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AURELIO BENAVIDES, M.D., INC. 401K PLAN 401k Plan overview

Plan NameAURELIO BENAVIDES, M.D., INC. 401K PLAN
Plan identification number 001

AURELIO BENAVIDES, M.D., INC. 401K 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
  • 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.
  • Life insurance

401k Sponsoring company profile

AURELIO BENAVIDES, M.D., INC. has sponsored the creation of one or more 401k plans.

Company Name:AURELIO BENAVIDES, M.D., INC.
Employer identification number (EIN):550614548
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AURELIO BENAVIDES, M.D., INC. 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012019-01-01
0012018-01-01
0012017-01-01AURELIO BENAVIDES, M.D.
0012016-01-01AURELIO BENAVIDES, M.D.
0012015-01-01AURELIO BENAVIDES, M.D.
0012014-01-01AURELIO BENAVIDES, M.D.
0012013-01-01AURELIO BENAVIDES, M.D.
0012012-01-01AURELIO BENAVIDES, M.D.
0012011-01-01AURELIO BENAVIDES, M.D.
0012010-01-01AURELIO BENAVIDES, M.D.
0012009-01-01AURELIO BENAVIDES, M.D.

Plan Statistics for AURELIO BENAVIDES, M.D., INC. 401K PLAN

401k plan membership statisitcs for AURELIO BENAVIDES, M.D., INC. 401K PLAN

Measure Date Value
2019: AURELIO BENAVIDES, M.D., INC. 401K PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-012
Total number of active participants reported on line 7a of the Form 55002019-01-012
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-012
Number of participants with account balances2019-01-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: AURELIO BENAVIDES, M.D., INC. 401K PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-012
Total number of active participants reported on line 7a of the Form 55002018-01-012
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-012
Number of participants with account balances2018-01-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: AURELIO BENAVIDES, M.D., INC. 401K PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-012
Total number of active participants reported on line 7a of the Form 55002017-01-012
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-012
Number of participants with account balances2017-01-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: AURELIO BENAVIDES, M.D., INC. 401K PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-012
Total number of active participants reported on line 7a of the Form 55002016-01-012
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 participants2016-01-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-012
Number of participants with account balances2016-01-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: AURELIO BENAVIDES, M.D., INC. 401K PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-012
Total number of active participants reported on line 7a of the Form 55002015-01-012
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-012
Number of participants with account balances2015-01-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: AURELIO BENAVIDES, M.D., INC. 401K PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-012
Total number of active participants reported on line 7a of the Form 55002014-01-012
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 participants2014-01-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-012
Number of participants with account balances2014-01-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: AURELIO BENAVIDES, M.D., INC. 401K PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-013
Total number of active participants reported on line 7a of the Form 55002013-01-012
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 participants2013-01-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-012
Number of participants with account balances2013-01-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: AURELIO BENAVIDES, M.D., INC. 401K PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-013
Total number of active participants reported on line 7a of the Form 55002012-01-013
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 participants2012-01-013
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-013
Number of participants with account balances2012-01-013
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: AURELIO BENAVIDES, M.D., INC. 401K PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-014
Total number of active participants reported on line 7a of the Form 55002011-01-013
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-013
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-013
Number of participants with account balances2011-01-013
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: AURELIO BENAVIDES, M.D., INC. 401K PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-014
Total number of active participants reported on line 7a of the Form 55002010-01-014
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-014
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-014
Number of participants with account balances2010-01-014
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: AURELIO BENAVIDES, M.D., INC. 401K PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-014
Total number of active participants reported on line 7a of the Form 55002009-01-014
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-014
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-014
Number of participants with account balances2009-01-014
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on AURELIO BENAVIDES, M.D., INC. 401K PLAN

Measure Date Value
2019 : AURELIO BENAVIDES, M.D., INC. 401K PLAN 2019 401k financial data
Transfers to/from the plan2019-12-31$0
Total plan liabilities at end of year2019-12-31$0
Total plan liabilities at beginning of year2019-12-31$0
Total income from all sources2019-12-31$245,861
Expenses. Total of all expenses incurred2019-12-31$107,031
Benefits paid (including direct rollovers)2019-12-31$85,700
Total plan assets at end of year2019-12-31$1,201,693
Total plan assets at beginning of year2019-12-31$1,062,863
Value of fidelity bond covering the plan2019-12-31$250,000
Total contributions received or receivable from participants2019-12-31$0
Expenses. Other expenses not covered elsewhere2019-12-31$4,958
Contributions received from other sources (not participants or employers)2019-12-31$0
Other income received2019-12-31$245,861
Noncash contributions received2019-12-31$0
Net income (gross income less expenses)2019-12-31$138,830
Net plan assets at end of year (total assets less liabilities)2019-12-31$1,201,693
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$1,062,863
Total contributions received or receivable from employer(s)2019-12-31$0
Value of certain deemed distributions of participant loans2019-12-31$0
Value of corrective distributions2019-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$16,373
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
2018 : AURELIO BENAVIDES, M.D., INC. 401K PLAN 2018 401k financial data
Transfers to/from the plan2018-12-31$0
Total plan liabilities at end of year2018-12-31$0
Total plan liabilities at beginning of year2018-12-31$0
Total income from all sources2018-12-31$-28,241
Expenses. Total of all expenses incurred2018-12-31$118,036
Benefits paid (including direct rollovers)2018-12-31$81,000
Total plan assets at end of year2018-12-31$1,062,863
Total plan assets at beginning of year2018-12-31$1,209,140
Value of fidelity bond covering the plan2018-12-31$250,000
Total contributions received or receivable from participants2018-12-31$0
Expenses. Other expenses not covered elsewhere2018-12-31$4,958
Contributions received from other sources (not participants or employers)2018-12-31$0
Other income received2018-12-31$-28,241
Noncash contributions received2018-12-31$0
Net income (gross income less expenses)2018-12-31$-146,277
Net plan assets at end of year (total assets less liabilities)2018-12-31$1,062,863
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$1,209,140
Total contributions received or receivable from employer(s)2018-12-31$0
Value of certain deemed distributions of participant loans2018-12-31$0
Value of corrective distributions2018-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$32,078
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
2017 : AURELIO BENAVIDES, M.D., INC. 401K PLAN 2017 401k financial data
Transfers to/from the plan2017-12-31$0
Total plan liabilities at end of year2017-12-31$0
Total plan liabilities at beginning of year2017-12-31$0
Total income from all sources2017-12-31$147,248
Expenses. Total of all expenses incurred2017-12-31$117,819
Benefits paid (including direct rollovers)2017-12-31$100,000
Total plan assets at end of year2017-12-31$1,209,140
Total plan assets at beginning of year2017-12-31$1,179,711
Value of fidelity bond covering the plan2017-12-31$250,000
Total contributions received or receivable from participants2017-12-31$0
Expenses. Other expenses not covered elsewhere2017-12-31$237
Contributions received from other sources (not participants or employers)2017-12-31$0
Other income received2017-12-31$147,248
Noncash contributions received2017-12-31$0
Net income (gross income less expenses)2017-12-31$29,429
Net plan assets at end of year (total assets less liabilities)2017-12-31$1,209,140
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$1,179,711
Total contributions received or receivable from employer(s)2017-12-31$0
Value of certain deemed distributions of participant loans2017-12-31$0
Value of corrective distributions2017-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$17,582
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : AURELIO BENAVIDES, M.D., INC. 401K PLAN 2016 401k financial data
Transfers to/from the plan2016-12-31$0
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$91,118
Expenses. Total of all expenses incurred2016-12-31$91,829
Benefits paid (including direct rollovers)2016-12-31$75,000
Total plan assets at end of year2016-12-31$1,179,711
Total plan assets at beginning of year2016-12-31$1,180,422
Value of fidelity bond covering the plan2016-12-31$250,000
Total contributions received or receivable from participants2016-12-31$0
Expenses. Other expenses not covered elsewhere2016-12-31$533
Contributions received from other sources (not participants or employers)2016-12-31$0
Other income received2016-12-31$91,118
Noncash contributions received2016-12-31$0
Net income (gross income less expenses)2016-12-31$-711
Net plan assets at end of year (total assets less liabilities)2016-12-31$1,179,711
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$1,180,422
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$16,296
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : AURELIO BENAVIDES, M.D., INC. 401K PLAN 2015 401k financial data
Transfers to/from the plan2015-12-31$0
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$27,211
Expenses. Total of all expenses incurred2015-12-31$76,465
Benefits paid (including direct rollovers)2015-12-31$63,000
Total plan assets at end of year2015-12-31$1,180,422
Total plan assets at beginning of year2015-12-31$1,229,676
Value of fidelity bond covering the plan2015-12-31$250,000
Total contributions received or receivable from participants2015-12-31$0
Expenses. Other expenses not covered elsewhere2015-12-31$141
Contributions received from other sources (not participants or employers)2015-12-31$0
Other income received2015-12-31$27,211
Noncash contributions received2015-12-31$0
Net income (gross income less expenses)2015-12-31$-49,254
Net plan assets at end of year (total assets less liabilities)2015-12-31$1,180,422
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$1,229,676
Total contributions received or receivable from employer(s)2015-12-31$0
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$13,324
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : AURELIO BENAVIDES, M.D., INC. 401K 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$80,682
Expenses. Total of all expenses incurred2014-12-31$59,443
Benefits paid (including direct rollovers)2014-12-31$43,931
Total plan assets at end of year2014-12-31$1,229,676
Total plan assets at beginning of year2014-12-31$1,208,437
Value of fidelity bond covering the plan2014-12-31$250,000
Total contributions received or receivable from participants2014-12-31$0
Expenses. Other expenses not covered elsewhere2014-12-31$1,560
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$80,682
Noncash contributions received2014-12-31$0
Net income (gross income less expenses)2014-12-31$21,239
Net plan assets at end of year (total assets less liabilities)2014-12-31$1,229,676
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$1,208,437
Total contributions received or receivable from employer(s)2014-12-31$0
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$13,952
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : AURELIO BENAVIDES, M.D., INC. 401K 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$0
Total income from all sources2013-12-31$-12,610
Expenses. Total of all expenses incurred2013-12-31$167,412
Benefits paid (including direct rollovers)2013-12-31$152,426
Total plan assets at end of year2013-12-31$1,208,437
Total plan assets at beginning of year2013-12-31$1,388,459
Value of fidelity bond covering the plan2013-12-31$250,000
Total contributions received or receivable from participants2013-12-31$0
Expenses. Other expenses not covered elsewhere2013-12-31$507
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$-12,610
Noncash contributions received2013-12-31$0
Net income (gross income less expenses)2013-12-31$-180,022
Net plan assets at end of year (total assets less liabilities)2013-12-31$1,208,437
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$1,388,459
Total contributions received or receivable from employer(s)2013-12-31$0
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$14,479
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : AURELIO BENAVIDES, M.D., INC. 401K PLAN 2012 401k financial data
Transfers to/from the plan2012-12-31$0
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$190,568
Expenses. Total of all expenses incurred2012-12-31$82,852
Benefits paid (including direct rollovers)2012-12-31$50,030
Total plan assets at end of year2012-12-31$1,388,459
Total plan assets at beginning of year2012-12-31$1,280,743
Value of fidelity bond covering the plan2012-12-31$250,000
Total contributions received or receivable from participants2012-12-31$11,000
Expenses. Other expenses not covered elsewhere2012-12-31$4,857
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$168,568
Noncash contributions received2012-12-31$0
Net income (gross income less expenses)2012-12-31$107,716
Net plan assets at end of year (total assets less liabilities)2012-12-31$1,388,459
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$1,280,743
Total contributions received or receivable from employer(s)2012-12-31$11,000
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$27,965
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : AURELIO BENAVIDES, M.D., INC. 401K 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$110,516
Expenses. Total of all expenses incurred2011-12-31$108,816
Benefits paid (including direct rollovers)2011-12-31$95,649
Total plan assets at end of year2011-12-31$1,280,743
Total plan assets at beginning of year2011-12-31$1,279,043
Value of fidelity bond covering the plan2011-12-31$250,000
Total contributions received or receivable from participants2011-12-31$17,764
Expenses. Other expenses not covered elsewhere2011-12-31$901
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$89,246
Noncash contributions received2011-12-31$0
Net income (gross income less expenses)2011-12-31$1,700
Net plan assets at end of year (total assets less liabilities)2011-12-31$1,280,743
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$1,279,043
Assets. Value of participant loans2011-12-31$0
Total contributions received or receivable from employer(s)2011-12-31$3,506
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$12,266
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : AURELIO BENAVIDES, M.D., INC. 401K 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$113,283
Expenses. Total of all expenses incurred2010-12-31$12,833
Benefits paid (including direct rollovers)2010-12-31$0
Total plan assets at end of year2010-12-31$1,279,043
Total plan assets at beginning of year2010-12-31$1,178,593
Value of fidelity bond covering the plan2010-12-31$250,000
Total contributions received or receivable from participants2010-12-31$22,000
Expenses. Other expenses not covered elsewhere2010-12-31$1,254
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$66,283
Noncash contributions received2010-12-31$0
Net income (gross income less expenses)2010-12-31$100,450
Net plan assets at end of year (total assets less liabilities)2010-12-31$1,279,043
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$1,178,593
Assets. Value of participant loans2010-12-31$5,417
Total contributions received or receivable from employer(s)2010-12-31$25,000
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$11,579

Form 5500 Responses for AURELIO BENAVIDES, M.D., INC. 401K PLAN

2019: AURELIO BENAVIDES, M.D., INC. 401K PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: AURELIO BENAVIDES, M.D., INC. 401K PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: AURELIO BENAVIDES, M.D., INC. 401K PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: AURELIO BENAVIDES, M.D., INC. 401K 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 filingNo
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: AURELIO BENAVIDES, M.D., INC. 401K 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: AURELIO BENAVIDES, M.D., INC. 401K 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: AURELIO BENAVIDES, M.D., INC. 401K 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: AURELIO BENAVIDES, M.D., INC. 401K 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: AURELIO BENAVIDES, M.D., INC. 401K 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: AURELIO BENAVIDES, M.D., INC. 401K 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: AURELIO BENAVIDES, M.D., INC. 401K 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

PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52421 )
Policy contract numberBOO160783
Policy instance 1
Insurance contract or identification numberBOO160783
Number of Individuals Covered1
Insurance policy start date2018-07-21
Insurance policy end date2019-07-20
Total amount of commissions paid to insurance brokerUSD $103
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $4,958
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $103
Insurance broker organization code?3
PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52421 )
Policy contract numberBOO160783
Policy instance 1
Insurance contract or identification numberBOO160783
Number of Individuals Covered1
Insurance policy start date2017-07-21
Insurance policy end date2018-07-20
Total amount of commissions paid to insurance brokerUSD $98
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $4,958
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $98
Insurance broker organization code?3
PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52421 )
Policy contract numberBOO160783
Policy instance 1
Insurance contract or identification numberBOO160783
Number of Individuals Covered1
Insurance policy start date2016-07-21
Insurance policy end date2017-07-20
Total amount of commissions paid to insurance brokerUSD $92
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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 $92
Insurance broker organization code?3
Insurance broker nameWILLIAM M MASON
PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52421 )
Policy contract numberBOO160783
Policy instance 1
Insurance contract or identification numberBOO160783
Number of Individuals Covered1
Insurance policy start date2014-07-21
Insurance policy end date2015-07-20
Total amount of commissions paid to insurance brokerUSD $72
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 BenefitYes
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 $72
Insurance broker organization code?3
Insurance broker nameWILLIAM M MASON
PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52421 )
Policy contract numberBOO160783
Policy instance 1
Insurance contract or identification numberBOO160783
Number of Individuals Covered1
Insurance policy start date2013-07-21
Insurance policy end date2014-07-20
Total amount of commissions paid to insurance brokerUSD $72
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 BenefitYes
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 $72
Insurance broker organization code?3
Insurance broker nameWILLIAM M MASON
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0155040
Policy instance 1
Insurance contract or identification number0155040
Number of Individuals Covered0
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $25
Total amount of fees paid to insurance companyUSD $7
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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 $25
Amount paid for insurance broker fees7
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker namePAUL ADAM SORTINO
PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52421 )
Policy contract numberBOO160783
Policy instance 2
Insurance contract or identification numberBOO160783
Number of Individuals Covered1
Insurance policy start date2012-07-21
Insurance policy end date2013-07-20
Total amount of commissions paid to insurance brokerUSD $65
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 BenefitYes
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 $65
Insurance broker organization code?3
Insurance broker nameWILLIAM M MASON
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0155040
Policy instance 1
Insurance contract or identification number0155040
Number of Individuals Covered1
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $42
Total amount of fees paid to insurance companyUSD $9
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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 $42
Amount paid for insurance broker fees9
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker namePAUL ADAM SORTINO
PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52421 )
Policy contract numberBOO160783
Policy instance 2
Insurance contract or identification numberBOO160783
Number of Individuals Covered1
Insurance policy start date2011-07-21
Insurance policy end date2012-07-20
Total amount of commissions paid to insurance brokerUSD $60
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 BenefitYes
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 $60
Insurance broker organization code?3
Insurance broker nameWILLIAM M MASON
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0155040
Policy instance 1
Insurance contract or identification number0155040
Number of Individuals Covered1
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $41
Total amount of fees paid to insurance companyUSD $9
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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
PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52421 )
Policy contract numberBOO160783
Policy instance 2
Insurance contract or identification numberBOO160783
Number of Individuals Covered1
Insurance policy start date2010-07-21
Insurance policy end date2011-07-20
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 BenefitYes
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
PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52421 )
Policy contract numberBOO160783
Policy instance 3
Insurance contract or identification numberBOO160783
Number of Individuals Covered1
Insurance policy start date2009-07-21
Insurance policy end date2010-07-20
Total amount of commissions paid to insurance brokerUSD $55
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 BenefitYes
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 $55
Insurance broker organization code?3
Insurance broker nameWILLIAM M MASON
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0155040
Policy instance 1
Insurance contract or identification number0155040
Number of Individuals Covered1
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $40
Total amount of fees paid to insurance companyUSD $8
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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 $40
Amount paid for insurance broker fees8
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker nameDAVID M CURETON
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract number1A22781250
Policy instance 2
Insurance contract or identification number1A22781250
Number of Individuals Covered1
Insurance policy start date2009-12-15
Insurance policy end date2010-12-14
Total amount of commissions paid to insurance brokerUSD $11
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 BenefitYes
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 $11
Insurance broker organization code?3
Insurance broker nameWILLIAM M. MASON

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