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ALLIANCE RADIOLOGY, PA PROFIT SHARING PLAN AND TRUST 401k Plan overview

Plan NameALLIANCE RADIOLOGY, PA PROFIT SHARING PLAN AND TRUST
Plan identification number 001

ALLIANCE RADIOLOGY, PA PROFIT SHARING PLAN AND TRUST 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.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

ALLIANCE RADIOLOGY, PA has sponsored the creation of one or more 401k plans.

Company Name:ALLIANCE RADIOLOGY, PA
Employer identification number (EIN):481200790
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ALLIANCE RADIOLOGY, PA PROFIT SHARING PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012023-01-01
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01
0012018-01-01
0012017-01-01
0012016-01-01
0012015-01-01
0012014-01-01HEATHER MCCLURE2015-09-30
0012013-01-01ROBERT NEWTH2014-10-03
0012012-01-01ROBERT NEWTH
0012011-01-01HEATHER MCCLURE
0012010-01-01HEATHER MCCLURE
0012009-01-01HEATHER MCCLURE ROBERT C. NEWTH2010-10-11

Plan Statistics for ALLIANCE RADIOLOGY, PA PROFIT SHARING PLAN AND TRUST

401k plan membership statisitcs for ALLIANCE RADIOLOGY, PA PROFIT SHARING PLAN AND TRUST

Measure Date Value
2012: ALLIANCE RADIOLOGY, PA PROFIT SHARING PLAN AND TRUST 2012 401k membership
Total participants, beginning-of-year2012-01-01109
Total number of active participants reported on line 7a of the Form 55002012-01-0187
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0115
Total of all active and inactive participants2012-01-01102
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-011
Total participants2012-01-01103
Number of participants with account balances2012-01-01103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-012
2011: ALLIANCE RADIOLOGY, PA PROFIT SHARING PLAN AND TRUST 2011 401k membership
Total participants, beginning-of-year2011-01-01117
Total number of active participants reported on line 7a of the Form 55002011-01-0190
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-0118
Total of all active and inactive participants2011-01-01108
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01108
Number of participants with account balances2011-01-01108
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-011
2010: ALLIANCE RADIOLOGY, PA PROFIT SHARING PLAN AND TRUST 2010 401k membership
Total participants, beginning-of-year2010-01-01112
Total number of active participants reported on line 7a of the Form 55002010-01-0196
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-0118
Total of all active and inactive participants2010-01-01114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-01114
Number of participants with account balances2010-01-01114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-013
2009: ALLIANCE RADIOLOGY, PA PROFIT SHARING PLAN AND TRUST 2009 401k membership
Total participants, beginning-of-year2009-01-01110
Total number of active participants reported on line 7a of the Form 55002009-01-0196
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0113
Total of all active and inactive participants2009-01-01109
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01109
Number of participants with account balances2009-01-01109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-015

Financial Data on ALLIANCE RADIOLOGY, PA PROFIT SHARING PLAN AND TRUST

Measure Date Value
2012 : ALLIANCE RADIOLOGY, PA PROFIT SHARING PLAN AND TRUST 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$3,386
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$3,374
Total income from all sources (including contributions)2012-12-31$6,196,454
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$3,947,123
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$3,849,294
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$2,837,637
Value of total assets at end of year2012-12-31$38,322,148
Value of total assets at beginning of year2012-12-31$36,072,805
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$97,829
Total interest from all sources2012-12-31$1,339
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$200,881
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2012-12-31$200,881
Assets. Real estate other than employer real property at end of year2012-12-31$0
Assets. Real estate other than employer real property at beginning of year2012-12-31$0
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$500,000
If this is an individual account plan, was there a blackout period2012-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$1,075,720
Participant contributions at end of year2012-12-31$37,563
Participant contributions at beginning of year2012-12-31$24,204
Participant contributions at end of year2012-12-31$7
Participant contributions at beginning of year2012-12-31$0
Assets. Other investments not covered elsewhere at end of year2012-12-31$29,442,043
Assets. Other investments not covered elsewhere at beginning of year2012-12-31$27,071,322
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$14,313
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-12-31$3,386
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$3,374
Other income not declared elsewhere2012-12-31$2,343,603
Total non interest bearing cash at end of year2012-12-31$81,182
Total non interest bearing cash at beginning of year2012-12-31$87,313
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$2,249,331
Value of net assets at end of year (total assets less liabilities)2012-12-31$38,318,762
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$36,069,431
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Investment advisory and management fees2012-12-31$97,114
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$8,254,158
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$7,921,449
Interest on participant loans2012-12-31$1,339
Value of interest in common/collective trusts at end of year2012-12-31$0
Value of interest in common/collective trusts at beginning of year2012-12-31$456,900
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$798,838
Net investment gain or loss from common/collective trusts2012-12-31$14,156
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$1,747,604
Employer contributions (assets) at end of year2012-12-31$507,195
Employer contributions (assets) at beginning of year2012-12-31$511,617
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$3,849,294
Contract administrator fees2012-12-31$715
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31MARKS NELSON VOHLAND CAMPBELL
Accountancy firm EIN2012-12-31481238645
2011 : ALLIANCE RADIOLOGY, PA PROFIT SHARING PLAN AND TRUST 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$3,374
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$2,525
Total income from all sources (including contributions)2011-12-31$1,941,966
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$3,017,705
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$2,933,090
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$2,898,417
Value of total assets at end of year2011-12-31$36,072,805
Value of total assets at beginning of year2011-12-31$37,147,695
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$84,615
Total interest from all sources2011-12-31$756
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$189,253
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$189,253
Assets. Real estate other than employer real property at end of year2011-12-31$0
Assets. Real estate other than employer real property at beginning of year2011-12-31$0
Administrative expenses professional fees incurred2011-12-31$575
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$500,000
If this is an individual account plan, was there a blackout period2011-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$1,112,235
Participant contributions at end of year2011-12-31$24,204
Participant contributions at beginning of year2011-12-31$11,459
Participant contributions at end of year2011-12-31$0
Participant contributions at beginning of year2011-12-31$0
Assets. Other investments not covered elsewhere at end of year2011-12-31$27,071,322
Assets. Other investments not covered elsewhere at beginning of year2011-12-31$28,050,603
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$2,677
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-12-31$3,374
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-12-31$2,525
Other income not declared elsewhere2011-12-31$-832,986
Total non interest bearing cash at end of year2011-12-31$87,313
Total non interest bearing cash at beginning of year2011-12-31$58,753
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-1,075,739
Value of net assets at end of year (total assets less liabilities)2011-12-31$36,069,431
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$37,145,170
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$7,921,449
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$8,062,880
Interest on participant loans2011-12-31$756
Value of interest in common/collective trusts at end of year2011-12-31$456,900
Value of interest in common/collective trusts at beginning of year2011-12-31$432,927
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$-337,447
Net investment gain or loss from common/collective trusts2011-12-31$23,973
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$1,783,505
Employer contributions (assets) at end of year2011-12-31$511,617
Employer contributions (assets) at beginning of year2011-12-31$531,073
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$2,933,090
Contract administrator fees2011-12-31$84,040
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31MARKS NELSON VOHLAND CAMPBELL
Accountancy firm EIN2011-12-31481238645
2010 : ALLIANCE RADIOLOGY, PA PROFIT SHARING PLAN AND TRUST 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$2,525
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$1,118
Total income from all sources (including contributions)2010-12-31$6,528,813
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$1,266,459
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$1,201,494
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$2,842,510
Value of total assets at end of year2010-12-31$37,147,695
Value of total assets at beginning of year2010-12-31$31,883,934
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$64,965
Total interest from all sources2010-12-31$441
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$170,692
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2010-12-31$170,692
Assets. Real estate other than employer real property at end of year2010-12-31$0
Assets. Real estate other than employer real property at beginning of year2010-12-31$0
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$500,000
If this is an individual account plan, was there a blackout period2010-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$1,097,382
Participant contributions at end of year2010-12-31$11,459
Participant contributions at beginning of year2010-12-31$2,141
Participant contributions at end of year2010-12-31$0
Participant contributions at beginning of year2010-12-31$0
Assets. Other investments not covered elsewhere at end of year2010-12-31$28,050,603
Assets. Other investments not covered elsewhere at beginning of year2010-12-31$24,126,319
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2010-12-31$2,525
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$1,118
Other income not declared elsewhere2010-12-31$2,825,614
Total non interest bearing cash at end of year2010-12-31$58,753
Total non interest bearing cash at beginning of year2010-12-31$83,787
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$5,262,354
Value of net assets at end of year (total assets less liabilities)2010-12-31$37,145,170
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$31,882,816
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$8,062,880
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$6,785,697
Income. Interest from loans (other than to participants)2010-12-31$441
Value of interest in common/collective trusts at end of year2010-12-31$432,927
Value of interest in common/collective trusts at beginning of year2010-12-31$390,989
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$647,618
Net investment gain or loss from common/collective trusts2010-12-31$41,938
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$1,745,128
Employer contributions (assets) at end of year2010-12-31$531,073
Employer contributions (assets) at beginning of year2010-12-31$495,001
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$1,201,494
Contract administrator fees2010-12-31$64,965
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31MARKS NELSON VOHLAND CAMPBELL
Accountancy firm EIN2010-12-31481238645
2009 : ALLIANCE RADIOLOGY, PA PROFIT SHARING PLAN AND TRUST 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 ALLIANCE RADIOLOGY, PA PROFIT SHARING PLAN AND TRUST

2012: ALLIANCE RADIOLOGY, PA PROFIT SHARING PLAN AND TRUST 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement - TrustYes
2011: ALLIANCE RADIOLOGY, PA PROFIT SHARING PLAN AND TRUST 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement - TrustYes
2010: ALLIANCE RADIOLOGY, PA PROFIT SHARING PLAN AND TRUST 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement - TrustYes
2009: ALLIANCE RADIOLOGY, PA PROFIT SHARING PLAN AND TRUST 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

RIVERSOURCE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65005 )
Policy contract number11389346
Policy instance 1
Insurance contract or identification number11389346
Number of Individuals Covered1
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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
Insurance broker organization code?3
Insurance broker nameAMERIPRISE FINANCIAL SERVICES

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