SF BAY EYE DBA ALAMEDA EYE PHYSICIANS has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan ALAMEDA EYE PHYSICIANS RETIREMENT PLAN
| Measure | Date | Value |
|---|
| 2022: ALAMEDA EYE PHYSICIANS RETIREMENT PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 15 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 13 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 5 |
| Total of all active and inactive participants | 2022-01-01 | 18 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2022-01-01 | 0 |
| Total participants | 2022-01-01 | 18 |
| Number of participants with account balances | 2022-01-01 | 18 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2022-01-01 | 2 |
| 2021: ALAMEDA EYE PHYSICIANS RETIREMENT PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 13 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 12 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 3 |
| Total of all active and inactive participants | 2021-01-01 | 15 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2021-01-01 | 0 |
| Total participants | 2021-01-01 | 15 |
| Number of participants with account balances | 2021-01-01 | 15 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2021-01-01 | 1 |
| 2020: ALAMEDA EYE PHYSICIANS RETIREMENT PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 14 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 12 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 1 |
| Total of all active and inactive participants | 2020-01-01 | 13 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2020-01-01 | 0 |
| Total participants | 2020-01-01 | 13 |
| Number of participants with account balances | 2020-01-01 | 13 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2020-01-01 | 1 |
| 2019: ALAMEDA EYE PHYSICIANS RETIREMENT PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 14 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 12 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 2 |
| Total of all active and inactive participants | 2019-01-01 | 14 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2019-01-01 | 0 |
| Total participants | 2019-01-01 | 14 |
| Number of participants with account balances | 2019-01-01 | 14 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2019-01-01 | 0 |
| 2018: ALAMEDA EYE PHYSICIANS RETIREMENT PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 22 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 9 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 4 |
| Total of all active and inactive participants | 2018-01-01 | 13 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2018-01-01 | 0 |
| Total participants | 2018-01-01 | 13 |
| Number of participants with account balances | 2018-01-01 | 13 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2018-01-01 | 4 |
| 2017: ALAMEDA EYE PHYSICIANS RETIREMENT PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 21 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 10 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 10 |
| Total of all active and inactive participants | 2017-01-01 | 20 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2017-01-01 | 0 |
| Total participants | 2017-01-01 | 20 |
| Number of participants with account balances | 2017-01-01 | 20 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2017-01-01 | 0 |
| 2016: ALAMEDA EYE PHYSICIANS RETIREMENT PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 19 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 14 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 7 |
| Total of all active and inactive participants | 2016-01-01 | 21 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2016-01-01 | 0 |
| Total participants | 2016-01-01 | 21 |
| Number of participants with account balances | 2016-01-01 | 21 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2016-01-01 | 2 |
| Measure | Date | Value |
|---|
| 2022 : ALAMEDA EYE PHYSICIANS RETIREMENT PLAN 2022 401k financial data |
|---|
| Total income from all sources | 2022-12-31 | $-245,579 |
| Expenses. Total of all expenses incurred | 2022-12-31 | $86,303 |
| Total plan assets at end of year | 2022-12-31 | $2,456,529 |
| Total plan assets at beginning of year | 2022-12-31 | $2,788,411 |
| Value of fidelity bond covering the plan | 2022-12-31 | $500,000 |
| Total contributions received or receivable from participants | 2022-12-31 | $22,753 |
| Expenses. Other expenses not covered elsewhere | 2022-12-31 | $79,098 |
| Other income received | 2022-12-31 | $-494,373 |
| Net income (gross income less expenses) | 2022-12-31 | $-331,882 |
| Net plan assets at end of year (total assets less liabilities) | 2022-12-31 | $2,456,529 |
| Net plan assets at beginning of year (total assets less liabilities) | 2022-12-31 | $2,788,411 |
| Assets. Value of participant loans | 2022-12-31 | $20,951 |
| Assets. Value of real-estate (other than employer real property) | 2022-12-31 | $618,143 |
| Total contributions received or receivable from employer(s) | 2022-12-31 | $226,041 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2022-12-31 | $7,205 |
| 2021 : ALAMEDA EYE PHYSICIANS RETIREMENT PLAN 2021 401k financial data |
|---|
| Total income from all sources | 2021-12-31 | $687,486 |
| Expenses. Total of all expenses incurred | 2021-12-31 | $89,626 |
| Benefits paid (including direct rollovers) | 2021-12-31 | $31,555 |
| Total plan assets at end of year | 2021-12-31 | $2,788,411 |
| Total plan assets at beginning of year | 2021-12-31 | $2,190,551 |
| Value of fidelity bond covering the plan | 2021-12-31 | $500,000 |
| Total contributions received or receivable from participants | 2021-12-31 | $20,582 |
| Expenses. Other expenses not covered elsewhere | 2021-12-31 | $53,386 |
| Other income received | 2021-12-31 | $465,672 |
| Net income (gross income less expenses) | 2021-12-31 | $597,860 |
| Net plan assets at end of year (total assets less liabilities) | 2021-12-31 | $2,788,411 |
| Net plan assets at beginning of year (total assets less liabilities) | 2021-12-31 | $2,190,551 |
| Assets. Value of participant loans | 2021-12-31 | $35,478 |
| Assets. Value of real-estate (other than employer real property) | 2021-12-31 | $921,118 |
| Total contributions received or receivable from employer(s) | 2021-12-31 | $201,232 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2021-12-31 | $4,685 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2021-12-31 | $0 |
| 2020 : ALAMEDA EYE PHYSICIANS RETIREMENT PLAN 2020 401k financial data |
|---|
| Total plan liabilities at end of year | 2020-12-31 | $0 |
| Total plan liabilities at beginning of year | 2020-12-31 | $962 |
| Total income from all sources | 2020-12-31 | $442,456 |
| Expenses. Total of all expenses incurred | 2020-12-31 | $164,307 |
| Benefits paid (including direct rollovers) | 2020-12-31 | $123,663 |
| Total plan assets at end of year | 2020-12-31 | $2,190,551 |
| Total plan assets at beginning of year | 2020-12-31 | $1,913,364 |
| Value of fidelity bond covering the plan | 2020-12-31 | $220,000 |
| Total contributions received or receivable from participants | 2020-12-31 | $53,296 |
| Expenses. Other expenses not covered elsewhere | 2020-12-31 | $40,156 |
| Other income received | 2020-12-31 | $224,057 |
| Net income (gross income less expenses) | 2020-12-31 | $278,149 |
| Net plan assets at end of year (total assets less liabilities) | 2020-12-31 | $2,190,551 |
| Net plan assets at beginning of year (total assets less liabilities) | 2020-12-31 | $1,912,402 |
| Assets. Value of participant loans | 2020-12-31 | $63,738 |
| Assets. Value of real-estate (other than employer real property) | 2020-12-31 | $753,301 |
| Total contributions received or receivable from employer(s) | 2020-12-31 | $165,103 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2020-12-31 | $488 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2020-12-31 | $0 |
| 2019 : ALAMEDA EYE PHYSICIANS RETIREMENT PLAN 2019 401k financial data |
|---|
| Total plan liabilities at end of year | 2019-12-31 | $962 |
| Total plan liabilities at beginning of year | 2019-12-31 | $0 |
| Total income from all sources | 2019-12-31 | $492,725 |
| Expenses. Total of all expenses incurred | 2019-12-31 | $80,970 |
| Benefits paid (including direct rollovers) | 2019-12-31 | $7,800 |
| Total plan assets at end of year | 2019-12-31 | $1,913,364 |
| Total plan assets at beginning of year | 2019-12-31 | $1,500,647 |
| Value of fidelity bond covering the plan | 2019-12-31 | $200,000 |
| Total contributions received or receivable from participants | 2019-12-31 | $41,131 |
| Expenses. Other expenses not covered elsewhere | 2019-12-31 | $72,032 |
| Other income received | 2019-12-31 | $311,870 |
| Net income (gross income less expenses) | 2019-12-31 | $411,755 |
| Net plan assets at end of year (total assets less liabilities) | 2019-12-31 | $1,912,402 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-12-31 | $1,500,647 |
| Assets. Value of participant loans | 2019-12-31 | $91,290 |
| Assets. Value of real-estate (other than employer real property) | 2019-12-31 | $752,494 |
| Total contributions received or receivable from employer(s) | 2019-12-31 | $139,724 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2019-12-31 | $1,138 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2019-12-31 | $0 |
| 2018 : ALAMEDA EYE PHYSICIANS RETIREMENT PLAN 2018 401k financial data |
|---|
| Total income from all sources | 2018-12-31 | $213,118 |
| Expenses. Total of all expenses incurred | 2018-12-31 | $266,908 |
| Benefits paid (including direct rollovers) | 2018-12-31 | $225,730 |
| Total plan assets at end of year | 2018-12-31 | $1,500,647 |
| Total plan assets at beginning of year | 2018-12-31 | $1,554,437 |
| Value of fidelity bond covering the plan | 2018-12-31 | $200,000 |
| Total contributions received or receivable from participants | 2018-12-31 | $24,717 |
| Expenses. Other expenses not covered elsewhere | 2018-12-31 | $38,728 |
| Other income received | 2018-12-31 | $27,488 |
| Net income (gross income less expenses) | 2018-12-31 | $-53,790 |
| Net plan assets at end of year (total assets less liabilities) | 2018-12-31 | $1,500,647 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-12-31 | $1,554,437 |
| Assets. Value of participant loans | 2018-12-31 | $13,067 |
| Assets. Value of real-estate (other than employer real property) | 2018-12-31 | $654,969 |
| Total contributions received or receivable from employer(s) | 2018-12-31 | $160,913 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2018-12-31 | $2,450 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2018-12-31 | $0 |
| 2017 : ALAMEDA EYE PHYSICIANS RETIREMENT PLAN 2017 401k financial data |
|---|
| Total income from all sources | 2017-12-31 | $402,381 |
| Expenses. Total of all expenses incurred | 2017-12-31 | $743,545 |
| Benefits paid (including direct rollovers) | 2017-12-31 | $705,777 |
| Total plan assets at end of year | 2017-12-31 | $1,554,437 |
| Total plan assets at beginning of year | 2017-12-31 | $1,895,601 |
| Value of fidelity bond covering the plan | 2017-12-31 | $200,000 |
| Total contributions received or receivable from participants | 2017-12-31 | $1,417 |
| Expenses. Other expenses not covered elsewhere | 2017-12-31 | $37,174 |
| Other income received | 2017-12-31 | $246,967 |
| Net income (gross income less expenses) | 2017-12-31 | $-341,164 |
| Net plan assets at end of year (total assets less liabilities) | 2017-12-31 | $1,554,437 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-12-31 | $1,895,601 |
| Assets. Value of participant loans | 2017-12-31 | $22,651 |
| Assets. Value of real-estate (other than employer real property) | 2017-12-31 | $645,428 |
| Total contributions received or receivable from employer(s) | 2017-12-31 | $153,997 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-12-31 | $594 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2017-12-31 | $0 |
| 2016 : ALAMEDA EYE PHYSICIANS RETIREMENT PLAN 2016 401k financial data |
|---|
| Total income from all sources | 2016-12-31 | $219,586 |
| Expenses. Total of all expenses incurred | 2016-12-31 | $218,570 |
| Benefits paid (including direct rollovers) | 2016-12-31 | $173,393 |
| Total plan assets at end of year | 2016-12-31 | $1,895,601 |
| Total plan assets at beginning of year | 2016-12-31 | $1,894,585 |
| Value of fidelity bond covering the plan | 2016-12-31 | $200,000 |
| Total contributions received or receivable from participants | 2016-12-31 | $9,315 |
| Expenses. Other expenses not covered elsewhere | 2016-12-31 | $44,593 |
| Other income received | 2016-12-31 | $72,310 |
| Net income (gross income less expenses) | 2016-12-31 | $1,016 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-31 | $1,895,601 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-31 | $1,894,585 |
| Assets. Value of participant loans | 2016-12-31 | $31,597 |
| Assets. Value of real-estate (other than employer real property) | 2016-12-31 | $620,859 |
| Total contributions received or receivable from employer(s) | 2016-12-31 | $137,961 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-12-31 | $584 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2016-12-31 | $0 |
| 2022: ALAMEDA EYE PHYSICIANS RETIREMENT PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Submission has been amended | No |
| 2022-01-01 | This submission is the final filing | No |
| 2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-01-01 | Plan is a collectively bargained plan | No |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – Trust | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement - Trust | Yes |
| 2021: ALAMEDA EYE PHYSICIANS RETIREMENT PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Submission has been amended | No |
| 2021-01-01 | This submission is the final filing | No |
| 2021-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-01-01 | Plan is a collectively bargained plan | No |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – Trust | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement - Trust | Yes |
| 2020: ALAMEDA EYE PHYSICIANS RETIREMENT PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Submission has been amended | No |
| 2020-01-01 | This submission is the final filing | No |
| 2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-01-01 | Plan is a collectively bargained plan | No |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – Trust | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement - Trust | Yes |
| 2019: ALAMEDA EYE PHYSICIANS RETIREMENT PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Submission has been amended | No |
| 2019-01-01 | This submission is the final filing | No |
| 2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-01-01 | Plan is a collectively bargained plan | No |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – Trust | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement - Trust | Yes |
| 2018: ALAMEDA EYE PHYSICIANS RETIREMENT PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Submission has been amended | No |
| 2018-01-01 | This submission is the final filing | No |
| 2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-01-01 | Plan is a collectively bargained plan | No |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – Trust | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement - Trust | Yes |
| 2017: ALAMEDA EYE PHYSICIANS RETIREMENT PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | No |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – Trust | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement - Trust | Yes |
| 2016: ALAMEDA EYE PHYSICIANS RETIREMENT PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – Trust | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement - Trust | Yes |
| VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 ) |
| Policy contract number | 81G724 |
| Policy instance | 1 |
| Insurance contract or identification number | 81G724 | | Number of Individuals Covered | 14 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $593 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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? | Yes | | 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 | | Amount paid for insurance broker fees | 593 | | Additional information about fees paid to insurance broker | TPA BASIS POINT FEES | | Insurance broker organization code? | 5 |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-833073 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-833073 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $1,112 | | Total amount of fees paid to insurance company | USD $159 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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? | Yes | | 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 | | Commission paid to Insurance Broker | USD $1,112 | | Amount paid for insurance broker fees | 159 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE ALLOWANCE | | Insurance broker organization code? | 3 |
|
| VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 ) |
| Policy contract number | 81G724 |
| Policy instance | 2 |
| Insurance contract or identification number | 81G724 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $363 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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? | Yes | | 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 | | Amount paid for insurance broker fees | 363 | | Additional information about fees paid to insurance broker | TPA BASIS POINT FEES | | Insurance broker organization code? | 5 |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-833073 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-833073 | | Number of Individuals Covered | 12 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $2,697 | | Total amount of fees paid to insurance company | USD $385 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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? | Yes | | 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 | | Commission paid to Insurance Broker | USD $2,697 | | Amount paid for insurance broker fees | 385 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE ALLOWANCE | | Insurance broker organization code? | 3 |
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| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-833073 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-833073 | | Number of Individuals Covered | 13 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $1,615 | | Total amount of fees paid to insurance company | USD $300 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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? | Yes | | 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 | | Commission paid to Insurance Broker | USD $1,615 | | Amount paid for insurance broker fees | 300 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE ALLOWANCE | | Insurance broker organization code? | 3 |
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| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-833073 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-833073 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $2,052 | | Total amount of fees paid to insurance company | USD $224 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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? | Yes | | 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 | | Commission paid to Insurance Broker | USD $2,052 | | Amount paid for insurance broker fees | 224 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE ALLOWANCE | | Insurance broker organization code? | 3 |
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| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-833073 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-833073 | | Number of Individuals Covered | 20 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $4,975 | | Total amount of fees paid to insurance company | USD $711 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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? | Yes | | 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 | | Commission paid to Insurance Broker | USD $4,975 | | Amount paid for insurance broker fees | 711 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE ALLOWANCE | | Insurance broker organization code? | 3 | | Insurance broker name | CBIZ RETIREMENT PLAN SERVICES |
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