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DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN 401k Plan overview

Plan NameDENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN
Plan identification number 001

DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • 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.
  • 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

DENT K. BURK ASSOCIATES, P.C. has sponsored the creation of one or more 401k plans.

Company Name:DENT K. BURK ASSOCIATES, P.C.
Employer identification number (EIN):521600059
NAIC Classification:541211
NAIC Description:Offices of Certified Public Accountants

Additional information about DENT K. BURK ASSOCIATES, P.C.

Jurisdiction of Incorporation: Virginia Secretary of State
Incorporation Date: 1988-12-20
Company Identification Number: 0331885
Legal Registered Office Address: 513 STATE ST

BRISTOL
United States of America (USA)
24201

More information about DENT K. BURK ASSOCIATES, P.C.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012016-01-01C. DON ROYSTON C. DON ROYSTON2017-07-24
0012015-01-01C. DON ROYSTON
0012014-01-01C. DON ROYSTON
0012013-01-01C. DON ROYSTON
0012012-01-01DAVID A. JENNINGS
0012011-01-01DAVID A. JENNINGS
0012010-01-01DAVID A. JENNINGS
0012009-01-01DAVID A. JENNINGS

Plan Statistics for DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN

401k plan membership statisitcs for DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN

Measure Date Value
2016: DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0171
Total number of active participants reported on line 7a of the Form 55002016-01-010
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-010
Number of participants with account balances2016-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0175
Total number of active participants reported on line 7a of the Form 55002015-01-0147
Number of retired or separated participants receiving benefits2015-01-012
Number of other retired or separated participants entitled to future benefits2015-01-0117
Total of all active and inactive participants2015-01-0166
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-012
Total participants2015-01-0168
Number of participants with account balances2015-01-0159
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-012
2014: DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0175
Total number of active participants reported on line 7a of the Form 55002014-01-0153
Number of retired or separated participants receiving benefits2014-01-014
Number of other retired or separated participants entitled to future benefits2014-01-0114
Total of all active and inactive participants2014-01-0171
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-012
Total participants2014-01-0173
Number of participants with account balances2014-01-0163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-012
2013: DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0175
Total number of active participants reported on line 7a of the Form 55002013-01-0154
Number of retired or separated participants receiving benefits2013-01-011
Number of other retired or separated participants entitled to future benefits2013-01-0116
Total of all active and inactive participants2013-01-0171
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-012
Total participants2013-01-0173
Number of participants with account balances2013-01-0166
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-012
2012: DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0170
Total number of active participants reported on line 7a of the Form 55002012-01-0153
Number of retired or separated participants receiving benefits2012-01-012
Number of other retired or separated participants entitled to future benefits2012-01-0114
Total of all active and inactive participants2012-01-0169
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-012
Total participants2012-01-0171
Number of participants with account balances2012-01-0164
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0172
Total number of active participants reported on line 7a of the Form 55002011-01-0157
Number of retired or separated participants receiving benefits2011-01-011
Number of other retired or separated participants entitled to future benefits2011-01-0111
Total of all active and inactive participants2011-01-0169
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-011
Total participants2011-01-0170
Number of participants with account balances2011-01-0163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-012
2010: DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0175
Total number of active participants reported on line 7a of the Form 55002010-01-0159
Number of retired or separated participants receiving benefits2010-01-011
Number of other retired or separated participants entitled to future benefits2010-01-0110
Total of all active and inactive participants2010-01-0170
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-011
Total participants2010-01-0171
Number of participants with account balances2010-01-0164
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-011
2009: DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0174
Total number of active participants reported on line 7a of the Form 55002009-01-0159
Number of retired or separated participants receiving benefits2009-01-011
Number of other retired or separated participants entitled to future benefits2009-01-0113
Total of all active and inactive participants2009-01-0173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-011
Total participants2009-01-0174
Number of participants with account balances2009-01-0166
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-011

Financial Data on DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN

Measure Date Value
2016 : DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN 2016 401k financial data
Total plan liabilities at end of year2016-12-31$0
Total plan liabilities at beginning of year2016-12-31$0
Total income from all sources2016-12-31$289,972
Expenses. Total of all expenses incurred2016-12-31$6,928,929
Benefits paid (including direct rollovers)2016-12-31$6,925,247
Total plan assets at end of year2016-12-31$0
Total plan assets at beginning of year2016-12-31$6,638,957
Value of fidelity bond covering the plan2016-12-31$500,000
Total contributions received or receivable from participants2016-12-31$0
Expenses. Other expenses not covered elsewhere2016-12-31$3,682
Contributions received from other sources (not participants or employers)2016-12-31$0
Other income received2016-12-31$289,972
Noncash contributions received2016-12-31$0
Net income (gross income less expenses)2016-12-31$-6,638,957
Net plan assets at end of year (total assets less liabilities)2016-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$6,638,957
Total contributions received or receivable from employer(s)2016-12-31$0
Value of certain deemed distributions of participant loans2016-12-31$0
Value of corrective distributions2016-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$0
2015 : DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN 2015 401k financial data
Total plan liabilities at end of year2015-12-31$0
Total plan liabilities at beginning of year2015-12-31$0
Total income from all sources2015-12-31$444,460
Expenses. Total of all expenses incurred2015-12-31$815,233
Benefits paid (including direct rollovers)2015-12-31$814,753
Total plan assets at end of year2015-12-31$6,638,957
Total plan assets at beginning of year2015-12-31$7,009,730
Value of fidelity bond covering the plan2015-12-31$500,000
Total contributions received or receivable from participants2015-12-31$266,098
Expenses. Other expenses not covered elsewhere2015-12-31$480
Contributions received from other sources (not participants or employers)2015-12-31$0
Other income received2015-12-31$97,725
Noncash contributions received2015-12-31$0
Net income (gross income less expenses)2015-12-31$-370,773
Net plan assets at end of year (total assets less liabilities)2015-12-31$6,638,957
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$7,009,730
Assets. Value of participant loans2015-12-31$70,174
Total contributions received or receivable from employer(s)2015-12-31$80,637
Value of certain deemed distributions of participant loans2015-12-31$0
Value of corrective distributions2015-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$0
2014 : DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN 2014 401k financial data
Transfers to/from the plan2014-12-31$0
Total plan liabilities at end of year2014-12-31$0
Total plan liabilities at beginning of year2014-12-31$0
Total income from all sources2014-12-31$633,369
Expenses. Total of all expenses incurred2014-12-31$503,099
Benefits paid (including direct rollovers)2014-12-31$502,469
Total plan assets at end of year2014-12-31$7,009,730
Total plan assets at beginning of year2014-12-31$6,879,460
Value of fidelity bond covering the plan2014-12-31$500,000
Total contributions received or receivable from participants2014-12-31$279,999
Expenses. Other expenses not covered elsewhere2014-12-31$630
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$269,194
Noncash contributions received2014-12-31$0
Net income (gross income less expenses)2014-12-31$130,270
Net plan assets at end of year (total assets less liabilities)2014-12-31$7,009,730
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$6,879,460
Assets. Value of participant loans2014-12-31$71,454
Total contributions received or receivable from employer(s)2014-12-31$84,176
Value of certain deemed distributions of participant loans2014-12-31$0
Value of corrective distributions2014-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$0
2013 : DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN 2013 401k financial data
Transfers to/from the plan2013-12-31$0
Total plan liabilities at end of year2013-12-31$0
Total plan liabilities at beginning of year2013-12-31$0
Total income from all sources2013-12-31$1,314,496
Expenses. Total of all expenses incurred2013-12-31$38,597
Benefits paid (including direct rollovers)2013-12-31$38,597
Total plan assets at end of year2013-12-31$6,879,460
Total plan assets at beginning of year2013-12-31$5,603,561
Value of fidelity bond covering the plan2013-12-31$500,000
Total contributions received or receivable from participants2013-12-31$231,169
Expenses. Other expenses not covered elsewhere2013-12-31$0
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$1,008,365
Noncash contributions received2013-12-31$0
Net income (gross income less expenses)2013-12-31$1,275,899
Net plan assets at end of year (total assets less liabilities)2013-12-31$6,879,460
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$5,603,561
Assets. Value of participant loans2013-12-31$90,925
Total contributions received or receivable from employer(s)2013-12-31$74,962
Value of certain deemed distributions of participant loans2013-12-31$0
Value of corrective distributions2013-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$0
2012 : DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN 2012 401k financial data
Total plan liabilities at end of year2012-12-31$0
Total plan liabilities at beginning of year2012-12-31$0
Total income from all sources2012-12-31$920,020
Expenses. Total of all expenses incurred2012-12-31$463,899
Benefits paid (including direct rollovers)2012-12-31$462,961
Total plan assets at end of year2012-12-31$5,603,561
Total plan assets at beginning of year2012-12-31$5,147,440
Value of fidelity bond covering the plan2012-12-31$400,000
Total contributions received or receivable from participants2012-12-31$243,032
Expenses. Other expenses not covered elsewhere2012-12-31$938
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$598,806
Noncash contributions received2012-12-31$0
Net income (gross income less expenses)2012-12-31$456,121
Net plan assets at end of year (total assets less liabilities)2012-12-31$5,603,561
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$5,147,440
Total contributions received or receivable from employer(s)2012-12-31$78,182
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$0
2011 : DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN 2011 401k financial data
Transfers to/from the plan2011-12-31$0
Total plan liabilities at end of year2011-12-31$0
Total plan liabilities at beginning of year2011-12-31$0
Total income from all sources2011-12-31$188,958
Expenses. Total of all expenses incurred2011-12-31$47,352
Benefits paid (including direct rollovers)2011-12-31$47,352
Total plan assets at end of year2011-12-31$5,147,440
Total plan assets at beginning of year2011-12-31$5,005,834
Value of fidelity bond covering the plan2011-12-31$400,000
Total contributions received or receivable from participants2011-12-31$282,893
Expenses. Other expenses not covered elsewhere2011-12-31$0
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-171,286
Noncash contributions received2011-12-31$0
Net income (gross income less expenses)2011-12-31$141,606
Net plan assets at end of year (total assets less liabilities)2011-12-31$5,147,440
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$5,005,834
Total contributions received or receivable from employer(s)2011-12-31$77,351
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$0
2010 : DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN 2010 401k financial data
Transfers to/from the plan2010-12-31$0
Total plan liabilities at end of year2010-12-31$0
Total plan liabilities at beginning of year2010-12-31$0
Total income from all sources2010-12-31$897,526
Expenses. Total of all expenses incurred2010-12-31$12,280
Benefits paid (including direct rollovers)2010-12-31$12,280
Total plan assets at end of year2010-12-31$5,005,834
Total plan assets at beginning of year2010-12-31$4,120,588
Value of fidelity bond covering the plan2010-12-31$400,000
Total contributions received or receivable from participants2010-12-31$307,417
Expenses. Other expenses not covered elsewhere2010-12-31$0
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$504,049
Noncash contributions received2010-12-31$0
Net income (gross income less expenses)2010-12-31$885,246
Net plan assets at end of year (total assets less liabilities)2010-12-31$5,005,834
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$4,120,588
Total contributions received or receivable from employer(s)2010-12-31$86,060
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$0

Form 5500 Responses for DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN

2016: DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingYes
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN 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 – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN 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 – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING PLAN 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 – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: DENT K. BURK ASSOCIATES, P.C. 401K PROFIT SHARING 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 – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
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 numberGA-800736
Policy instance 1
Insurance contract or identification numberGA-800736
Number of Individuals Covered57
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $22,824
Total amount of fees paid to insurance companyUSD $3,120
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,130
Insurance broker organization code?3
Amount paid for insurance broker fees3120
Additional information about fees paid to insurance brokerFEES
Insurance broker nameWELLS FARGO WEALTH BROKERAGE INS.
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-800736
Policy instance 1
Insurance contract or identification numberGA-800736
Number of Individuals Covered60
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $22,035
Total amount of fees paid to insurance companyUSD $3,122
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,891
Insurance broker organization code?3
Amount paid for insurance broker fees3122
Additional information about fees paid to insurance brokerFEES
Insurance broker nameWELLS FARGO WEALTH BROKERAGE INS.
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-800736
Policy instance 1
Insurance contract or identification numberGA-800736
Number of Individuals Covered63
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $21,763
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?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
Commission paid to Insurance BrokerUSD $19,119
Insurance broker organization code?3
Additional information about fees paid to insurance brokerFEES
Insurance broker nameERISA SERVICES, INC.
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-800736
Policy instance 1
Insurance contract or identification numberGA-800736
Number of Individuals Covered62
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $17,600
Total amount of fees paid to insurance companyUSD $2,383
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $17,600
Insurance broker organization code?3
Amount paid for insurance broker fees2383
Additional information about fees paid to insurance brokerFEES
Insurance broker nameERISA SERVICES, INC.
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-800736
Policy instance 1
Insurance contract or identification numberGA-800736
Number of Individuals Covered61
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $17,261
Total amount of fees paid to insurance companyUSD $2,249
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-800736
Policy instance 1
Insurance contract or identification numberGA-800736
Number of Individuals Covered62
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $14,890
Total amount of fees paid to insurance companyUSD $1,838
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $14,890
Insurance broker organization code?3
Amount paid for insurance broker fees1838
Additional information about fees paid to insurance brokerFEES
Insurance broker nameERISA SERVICES, INC.

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