02 JOHN A SCHAEFER JR2017-11-02
0012015-07-01JOHN A SCHAEFER JR2016-11-10 JOHN A SCHAEFER JR2016-11-10
0012014-07-01JOHN A SCHAEFER JR JOHN A SCHAEFER JR2015-11-13
0012013-07-01JOHN SCHAEFER
0012012-07-01JOHN SCHAEFER JOHN SCHAEFER2013-12-07
0012011-07-01JOHN SCHAEFER
0012010-07-01JOHN SCHAEFER
0012009-07-01JOHN SCHAEFER

Plan Statistics for JACK BROWN PRODUCE, INC. EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for JACK BROWN PRODUCE, INC. EMPLOYEE BENEFIT PLAN

Measure Date Value
2014: JACK BROWN PRODUCE, INC. EMPLOYEE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-0157
Total number of active participants reported on line 7a of the Form 55002014-07-0152
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-0126
Total of all active and inactive participants2014-07-0178
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-07-010
Total participants2014-07-0178
Number of participants with account balances2014-07-0152
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-07-011
2013: JACK BROWN PRODUCE, INC. EMPLOYEE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-0156
Total number of active participants reported on line 7a of the Form 55002013-07-0135
Number of retired or separated participants receiving benefits2013-07-010
Number of other retired or separated participants entitled to future benefits2013-07-0126
Total of all active and inactive participants2013-07-0161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-07-010
Total participants2013-07-0161
Number of participants with account balances2013-07-0153
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-07-012
2012: JACK BROWN PRODUCE, INC. EMPLOYEE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-07-0173
Total number of active participants reported on line 7a of the Form 55002012-07-0119
Number of retired or separated participants receiving benefits2012-07-010
Number of other retired or separated participants entitled to future benefits2012-07-0127
Total of all active and inactive participants2012-07-0146
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-07-010
Total participants2012-07-0146
Number of participants with account balances2012-07-0146
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-07-0115
2011: JACK BROWN PRODUCE, INC. EMPLOYEE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-07-0172
Total number of active participants reported on line 7a of the Form 55002011-07-0144
Number of retired or separated participants receiving benefits2011-07-010
Number of other retired or separated participants entitled to future benefits2011-07-0122
Total of all active and inactive participants2011-07-0166
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-07-010
Total participants2011-07-0166
Number of participants with account balances2011-07-0144
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-07-0121
2010: JACK BROWN PRODUCE, INC. EMPLOYEE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-07-0159
Total number of active participants reported on line 7a of the Form 55002010-07-0145
Number of retired or separated participants receiving benefits2010-07-010
Number of other retired or separated participants entitled to future benefits2010-07-0112
Total of all active and inactive participants2010-07-0157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-07-010
Total participants2010-07-0157
Number of participants with account balances2010-07-0157
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-07-010
2009: JACK BROWN PRODUCE, INC. EMPLOYEE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-07-0162
Total number of active participants reported on line 7a of the Form 55002009-07-0140
Number of retired or separated participants receiving benefits2009-07-010
Number of other retired or separated participants entitled to future benefits2009-07-0114
Total of all active and inactive participants2009-07-0154
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-07-010
Total participants2009-07-0154
Number of participants with account balances2009-07-0154
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-07-010

Financial Data on JACK BROWN PRODUCE, INC. EMPLOYEE BENEFIT PLAN

Measure Date Value
2015 : JACK BROWN PRODUCE, INC. EMPLOYEE BENEFIT PLAN 2015 401k financial data
Transfers to/from the plan2015-06-30$0
Total income from all sources2015-06-30$123,160
Expenses. Total of all expenses incurred2015-06-30$119,976
Benefits paid (including direct rollovers)2015-06-30$119,976
Total plan assets at end of year2015-06-30$1,031,277
Total plan assets at beginning of year2015-06-30$1,028,093
Value of fidelity bond covering the plan2015-06-30$100,000
Total contributions received or receivable from participants2015-06-30$76,112
Expenses. Other expenses not covered elsewhere2015-06-30$0
Contributions received from other sources (not participants or employers)2015-06-30$0
Other income received2015-06-30$28,159
Net income (gross income less expenses)2015-06-30$3,184
Net plan assets at end of year (total assets less liabilities)2015-06-30$1,031,277
Net plan assets at beginning of year (total assets less liabilities)2015-06-30$1,028,093
Assets. Value of participant loans2015-06-30$9,348
Total contributions received or receivable from employer(s)2015-06-30$18,889
Value of certain deemed distributions of participant loans2015-06-30$0
Value of corrective distributions2015-06-30$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-06-30$0
Funding deficiency by the employer to the plan for this plan year2015-06-30$0
Minimum employer required contribution for this plan year2015-06-30$0
Amount contributed by the employer to the plan for this plan year2015-06-30$0
2014 : JACK BROWN PRODUCE, INC. EMPLOYEE BENEFIT PLAN 2014 401k financial data
Transfers to/from the plan2014-06-30$0
Total income from all sources2014-06-30$261,619
Expenses. Total of all expenses incurred2014-06-30$85,780
Benefits paid (including direct rollovers)2014-06-30$85,710
Total plan assets at end of year2014-06-30$1,028,093
Total plan assets at beginning of year2014-06-30$852,254
Value of fidelity bond covering the plan2014-06-30$100,000
Total contributions received or receivable from participants2014-06-30$75,594
Expenses. Other expenses not covered elsewhere2014-06-30$70
Contributions received from other sources (not participants or employers)2014-06-30$0
Other income received2014-06-30$176,223
Net income (gross income less expenses)2014-06-30$175,839
Net plan assets at end of year (total assets less liabilities)2014-06-30$1,028,093
Net plan assets at beginning of year (total assets less liabilities)2014-06-30$852,254
Assets. Value of participant loans2014-06-30$35,905
Total contributions received or receivable from employer(s)2014-06-30$9,802
Value of certain deemed distributions of participant loans2014-06-30$0
Value of corrective distributions2014-06-30$0
Funding deficiency by the employer to the plan for this plan year2014-06-30$0
Minimum employer required contribution for this plan year2014-06-30$0
Amount contributed by the employer to the plan for this plan year2014-06-30$0
2013 : JACK BROWN PRODUCE, INC. EMPLOYEE BENEFIT PLAN 2013 401k financial data
Transfers to/from the plan2013-06-30$0
Total income from all sources2013-06-30$190,798
Expenses. Total of all expenses incurred2013-06-30$35,709
Benefits paid (including direct rollovers)2013-06-30$35,569
Total plan assets at end of year2013-06-30$852,254
Total plan assets at beginning of year2013-06-30$697,165
Value of fidelity bond covering the plan2013-06-30$100,000
Total contributions received or receivable from participants2013-06-30$57,767
Expenses. Other expenses not covered elsewhere2013-06-30$140
Contributions received from other sources (not participants or employers)2013-06-30$0
Other income received2013-06-30$125,836
Net income (gross income less expenses)2013-06-30$155,089
Net plan assets at end of year (total assets less liabilities)2013-06-30$852,254
Net plan assets at beginning of year (total assets less liabilities)2013-06-30$697,165
Assets. Value of participant loans2013-06-30$53,011
Total contributions received or receivable from employer(s)2013-06-30$7,195
Value of certain deemed distributions of participant loans2013-06-30$0
Value of corrective distributions2013-06-30$0
Funding deficiency by the employer to the plan for this plan year2013-06-30$0
Minimum employer required contribution for this plan year2013-06-30$0
Amount contributed by the employer to the plan for this plan year2013-06-30$0
2012 : JACK BROWN PRODUCE, INC. EMPLOYEE BENEFIT PLAN 2012 401k financial data
Transfers to/from the plan2012-06-30$0
Total income from all sources2012-06-30$44,483
Expenses. Total of all expenses incurred2012-06-30$144,746
Benefits paid (including direct rollovers)2012-06-30$144,606
Total plan assets at end of year2012-06-30$697,165
Total plan assets at beginning of year2012-06-30$797,428
Value of fidelity bond covering the plan2012-06-30$100,000
Total contributions received or receivable from participants2012-06-30$54,789
Expenses. Other expenses not covered elsewhere2012-06-30$140
Contributions received from other sources (not participants or employers)2012-06-30$0
Other income received2012-06-30$-19,683
Net income (gross income less expenses)2012-06-30$-100,263
Net plan assets at end of year (total assets less liabilities)2012-06-30$697,165
Net plan assets at beginning of year (total assets less liabilities)2012-06-30$797,428
Assets. Value of participant loans2012-06-30$63,446
Total contributions received or receivable from employer(s)2012-06-30$9,377
Value of certain deemed distributions of participant loans2012-06-30$0
Value of corrective distributions2012-06-30$0
Funding deficiency by the employer to the plan for this plan year2012-06-30$0
Minimum employer required contribution for this plan year2012-06-30$0
Amount contributed by the employer to the plan for this plan year2012-06-30$0
2011 : JACK BROWN PRODUCE, INC. EMPLOYEE BENEFIT PLAN 2011 401k financial data
Transfers to/from the plan2011-06-30$0
Total income from all sources2011-06-30$207,069
Expenses. Total of all expenses incurred2011-06-30$43,278
Benefits paid (including direct rollovers)2011-06-30$42,583
Total plan assets at end of year2011-06-30$797,428
Total plan assets at beginning of year2011-06-30$633,637
Value of fidelity bond covering the plan2011-06-30$100,000
Total contributions received or receivable from participants2011-06-30$40,170
Expenses. Other expenses not covered elsewhere2011-06-30$210
Contributions received from other sources (not participants or employers)2011-06-30$0
Other income received2011-06-30$159,352
Net income (gross income less expenses)2011-06-30$163,791
Net plan assets at end of year (total assets less liabilities)2011-06-30$797,428
Net plan assets at beginning of year (total assets less liabilities)2011-06-30$633,637
Assets. Value of participant loans2011-06-30$67,810
Total contributions received or receivable from employer(s)2011-06-30$7,547
Value of certain deemed distributions of participant loans2011-06-30$0
Value of corrective distributions2011-06-30$485
Funding deficiency by the employer to the plan for this plan year2011-06-30$0
Minimum employer required contribution for this plan year2011-06-30$0
Amount contributed by the employer to the plan for this plan year2011-06-30$0
2010 : JACK BROWN PRODUCE, INC. EMPLOYEE BENEFIT PLAN 2010 401k financial data
Transfers to/from the plan2010-06-30$0
Total income from all sources2010-06-30$118,091
Expenses. Total of all expenses incurred2010-06-30$20,836
Benefits paid (including direct rollovers)2010-06-30$20,676
Total plan assets at end of year2010-06-30$633,637
Total plan assets at beginning of year2010-06-30$536,382
Value of fidelity bond covering the plan2010-06-30$100,000
Total contributions received or receivable from participants2010-06-30$44,971
Expenses. Other expenses not covered elsewhere2010-06-30$160
Contributions received from other sources (not participants or employers)2010-06-30$0
Other income received2010-06-30$64,200
Net income (gross income less expenses)2010-06-30$97,255
Net plan assets at end of year (total assets less liabilities)2010-06-30$633,637
Net plan assets at beginning of year (total assets less liabilities)2010-06-30$536,382
Assets. Value of participant loans2010-06-30$22,011
Total contributions received or receivable from employer(s)2010-06-30$8,920
Value of certain deemed distributions of participant loans2010-06-30$0
Value of corrective distributions2010-06-30$0
Funding deficiency by the employer to the plan for this plan year2010-06-30$0
Minimum employer required contribution for this plan year2010-06-30$0
Amount contributed by the employer to the plan for this plan year2010-06-30$0

Form 5500 Responses for JACK BROWN PRODUCE, INC. EMPLOYEE BENEFIT PLAN

2014: JACK BROWN PRODUCE, INC. EMPLOYEE BENEFIT PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan funding arrangement – TrustYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: JACK BROWN PRODUCE, INC. EMPLOYEE BENEFIT PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan funding arrangement – TrustYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: JACK BROWN PRODUCE, INC. EMPLOYEE BENEFIT PLAN 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan funding arrangement – TrustYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: JACK BROWN PRODUCE, INC. EMPLOYEE BENEFIT PLAN 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan funding arrangement – TrustYes
2011-07-01Plan benefit arrangement – InsuranceYes
2010: JACK BROWN PRODUCE, INC. EMPLOYEE BENEFIT PLAN 2010 form 5500 responses
2010-07-01Type of plan entitySingle employer plan
2010-07-01Submission has been amendedNo
2010-07-01This submission is the final filingNo
2010-07-01This return/report is a short plan year return/report (less than 12 months)No
2010-07-01Plan is a collectively bargained planNo
2010-07-01Plan funding arrangement – InsuranceYes
2010-07-01Plan funding arrangement – TrustYes
2010-07-01Plan benefit arrangement – InsuranceYes
2009: JACK BROWN PRODUCE, INC. EMPLOYEE BENEFIT PLAN 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedYes
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan funding arrangement – TrustYes
2009-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-018122
Policy instance 1
Insurance contract or identification numberGA-018122
Number of Individuals Covered52
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $2,461
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 $2,461
Insurance broker organization code?3
Insurance broker nameEDWARD D JONES & CO L P.
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-018122
Policy instance 1
Insurance contract or identification numberGA-018122
Number of Individuals Covered53
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $2,122
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 $2,122
Insurance broker organization code?3
Insurance broker nameEDWARD D JONES & CO L P.
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-018122
Policy instance 1
Insurance contract or identification numberGA-018122
Number of Individuals Covered46
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $1,656
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 $1,656
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-018122
Policy instance 1
Insurance contract or identification numberGA-018122
Number of Individuals Covered44
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $1,655
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
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-018122
Policy instance 1
Insurance contract or identification numberGA-018122
Number of Individuals Covered57
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $1,486
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

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