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ADTEC, AERIAL FABRICS, 401(K) RETIREMENT PLAN 401k Plan overview

Plan NameADTEC, AERIAL FABRICS, 401(K) RETIREMENT PLAN
Plan identification number 001

ADTEC, AERIAL FABRICS, 401(K) RETIREMENT 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.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

FABRITEX, SOUTHERN UMBRELLA, INC has sponsored the creation of one or more 401k plans.

Company Name:FABRITEX, SOUTHERN UMBRELLA, INC
Employer identification number (EIN):581830058
NAIC Classification:332900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ADTEC, AERIAL FABRICS, 401(K) RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-01-01BLAKE MILLER2021-07-27
0012019-01-01BLAKE MILLER2020-07-13
0012019-01-01BLAKE MILLER2021-07-27
0012018-01-01BLAKE MILLER2019-06-25
0012017-01-01BLAKE MILLER2018-06-21 BLAKE MILLER2018-06-21
0012016-01-01BLAKE MILLER2017-10-05
0012015-01-01BLAKE MILLER
0012015-01-01BLAKE MILLER
0012014-01-01BLAKE MILLER
0012013-01-01BLAKE MILLER
0012012-01-01BLAKE MILLER
0012011-01-01DEL EMERY
0012010-01-01DEL EMERY
0012009-01-01DEL EMERY

Plan Statistics for ADTEC, AERIAL FABRICS, 401(K) RETIREMENT PLAN

401k plan membership statisitcs for ADTEC, AERIAL FABRICS, 401(K) RETIREMENT PLAN

Measure Date Value
2015: ADTEC, AERIAL FABRICS, 401(K) RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01125
Total number of active participants reported on line 7a of the Form 55002015-01-01119
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-019
Total of all active and inactive participants2015-01-01128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01128
Number of participants with account balances2015-01-0136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: ADTEC, AERIAL FABRICS, 401(K) RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0191
Total number of active participants reported on line 7a of the Form 55002014-01-01125
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-018
Total of all active and inactive participants2014-01-01133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01133
Number of participants with account balances2014-01-0136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: ADTEC, AERIAL FABRICS, 401(K) RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0186
Total number of active participants reported on line 7a of the Form 55002013-01-0185
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-018
Total of all active and inactive participants2013-01-0193
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0193
Number of participants with account balances2013-01-0134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-014
2012: ADTEC, AERIAL FABRICS, 401(K) RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0179
Total number of active participants reported on line 7a of the Form 55002012-01-0176
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-017
Total of all active and inactive participants2012-01-0183
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0183
Number of participants with account balances2012-01-0176
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-014
2011: ADTEC, AERIAL FABRICS, 401(K) RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0183
Total number of active participants reported on line 7a of the Form 55002011-01-0179
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 participants2011-01-0179
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0179
Number of participants with account balances2011-01-0132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: ADTEC, AERIAL FABRICS, 401(K) RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0181
Total number of active participants reported on line 7a of the Form 55002010-01-0181
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 participants2010-01-0181
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0181
Number of participants with account balances2010-01-0135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: ADTEC, AERIAL FABRICS, 401(K) RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0168
Total number of active participants reported on line 7a of the Form 55002009-01-0166
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-016
Total of all active and inactive participants2009-01-0172
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0172
Number of participants with account balances2009-01-0131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on ADTEC, AERIAL FABRICS, 401(K) RETIREMENT PLAN

Measure Date Value
2015 : ADTEC, AERIAL FABRICS, 401(K) RETIREMENT PLAN 2015 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2015-12-31$0
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total transfer of assets to this plan2015-12-31$0
Total transfer of assets from this plan2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$52,579
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$2,862
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$778
Expenses. Certain deemed distributions of participant loans2015-12-31$0
Value of total corrective distributions2015-12-31$1,154
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$59,102
Value of total assets at end of year2015-12-31$662,088
Value of total assets at beginning of year2015-12-31$612,371
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$930
Total interest from all sources2015-12-31$1,283
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$56,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$59,102
Participant contributions at end of year2015-12-31$8,854
Participant contributions at beginning of year2015-12-31$7,158
Participant contributions at end of year2015-12-31$1,780
Assets. Other investments not covered elsewhere at end of year2015-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2015-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$0
Other income not declared elsewhere2015-12-31$0
Administrative expenses (other) incurred2015-12-31$930
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$49,717
Value of net assets at end of year (total assets less liabilities)2015-12-31$662,088
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$612,371
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$608,700
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$576,007
Value of interest in pooled separate accounts at end of year2015-12-31$0
Value of interest in pooled separate accounts at beginning of year2015-12-31$0
Interest on participant loans2015-12-31$251
Interest earned on other investments2015-12-31$1,032
Value of interest in common/collective trusts at end of year2015-12-31$0
Value of interest in common/collective trusts at beginning of year2015-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$42,754
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$29,206
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$0
Net investment gain/loss from pooled separate accounts2015-12-31$-7,806
Net investment gain or loss from common/collective trusts2015-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Assets. Invements in employer securities at end of year2015-12-31$0
Assets. Invements in employer securities at beginning of year2015-12-31$0
Contributions received in cash from employer2015-12-31$0
Income. Dividends from common stock2015-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$778
Asset. Corporate debt instrument debt (other) at end of year2015-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2015-12-31$0
Assets. Corporate common stocks other than exployer securities at end of year2015-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2015-12-31$0
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31BURCH, CROOMS & COMPANY, LLP
Accountancy firm EIN2015-12-31261582736
2014 : ADTEC, AERIAL FABRICS, 401(K) RETIREMENT PLAN 2014 401k financial data
Transfers to/from the plan2014-12-31$333
Total income from all sources2014-12-31$84,499
Expenses. Total of all expenses incurred2014-12-31$17,148
Benefits paid (including direct rollovers)2014-12-31$15,633
Total plan assets at end of year2014-12-31$612,371
Total plan assets at beginning of year2014-12-31$544,687
Value of fidelity bond covering the plan2014-12-31$56,000
Total contributions received or receivable from participants2014-12-31$50,190
Expenses. Other expenses not covered elsewhere2014-12-31$1,515
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$34,309
Net income (gross income less expenses)2014-12-31$67,351
Net plan assets at end of year (total assets less liabilities)2014-12-31$612,371
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$544,687
Assets. Value of participant loans2014-12-31$7,158
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
Funding deficiency by the employer to the plan for this plan year2014-12-31$0
Minimum employer required contribution for this plan year2014-12-31$0
Amount contributed by the employer to the plan for this plan year2014-12-31$0
2013 : ADTEC, AERIAL FABRICS, 401(K) RETIREMENT PLAN 2013 401k financial data
Transfers to/from the plan2013-12-31$473
Total income from all sources2013-12-31$184,927
Expenses. Total of all expenses incurred2013-12-31$114,618
Benefits paid (including direct rollovers)2013-12-31$112,693
Total plan assets at end of year2013-12-31$544,689
Total plan assets at beginning of year2013-12-31$473,907
Value of fidelity bond covering the plan2013-12-31$56,000
Total contributions received or receivable from participants2013-12-31$71,951
Expenses. Other expenses not covered elsewhere2013-12-31$1,925
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$112,976
Net income (gross income less expenses)2013-12-31$70,309
Net plan assets at end of year (total assets less liabilities)2013-12-31$544,689
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$473,907
Assets. Value of participant loans2013-12-31$9,558
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
Funding deficiency by the employer to the plan for this plan year2013-12-31$0
Minimum employer required contribution for this plan year2013-12-31$0
Amount contributed by the employer to the plan for this plan year2013-12-31$0
2012 : ADTEC, AERIAL FABRICS, 401(K) RETIREMENT PLAN 2012 401k financial data
Transfers to/from the plan2012-12-31$0
Total income from all sources2012-12-31$130,106
Expenses. Total of all expenses incurred2012-12-31$7,469
Benefits paid (including direct rollovers)2012-12-31$5,734
Total plan assets at end of year2012-12-31$473,907
Total plan assets at beginning of year2012-12-31$351,270
Value of fidelity bond covering the plan2012-12-31$56,000
Total contributions received or receivable from participants2012-12-31$66,248
Expenses. Other expenses not covered elsewhere2012-12-31$1,735
Contributions received from other sources (not participants or employers)2012-12-31$12,893
Other income received2012-12-31$50,965
Net income (gross income less expenses)2012-12-31$122,637
Net plan assets at end of year (total assets less liabilities)2012-12-31$473,907
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$351,270
Assets. Value of participant loans2012-12-31$6,331
Total contributions received or receivable from employer(s)2012-12-31$0
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$0
Funding deficiency by the employer to the plan for this plan year2012-12-31$0
Minimum employer required contribution for this plan year2012-12-31$0
Amount contributed by the employer to the plan for this plan year2012-12-31$0
2011 : ADTEC, AERIAL FABRICS, 401(K) RETIREMENT PLAN 2011 401k financial data
Transfers to/from the plan2011-12-31$0
Total income from all sources2011-12-31$31,649
Expenses. Total of all expenses incurred2011-12-31$8,817
Benefits paid (including direct rollovers)2011-12-31$7,067
Total plan assets at end of year2011-12-31$351,270
Total plan assets at beginning of year2011-12-31$328,438
Value of fidelity bond covering the plan2011-12-31$56,000
Total contributions received or receivable from participants2011-12-31$46,079
Expenses. Other expenses not covered elsewhere2011-12-31$1,750
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-14,430
Net income (gross income less expenses)2011-12-31$22,832
Net plan assets at end of year (total assets less liabilities)2011-12-31$351,270
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$328,438
Assets. Value of participant loans2011-12-31$4,444
Total contributions received or receivable from employer(s)2011-12-31$0
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$0
Funding deficiency by the employer to the plan for this plan year2011-12-31$0
Minimum employer required contribution for this plan year2011-12-31$0
Amount contributed by the employer to the plan for this plan year2011-12-31$0
2010 : ADTEC, AERIAL FABRICS, 401(K) RETIREMENT PLAN 2010 401k financial data
Transfers to/from the plan2010-12-31$0
Total income from all sources2010-12-31$66,392
Expenses. Total of all expenses incurred2010-12-31$1,084
Benefits paid (including direct rollovers)2010-12-31$0
Total plan assets at end of year2010-12-31$328,438
Total plan assets at beginning of year2010-12-31$263,130
Value of fidelity bond covering the plan2010-12-31$56,000
Total contributions received or receivable from participants2010-12-31$35,963
Expenses. Other expenses not covered elsewhere2010-12-31$640
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$30,429
Net income (gross income less expenses)2010-12-31$65,308
Net plan assets at end of year (total assets less liabilities)2010-12-31$328,438
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$263,130
Assets. Value of participant loans2010-12-31$16
Total contributions received or receivable from employer(s)2010-12-31$0
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$444
Funding deficiency by the employer to the plan for this plan year2010-12-31$0
Minimum employer required contribution for this plan year2010-12-31$0
Amount contributed by the employer to the plan for this plan year2010-12-31$0
2009 : ADTEC, AERIAL FABRICS, 401(K) RETIREMENT PLAN 2009 401k financial data
Funding deficiency by the employer to the plan for this plan year2009-12-31$0
Minimum employer required contribution for this plan year2009-12-31$0
Amount contributed by the employer to the plan for this plan year2009-12-31$0

Form 5500 Responses for ADTEC, AERIAL FABRICS, 401(K) RETIREMENT PLAN

2015: ADTEC, AERIAL FABRICS, 401(K) RETIREMENT PLAN 2015 form 5500 responses
2015-01-01Type of plan entityMulitple 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
2014: ADTEC, AERIAL FABRICS, 401(K) RETIREMENT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: ADTEC, AERIAL FABRICS, 401(K) RETIREMENT 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
2012: ADTEC, AERIAL FABRICS, 401(K) RETIREMENT 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
2011: ADTEC, AERIAL FABRICS, 401(K) RETIREMENT 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
2010: ADTEC, AERIAL FABRICS, 401(K) RETIREMENT 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
2009: ADTEC, AERIAL FABRICS, 401(K) RETIREMENT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-019802
Policy instance 1
Insurance contract or identification numberGA-019802
Number of Individuals Covered36
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,873
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,873
Insurance broker organization code?3
Insurance broker nameNYLIFE SECURITIES LLC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-019802
Policy instance 1
Insurance contract or identification numberGA-019802
Number of Individuals Covered36
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,664
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,664
Insurance broker organization code?3
Insurance broker nameNYLIFE SECURITIES LLC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-019802
Policy instance 1
Insurance contract or identification numberGA-019802
Number of Individuals Covered34
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,525
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,525
Insurance broker organization code?3
Insurance broker nameNYLIFE SECURITIES LLC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-019802
Policy instance 1
Insurance contract or identification numberGA-019802
Number of Individuals Covered76
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,129
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,129
Insurance broker organization code?3
Insurance broker nameNYLIFE SECURITIES LLC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-019802
Policy instance 1
Insurance contract or identification numberGA-019802
Number of Individuals Covered32
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $1,010
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-019802
Policy instance 1
Insurance contract or identification numberGA-019802
Number of Individuals Covered35
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $805
Total amount of fees paid to insurance companyUSD $659
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees659
Additional information about fees paid to insurance brokerSALES/MARKETING
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $596
Insurance broker nameNYLIFE SECURITIES LLC

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