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JOHN F. CONAGHAN DDS PC CASH BALANCE PLAN 401k Plan overview

Plan NameJOHN F. CONAGHAN DDS PC CASH BALANCE PLAN
Plan identification number 002

JOHN F. CONAGHAN DDS PC CASH BALANCE PLAN Benefits

401k Plan TypeDefined Benefit Pension
Plan Features/Benefits
  • Benefits are primarily pay related
  • Benefits are primarily flat dollar (includes dollars per year of service)
  • Cash balance or similar plan - Plan has a "cash balance" formula. For this purpose, a "cash balance" formula is a benefit formula in a defined benefit plan by whatever name (for example, personal account plan, pension equity plan, life cycle plan, cash account plan, etc.) that rather than, or in addition to, expressing the accrued benefit as a life annuity commencing at normal retirement age, defines benefits for each employee in terms more common to a defined contribution plan such as a single sum distribution amount (for example, 10 percent of final average pay times years of service, or the amount of the employee's hypothetical account balance).
  • 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.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

JOHN F CONAGHAN DDS PC has sponsored the creation of one or more 401k plans.

Company Name:JOHN F CONAGHAN DDS PC
Employer identification number (EIN):521858473
NAIC Classification:621210
NAIC Description:Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JOHN F. CONAGHAN DDS PC CASH BALANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022020-01-01JOHN CONAGHAN2021-11-22
0022019-01-01JOHN CONAGHAN2020-09-02
0022018-01-01JOHN CONAGHAN2019-09-25
0022017-01-01JOHN CONAGHAN2018-10-15
0022016-01-01JOHN CONAGHAN2017-09-09
0022015-01-01JOHN F CONAGHAN DDS2016-07-15 JOHN F CONAGHAN DDS2016-07-15
0022015-01-01JOHN CONAGHAN2016-10-14
0022014-01-01JOHN CONAGHAN
0022014-01-01JOHN CONAGHAN2015-09-22
0022013-01-01JOHN CONAGHAN
0022012-01-01JOHN CONAGHAN
0022009-01-01JOHN CONAGHAN JOHN CONAGHAN2010-10-14

Plan Statistics for JOHN F. CONAGHAN DDS PC CASH BALANCE PLAN

401k plan membership statisitcs for JOHN F. CONAGHAN DDS PC CASH BALANCE PLAN

Measure Date Value
2019: JOHN F. CONAGHAN DDS PC CASH BALANCE PLAN 2019 401k membership
Market value of plan assets2019-12-31823,173
Acturial value of plan assets2019-12-31823,173
Funding target for retired participants and beneficiaries receiving payment2019-12-310
Number of terminated vested participants2019-12-311
Fundng target for terminated vested participants2019-12-31282
Active participant vested funding target2019-12-31730,089
Number of active participants2019-12-316
Total funding liabilities for active participants2019-12-31730,089
Total participant count2019-12-317
Total funding target for all participants2019-12-31730,371
Balance at beginning of prior year after applicable adjustments2019-12-310
Prefunding balance at beginning of prior year after applicable adjustments2019-12-310
Carryover balanced portion elected for use to offset prior years funding requirement2019-12-310
Prefunding balanced used to offset prior years funding requirement2019-12-310
Amount remaining of carryover balance2019-12-310
Amount remaining of prefunding balance2019-12-310
Present value of excess contributions2019-12-312,119
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2019-12-312,119
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2019-12-310
Reductions in caryover balances due to elections or deemed elections2019-12-310
Reductions in prefunding balances due to elections or deemed elections2019-12-310
Balance of carryovers at beginning of current year2019-12-310
Balance of prefunding at beginning of current year2019-12-310
Total employer contributions2019-12-310
Total employee contributions2019-12-310
Contributions allocated toward unpaid minimum require contributions from prior years2019-12-310
Contributions made to avoid restrictions adjusted to valuation date2019-12-310
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2019-12-310
Liquidity shortfalls end of Q12019-12-310
Liquidity shortfalls end of Q22019-12-310
Liquidity shortfalls end of Q32019-12-310
Liquidity shortfalls end of Q42019-12-310
Unpaid minimum required contributions for all prior years2019-12-310
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2019-12-310
Remaining amount of unpaid minimum required contributions2019-12-310
Minimum required contributions for current year target normal cost2019-12-3192,540
Net shortfall amortization installment of oustanding balance2019-12-310
Waiver amortization installment2019-12-310
Total funding amount beforereflecting carryover/prefunding balances2019-12-310
Carryover balance elected to use to offset funding requirement2019-12-310
Prefunding balance elected to use to offset funding requirement2019-12-310
Additional cash requirement2019-12-310
Contributions allocatedtoward minimum required contributions for current year2019-12-310
Unpaid minimum required contributions for current year2019-12-310
Unpaid minimum required contributions for all years2019-12-310
2018: JOHN F. CONAGHAN DDS PC CASH BALANCE PLAN 2018 401k membership
Market value of plan assets2018-12-31560,631
Acturial value of plan assets2018-12-31560,631
Funding target for retired participants and beneficiaries receiving payment2018-12-310
Number of terminated vested participants2018-12-310
Fundng target for terminated vested participants2018-12-310
Active participant vested funding target2018-12-31600,732
Number of active participants2018-12-316
Total funding liabilities for active participants2018-12-31600,732
Total participant count2018-12-316
Total funding target for all participants2018-12-31600,732
Balance at beginning of prior year after applicable adjustments2018-12-310
Prefunding balance at beginning of prior year after applicable adjustments2018-12-310
Carryover balanced portion elected for use to offset prior years funding requirement2018-12-310
Prefunding balanced used to offset prior years funding requirement2018-12-310
Amount remaining of carryover balance2018-12-310
Amount remaining of prefunding balance2018-12-310
Present value of excess contributions2018-12-3167,543
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2018-12-3167,543
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2018-12-310
Reductions in caryover balances due to elections or deemed elections2018-12-310
Reductions in prefunding balances due to elections or deemed elections2018-12-310
Balance of carryovers at beginning of current year2018-12-310
Balance of prefunding at beginning of current year2018-12-310
Total employer contributions2018-12-31110,000
Total employee contributions2018-12-310
Contributions allocated toward unpaid minimum require contributions from prior years2018-12-310
Contributions made to avoid restrictions adjusted to valuation date2018-12-310
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2018-12-31107,693
Unpaid minimum required contributions for all prior years2018-12-310
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2018-12-310
Remaining amount of unpaid minimum required contributions2018-12-310
Minimum required contributions for current year target normal cost2018-12-3199,028
Net shortfall amortization installment of oustanding balance2018-12-3140,101
Waiver amortization installment2018-12-310
Total funding amount beforereflecting carryover/prefunding balances2018-12-31105,574
Carryover balance elected to use to offset funding requirement2018-12-310
Prefunding balance elected to use to offset funding requirement2018-12-310
Additional cash requirement2018-12-31105,574
Contributions allocatedtoward minimum required contributions for current year2018-12-31107,693
Unpaid minimum required contributions for current year2018-12-310
Unpaid minimum required contributions for all years2018-12-310
2017: JOHN F. CONAGHAN DDS PC CASH BALANCE PLAN 2017 401k membership
Market value of plan assets2017-12-31498,886
Acturial value of plan assets2017-12-31498,886
Funding target for retired participants and beneficiaries receiving payment2017-12-310
Number of terminated vested participants2017-12-310
Fundng target for terminated vested participants2017-12-310
Active participant vested funding target2017-12-31401,237
Number of active participants2017-12-318
Total funding liabilities for active participants2017-12-31401,237
Total participant count2017-12-318
Total funding target for all participants2017-12-31401,237
Balance at beginning of prior year after applicable adjustments2017-12-310
Prefunding balance at beginning of prior year after applicable adjustments2017-12-310
Carryover balanced portion elected for use to offset prior years funding requirement2017-12-310
Prefunding balanced used to offset prior years funding requirement2017-12-310
Amount remaining of carryover balance2017-12-310
Amount remaining of prefunding balance2017-12-310
Present value of excess contributions2017-12-3139,453
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2017-12-3139,453
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2017-12-310
Reductions in caryover balances due to elections or deemed elections2017-12-310
Reductions in prefunding balances due to elections or deemed elections2017-12-310
Balance of carryovers at beginning of current year2017-12-310
Balance of prefunding at beginning of current year2017-12-310
Total employer contributions2017-12-31100,000
Total employee contributions2017-12-310
Contributions allocated toward unpaid minimum require contributions from prior years2017-12-310
Contributions made to avoid restrictions adjusted to valuation date2017-12-310
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2017-12-3196,987
Unpaid minimum required contributions for all prior years2017-12-310
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2017-12-310
Remaining amount of unpaid minimum required contributions2017-12-310
Minimum required contributions for current year target normal cost2017-12-31127,093
Net shortfall amortization installment of oustanding balance2017-12-310
Waiver amortization installment2017-12-310
Total funding amount beforereflecting carryover/prefunding balances2017-12-3129,444
Carryover balance elected to use to offset funding requirement2017-12-310
Prefunding balance elected to use to offset funding requirement2017-12-310
Additional cash requirement2017-12-3129,444
Contributions allocatedtoward minimum required contributions for current year2017-12-3196,987
Unpaid minimum required contributions for current year2017-12-310
Unpaid minimum required contributions for all years2017-12-310
2016: JOHN F. CONAGHAN DDS PC CASH BALANCE PLAN 2016 401k membership
Market value of plan assets2016-12-31286,905
Acturial value of plan assets2016-12-31286,905
Funding target for retired participants and beneficiaries receiving payment2016-12-310
Number of terminated vested participants2016-12-310
Fundng target for terminated vested participants2016-12-310
Active participant vested funding target2016-12-31257,878
Number of active participants2016-12-315
Total funding liabilities for active participants2016-12-31257,878
Total participant count2016-12-315
Total funding target for all participants2016-12-31257,878
Balance at beginning of prior year after applicable adjustments2016-12-310
Prefunding balance at beginning of prior year after applicable adjustments2016-12-310
Carryover balanced portion elected for use to offset prior years funding requirement2016-12-310
Prefunding balanced used to offset prior years funding requirement2016-12-310
Amount remaining of carryover balance2016-12-310
Amount remaining of prefunding balance2016-12-310
Present value of excess contributions2016-12-3128,594
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2016-12-3128,594
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2016-12-310
Reductions in caryover balances due to elections or deemed elections2016-12-310
Reductions in prefunding balances due to elections or deemed elections2016-12-310
Balance of carryovers at beginning of current year2016-12-310
Balance of prefunding at beginning of current year2016-12-310
Total employer contributions2016-12-31130,000
Total employee contributions2016-12-310
Contributions allocated toward unpaid minimum require contributions from prior years2016-12-310
Contributions made to avoid restrictions adjusted to valuation date2016-12-310
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2016-12-31125,703
Unpaid minimum required contributions for all prior years2016-12-310
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2016-12-310
Remaining amount of unpaid minimum required contributions2016-12-310
Minimum required contributions for current year target normal cost2016-12-31115,277
Net shortfall amortization installment of oustanding balance2016-12-310
Waiver amortization installment2016-12-310
Waived amount of outstanding balance2016-12-310
Total funding amount beforereflecting carryover/prefunding balances2016-12-3186,250
Carryover balance elected to use to offset funding requirement2016-12-310
Prefunding balance elected to use to offset funding requirement2016-12-310
Additional cash requirement2016-12-3186,250
Contributions allocatedtoward minimum required contributions for current year2016-12-31125,703
Unpaid minimum required contributions for current year2016-12-310
Unpaid minimum required contributions for all years2016-12-310
2014: JOHN F. CONAGHAN DDS PC CASH BALANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0112
Total number of active participants reported on line 7a of the Form 55002014-01-0112
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-0112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0112
Number of participants with account balances2014-01-016
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: JOHN F. CONAGHAN DDS PC CASH BALANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-016
Total number of active participants reported on line 7a of the Form 55002013-01-016
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-016
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-016
Number of participants with account balances2013-01-016
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: JOHN F. CONAGHAN DDS PC CASH BALANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-017
Total number of active participants reported on line 7a of the Form 55002012-01-017
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-017
Number of participants with account balances2012-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2009: JOHN F. CONAGHAN DDS PC CASH BALANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-015
Total number of active participants reported on line 7a of the Form 55002009-01-015
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-011
Total of all active and inactive participants2009-01-016
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-016
Number of participants with account balances2009-01-016
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on JOHN F. CONAGHAN DDS PC CASH BALANCE PLAN

Measure Date Value
2014 : JOHN F. CONAGHAN DDS PC CASH BALANCE PLAN 2014 401k financial data
Transfers to/from the plan2014-12-31$0
Total income from all sources2014-12-31$74,179
Expenses. Total of all expenses incurred2014-12-31$441
Benefits paid (including direct rollovers)2014-12-31$0
Total plan assets at end of year2014-12-31$607,672
Total plan assets at beginning of year2014-12-31$533,934
Value of fidelity bond covering the plan2014-12-31$60,000
Total contributions received or receivable from participants2014-12-31$39,182
Expenses. Other expenses not covered elsewhere2014-12-31$441
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$21,129
Net income (gross income less expenses)2014-12-31$73,738
Net plan assets at end of year (total assets less liabilities)2014-12-31$607,672
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$533,934
Assets. Value of participant loans2014-12-31$6,816
Total contributions received or receivable from employer(s)2014-12-31$13,868
Value of certain deemed distributions of participant loans2014-12-31$0
Value of corrective distributions2014-12-31$0
2013 : JOHN F. CONAGHAN DDS PC CASH BALANCE PLAN 2013 401k financial data
Transfers to/from the plan2013-12-31$0
Total income from all sources2013-12-31$151,772
Expenses. Total of all expenses incurred2013-12-31$441
Benefits paid (including direct rollovers)2013-12-31$0
Total plan assets at end of year2013-12-31$533,934
Total plan assets at beginning of year2013-12-31$382,603
Value of fidelity bond covering the plan2013-12-31$60,000
Total contributions received or receivable from participants2013-12-31$34,470
Expenses. Other expenses not covered elsewhere2013-12-31$441
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$103,134
Net income (gross income less expenses)2013-12-31$151,331
Net plan assets at end of year (total assets less liabilities)2013-12-31$533,934
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$382,603
Assets. Value of participant loans2013-12-31$6,816
Total contributions received or receivable from employer(s)2013-12-31$14,168
Value of certain deemed distributions of participant loans2013-12-31$0
Value of corrective distributions2013-12-31$0
2012 : JOHN F. CONAGHAN DDS PC CASH BALANCE PLAN 2012 401k financial data
Transfers to/from the plan2012-12-31$0
Total income from all sources2012-12-31$103,777
Expenses. Total of all expenses incurred2012-12-31$466
Benefits paid (including direct rollovers)2012-12-31$0
Total plan assets at end of year2012-12-31$382,603
Total plan assets at beginning of year2012-12-31$279,292
Value of fidelity bond covering the plan2012-12-31$50,000
Total contributions received or receivable from participants2012-12-31$36,759
Expenses. Other expenses not covered elsewhere2012-12-31$466
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$54,812
Net income (gross income less expenses)2012-12-31$103,311
Net plan assets at end of year (total assets less liabilities)2012-12-31$382,603
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$279,292
Assets. Value of participant loans2012-12-31$6,816
Total contributions received or receivable from employer(s)2012-12-31$12,206
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$0

Form 5500 Responses for JOHN F. CONAGHAN DDS PC CASH BALANCE PLAN

2014: JOHN F. CONAGHAN DDS PC CASH BALANCE 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
2013: JOHN F. CONAGHAN DDS PC CASH BALANCE PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedYes
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
2012: JOHN F. CONAGHAN DDS PC CASH BALANCE 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
2009: JOHN F. CONAGHAN DDS PC CASH BALANCE 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

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-813113
Policy instance 1
Insurance contract or identification numberGA-813113
Number of Individuals Covered6
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $2,181
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?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-813113
Policy instance 1
Insurance contract or identification numberGA-813113
Number of Individuals Covered6
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,665
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?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
Commission paid to Insurance BrokerUSD $1,665
Insurance broker organization code?3
Insurance broker nameSBHU LIFE AGCY INC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-813113
Policy instance 1
Insurance contract or identification numberGA-813113
Number of Individuals Covered7
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,247
Total amount of fees paid to insurance companyUSD $107
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?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
Commission paid to Insurance BrokerUSD $1,247
Insurance broker organization code?3
Amount paid for insurance broker fees82
Additional information about fees paid to insurance brokerSALES/MARKETING
Insurance broker nameMORGANSTANLEY SMITHBARNEY LLC

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