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CHESTERFIELD FAMILY PRACTICE CENTER, P.C. PROFIT SHARING PLAN 401k Plan overview

Plan NameCHESTERFIELD FAMILY PRACTICE CENTER, P.C. PROFIT SHARING PLAN
Plan identification number 002

CHESTERFIELD FAMILY PRACTICE CENTER, P.C. PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of 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.
  • 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.
  • Life insurance

401k Sponsoring company profile

CHESTERFIELD FAMILY PRACTICE CENTER , P.C. has sponsored the creation of one or more 401k plans.

Company Name:CHESTERFIELD FAMILY PRACTICE CENTER , P.C.
Employer identification number (EIN):541636861
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CHESTERFIELD FAMILY PRACTICE CENTER, P.C. PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022018-10-01RICHARD H. HOFFMAN2019-06-21
0022017-10-01RICHARD H. HOFFMAN2018-12-17 RICHARD H. HOFFMAN2018-12-17
0022016-10-01RICHARD H. HOFFMAN2018-02-23 RICHARD H. HOFFMAN2018-02-23
0022015-10-01RICHARD H. HOFFMAN2017-07-14
0022014-10-01RICHARD H. HOFFMAN2016-01-19
0022013-10-01RICHARD H. HOFFMAN
0022012-10-01RICHARD H. HOFFMAN, M.D.
0022011-10-01WALTER FOLIACO M.D. WALTER FOLIACO, M.D.2013-02-14
0022010-10-01PATRICK W. MITCHELL, M.D.
0022008-10-01
0022008-10-01

Plan Statistics for CHESTERFIELD FAMILY PRACTICE CENTER, P.C. PROFIT SHARING PLAN

401k plan membership statisitcs for CHESTERFIELD FAMILY PRACTICE CENTER, P.C. PROFIT SHARING PLAN

Measure Date Value
2013: CHESTERFIELD FAMILY PRACTICE CENTER, P.C. PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-10-0132
Total number of active participants reported on line 7a of the Form 55002013-10-0125
Number of retired or separated participants receiving benefits2013-10-010
Number of other retired or separated participants entitled to future benefits2013-10-019
Total of all active and inactive participants2013-10-0134
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-10-010
Total participants2013-10-0134
Number of participants with account balances2013-10-0134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-10-010
2012: CHESTERFIELD FAMILY PRACTICE CENTER, P.C. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-10-0134
Total number of active participants reported on line 7a of the Form 55002012-10-0125
Number of retired or separated participants receiving benefits2012-10-010
Number of other retired or separated participants entitled to future benefits2012-10-017
Total of all active and inactive participants2012-10-0132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-10-010
Total participants2012-10-0132
Number of participants with account balances2012-10-0132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-10-011
2011: CHESTERFIELD FAMILY PRACTICE CENTER, P.C. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-10-0133
Total number of active participants reported on line 7a of the Form 55002011-10-0126
Number of retired or separated participants receiving benefits2011-10-010
Number of other retired or separated participants entitled to future benefits2011-10-016
Total of all active and inactive participants2011-10-0132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-10-010
Total participants2011-10-0132
Number of participants with account balances2011-10-0132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-10-013
2010: CHESTERFIELD FAMILY PRACTICE CENTER, P.C. PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year2010-10-0146
Total number of active participants reported on line 7a of the Form 55002010-10-0134
Number of retired or separated participants receiving benefits2010-10-010
Number of other retired or separated participants entitled to future benefits2010-10-014
Total of all active and inactive participants2010-10-0138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-10-010
Total participants2010-10-0138
Number of participants with account balances2010-10-0133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-10-011

Financial Data on CHESTERFIELD FAMILY PRACTICE CENTER, P.C. PROFIT SHARING PLAN

Measure Date Value
2014 : CHESTERFIELD FAMILY PRACTICE CENTER, P.C. PROFIT SHARING PLAN 2014 401k financial data
Transfers to/from the plan2014-09-30$0
Total plan liabilities at end of year2014-09-30$369
Total plan liabilities at beginning of year2014-09-30$365
Total income from all sources2014-09-30$965,254
Expenses. Total of all expenses incurred2014-09-30$539,656
Benefits paid (including direct rollovers)2014-09-30$536,444
Total plan assets at end of year2014-09-30$6,171,092
Total plan assets at beginning of year2014-09-30$5,745,490
Value of fidelity bond covering the plan2014-09-30$500,000
Total contributions received or receivable from participants2014-09-30$118,390
Expenses. Other expenses not covered elsewhere2014-09-30$2,144
Contributions received from other sources (not participants or employers)2014-09-30$0
Other income received2014-09-30$646,514
Noncash contributions received2014-09-30$0
Net income (gross income less expenses)2014-09-30$425,598
Net plan assets at end of year (total assets less liabilities)2014-09-30$6,170,723
Net plan assets at beginning of year (total assets less liabilities)2014-09-30$5,745,125
Assets. Value of participant loans2014-09-30$24,665
Total contributions received or receivable from employer(s)2014-09-30$200,350
Value of certain deemed distributions of participant loans2014-09-30$0
Value of corrective distributions2014-09-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2014-09-30$1,068
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-09-30$0
2013 : CHESTERFIELD FAMILY PRACTICE CENTER, P.C. PROFIT SHARING PLAN 2013 401k financial data
Transfers to/from the plan2013-09-30$0
Total plan liabilities at end of year2013-09-30$365
Total plan liabilities at beginning of year2013-09-30$575
Total income from all sources2013-09-30$939,005
Expenses. Total of all expenses incurred2013-09-30$515,424
Benefits paid (including direct rollovers)2013-09-30$507,587
Total plan assets at end of year2013-09-30$5,745,490
Total plan assets at beginning of year2013-09-30$5,322,119
Value of fidelity bond covering the plan2013-09-30$500,000
Total contributions received or receivable from participants2013-09-30$118,535
Expenses. Other expenses not covered elsewhere2013-09-30$7,837
Contributions received from other sources (not participants or employers)2013-09-30$0
Other income received2013-09-30$586,123
Noncash contributions received2013-09-30$0
Net income (gross income less expenses)2013-09-30$423,581
Net plan assets at end of year (total assets less liabilities)2013-09-30$5,745,125
Net plan assets at beginning of year (total assets less liabilities)2013-09-30$5,321,544
Assets. Value of participant loans2013-09-30$23,647
Total contributions received or receivable from employer(s)2013-09-30$234,347
Value of certain deemed distributions of participant loans2013-09-30$0
Value of corrective distributions2013-09-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2013-09-30$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-09-30$0
2012 : CHESTERFIELD FAMILY PRACTICE CENTER, P.C. PROFIT SHARING PLAN 2012 401k financial data
Transfers to/from the plan2012-09-30$0
Total plan liabilities at end of year2012-09-30$575
Total plan liabilities at beginning of year2012-09-30$241
Total income from all sources2012-09-30$1,057,712
Expenses. Total of all expenses incurred2012-09-30$68,587
Benefits paid (including direct rollovers)2012-09-30$65,047
Total plan assets at end of year2012-09-30$5,322,119
Total plan assets at beginning of year2012-09-30$4,332,660
Value of fidelity bond covering the plan2012-09-30$500,000
Total contributions received or receivable from participants2012-09-30$117,662
Expenses. Other expenses not covered elsewhere2012-09-30$3,540
Contributions received from other sources (not participants or employers)2012-09-30$3,702
Other income received2012-09-30$691,950
Noncash contributions received2012-09-30$0
Net income (gross income less expenses)2012-09-30$989,125
Net plan assets at end of year (total assets less liabilities)2012-09-30$5,321,544
Net plan assets at beginning of year (total assets less liabilities)2012-09-30$4,332,419
Assets. Value of participant loans2012-09-30$3,656
Total contributions received or receivable from employer(s)2012-09-30$244,398
Value of certain deemed distributions of participant loans2012-09-30$0
Value of corrective distributions2012-09-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2012-09-30$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-09-30$0
2011 : CHESTERFIELD FAMILY PRACTICE CENTER, P.C. PROFIT SHARING PLAN 2011 401k financial data
Transfers to/from the plan2011-09-30$0
Total plan liabilities at end of year2011-09-30$241
Total plan liabilities at beginning of year2011-09-30$1,234
Total income from all sources2011-09-30$283,224
Expenses. Total of all expenses incurred2011-09-30$99,944
Benefits paid (including direct rollovers)2011-09-30$91,967
Total plan assets at end of year2011-09-30$4,332,660
Total plan assets at beginning of year2011-09-30$4,150,373
Value of fidelity bond covering the plan2011-09-30$500,000
Total contributions received or receivable from participants2011-09-30$88,605
Expenses. Other expenses not covered elsewhere2011-09-30$7,827
Contributions received from other sources (not participants or employers)2011-09-30$0
Other income received2011-09-30$-82,128
Noncash contributions received2011-09-30$0
Net income (gross income less expenses)2011-09-30$183,280
Net plan assets at end of year (total assets less liabilities)2011-09-30$4,332,419
Net plan assets at beginning of year (total assets less liabilities)2011-09-30$4,149,139
Assets. Value of participant loans2011-09-30$3,903
Total contributions received or receivable from employer(s)2011-09-30$276,747
Value of certain deemed distributions of participant loans2011-09-30$0
Value of corrective distributions2011-09-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2011-09-30$150
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-09-30$0

Form 5500 Responses for CHESTERFIELD FAMILY PRACTICE CENTER, P.C. PROFIT SHARING PLAN

2013: CHESTERFIELD FAMILY PRACTICE CENTER, P.C. PROFIT SHARING PLAN 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Submission has been amendedNo
2013-10-01This submission is the final filingNo
2013-10-01This return/report is a short plan year return/report (less than 12 months)No
2013-10-01Plan is a collectively bargained planNo
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan funding arrangement – TrustYes
2013-10-01Plan benefit arrangement – InsuranceYes
2013-10-01Plan benefit arrangement - TrustYes
2012: CHESTERFIELD FAMILY PRACTICE CENTER, P.C. PROFIT SHARING PLAN 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Submission has been amendedNo
2012-10-01This submission is the final filingNo
2012-10-01This return/report is a short plan year return/report (less than 12 months)No
2012-10-01Plan is a collectively bargained planNo
2012-10-01Plan funding arrangement – InsuranceYes
2012-10-01Plan funding arrangement – TrustYes
2012-10-01Plan benefit arrangement – InsuranceYes
2012-10-01Plan benefit arrangement - TrustYes
2011: CHESTERFIELD FAMILY PRACTICE CENTER, P.C. PROFIT SHARING PLAN 2011 form 5500 responses
2011-10-01Type of plan entitySingle employer plan
2011-10-01Submission has been amendedNo
2011-10-01This submission is the final filingNo
2011-10-01This return/report is a short plan year return/report (less than 12 months)No
2011-10-01Plan is a collectively bargained planNo
2011-10-01Plan funding arrangement – InsuranceYes
2011-10-01Plan funding arrangement – TrustYes
2011-10-01Plan benefit arrangement – InsuranceYes
2011-10-01Plan benefit arrangement - TrustYes
2010: CHESTERFIELD FAMILY PRACTICE CENTER, P.C. PROFIT SHARING PLAN 2010 form 5500 responses
2010-10-01Type of plan entitySingle employer plan
2010-10-01Submission has been amendedNo
2010-10-01This submission is the final filingNo
2010-10-01This return/report is a short plan year return/report (less than 12 months)No
2010-10-01Plan is a collectively bargained planNo
2010-10-01Plan funding arrangement – InsuranceYes
2010-10-01Plan funding arrangement – TrustYes
2010-10-01Plan benefit arrangement – InsuranceYes
2010-10-01Plan benefit arrangement - TrustYes
2008: CHESTERFIELD FAMILY PRACTICE CENTER, P.C. PROFIT SHARING PLAN 2008 form 5500 responses
2008-10-01Type of plan entitySingle employer plan
2008-10-01Submission has been amendedYes
2008-10-01This submission is the final filingNo
2008-10-01This return/report is a short plan year return/report (less than 12 months)No
2008-10-01Plan is a collectively bargained planNo

Insurance Providers Used on plan

PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 )
Policy contract number988956K
Policy instance 1
Insurance contract or identification number988956K
Number of Individuals Covered1
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
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?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
PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 )
Policy contract number988956L
Policy instance 2
Insurance contract or identification number988956L
Number of Individuals Covered1
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
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?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
PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 )
Policy contract number988956K
Policy instance 1
Insurance contract or identification number988956K
Number of Individuals Covered1
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Total amount of commissions paid to insurance brokerUSD $50
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 $50
Insurance broker organization code?3
Insurance broker nameTHOMAS R. CLARY
PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 )
Policy contract number988956L
Policy instance 2
Insurance contract or identification number988956L
Number of Individuals Covered1
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Total amount of commissions paid to insurance brokerUSD $106
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 $106
Insurance broker organization code?3
Insurance broker nameTHOMAS R. CLARY
PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 )
Policy contract number988956K
Policy instance 1
Insurance contract or identification number988956K
Number of Individuals Covered1
Insurance policy start date2011-10-01
Insurance policy end date2012-09-30
Total amount of commissions paid to insurance brokerUSD $17
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
PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 )
Policy contract number988956L
Policy instance 2
Insurance contract or identification number988956L
Number of Individuals Covered1
Insurance policy start date2011-10-01
Insurance policy end date2012-09-30
Total amount of commissions paid to insurance brokerUSD $17
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
PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 )
Policy contract number988956K
Policy instance 3
Insurance contract or identification number988956K
Number of Individuals Covered1
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Total amount of commissions paid to insurance brokerUSD $50
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
PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 )
Policy contract number988956L
Policy instance 4
Insurance contract or identification number988956L
Number of Individuals Covered1
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Total amount of commissions paid to insurance brokerUSD $106
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
PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 )
Policy contract number2602946
Policy instance 1
Insurance contract or identification number2602946
Number of Individuals Covered14
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Total amount of commissions paid to insurance brokerUSD $109
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
PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 )
Policy contract number2602950
Policy instance 2
Insurance contract or identification number2602950
Number of Individuals Covered1
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Total amount of commissions paid to insurance brokerUSD $66
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

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