TILTON EQUIPMENT COMPANY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan TILTON EQUIPMENT COMPANY 401(K) PLAN
Measure | Date | Value |
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2016: TILTON EQUIPMENT COMPANY 401(K) PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-07-01 | 27 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 0 |
Number of retired or separated participants receiving benefits | 2016-07-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2016-07-01 | 0 |
Total of all active and inactive participants | 2016-07-01 | 0 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2016-07-01 | 0 |
Total participants | 2016-07-01 | 0 |
Number of participants with account balances | 2016-07-01 | 0 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2016-07-01 | 0 |
2015: TILTON EQUIPMENT COMPANY 401(K) PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-07-01 | 31 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-07-01 | 18 |
Number of retired or separated participants receiving benefits | 2015-07-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-07-01 | 9 |
Total of all active and inactive participants | 2015-07-01 | 27 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2015-07-01 | 0 |
Total participants | 2015-07-01 | 27 |
Number of participants with account balances | 2015-07-01 | 27 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2015-07-01 | 0 |
2014: TILTON EQUIPMENT COMPANY 401(K) PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-07-01 | 33 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 22 |
Number of retired or separated participants receiving benefits | 2014-07-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2014-07-01 | 9 |
Total of all active and inactive participants | 2014-07-01 | 32 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-07-01 | 0 |
Total participants | 2014-07-01 | 32 |
Number of participants with account balances | 2014-07-01 | 31 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2014-07-01 | 0 |
2013: TILTON EQUIPMENT COMPANY 401(K) PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-07-01 | 37 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 22 |
Number of retired or separated participants receiving benefits | 2013-07-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2013-07-01 | 10 |
Total of all active and inactive participants | 2013-07-01 | 33 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-07-01 | 0 |
Total participants | 2013-07-01 | 33 |
Number of participants with account balances | 2013-07-01 | 33 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-07-01 | 0 |
2012: TILTON EQUIPMENT COMPANY 401(K) PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-07-01 | 46 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 27 |
Number of retired or separated participants receiving benefits | 2012-07-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2012-07-01 | 9 |
Total of all active and inactive participants | 2012-07-01 | 37 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-07-01 | 0 |
Total participants | 2012-07-01 | 37 |
Number of participants with account balances | 2012-07-01 | 35 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-07-01 | 0 |
Measure | Date | Value |
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2016 : TILTON EQUIPMENT COMPANY 401(K) PLAN 2016 401k financial data |
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Total income from all sources | 2016-11-28 | $122,172 |
Expenses. Total of all expenses incurred | 2016-11-28 | $3,452,248 |
Benefits paid (including direct rollovers) | 2016-11-28 | $3,448,606 |
Total plan assets at end of year | 2016-11-28 | $0 |
Total plan assets at beginning of year | 2016-11-28 | $3,330,076 |
Value of fidelity bond covering the plan | 2016-11-28 | $500,000 |
Total contributions received or receivable from participants | 2016-11-28 | $11,060 |
Contributions received from other sources (not participants or employers) | 2016-11-28 | $0 |
Other income received | 2016-11-28 | $103,243 |
Net income (gross income less expenses) | 2016-11-28 | $-3,330,076 |
Net plan assets at end of year (total assets less liabilities) | 2016-11-28 | $0 |
Net plan assets at beginning of year (total assets less liabilities) | 2016-11-28 | $3,330,076 |
Total contributions received or receivable from employer(s) | 2016-11-28 | $7,869 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2016-11-28 | $3,642 |
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2016-11-28 | $0 |
Total income from all sources | 2016-06-30 | $16,801 |
Expenses. Total of all expenses incurred | 2016-06-30 | $1,038,608 |
Benefits paid (including direct rollovers) | 2016-06-30 | $1,030,921 |
Total plan assets at end of year | 2016-06-30 | $3,330,076 |
Total plan assets at beginning of year | 2016-06-30 | $4,351,883 |
Value of fidelity bond covering the plan | 2016-06-30 | $500,000 |
Total contributions received or receivable from participants | 2016-06-30 | $37,466 |
Expenses. Other expenses not covered elsewhere | 2016-06-30 | $0 |
Contributions received from other sources (not participants or employers) | 2016-06-30 | $0 |
Other income received | 2016-06-30 | $-47,032 |
Net income (gross income less expenses) | 2016-06-30 | $-1,021,807 |
Net plan assets at end of year (total assets less liabilities) | 2016-06-30 | $3,330,076 |
Net plan assets at beginning of year (total assets less liabilities) | 2016-06-30 | $4,351,883 |
Total contributions received or receivable from employer(s) | 2016-06-30 | $26,367 |
Value of certain deemed distributions of participant loans | 2016-06-30 | $0 |
Value of corrective distributions | 2016-06-30 | $0 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2016-06-30 | $7,687 |
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2016-06-30 | $0 |
2015 : TILTON EQUIPMENT COMPANY 401(K) PLAN 2015 401k financial data |
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Total income from all sources | 2015-06-30 | $133,288 |
Expenses. Total of all expenses incurred | 2015-06-30 | $234,505 |
Benefits paid (including direct rollovers) | 2015-06-30 | $226,282 |
Total plan assets at end of year | 2015-06-30 | $4,351,883 |
Total plan assets at beginning of year | 2015-06-30 | $4,453,100 |
Value of fidelity bond covering the plan | 2015-06-30 | $500,000 |
Total contributions received or receivable from participants | 2015-06-30 | $38,134 |
Other income received | 2015-06-30 | $66,542 |
Net income (gross income less expenses) | 2015-06-30 | $-101,217 |
Net plan assets at end of year (total assets less liabilities) | 2015-06-30 | $4,351,883 |
Net plan assets at beginning of year (total assets less liabilities) | 2015-06-30 | $4,453,100 |
Total contributions received or receivable from employer(s) | 2015-06-30 | $28,612 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2015-06-30 | $8,223 |
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2015-06-30 | $0 |
2014 : TILTON EQUIPMENT COMPANY 401(K) PLAN 2014 401k financial data |
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Total income from all sources | 2014-06-30 | $605,236 |
Expenses. Total of all expenses incurred | 2014-06-30 | $196,101 |
Benefits paid (including direct rollovers) | 2014-06-30 | $188,089 |
Total plan assets at end of year | 2014-06-30 | $4,453,100 |
Total plan assets at beginning of year | 2014-06-30 | $4,043,965 |
Value of fidelity bond covering the plan | 2014-06-30 | $500,000 |
Total contributions received or receivable from participants | 2014-06-30 | $39,581 |
Other income received | 2014-06-30 | $536,392 |
Net income (gross income less expenses) | 2014-06-30 | $409,135 |
Net plan assets at end of year (total assets less liabilities) | 2014-06-30 | $4,453,100 |
Net plan assets at beginning of year (total assets less liabilities) | 2014-06-30 | $4,043,965 |
Total contributions received or receivable from employer(s) | 2014-06-30 | $29,263 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2014-06-30 | $8,012 |
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2014-06-30 | $0 |
2013 : TILTON EQUIPMENT COMPANY 401(K) PLAN 2013 401k financial data |
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Total income from all sources | 2013-06-30 | $428,471 |
Expenses. Total of all expenses incurred | 2013-06-30 | $196,636 |
Benefits paid (including direct rollovers) | 2013-06-30 | $189,074 |
Total plan assets at end of year | 2013-06-30 | $4,043,965 |
Total plan assets at beginning of year | 2013-06-30 | $3,812,130 |
Value of fidelity bond covering the plan | 2013-06-30 | $1,000,000 |
Total contributions received or receivable from participants | 2013-06-30 | $46,394 |
Other income received | 2013-06-30 | $349,910 |
Net income (gross income less expenses) | 2013-06-30 | $231,835 |
Net plan assets at end of year (total assets less liabilities) | 2013-06-30 | $4,043,965 |
Net plan assets at beginning of year (total assets less liabilities) | 2013-06-30 | $3,812,130 |
Total contributions received or receivable from employer(s) | 2013-06-30 | $32,167 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2013-06-30 | $7,562 |
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2013-06-30 | $0 |
2016: TILTON EQUIPMENT COMPANY 401(K) PLAN 2016 form 5500 responses |
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2016-07-01 | Type of plan entity | Single employer plan |
2016-07-01 | Submission has been amended | No |
2016-07-01 | This submission is the final filing | Yes |
2016-07-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
2016-07-01 | Plan is a collectively bargained plan | No |
2016-07-01 | Plan funding arrangement – Insurance | Yes |
2016-07-01 | Plan funding arrangement – Trust | Yes |
2016-07-01 | Plan benefit arrangement - Trust | Yes |
2015: TILTON EQUIPMENT COMPANY 401(K) PLAN 2015 form 5500 responses |
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2015-07-01 | Type of plan entity | Single employer plan |
2015-07-01 | Submission has been amended | No |
2015-07-01 | This submission is the final filing | No |
2015-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-07-01 | Plan is a collectively bargained plan | No |
2015-07-01 | Plan funding arrangement – Insurance | Yes |
2015-07-01 | Plan funding arrangement – Trust | Yes |
2015-07-01 | Plan benefit arrangement - Trust | Yes |
2014: TILTON EQUIPMENT COMPANY 401(K) PLAN 2014 form 5500 responses |
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2014-07-01 | Type of plan entity | Single employer plan |
2014-07-01 | Submission has been amended | No |
2014-07-01 | This submission is the final filing | No |
2014-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-07-01 | Plan is a collectively bargained plan | No |
2014-07-01 | Plan funding arrangement – Insurance | Yes |
2014-07-01 | Plan funding arrangement – Trust | Yes |
2014-07-01 | Plan benefit arrangement - Trust | Yes |
2013: TILTON EQUIPMENT COMPANY 401(K) PLAN 2013 form 5500 responses |
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2013-07-01 | Type of plan entity | Single employer plan |
2013-07-01 | Submission has been amended | No |
2013-07-01 | This submission is the final filing | No |
2013-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-07-01 | Plan is a collectively bargained plan | No |
2013-07-01 | Plan funding arrangement – Insurance | Yes |
2013-07-01 | Plan funding arrangement – Trust | Yes |
2013-07-01 | Plan benefit arrangement - Trust | Yes |
2012: TILTON EQUIPMENT COMPANY 401(K) PLAN 2012 form 5500 responses |
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2012-07-01 | Type of plan entity | Single employer plan |
2012-07-01 | Submission has been amended | No |
2012-07-01 | This submission is the final filing | No |
2012-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-07-01 | Plan is a collectively bargained plan | No |
2012-07-01 | Plan funding arrangement – Insurance | Yes |
2012-07-01 | Plan funding arrangement – Trust | Yes |
2012-07-01 | Plan benefit arrangement - Trust | Yes |
PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001681 |
Policy instance | 8 |
Insurance contract or identification number | U001681 | Number of Individuals Covered | 1 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE AND ANNUITY CONTRACT |
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JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
Policy contract number | 39366 |
Policy instance | 1 |
Insurance contract or identification number | 39366 | Number of Individuals Covered | 27 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | Total amount of commissions paid to insurance broker | USD $7,431 | Total amount of fees paid to insurance company | USD $1,883 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | Yes | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,431 | Insurance broker organization code? | 4 | Amount paid for insurance broker fees | 1883 | Additional information about fees paid to insurance broker | TPA FORUM PAYMENT | Insurance broker name | THIRD PARTY ADMINISTRATORS, INC. |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001671 |
Policy instance | 2 |
Insurance contract or identification number | U001671 | Number of Individuals Covered | 0 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE AND ANNUITY CONTRACT |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001673 |
Policy instance | 3 |
Insurance contract or identification number | U001673 | Number of Individuals Covered | 0 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE AND ANNUITY CONTRACT |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001696 |
Policy instance | 4 |
Insurance contract or identification number | U001696 | Number of Individuals Covered | 1 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE AND ANNUITY CONTRACT |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001735 |
Policy instance | 5 |
Insurance contract or identification number | U001735 | Number of Individuals Covered | 1 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE AND ANNUITY CONTRACT |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001741 |
Policy instance | 6 |
Insurance contract or identification number | U001741 | Number of Individuals Covered | 0 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE AND ANNUITY CONTRACT |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001780 |
Policy instance | 7 |
Insurance contract or identification number | U001780 | Number of Individuals Covered | 0 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE COMPANY AND ANNUITY CONTRACT |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001671 |
Policy instance | 2 |
Insurance contract or identification number | U001671 | Number of Individuals Covered | 1 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE AND ANNUITY CONTRACT |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001673 |
Policy instance | 3 |
Insurance contract or identification number | U001673 | Number of Individuals Covered | 1 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE AND ANNUITY CONTRACT |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001696 |
Policy instance | 4 |
Insurance contract or identification number | U001696 | Number of Individuals Covered | 1 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE AND ANNUITY CONTRACT |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001741 |
Policy instance | 6 |
Insurance contract or identification number | U001741 | Number of Individuals Covered | 1 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE AND ANNUITY CONTRACT |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001735 |
Policy instance | 5 |
Insurance contract or identification number | U001735 | Number of Individuals Covered | 1 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE AND ANNUITY CONTRACT |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001780 |
Policy instance | 7 |
Insurance contract or identification number | U001780 | Number of Individuals Covered | 1 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE COMPANY AND ANNUITY CONTRACT |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001706 |
Policy instance | 8 |
Insurance contract or identification number | U001706 | Number of Individuals Covered | 0 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE AND ANNUITY CONTRACT |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001861 |
Policy instance | 9 |
Insurance contract or identification number | U001861 | Number of Individuals Covered | 1 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE AND ANNUITY CONTRACT |
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JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
Policy contract number | 39366 |
Policy instance | 1 |
Insurance contract or identification number | 39366 | Number of Individuals Covered | 33 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $7,884 | Total amount of fees paid to insurance company | USD $2,004 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | Yes | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,884 | Insurance broker organization code? | 4 | Amount paid for insurance broker fees | 2004 | Additional information about fees paid to insurance broker | TPA FORUM PAYMENT | Insurance broker name | THIRD PARTY ADMINISTRATORS, INC. |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001861 |
Policy instance | 9 |
Insurance contract or identification number | U001861 | Number of Individuals Covered | 1 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE AND ANNUITY CONTRACT |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001780 |
Policy instance | 8 |
Insurance contract or identification number | U001780 | Number of Individuals Covered | 1 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE COMPANY AND ANNUITY CONTRACT |
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JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
Policy contract number | 39366 |
Policy instance | 1 |
Insurance contract or identification number | 39366 | Number of Individuals Covered | 33 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $1,776 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | Yes | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1776 | Additional information about fees paid to insurance broker | TPA FORUM PAYMENT | Insurance broker organization code? | 5 | Insurance broker name | THIRD PARTY ADMINISTRATORS, INC. |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001671 |
Policy instance | 2 |
Insurance contract or identification number | U001671 | Number of Individuals Covered | 1 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE AND ANNUITY CONTRACT |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001673 |
Policy instance | 3 |
Insurance contract or identification number | U001673 | Number of Individuals Covered | 1 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE AND ANNUITY CONTRACT |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001696 |
Policy instance | 4 |
Insurance contract or identification number | U001696 | Number of Individuals Covered | 1 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE AND ANNUITY CONTRACT |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001706 |
Policy instance | 5 |
Insurance contract or identification number | U001706 | Number of Individuals Covered | 1 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE AND ANNUITY CONTRACT |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001735 |
Policy instance | 6 |
Insurance contract or identification number | U001735 | Number of Individuals Covered | 1 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $3,000 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE AND ANNUITY CONTRACT | Commission paid to Insurance Broker | USD $3,000 | Insurance broker organization code? | 3 | Insurance broker name | ALTISURE GROUP, LLC |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001741 |
Policy instance | 7 |
Insurance contract or identification number | U001741 | Number of Individuals Covered | 1 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE AND ANNUITY CONTRACT |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001706 |
Policy instance | 2 |
Insurance contract or identification number | U001706 | Number of Individuals Covered | 1 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE AND ANNUITY CONTRACT |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001780 |
Policy instance | 3 |
Insurance contract or identification number | U001780 | Number of Individuals Covered | 1 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE AND ANNUITY CONTRACT |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001741 |
Policy instance | 4 |
Insurance contract or identification number | U001741 | Number of Individuals Covered | 1 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE AND ANNUITY CONTRACT |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001861 |
Policy instance | 5 |
Insurance contract or identification number | U001861 | Number of Individuals Covered | 1 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE AND ANNUITY CONTRACT |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001735 |
Policy instance | 6 |
Insurance contract or identification number | U001735 | Number of Individuals Covered | 1 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE AND ANNUITY CONTRACT |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001673 |
Policy instance | 7 |
Insurance contract or identification number | U001673 | Number of Individuals Covered | 1 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE AND ANNUITY CONTRACT |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001696 |
Policy instance | 8 |
Insurance contract or identification number | U001696 | Number of Individuals Covered | 1 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE COMPANY AND ANNUITY CONTRACT |
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PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 ) |
Policy contract number | U001671 |
Policy instance | 9 |
Insurance contract or identification number | U001671 | Number of Individuals Covered | 1 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | 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? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Other information about contract | INDIVIDUAL LIFE INSURANCE AND ANNUITY CONTRACT |
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JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
Policy contract number | 39366 |
Policy instance | 1 |
Insurance contract or identification number | 39366 | Number of Individuals Covered | 37 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $1,815 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | Yes | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1815 | Additional information about fees paid to insurance broker | TPA FORUM PAYMENT | Insurance broker organization code? | 5 | Insurance broker name | THIRD PARTY ADMINISTRATORS, INC. |
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