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JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 401k Plan overview

Plan NameJACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN
Plan identification number 002

JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 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
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

BOBBY T SHIRLEY DMD PC has sponsored the creation of one or more 401k plans.

Company Name:BOBBY T SHIRLEY DMD PC
Employer identification number (EIN):581445391
NAIC Classification:621210
NAIC Description:Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022021-08-01
0022020-08-01
0022019-08-01
0022018-08-01
0022017-08-01JACK F BICKFORD DDS
0022016-08-01JACK F BICKFORD DDS
0022015-08-01JACK F BICKFORD DDS
0022014-08-01JACK F BICKFORD DDS
0022013-08-01JACK F BICKFORD DDS
0022012-08-01JACK F BICKFORD DDS
0022011-08-01JACK F BICKFORD DDS
0022009-08-01JACK F BICKFORD DDS

Plan Statistics for JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN

401k plan membership statisitcs for JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN

Measure Date Value
2020: JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2020 401k membership
Total participants, beginning-of-year2020-08-0117
Total number of active participants reported on line 7a of the Form 55002020-08-0114
Number of retired or separated participants receiving benefits2020-08-012
Total of all active and inactive participants2020-08-0116
Total participants2020-08-0116
Number of participants with account balances2020-08-0116
2019: JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2019 401k membership
Total participants, beginning-of-year2019-08-0113
Total number of active participants reported on line 7a of the Form 55002019-08-0116
Number of other retired or separated participants entitled to future benefits2019-08-011
Total of all active and inactive participants2019-08-0117
Total participants2019-08-0117
Number of participants with account balances2019-08-0117
2018: JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2018 401k membership
Total participants, beginning-of-year2018-08-0115
Total number of active participants reported on line 7a of the Form 55002018-08-0112
Number of other retired or separated participants entitled to future benefits2018-08-011
Total of all active and inactive participants2018-08-0113
Total participants2018-08-0113
Number of participants with account balances2018-08-0113
2017: JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2017 401k membership
Total participants, beginning-of-year2017-08-0115
Total number of active participants reported on line 7a of the Form 55002017-08-0115
Total of all active and inactive participants2017-08-0115
Total participants2017-08-0115
Number of participants with account balances2017-08-0115
2016: JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2016 401k membership
Total participants, beginning-of-year2016-08-0116
Total number of active participants reported on line 7a of the Form 55002016-08-0115
Total of all active and inactive participants2016-08-0115
Total participants2016-08-0115
Number of participants with account balances2016-08-0115
2015: JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2015 401k membership
Total participants, beginning-of-year2015-08-0115
Total number of active participants reported on line 7a of the Form 55002015-08-0114
Total of all active and inactive participants2015-08-0114
Total participants2015-08-0114
Number of participants with account balances2015-08-0115
2014: JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2014 401k membership
Total participants, beginning-of-year2014-08-0115
Total of all active and inactive participants2014-08-010
Total participants2014-08-010
Number of participants with account balances2014-08-0115
2013: JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2013 401k membership
Total participants, beginning-of-year2013-08-0116
Total number of active participants reported on line 7a of the Form 55002013-08-0115
Total of all active and inactive participants2013-08-0115
Total participants2013-08-0115
Number of participants with account balances2013-08-0115
2012: JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2012 401k membership
Total participants, beginning-of-year2012-08-0116
Total number of active participants reported on line 7a of the Form 55002012-08-0115
Number of other retired or separated participants entitled to future benefits2012-08-011
Total of all active and inactive participants2012-08-0116
Total participants2012-08-0116
Number of participants with account balances2012-08-0116
2011: JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2011 401k membership
Total participants, beginning-of-year2011-08-0118
Total number of active participants reported on line 7a of the Form 55002011-08-0115
Number of other retired or separated participants entitled to future benefits2011-08-011
Total of all active and inactive participants2011-08-0116
Total participants2011-08-0116
Number of participants with account balances2011-08-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-08-011
2009: JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2009 401k membership
Total participants, beginning-of-year2009-08-0118
Total number of active participants reported on line 7a of the Form 55002009-08-0117
Number of other retired or separated participants entitled to future benefits2009-08-011
Total of all active and inactive participants2009-08-0118
Total participants2009-08-0118
Number of participants with account balances2009-08-0118

Financial Data on JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN

Measure Date Value
2021 : JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2021 401k financial data
Total income from all sources2021-07-31$340,711
Expenses. Total of all expenses incurred2021-07-31$367,742
Benefits paid (including direct rollovers)2021-07-31$361,263
Total plan assets at end of year2021-07-31$1,247,726
Total plan assets at beginning of year2021-07-31$1,274,757
Value of fidelity bond covering the plan2021-07-31$400,000
Total contributions received or receivable from participants2021-07-31$86,183
Expenses. Other expenses not covered elsewhere2021-07-31$6,479
Other income received2021-07-31$221,155
Net income (gross income less expenses)2021-07-31$-27,031
Net plan assets at end of year (total assets less liabilities)2021-07-31$1,247,726
Net plan assets at beginning of year (total assets less liabilities)2021-07-31$1,274,757
Assets. Value of participant loans2021-07-31$27,986
Total contributions received or receivable from employer(s)2021-07-31$33,373
2020 : JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2020 401k financial data
Total income from all sources2020-07-31$192,808
Expenses. Total of all expenses incurred2020-07-31$5,460
Total plan assets at end of year2020-07-31$1,274,757
Total plan assets at beginning of year2020-07-31$1,087,409
Value of fidelity bond covering the plan2020-07-31$400,000
Total contributions received or receivable from participants2020-07-31$98,957
Expenses. Other expenses not covered elsewhere2020-07-31$5,460
Other income received2020-07-31$59,603
Net income (gross income less expenses)2020-07-31$187,348
Net plan assets at end of year (total assets less liabilities)2020-07-31$1,274,757
Net plan assets at beginning of year (total assets less liabilities)2020-07-31$1,087,409
Total contributions received or receivable from employer(s)2020-07-31$34,248
2019 : JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2019 401k financial data
Total income from all sources2019-07-31$139,378
Expenses. Total of all expenses incurred2019-07-31$2,882,053
Benefits paid (including direct rollovers)2019-07-31$2,866,122
Total plan assets at end of year2019-07-31$1,087,409
Total plan assets at beginning of year2019-07-31$3,830,084
Value of fidelity bond covering the plan2019-07-31$400,000
Total contributions received or receivable from participants2019-07-31$53,743
Expenses. Other expenses not covered elsewhere2019-07-31$15,931
Other income received2019-07-31$59,808
Net income (gross income less expenses)2019-07-31$-2,742,675
Net plan assets at end of year (total assets less liabilities)2019-07-31$1,087,409
Net plan assets at beginning of year (total assets less liabilities)2019-07-31$3,830,084
Total contributions received or receivable from employer(s)2019-07-31$25,827
2018 : JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2018 401k financial data
Total income from all sources2018-07-31$419,415
Expenses. Total of all expenses incurred2018-07-31$26,215
Total plan assets at end of year2018-07-31$3,830,084
Total plan assets at beginning of year2018-07-31$3,436,884
Value of fidelity bond covering the plan2018-07-31$400,000
Total contributions received or receivable from participants2018-07-31$74,395
Expenses. Other expenses not covered elsewhere2018-07-31$26,215
Other income received2018-07-31$263,736
Net income (gross income less expenses)2018-07-31$393,200
Net plan assets at end of year (total assets less liabilities)2018-07-31$3,830,084
Net plan assets at beginning of year (total assets less liabilities)2018-07-31$3,436,884
Total contributions received or receivable from employer(s)2018-07-31$81,284
2017 : JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2017 401k financial data
Total income from all sources2017-07-31$425,108
Expenses. Total of all expenses incurred2017-07-31$23,219
Benefits paid (including direct rollovers)2017-07-31$643
Total plan assets at end of year2017-07-31$3,436,884
Total plan assets at beginning of year2017-07-31$3,034,995
Value of fidelity bond covering the plan2017-07-31$325,000
Total contributions received or receivable from participants2017-07-31$70,670
Expenses. Other expenses not covered elsewhere2017-07-31$22,576
Other income received2017-07-31$274,141
Net income (gross income less expenses)2017-07-31$401,889
Net plan assets at end of year (total assets less liabilities)2017-07-31$3,436,884
Net plan assets at beginning of year (total assets less liabilities)2017-07-31$3,034,995
Assets. Value of participant loans2017-07-31$72,473
Total contributions received or receivable from employer(s)2017-07-31$80,297
2016 : JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2016 401k financial data
Total income from all sources2016-07-31$202,971
Expenses. Total of all expenses incurred2016-07-31$92,578
Benefits paid (including direct rollovers)2016-07-31$72,435
Total plan assets at end of year2016-07-31$3,034,995
Total plan assets at beginning of year2016-07-31$2,924,602
Value of fidelity bond covering the plan2016-07-31$325,000
Total contributions received or receivable from participants2016-07-31$67,645
Expenses. Other expenses not covered elsewhere2016-07-31$20,143
Other income received2016-07-31$56,854
Net income (gross income less expenses)2016-07-31$110,393
Net plan assets at end of year (total assets less liabilities)2016-07-31$3,034,995
Net plan assets at beginning of year (total assets less liabilities)2016-07-31$2,924,602
Assets. Value of participant loans2016-07-31$92,118
Total contributions received or receivable from employer(s)2016-07-31$78,472
2015 : JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2015 401k financial data
Total income from all sources2015-07-31$306,448
Expenses. Total of all expenses incurred2015-07-31$19,744
Total plan assets at end of year2015-07-31$2,924,602
Total plan assets at beginning of year2015-07-31$2,637,898
Value of fidelity bond covering the plan2015-07-31$250,000
Total contributions received or receivable from participants2015-07-31$73,820
Expenses. Other expenses not covered elsewhere2015-07-31$19,744
Other income received2015-07-31$154,791
Net income (gross income less expenses)2015-07-31$286,704
Net plan assets at end of year (total assets less liabilities)2015-07-31$2,924,602
Net plan assets at beginning of year (total assets less liabilities)2015-07-31$2,637,898
Assets. Value of participant loans2015-07-31$97,900
Total contributions received or receivable from employer(s)2015-07-31$77,837
2014 : JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2014 401k financial data
Total income from all sources2014-07-31$347,974
Expenses. Total of all expenses incurred2014-07-31$21,102
Benefits paid (including direct rollovers)2014-07-31$20
Total plan assets at end of year2014-07-31$2,637,898
Total plan assets at beginning of year2014-07-31$2,311,026
Value of fidelity bond covering the plan2014-07-31$250,000
Total contributions received or receivable from participants2014-07-31$68,020
Expenses. Other expenses not covered elsewhere2014-07-31$21,082
Other income received2014-07-31$205,814
Net income (gross income less expenses)2014-07-31$326,872
Net plan assets at end of year (total assets less liabilities)2014-07-31$2,637,898
Net plan assets at beginning of year (total assets less liabilities)2014-07-31$2,311,026
Assets. Value of participant loans2014-07-31$63,339
Total contributions received or receivable from employer(s)2014-07-31$74,140
2013 : JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2013 401k financial data
Total income from all sources2013-07-31$271,317
Expenses. Total of all expenses incurred2013-07-31$20,294
Benefits paid (including direct rollovers)2013-07-31$1,812
Total plan assets at end of year2013-07-31$2,311,026
Total plan assets at beginning of year2013-07-31$2,060,003
Value of fidelity bond covering the plan2013-07-31$250,000
Total contributions received or receivable from participants2013-07-31$64,640
Expenses. Other expenses not covered elsewhere2013-07-31$18,482
Other income received2013-07-31$136,329
Net income (gross income less expenses)2013-07-31$251,023
Net plan assets at end of year (total assets less liabilities)2013-07-31$2,311,026
Net plan assets at beginning of year (total assets less liabilities)2013-07-31$2,060,003
Assets. Value of participant loans2013-07-31$36,177
Total contributions received or receivable from employer(s)2013-07-31$70,348
2012 : JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2012 401k financial data
Transfers to/from the plan2012-07-31$2,035
Total income from all sources2012-07-31$62,885
Expenses. Total of all expenses incurred2012-07-31$35,770
Benefits paid (including direct rollovers)2012-07-31$18,456
Total plan assets at end of year2012-07-31$2,060,003
Total plan assets at beginning of year2012-07-31$2,030,853
Value of fidelity bond covering the plan2012-07-31$215,000
Total contributions received or receivable from participants2012-07-31$63,090
Expenses. Other expenses not covered elsewhere2012-07-31$17,314
Other income received2012-07-31$-71,902
Net income (gross income less expenses)2012-07-31$27,115
Net plan assets at end of year (total assets less liabilities)2012-07-31$2,060,003
Net plan assets at beginning of year (total assets less liabilities)2012-07-31$2,030,853
Assets. Value of participant loans2012-07-31$16,709
Total contributions received or receivable from employer(s)2012-07-31$71,697
2011 : JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2011 401k financial data
Transfers to/from the plan2011-07-31$68,293
Total income from all sources2011-07-31$317,329
Expenses. Total of all expenses incurred2011-07-31$17,569
Total plan assets at end of year2011-07-31$2,030,853
Total plan assets at beginning of year2011-07-31$1,662,800
Value of fidelity bond covering the plan2011-07-31$215,000
Total contributions received or receivable from participants2011-07-31$61,375
Expenses. Other expenses not covered elsewhere2011-07-31$17,569
Other income received2011-07-31$183,768
Net income (gross income less expenses)2011-07-31$299,760
Net plan assets at end of year (total assets less liabilities)2011-07-31$2,030,853
Net plan assets at beginning of year (total assets less liabilities)2011-07-31$1,662,800
Assets. Value of participant loans2011-07-31$14,000
Total contributions received or receivable from employer(s)2011-07-31$72,186

Form 5500 Responses for JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN

2020: JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2020 form 5500 responses
2020-08-01Type of plan entitySingle employer plan
2020-08-01Plan funding arrangement – TrustYes
2020-08-01Plan benefit arrangement - TrustYes
2019: JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2019 form 5500 responses
2019-08-01Type of plan entitySingle employer plan
2019-08-01Plan funding arrangement – TrustYes
2019-08-01Plan benefit arrangement - TrustYes
2018: JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2018 form 5500 responses
2018-08-01Type of plan entitySingle employer plan
2018-08-01Plan funding arrangement – InsuranceYes
2018-08-01Plan funding arrangement – TrustYes
2018-08-01Plan benefit arrangement – InsuranceYes
2018-08-01Plan benefit arrangement - TrustYes
2017: JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2017 form 5500 responses
2017-08-01Type of plan entitySingle employer plan
2017-08-01Plan funding arrangement – InsuranceYes
2017-08-01Plan funding arrangement – TrustYes
2017-08-01Plan benefit arrangement – InsuranceYes
2017-08-01Plan benefit arrangement - TrustYes
2016: JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2016 form 5500 responses
2016-08-01Type of plan entitySingle employer plan
2016-08-01Plan funding arrangement – InsuranceYes
2016-08-01Plan funding arrangement – TrustYes
2016-08-01Plan benefit arrangement – InsuranceYes
2016-08-01Plan benefit arrangement - TrustYes
2015: JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2015 form 5500 responses
2015-08-01Type of plan entitySingle employer plan
2015-08-01Plan funding arrangement – InsuranceYes
2015-08-01Plan funding arrangement – TrustYes
2015-08-01Plan benefit arrangement – InsuranceYes
2015-08-01Plan benefit arrangement - TrustYes
2014: JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2014 form 5500 responses
2014-08-01Type of plan entitySingle employer plan
2014-08-01Plan funding arrangement – InsuranceYes
2014-08-01Plan funding arrangement – TrustYes
2014-08-01Plan benefit arrangement – InsuranceYes
2014-08-01Plan benefit arrangement - TrustYes
2013: JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2013 form 5500 responses
2013-08-01Type of plan entitySingle employer plan
2013-08-01Plan funding arrangement – InsuranceYes
2013-08-01Plan funding arrangement – TrustYes
2013-08-01Plan benefit arrangement – InsuranceYes
2013-08-01Plan benefit arrangement - TrustYes
2012: JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2012 form 5500 responses
2012-08-01Type of plan entitySingle employer plan
2012-08-01Plan funding arrangement – InsuranceYes
2012-08-01Plan funding arrangement – TrustYes
2012-08-01Plan benefit arrangement – InsuranceYes
2012-08-01Plan benefit arrangement - TrustYes
2011: JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2011 form 5500 responses
2011-08-01Type of plan entitySingle employer plan
2011-08-01Plan funding arrangement – InsuranceYes
2011-08-01Plan funding arrangement – TrustYes
2011-08-01Plan benefit arrangement – InsuranceYes
2011-08-01Plan benefit arrangement - TrustYes
2009: JACK F BICKFORD DDS & BOBBY T SHIRLEY DMD PC 401K PLAN 2009 form 5500 responses
2009-08-01Type of plan entitySingle employer plan
2009-08-01Plan funding arrangement – InsuranceYes
2009-08-01Plan funding arrangement – TrustYes
2009-08-01Plan benefit arrangement – InsuranceYes
2009-08-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 )
Policy contract numberJ00038770
Policy instance 1
Insurance contract or identification numberJ00038770
Insurance policy start date2018-08-21
Insurance policy end date2018-11-01
Are there contracts with allocated funds for individual policies?1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerANNUAL PREMIUM
Insurance broker organization code?3
PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 )
Policy contract numberJ00038770
Policy instance 1
Insurance contract or identification numberJ00038770
Number of Individuals Covered1
Insurance policy start date2017-08-21
Insurance policy end date2018-08-21
Total amount of fees paid to insurance companyUSD $1,956
Are there contracts with allocated funds for individual policies?1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1956
Additional information about fees paid to insurance brokerANNUAL PREMIUM
Insurance broker organization code?3
Insurance broker nameMICHAEL A HARRINGTON
PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 )
Policy contract numberJ00038770
Policy instance 1
Insurance contract or identification numberJ00038770
Number of Individuals Covered1
Insurance policy start date2014-08-21
Insurance policy end date2015-08-21
Total amount of fees paid to insurance companyUSD $1,956
Are there contracts with allocated funds for individual policies?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1956
Additional information about fees paid to insurance brokerANNUAL PREMIUM
Insurance broker organization code?3
Insurance broker nameMICHAEL A HARRINGTON
PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 )
Policy contract numberJ00038770
Policy instance 1
Insurance contract or identification numberJ00038770
Insurance policy start date2013-08-21
Insurance policy end date2014-08-21
Total amount of fees paid to insurance companyUSD $1,956
Are there contracts with allocated funds for individual policies?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1956
Additional information about fees paid to insurance brokerANNUAL PREMIUM
Insurance broker organization code?3
Insurance broker nameMICHAEL A HARRINGTON
PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 )
Policy contract numberJ00038770
Policy instance 1
Insurance contract or identification numberJ00038770
Number of Individuals Covered1
Insurance policy start date2013-08-21
Insurance policy end date2014-08-21
Total amount of fees paid to insurance companyUSD $1,956
Are there contracts with allocated funds for individual policies?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1956
Additional information about fees paid to insurance brokerANNUAL PREMIUM
Insurance broker organization code?3
Insurance broker nameMICHAEL A HARRINGTON
PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 )
Policy contract numberJ00038770
Policy instance 1
Insurance contract or identification numberJ00038770
Number of Individuals Covered1
Insurance policy start date2012-08-21
Insurance policy end date2013-08-21
Total amount of fees paid to insurance companyUSD $1,956
Are there contracts with allocated funds for individual policies?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1956
Additional information about fees paid to insurance brokerANNUAL PREMIUM
Insurance broker organization code?3
Insurance broker nameMICHAEL A HARRINGTON
PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 )
Policy contract numberJ00038770
Policy instance 1
Insurance contract or identification numberJ00038770
Insurance policy start date2011-08-21
Insurance policy end date2012-08-21
Are there contracts with allocated funds for individual policies?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PHOENIX LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 67814 )
Policy contract numberJ00038770
Policy instance 1
Insurance contract or identification numberJ00038770
Insurance policy start date2010-08-21
Insurance policy end date2011-08-21
Are there contracts with allocated funds for individual policies?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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