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SHAPE DYNAMICS INC. UNION SAVINGS PLAN 401k Plan overview

Plan NameSHAPE DYNAMICS INC. UNION SAVINGS PLAN
Plan identification number 002

SHAPE DYNAMICS INC. UNION SAVINGS 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.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

SHAPE DYNAMICS, INC. has sponsored the creation of one or more 401k plans.

Company Name:SHAPE DYNAMICS, INC.
Employer identification number (EIN):382699992
NAIC Classification:551112
NAIC Description:Offices of Other Holding Companies

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SHAPE DYNAMICS INC. UNION SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022021-10-01
0022020-10-01
0022019-10-01
0022018-10-01
0022017-10-01
0022016-10-01
0022015-10-01
0022014-10-01
0022013-10-01JOHN MCINTYRE
0022012-10-01MICHAEL EVANS2014-01-25
0022011-10-01MICHAEL EVANS2013-01-15
0022010-10-01JANELL SPICER2012-01-18

Plan Statistics for SHAPE DYNAMICS INC. UNION SAVINGS PLAN

401k plan membership statisitcs for SHAPE DYNAMICS INC. UNION SAVINGS PLAN

Measure Date Value
2016: SHAPE DYNAMICS INC. UNION SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-01103
Total number of active participants reported on line 7a of the Form 55002016-10-0189
Number of retired or separated participants receiving benefits2016-10-010
Number of other retired or separated participants entitled to future benefits2016-10-017
Total of all active and inactive participants2016-10-0196
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-10-010
Total participants2016-10-0196
Number of participants with account balances2016-10-0154
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-10-010
2015: SHAPE DYNAMICS INC. UNION SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-01112
Total number of active participants reported on line 7a of the Form 55002015-10-0198
Number of retired or separated participants receiving benefits2015-10-010
Number of other retired or separated participants entitled to future benefits2015-10-014
Total of all active and inactive participants2015-10-01102
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-10-010
Total participants2015-10-01102
Number of participants with account balances2015-10-0156
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-10-010
2014: SHAPE DYNAMICS INC. UNION SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year2014-10-01113
Total number of active participants reported on line 7a of the Form 55002014-10-01103
Number of retired or separated participants receiving benefits2014-10-010
Number of other retired or separated participants entitled to future benefits2014-10-017
Total of all active and inactive participants2014-10-01110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-10-010
Total participants2014-10-01110
Number of participants with account balances2014-10-0158
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-10-010
2013: SHAPE DYNAMICS INC. UNION SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year2013-10-01124
Total number of active participants reported on line 7a of the Form 55002013-10-01113
Number of retired or separated participants receiving benefits2013-10-010
Number of other retired or separated participants entitled to future benefits2013-10-014
Total of all active and inactive participants2013-10-01117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-10-010
Total participants2013-10-01117
Number of participants with account balances2013-10-0156
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-10-010

Financial Data on SHAPE DYNAMICS INC. UNION SAVINGS PLAN

Measure Date Value
2017 : SHAPE DYNAMICS INC. UNION SAVINGS PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-09-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-09-30$0
Total income from all sources (including contributions)2017-09-30$589,521
Total loss/gain on sale of assets2017-09-30$0
Total of all expenses incurred2017-09-30$692,471
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-09-30$692,471
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-09-30$230,062
Value of total assets at end of year2017-09-30$2,760,254
Value of total assets at beginning of year2017-09-30$2,863,204
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-09-30$0
Total interest from all sources2017-09-30$3,109
Total dividends received (eg from common stock, registered investment company shares)2017-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-09-30No
Was this plan covered by a fidelity bond2017-09-30Yes
Value of fidelity bond cover2017-09-30$500,000
If this is an individual account plan, was there a blackout period2017-09-30No
Were there any nonexempt tranactions with any party-in-interest2017-09-30No
Contributions received from participants2017-09-30$199,578
Participant contributions at end of year2017-09-30$56,471
Participant contributions at beginning of year2017-09-30$94,985
Participant contributions at end of year2017-09-30$0
Participant contributions at beginning of year2017-09-30$7,677
Income. Received or receivable in cash from other sources (including rollovers)2017-09-30$30,484
Liabilities. Value of operating payables at end of year2017-09-30$0
Liabilities. Value of operating payables at beginning of year2017-09-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-09-30No
Value of net income/loss2017-09-30$-102,950
Value of net assets at end of year (total assets less liabilities)2017-09-30$2,760,254
Value of net assets at beginning of year (total assets less liabilities)2017-09-30$2,863,204
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2017-09-30No
Were any leases to which the plan was party in default or uncollectible2017-09-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-09-30$2,703,783
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-09-30$2,733,828
Interest on participant loans2017-09-30$3,109
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-09-30$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-09-30$26,714
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-09-30$26,714
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-09-30$0
Net investment gain/loss from pooled separate accounts2017-09-30$356,350
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-09-30No
Was there a failure to transmit to the plan any participant contributions2017-09-30Yes
Has the plan failed to provide any benefit when due under the plan2017-09-30No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-09-30$692,471
Did the plan have assets held for investment2017-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-09-30Yes
Opinion of an independent qualified public accountant for this plan2017-09-30Disclaimer
Accountancy firm name2017-09-30PLANTE & MORAN, PLLC
Accountancy firm EIN2017-09-30381357951
2016 : SHAPE DYNAMICS INC. UNION SAVINGS PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-09-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-09-30$3,030
Total income from all sources (including contributions)2016-09-30$618,758
Total loss/gain on sale of assets2016-09-30$0
Total of all expenses incurred2016-09-30$363,605
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-09-30$361,373
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-09-30$382,715
Value of total assets at end of year2016-09-30$2,863,204
Value of total assets at beginning of year2016-09-30$2,611,081
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-09-30$2,232
Total interest from all sources2016-09-30$236,043
Total dividends received (eg from common stock, registered investment company shares)2016-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-09-30No
Administrative expenses professional fees incurred2016-09-30$2,232
Was this plan covered by a fidelity bond2016-09-30Yes
Value of fidelity bond cover2016-09-30$500,000
If this is an individual account plan, was there a blackout period2016-09-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-09-30$0
Were there any nonexempt tranactions with any party-in-interest2016-09-30No
Contributions received from participants2016-09-30$220,803
Participant contributions at end of year2016-09-30$94,985
Participant contributions at beginning of year2016-09-30$84,899
Participant contributions at end of year2016-09-30$7,677
Participant contributions at beginning of year2016-09-30$10,154
Income. Received or receivable in cash from other sources (including rollovers)2016-09-30$161,912
Liabilities. Value of operating payables at end of year2016-09-30$0
Liabilities. Value of operating payables at beginning of year2016-09-30$3,030
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-09-30No
Value of net income/loss2016-09-30$255,153
Value of net assets at end of year (total assets less liabilities)2016-09-30$2,863,204
Value of net assets at beginning of year (total assets less liabilities)2016-09-30$2,608,051
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2016-09-30No
Were any leases to which the plan was party in default or uncollectible2016-09-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-09-30$2,733,828
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-09-30$2,453,914
Interest on participant loans2016-09-30$3,561
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-09-30$26,714
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-09-30$62,114
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-09-30$62,114
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-09-30$232,482
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-09-30No
Was there a failure to transmit to the plan any participant contributions2016-09-30No
Has the plan failed to provide any benefit when due under the plan2016-09-30No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-09-30$361,373
Did the plan have assets held for investment2016-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-09-30Yes
Opinion of an independent qualified public accountant for this plan2016-09-30Disclaimer
Accountancy firm name2016-09-30CROWE HORWATH LLP
Accountancy firm EIN2016-09-30350921680
2015 : SHAPE DYNAMICS INC. UNION SAVINGS PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-09-30$3,030
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-09-30$6,115
Total income from all sources (including contributions)2015-09-30$138,766
Total loss/gain on sale of assets2015-09-30$0
Total of all expenses incurred2015-09-30$11,240
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-09-30$1,769
Expenses. Certain deemed distributions of participant loans2015-09-30$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-09-30$231,598
Value of total assets at end of year2015-09-30$2,611,081
Value of total assets at beginning of year2015-09-30$2,486,640
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-09-30$9,471
Total interest from all sources2015-09-30$162,447
Total dividends received (eg from common stock, registered investment company shares)2015-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-09-30No
Administrative expenses professional fees incurred2015-09-30$9,471
Was this plan covered by a fidelity bond2015-09-30Yes
Value of fidelity bond cover2015-09-30$500,000
If this is an individual account plan, was there a blackout period2015-09-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-09-30$0
Were there any nonexempt tranactions with any party-in-interest2015-09-30No
Contributions received from participants2015-09-30$222,329
Participant contributions at end of year2015-09-30$84,899
Participant contributions at beginning of year2015-09-30$76,634
Participant contributions at end of year2015-09-30$10,154
Participant contributions at beginning of year2015-09-30$13,199
Income. Received or receivable in cash from other sources (including rollovers)2015-09-30$9,269
Liabilities. Value of operating payables at end of year2015-09-30$3,030
Liabilities. Value of operating payables at beginning of year2015-09-30$6,115
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-09-30No
Value of net income/loss2015-09-30$127,526
Value of net assets at end of year (total assets less liabilities)2015-09-30$2,608,051
Value of net assets at beginning of year (total assets less liabilities)2015-09-30$2,480,525
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2015-09-30No
Were any leases to which the plan was party in default or uncollectible2015-09-30No
Value of interest in pooled separate accounts at end of year2015-09-30$2,453,914
Value of interest in pooled separate accounts at beginning of year2015-09-30$2,373,275
Interest on participant loans2015-09-30$2,917
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-09-30$62,114
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-09-30$23,532
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-09-30$23,532
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-09-30$159,530
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-09-30$-255,279
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-09-30No
Was there a failure to transmit to the plan any participant contributions2015-09-30No
Has the plan failed to provide any benefit when due under the plan2015-09-30No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-09-30$1,769
Did the plan have assets held for investment2015-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-09-30Yes
Opinion of an independent qualified public accountant for this plan2015-09-30Disclaimer
Accountancy firm name2015-09-30REHMANN ROBSON LLC
Accountancy firm EIN2015-09-30383635706
2014 : SHAPE DYNAMICS INC. UNION SAVINGS PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-09-30$6,115
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-09-30$0
Total income from all sources (including contributions)2014-09-30$385,291
Total loss/gain on sale of assets2014-09-30$0
Total of all expenses incurred2014-09-30$315,371
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-09-30$308,027
Expenses. Certain deemed distributions of participant loans2014-09-30$970
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-09-30$218,134
Value of total assets at end of year2014-09-30$2,486,640
Value of total assets at beginning of year2014-09-30$2,410,605
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-09-30$6,374
Total interest from all sources2014-09-30$96,767
Total dividends received (eg from common stock, registered investment company shares)2014-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-09-30No
Administrative expenses professional fees incurred2014-09-30$6,374
Was this plan covered by a fidelity bond2014-09-30Yes
Value of fidelity bond cover2014-09-30$500,000
If this is an individual account plan, was there a blackout period2014-09-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-09-30$0
Were there any nonexempt tranactions with any party-in-interest2014-09-30No
Contributions received from participants2014-09-30$218,134
Participant contributions at end of year2014-09-30$76,634
Participant contributions at beginning of year2014-09-30$46,958
Participant contributions at end of year2014-09-30$13,199
Participant contributions at beginning of year2014-09-30$0
Income. Received or receivable in cash from other sources (including rollovers)2014-09-30$0
Liabilities. Value of operating payables at end of year2014-09-30$6,115
Liabilities. Value of operating payables at beginning of year2014-09-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-09-30No
Income. Non cash contributions2014-09-30$0
Value of net income/loss2014-09-30$69,920
Value of net assets at end of year (total assets less liabilities)2014-09-30$2,480,525
Value of net assets at beginning of year (total assets less liabilities)2014-09-30$2,410,605
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2014-09-30No
Were any leases to which the plan was party in default or uncollectible2014-09-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-09-30$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-09-30$2,124,090
Value of interest in pooled separate accounts at end of year2014-09-30$2,373,275
Value of interest in pooled separate accounts at beginning of year2014-09-30$0
Income. Interest from loans (other than to participants)2014-09-30$2,164
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-09-30$23,532
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-09-30$239,557
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-09-30$239,557
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-09-30$94,603
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-09-30$70,390
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-09-30No
Was there a failure to transmit to the plan any participant contributions2014-09-30Yes
Has the plan failed to provide any benefit when due under the plan2014-09-30No
Contributions received in cash from employer2014-09-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-09-30$308,027
Did the plan have assets held for investment2014-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-09-30Yes
Opinion of an independent qualified public accountant for this plan2014-09-30Disclaimer
Accountancy firm name2014-09-30REHMANN ROBSON LLC
Accountancy firm EIN2014-09-30383635706

Form 5500 Responses for SHAPE DYNAMICS INC. UNION SAVINGS PLAN

2016: SHAPE DYNAMICS INC. UNION SAVINGS PLAN 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Submission has been amendedNo
2016-10-01This submission is the final filingNo
2016-10-01This return/report is a short plan year return/report (less than 12 months)No
2016-10-01Plan is a collectively bargained planNo
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan funding arrangement – TrustYes
2016-10-01Plan benefit arrangement – InsuranceYes
2016-10-01Plan benefit arrangement - TrustYes
2015: SHAPE DYNAMICS INC. UNION SAVINGS PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Submission has been amendedNo
2015-10-01This submission is the final filingNo
2015-10-01This return/report is a short plan year return/report (less than 12 months)No
2015-10-01Plan is a collectively bargained planNo
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan funding arrangement – TrustYes
2015-10-01Plan benefit arrangement – InsuranceYes
2015-10-01Plan benefit arrangement - TrustYes
2014: SHAPE DYNAMICS INC. UNION SAVINGS PLAN 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Submission has been amendedNo
2014-10-01This submission is the final filingNo
2014-10-01This return/report is a short plan year return/report (less than 12 months)No
2014-10-01Plan is a collectively bargained planNo
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan funding arrangement – TrustYes
2014-10-01Plan benefit arrangement – InsuranceYes
2014-10-01Plan benefit arrangement - TrustYes
2013: SHAPE DYNAMICS INC. UNION SAVINGS PLAN 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Submission has been amendedNo
2013-10-01This submission is the final filingNo
2013-10-01This return/report is a short plan year return/report (less than 12 months)No
2013-10-01Plan is a collectively bargained planNo
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan funding arrangement – TrustYes
2013-10-01Plan benefit arrangement – InsuranceYes
2013-10-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-821912
Policy instance 1
Insurance contract or identification numberGA-821912
Number of Individuals Covered58
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $9,942
Total amount of fees paid to insurance companyUSD $1,008
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 $9,942
Insurance broker organization code?3
Amount paid for insurance broker fees1008
Additional information about fees paid to insurance brokerSALES/MARKETING
Insurance broker nameMESIROW FINANCIAL INVEST MNGMT INC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-821912
Policy instance 1
Insurance contract or identification numberGA-821912
Number of Individuals Covered56
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Total amount of commissions paid to insurance brokerUSD $8,911
Total amount of fees paid to insurance companyUSD $975
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 $8,911
Insurance broker organization code?3
Amount paid for insurance broker fees975
Additional information about fees paid to insurance brokerSALES/MARKETING
Insurance broker nameMERRILL LYNCH, PIERCE, FENNER &

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