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MERLIN LAW GROUP, P.A. 401(K) PLAN 401k Plan overview

Plan NameMERLIN LAW GROUP, P.A. 401(K) PLAN
Plan identification number 001

MERLIN LAW GROUP, P.A. 401(K) PLAN Benefits

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

401k Sponsoring company profile

MERLIN LAW GROUP, P.A. has sponsored the creation of one or more 401k plans.

Company Name:MERLIN LAW GROUP, P.A.
Employer identification number (EIN):470948426
NAIC Classification:541110
NAIC Description:Offices of Lawyers

Additional information about MERLIN LAW GROUP, P.A.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations
Incorporation Date: 2004-11-24
Company Identification Number: P04000160333
Legal Registered Office Address: 1201 HAYS STREET

TALLAHASSEE

32301

More information about MERLIN LAW GROUP, P.A.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MERLIN LAW GROUP, P.A. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01KEONA WILLIAMS2023-07-27
0012021-01-01KEONA WILLIAMS2022-10-17
0012020-01-01
0012019-01-01KEONA WILLIAMS2020-10-12 KEONA WILLIAMS2020-10-12
0012018-01-01KEONA WILLIAMS2019-10-14
0012017-01-01
0012016-01-01KEONA WILLIAMS2017-10-04
0012015-01-01KEONA WILLIAMS2016-06-30
0012014-01-01KEONA WILLIAMS2015-06-30
0012013-01-01KEONA WILLIAMS2014-10-13
0012012-01-01KEONA WILLIAMS2013-10-08
0012011-01-01KEONA WILLIAMS2012-10-09
0012009-01-01DEBRA PENTON

Plan Statistics for MERLIN LAW GROUP, P.A. 401(K) PLAN

401k plan membership statisitcs for MERLIN LAW GROUP, P.A. 401(K) PLAN

Measure Date Value
2022: MERLIN LAW GROUP, P.A. 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01130
Total number of active participants reported on line 7a of the Form 55002022-01-0185
Number of retired or separated participants receiving benefits2022-01-011
Number of other retired or separated participants entitled to future benefits2022-01-0119
Total of all active and inactive participants2022-01-01105
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01105
Number of participants with account balances2022-01-0170
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: MERLIN LAW GROUP, P.A. 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01135
Total number of active participants reported on line 7a of the Form 55002021-01-01105
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0123
Total of all active and inactive participants2021-01-01128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01128
Number of participants with account balances2021-01-0179
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: MERLIN LAW GROUP, P.A. 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01130
Total number of active participants reported on line 7a of the Form 55002020-01-01118
Number of retired or separated participants receiving benefits2020-01-011
Number of other retired or separated participants entitled to future benefits2020-01-016
Total of all active and inactive participants2020-01-01125
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01125
Number of participants with account balances2020-01-0172
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2009: MERLIN LAW GROUP, P.A. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0153
Total number of active participants reported on line 7a of the Form 55002009-01-0149
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-015
Total of all active and inactive participants2009-01-0154
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0154
Number of participants with account balances2009-01-0132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on MERLIN LAW GROUP, P.A. 401(K) PLAN

Measure Date Value
2022 : MERLIN LAW GROUP, P.A. 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$-284,653
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$1,265,311
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$1,225,686
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$716,575
Value of total assets at end of year2022-12-31$5,789,853
Value of total assets at beginning of year2022-12-31$7,339,817
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$39,625
Total interest from all sources2022-12-31$1,592
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$452,757
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$452,757
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$540,845
Participant contributions at end of year2022-12-31$54,916
Participant contributions at beginning of year2022-12-31$34,414
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$11,488
Assets. Loans (other than to participants) at end of year2022-12-31$0
Assets. Loans (other than to participants) at beginning of year2022-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-1,549,964
Value of net assets at end of year (total assets less liabilities)2022-12-31$5,789,853
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$7,339,817
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Investment advisory and management fees2022-12-31$39,625
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$5,100,409
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$5,338,334
Interest on participant loans2022-12-31$1,352
Interest earned on other investments2022-12-31$240
Value of interest in common/collective trusts at end of year2022-12-31$0
Value of interest in common/collective trusts at beginning of year2022-12-31$470,790
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$634,528
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$1,496,279
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-1,455,577
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31Yes
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$164,242
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$1,225,686
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31ASSURANCE DIMENSIONS
Accountancy firm EIN2022-12-31263429295
2021 : MERLIN LAW GROUP, P.A. 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$1,500,676
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$1,733,219
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$1,690,292
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$842,770
Value of total assets at end of year2021-12-31$7,339,817
Value of total assets at beginning of year2021-12-31$7,572,360
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$42,927
Total interest from all sources2021-12-31$1,870
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$656,036
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$656,036
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$603,268
Participant contributions at end of year2021-12-31$34,414
Participant contributions at beginning of year2021-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$39,396
Assets. Loans (other than to participants) at end of year2021-12-31$0
Assets. Loans (other than to participants) at beginning of year2021-12-31$64,152
Administrative expenses (other) incurred2021-12-31$126
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$-232,543
Value of net assets at end of year (total assets less liabilities)2021-12-31$7,339,817
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$7,572,360
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Investment advisory and management fees2021-12-31$42,801
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$5,338,334
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$6,004,210
Interest on participant loans2021-12-31$1,836
Interest earned on other investments2021-12-31$34
Value of interest in common/collective trusts at end of year2021-12-31$470,790
Value of interest in common/collective trusts at beginning of year2021-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$1,496,279
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$1,503,998
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$200,106
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$1,690,292
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31ASSURANCE DIMENSION
Accountancy firm EIN2021-12-31263429295
2020 : MERLIN LAW GROUP, P.A. 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$1,730,668
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$959,714
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$918,903
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$924,751
Value of total assets at end of year2020-12-31$7,572,360
Value of total assets at beginning of year2020-12-31$6,801,406
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$40,811
Total interest from all sources2020-12-31$3,268
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$289,260
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$289,260
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$663,864
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$53,107
Assets. Loans (other than to participants) at end of year2020-12-31$64,152
Assets. Loans (other than to participants) at beginning of year2020-12-31$48,166
Total non interest bearing cash at end of year2020-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$770,954
Value of net assets at end of year (total assets less liabilities)2020-12-31$7,572,360
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$6,801,406
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Investment advisory and management fees2020-12-31$40,811
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$6,004,210
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$5,697,201
Interest on participant loans2020-12-31$3,268
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$1,503,998
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$1,056,039
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$513,389
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$207,780
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$918,903
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31ASSURANCE DIMENSION
Accountancy firm EIN2020-12-31263429295
2010 : MERLIN LAW GROUP, P.A. 401(K) PLAN 2010 401k financial data
Total income from all sources2010-12-31$369,003
Expenses. Total of all expenses incurred2010-12-31$87,186
Benefits paid (including direct rollovers)2010-12-31$86,803
Total plan assets at end of year2010-12-31$1,374,273
Total plan assets at beginning of year2010-12-31$1,092,456
Value of fidelity bond covering the plan2010-12-31$300,000
Total contributions received or receivable from participants2010-12-31$165,948
Contributions received from other sources (not participants or employers)2010-12-31$1,679
Other income received2010-12-31$175,376
Net income (gross income less expenses)2010-12-31$281,817
Net plan assets at end of year (total assets less liabilities)2010-12-31$1,374,273
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$1,092,456
Assets. Value of participant loans2010-12-31$37,519
Total contributions received or receivable from employer(s)2010-12-31$26,000
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$383
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
2009 : MERLIN LAW GROUP, P.A. 401(K) PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for MERLIN LAW GROUP, P.A. 401(K) PLAN

2022: MERLIN LAW GROUP, P.A. 401(K) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: MERLIN LAW GROUP, P.A. 401(K) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: MERLIN LAW GROUP, P.A. 401(K) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2009: MERLIN LAW GROUP, P.A. 401(K) PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number753295-01
Policy instance 1
Insurance contract or identification number753295-01
Number of Individuals Covered69
Insurance policy start date2022-06-18
Insurance policy end date2022-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-826533
Policy instance 2
Insurance contract or identification numberGA-826533
Number of Individuals Covered0
Insurance policy start date2022-01-01
Insurance policy end date2022-06-17
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $1,773
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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1773
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker organization code?5
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-826533
Policy instance 1
Insurance contract or identification numberGA-826533
Number of Individuals Covered79
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,761
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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees3326
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker organization code?5
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-826533
Policy instance 1
Insurance contract or identification numberGA-826533
Number of Individuals Covered80
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,362
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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees3362
Additional information about fees paid to insurance brokerTPA FEE
Insurance broker organization code?5

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