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TOCO HILL, INC. RETIREMENT TRUST 401k Plan overview

Plan NameTOCO HILL, INC. RETIREMENT TRUST
Plan identification number 001

TOCO HILL, INC. RETIREMENT TRUST Benefits

401k Plan TypeDefined Benefit Pension
Plan Features/Benefits
  • Benefits are primarily pay related
  • Covered by PBGC - Plan is covered under the PBGC insurance program (see ERISA section 4021).
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).
  • Life insurance

401k Sponsoring company profile

TOCO HILL, INC. has sponsored the creation of one or more 401k plans.

Company Name:TOCO HILL, INC.
Employer identification number (EIN):586020692
NAIC Classification:531310

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TOCO HILL, INC. RETIREMENT TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012021-01-01W.C SHEPHERD, III2022-07-09
0012020-01-01W.C SHEPHERD, III2021-09-23
0012019-01-01W.C SHEPHERD, III2020-06-02
0012018-01-01W.C SHEPHERD, III2019-09-18
0012017-01-01
0012016-01-01W.C. SHEPHERD, III
0012015-01-01W.C. SHEPHERD, III
0012015-01-01W.C. SHEPHERD, III
0012014-01-01W.C. SHEPHERD, III
0012013-01-01W.C. SHEPHERD, III
0012012-01-01W.C. SHEPHERD, III
0012011-01-01W.C. SHEPHERD, III
0012009-01-01W.C. SHEPHERD, III W.C. SHEPHERD, III2010-10-07

Plan Statistics for TOCO HILL, INC. RETIREMENT TRUST

401k plan membership statisitcs for TOCO HILL, INC. RETIREMENT TRUST

Measure Date Value
2021: TOCO HILL, INC. RETIREMENT TRUST 2021 401k membership
Market value of plan assets2021-12-312,557,470
Acturial value of plan assets2021-12-312,557,470
Funding target for retired participants and beneficiaries receiving payment2021-12-310
Number of terminated vested participants2021-12-310
Fundng target for terminated vested participants2021-12-310
Active participant vested funding target2021-12-312,116,451
Number of active participants2021-12-313
Total funding liabilities for active participants2021-12-312,116,451
Total participant count2021-12-313
Total funding target for all participants2021-12-312,116,451
Balance at beginning of prior year after applicable adjustments2021-12-310
Prefunding balance at beginning of prior year after applicable adjustments2021-12-310
Amount remaining of carryover balance2021-12-310
Amount remaining of prefunding balance2021-12-310
Present value of excess contributions2021-12-310
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2021-12-310
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2021-12-310
Reductions in caryover balances due to elections or deemed elections2021-12-310
Reductions in prefunding balances due to elections or deemed elections2021-12-310
Balance of carryovers at beginning of current year2021-12-310
Balance of prefunding at beginning of current year2021-12-310
Total employer contributions2021-12-310
Total employee contributions2021-12-310
Contributions allocated toward unpaid minimum require contributions from prior years2021-12-310
Contributions made to avoid restrictions adjusted to valuation date2021-12-310
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2021-12-310
Unpaid minimum required contributions for all prior years2021-12-310
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2021-12-310
Remaining amount of unpaid minimum required contributions2021-12-310
Minimum required contributions for current year target normal cost2021-12-3189,757
Total funding amount beforereflecting carryover/prefunding balances2021-12-310
Additional cash requirement2021-12-310
Contributions allocatedtoward minimum required contributions for current year2021-12-310
Unpaid minimum required contributions for current year2021-12-310
Unpaid minimum required contributions for all years2021-12-310
Total participants, beginning-of-year2021-01-013
Total number of active participants reported on line 7a of the Form 55002021-01-011
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-011
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-011
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: TOCO HILL, INC. RETIREMENT TRUST 2020 401k membership
Market value of plan assets2020-12-312,387,926
Acturial value of plan assets2020-12-312,387,926
Funding target for retired participants and beneficiaries receiving payment2020-12-310
Number of terminated vested participants2020-12-310
Fundng target for terminated vested participants2020-12-310
Active participant vested funding target2020-12-311,891,645
Number of active participants2020-12-313
Total funding liabilities for active participants2020-12-311,891,645
Total participant count2020-12-313
Total funding target for all participants2020-12-311,891,645
Balance at beginning of prior year after applicable adjustments2020-12-310
Prefunding balance at beginning of prior year after applicable adjustments2020-12-310
Amount remaining of carryover balance2020-12-310
Amount remaining of prefunding balance2020-12-310
Present value of excess contributions2020-12-310
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2020-12-310
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2020-12-310
Reductions in prefunding balances due to elections or deemed elections2020-12-310
Balance of carryovers at beginning of current year2020-12-310
Balance of prefunding at beginning of current year2020-12-310
Total employer contributions2020-12-310
Total employee contributions2020-12-310
Contributions allocated toward unpaid minimum require contributions from prior years2020-12-310
Contributions made to avoid restrictions adjusted to valuation date2020-12-310
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2020-12-310
Unpaid minimum required contributions for all prior years2020-12-310
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2020-12-310
Remaining amount of unpaid minimum required contributions2020-12-310
Minimum required contributions for current year target normal cost2020-12-31133,607
Net shortfall amortization installment of oustanding balance2020-12-310
Waiver amortization installment2020-12-310
Total funding amount beforereflecting carryover/prefunding balances2020-12-310
Additional cash requirement2020-12-310
Contributions allocatedtoward minimum required contributions for current year2020-12-310
Unpaid minimum required contributions for current year2020-12-310
Unpaid minimum required contributions for all years2020-12-310
Total participants, beginning-of-year2020-01-013
Total number of active participants reported on line 7a of the Form 55002020-01-013
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-013
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-013
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: TOCO HILL, INC. RETIREMENT TRUST 2019 401k membership
Market value of plan assets2019-12-312,034,875
Acturial value of plan assets2019-12-312,034,875
Funding target for retired participants and beneficiaries receiving payment2019-12-310
Number of terminated vested participants2019-12-310
Fundng target for terminated vested participants2019-12-310
Active participant vested funding target2019-12-311,484,420
Number of active participants2019-12-313
Total funding liabilities for active participants2019-12-311,484,420
Total participant count2019-12-313
Total funding target for all participants2019-12-311,484,420
Balance at beginning of prior year after applicable adjustments2019-12-310
Prefunding balance at beginning of prior year after applicable adjustments2019-12-310
Amount remaining of carryover balance2019-12-310
Amount remaining of prefunding balance2019-12-310
Present value of excess contributions2019-12-310
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2019-12-310
Balance of carryovers at beginning of current year2019-12-310
Balance of prefunding at beginning of current year2019-12-310
Total employer contributions2019-12-310
Total employee contributions2019-12-310
Contributions allocated toward unpaid minimum require contributions from prior years2019-12-310
Contributions made to avoid restrictions adjusted to valuation date2019-12-310
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2019-12-310
Unpaid minimum required contributions for all prior years2019-12-310
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2019-12-310
Remaining amount of unpaid minimum required contributions2019-12-310
Minimum required contributions for current year target normal cost2019-12-31108,083
Total funding amount beforereflecting carryover/prefunding balances2019-12-310
Additional cash requirement2019-12-310
Contributions allocatedtoward minimum required contributions for current year2019-12-310
Unpaid minimum required contributions for current year2019-12-310
Unpaid minimum required contributions for all years2019-12-310
Total participants, beginning-of-year2019-01-013
Total number of active participants reported on line 7a of the Form 55002019-01-013
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 participants2019-01-013
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-013
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: TOCO HILL, INC. RETIREMENT TRUST 2018 401k membership
Market value of plan assets2018-12-312,579,074
Acturial value of plan assets2018-12-312,579,074
Funding target for retired participants and beneficiaries receiving payment2018-12-310
Number of terminated vested participants2018-12-311
Fundng target for terminated vested participants2018-12-31350,571
Active participant vested funding target2018-12-311,120,000
Number of active participants2018-12-314
Total funding liabilities for active participants2018-12-311,120,000
Total participant count2018-12-315
Total funding target for all participants2018-12-311,470,571
Balance at beginning of prior year after applicable adjustments2018-12-310
Prefunding balance at beginning of prior year after applicable adjustments2018-12-310
Amount remaining of carryover balance2018-12-310
Amount remaining of prefunding balance2018-12-310
Present value of excess contributions2018-12-319,210
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2018-12-319,752
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2018-12-310
Reductions in caryover balances due to elections or deemed elections2018-12-310
Reductions in prefunding balances due to elections or deemed elections2018-12-310
Balance of carryovers at beginning of current year2018-12-310
Balance of prefunding at beginning of current year2018-12-310
Total employer contributions2018-12-310
Total employee contributions2018-12-310
Contributions allocated toward unpaid minimum require contributions from prior years2018-12-310
Contributions made to avoid restrictions adjusted to valuation date2018-12-310
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2018-12-310
Unpaid minimum required contributions for all prior years2018-12-310
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2018-12-310
Remaining amount of unpaid minimum required contributions2018-12-310
Minimum required contributions for current year target normal cost2018-12-310
Total funding amount beforereflecting carryover/prefunding balances2018-12-310
Additional cash requirement2018-12-310
Contributions allocatedtoward minimum required contributions for current year2018-12-310
Unpaid minimum required contributions for current year2018-12-310
Unpaid minimum required contributions for all years2018-12-310
Total participants, beginning-of-year2018-01-015
Total number of active participants reported on line 7a of the Form 55002018-01-013
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 participants2018-01-013
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-013
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: TOCO HILL, INC. RETIREMENT TRUST 2017 401k membership
Market value of plan assets2017-12-312,253,319
Acturial value of plan assets2017-12-312,253,319
Funding target for retired participants and beneficiaries receiving payment2017-12-310
Number of terminated vested participants2017-12-311
Fundng target for terminated vested participants2017-12-31395,759
Active participant vested funding target2017-12-31996,970
Number of active participants2017-12-314
Total funding liabilities for active participants2017-12-31996,970
Total participant count2017-12-315
Total funding target for all participants2017-12-311,392,729
Balance at beginning of prior year after applicable adjustments2017-12-310
Prefunding balance at beginning of prior year after applicable adjustments2017-12-310
Amount remaining of carryover balance2017-12-310
Amount remaining of prefunding balance2017-12-310
Present value of excess contributions2017-12-319,136
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2017-12-319,694
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2017-12-310
Reductions in caryover balances due to elections or deemed elections2017-12-310
Reductions in prefunding balances due to elections or deemed elections2017-12-310
Balance of carryovers at beginning of current year2017-12-310
Balance of prefunding at beginning of current year2017-12-310
Total employer contributions2017-12-3110,000
Total employee contributions2017-12-310
Contributions allocated toward unpaid minimum require contributions from prior years2017-12-310
Contributions made to avoid restrictions adjusted to valuation date2017-12-310
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2017-12-319,210
Unpaid minimum required contributions for all prior years2017-12-310
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2017-12-310
Remaining amount of unpaid minimum required contributions2017-12-310
Minimum required contributions for current year target normal cost2017-12-313,931
Total funding amount beforereflecting carryover/prefunding balances2017-12-310
Additional cash requirement2017-12-310
Contributions allocatedtoward minimum required contributions for current year2017-12-319,210
Unpaid minimum required contributions for current year2017-12-310
Unpaid minimum required contributions for all years2017-12-310
Total participants, beginning-of-year2017-01-015
Total number of active participants reported on line 7a of the Form 55002017-01-014
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-011
Total of all active and inactive participants2017-01-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-015
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: TOCO HILL, INC. RETIREMENT TRUST 2016 401k membership
Market value of plan assets2016-12-312,117,560
Acturial value of plan assets2016-12-312,117,560
Funding target for retired participants and beneficiaries receiving payment2016-12-310
Number of terminated vested participants2016-12-311
Fundng target for terminated vested participants2016-12-31375,874
Active participant vested funding target2016-12-31904,828
Number of active participants2016-12-314
Total funding liabilities for active participants2016-12-31904,828
Total participant count2016-12-315
Total funding target for all participants2016-12-311,280,702
Balance at beginning of prior year after applicable adjustments2016-12-310
Prefunding balance at beginning of prior year after applicable adjustments2016-12-310
Amount remaining of carryover balance2016-12-310
Amount remaining of prefunding balance2016-12-310
Present value of excess contributions2016-12-3145,107
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2016-12-3147,953
Reductions in prefunding balances due to elections or deemed elections2016-12-310
Balance of carryovers at beginning of current year2016-12-310
Balance of prefunding at beginning of current year2016-12-310
Total employer contributions2016-12-3110,000
Total employee contributions2016-12-310
Contributions allocated toward unpaid minimum require contributions from prior years2016-12-310
Contributions made to avoid restrictions adjusted to valuation date2016-12-310
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2016-12-319,136
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2016-12-310
Remaining amount of unpaid minimum required contributions2016-12-310
Minimum required contributions for current year target normal cost2016-12-314,279
Total funding amount beforereflecting carryover/prefunding balances2016-12-310
Additional cash requirement2016-12-310
Contributions allocatedtoward minimum required contributions for current year2016-12-319,136
Unpaid minimum required contributions for current year2016-12-310
Unpaid minimum required contributions for all years2016-12-310
Total participants, beginning-of-year2016-01-015
Total number of active participants reported on line 7a of the Form 55002016-01-013
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-012
Total of all active and inactive participants2016-01-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-015
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: TOCO HILL, INC. RETIREMENT TRUST 2015 401k membership
Total participants, beginning-of-year2015-01-015
Total number of active participants reported on line 7a of the Form 55002015-01-013
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-012
Total of all active and inactive participants2015-01-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-015
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: TOCO HILL, INC. RETIREMENT TRUST 2014 401k membership
Total participants, beginning-of-year2014-01-015
Total number of active participants reported on line 7a of the Form 55002014-01-014
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-011
Total of all active and inactive participants2014-01-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-015
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: TOCO HILL, INC. RETIREMENT TRUST 2013 401k membership
Total participants, beginning-of-year2013-01-015
Total number of active participants reported on line 7a of the Form 55002013-01-014
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-011
Total of all active and inactive participants2013-01-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-015
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: TOCO HILL, INC. RETIREMENT TRUST 2012 401k membership
Total participants, beginning-of-year2012-01-015
Total number of active participants reported on line 7a of the Form 55002012-01-013
Number of retired or separated participants receiving benefits2012-01-012
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-015
Number of participants with account balances2012-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: TOCO HILL, INC. RETIREMENT TRUST 2011 401k membership
Total participants, beginning-of-year2011-01-016
Total number of active participants reported on line 7a of the Form 55002011-01-014
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-012
Total of all active and inactive participants2011-01-016
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-016
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: TOCO HILL, INC. RETIREMENT TRUST 2009 401k membership
Total participants, beginning-of-year2009-01-017
Total number of active participants reported on line 7a of the Form 55002009-01-016
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-011
Total of all active and inactive participants2009-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on TOCO HILL, INC. RETIREMENT TRUST

Measure Date Value
2021 : TOCO HILL, INC. RETIREMENT TRUST 2021 401k financial data
Transfers to/from the plan2021-12-31$0
Total plan liabilities at beginning of year2021-12-31$0
Total income from all sources2021-12-31$292,253
Expenses. Total of all expenses incurred2021-12-31$1,345,448
Benefits paid (including direct rollovers)2021-12-31$1,322,607
Total plan assets at end of year2021-12-31$1,504,275
Total plan assets at beginning of year2021-12-31$2,557,470
Value of fidelity bond covering the plan2021-12-31$500,000
Assets. Value of tangible personal property2021-12-31$459,309
Total contributions received or receivable from participants2021-12-31$0
Expenses. Other expenses not covered elsewhere2021-12-31$9,315
Contributions received from other sources (not participants or employers)2021-12-31$0
Other income received2021-12-31$292,253
Noncash contributions received2021-12-31$0
Net income (gross income less expenses)2021-12-31$-1,053,195
Net plan assets at end of year (total assets less liabilities)2021-12-31$1,504,275
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$2,557,470
Total contributions received or receivable from employer(s)2021-12-31$0
Value of certain deemed distributions of participant loans2021-12-31$0
Value of corrective distributions2021-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$13,526
2020 : TOCO HILL, INC. RETIREMENT TRUST 2020 401k financial data
Transfers to/from the plan2020-12-31$0
Total plan liabilities at end of year2020-12-31$0
Total plan liabilities at beginning of year2020-12-31$0
Total income from all sources2020-12-31$261,935
Expenses. Total of all expenses incurred2020-12-31$92,391
Benefits paid (including direct rollovers)2020-12-31$65,707
Total plan assets at end of year2020-12-31$2,557,470
Total plan assets at beginning of year2020-12-31$2,387,926
Value of fidelity bond covering the plan2020-12-31$500,000
Assets. Value of tangible personal property2020-12-31$462,615
Total contributions received or receivable from participants2020-12-31$0
Expenses. Other expenses not covered elsewhere2020-12-31$12,403
Contributions received from other sources (not participants or employers)2020-12-31$0
Other income received2020-12-31$261,935
Net income (gross income less expenses)2020-12-31$169,544
Net plan assets at end of year (total assets less liabilities)2020-12-31$2,557,470
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$2,387,926
Total contributions received or receivable from employer(s)2020-12-31$0
Value of certain deemed distributions of participant loans2020-12-31$0
Value of corrective distributions2020-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$14,281
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
2019 : TOCO HILL, INC. RETIREMENT TRUST 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$377,284
Expenses. Total of all expenses incurred2019-12-31$24,233
Benefits paid (including direct rollovers)2019-12-31$0
Total plan assets at end of year2019-12-31$2,387,926
Total plan assets at beginning of year2019-12-31$2,034,875
Value of fidelity bond covering the plan2019-12-31$500,000
Assets. Value of tangible personal property2019-12-31$387,335
Total contributions received or receivable from participants2019-12-31$0
Expenses. Other expenses not covered elsewhere2019-12-31$5,640
Contributions received from other sources (not participants or employers)2019-12-31$0
Other income received2019-12-31$377,284
Noncash contributions received2019-12-31$0
Net income (gross income less expenses)2019-12-31$353,051
Net plan assets at end of year (total assets less liabilities)2019-12-31$2,387,926
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$2,034,875
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$18,593
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
2018 : TOCO HILL, INC. RETIREMENT TRUST 2018 401k financial data
Total plan liabilities at end of year2018-12-31$0
Total plan liabilities at beginning of year2018-12-31$0
Total income from all sources2018-12-31$-65,708
Expenses. Total of all expenses incurred2018-12-31$478,491
Benefits paid (including direct rollovers)2018-12-31$434,314
Total plan assets at end of year2018-12-31$2,034,875
Total plan assets at beginning of year2018-12-31$2,579,074
Value of fidelity bond covering the plan2018-12-31$500,000
Assets. Value of tangible personal property2018-12-31$325,280
Total contributions received or receivable from participants2018-12-31$0
Expenses. Other expenses not covered elsewhere2018-12-31$24,190
Contributions received from other sources (not participants or employers)2018-12-31$0
Other income received2018-12-31$-65,708
Noncash contributions received2018-12-31$0
Net income (gross income less expenses)2018-12-31$-544,199
Net plan assets at end of year (total assets less liabilities)2018-12-31$2,034,875
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$2,579,074
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$19,987
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
2017 : TOCO HILL, INC. RETIREMENT TRUST 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$371,812
Expenses. Total of all expenses incurred2017-12-31$46,057
Benefits paid (including direct rollovers)2017-12-31$0
Total plan assets at end of year2017-12-31$2,579,074
Total plan assets at beginning of year2017-12-31$2,253,319
Value of fidelity bond covering the plan2017-12-31$250,000
Assets. Value of tangible personal property2017-12-31$329,732
Total contributions received or receivable from participants2017-12-31$0
Expenses. Other expenses not covered elsewhere2017-12-31$25,346
Contributions received from other sources (not participants or employers)2017-12-31$0
Other income received2017-12-31$361,812
Net income (gross income less expenses)2017-12-31$325,755
Net plan assets at end of year (total assets less liabilities)2017-12-31$2,579,074
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$2,253,319
Total contributions received or receivable from employer(s)2017-12-31$10,000
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$20,711
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : TOCO HILL, INC. RETIREMENT TRUST 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$186,979
Expenses. Total of all expenses incurred2016-12-31$51,220
Benefits paid (including direct rollovers)2016-12-31$0
Total plan assets at end of year2016-12-31$2,253,319
Total plan assets at beginning of year2016-12-31$2,117,560
Value of fidelity bond covering the plan2016-12-31$250,000
Assets. Value of tangible personal property2016-12-31$307,890
Total contributions received or receivable from participants2016-12-31$0
Expenses. Other expenses not covered elsewhere2016-12-31$27,290
Contributions received from other sources (not participants or employers)2016-12-31$0
Other income received2016-12-31$176,979
Net income (gross income less expenses)2016-12-31$135,759
Net plan assets at end of year (total assets less liabilities)2016-12-31$2,253,319
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$2,117,560
Total contributions received or receivable from employer(s)2016-12-31$10,000
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$23,930
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : TOCO HILL, INC. RETIREMENT TRUST 2015 401k financial data
Transfers to/from the plan2015-12-31$0
Total plan liabilities at beginning of year2015-12-31$0
Total income from all sources2015-12-31$-20,865
Expenses. Total of all expenses incurred2015-12-31$49,513
Benefits paid (including direct rollovers)2015-12-31$0
Total plan assets at end of year2015-12-31$2,067,560
Total plan assets at beginning of year2015-12-31$2,137,938
Value of fidelity bond covering the plan2015-12-31$250,000
Assets. Value of tangible personal property2015-12-31$295,481
Total contributions received or receivable from participants2015-12-31$0
Expenses. Other expenses not covered elsewhere2015-12-31$30,493
Contributions received from other sources (not participants or employers)2015-12-31$0
Other income received2015-12-31$-20,865
Net income (gross income less expenses)2015-12-31$-70,378
Net plan assets at end of year (total assets less liabilities)2015-12-31$2,067,560
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$2,137,938
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$19,020
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : TOCO HILL, INC. RETIREMENT TRUST 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$36,899
Expenses. Total of all expenses incurred2014-12-31$15,990
Benefits paid (including direct rollovers)2014-12-31$0
Total plan assets at end of year2014-12-31$2,137,938
Total plan assets at beginning of year2014-12-31$2,117,029
Value of fidelity bond covering the plan2014-12-31$250,000
Assets. Value of tangible personal property2014-12-31$329,756
Total contributions received or receivable from participants2014-12-31$0
Expenses. Other expenses not covered elsewhere2014-12-31$588
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$36,899
Noncash contributions received2014-12-31$0
Net income (gross income less expenses)2014-12-31$20,909
Net plan assets at end of year (total assets less liabilities)2014-12-31$2,137,938
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$2,117,029
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$15,402
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : TOCO HILL, INC. RETIREMENT TRUST 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$147,936
Expenses. Total of all expenses incurred2013-12-31$34,558
Benefits paid (including direct rollovers)2013-12-31$0
Total plan assets at end of year2013-12-31$2,117,029
Total plan assets at beginning of year2013-12-31$2,003,651
Value of fidelity bond covering the plan2013-12-31$250,000
Assets. Value of tangible personal property2013-12-31$335,856
Total contributions received or receivable from participants2013-12-31$0
Expenses. Other expenses not covered elsewhere2013-12-31$24,145
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$147,936
Noncash contributions received2013-12-31$0
Net income (gross income less expenses)2013-12-31$113,378
Net plan assets at end of year (total assets less liabilities)2013-12-31$2,117,029
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$2,003,651
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$10,413
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : TOCO HILL, INC. RETIREMENT TRUST 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$204,966
Expenses. Total of all expenses incurred2012-12-31$39,856
Benefits paid (including direct rollovers)2012-12-31$2,442
Total plan assets at end of year2012-12-31$1,828,410
Total plan assets at beginning of year2012-12-31$1,663,300
Value of fidelity bond covering the plan2012-12-31$2,500,000
Assets. Value of tangible personal property2012-12-31$448,932
Total contributions received or receivable from participants2012-12-31$0
Expenses. Other expenses not covered elsewhere2012-12-31$24,154
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$204,966
Noncash contributions received2012-12-31$0
Net income (gross income less expenses)2012-12-31$165,110
Net plan assets at end of year (total assets less liabilities)2012-12-31$1,828,410
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$1,663,300
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
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$13,260
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : TOCO HILL, INC. RETIREMENT TRUST 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$0
Total income from all sources2011-12-31$-76,386
Expenses. Total of all expenses incurred2011-12-31$39,730
Benefits paid (including direct rollovers)2011-12-31$24,190
Total plan assets at end of year2011-12-31$1,663,300
Total plan assets at beginning of year2011-12-31$1,779,416
Value of fidelity bond covering the plan2011-12-31$1,500,000
Assets. Value of tangible personal property2011-12-31$435,331
Total contributions received or receivable from participants2011-12-31$0
Expenses. Other expenses not covered elsewhere2011-12-31$0
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-76,386
Noncash contributions received2011-12-31$0
Net income (gross income less expenses)2011-12-31$-116,116
Net plan assets at end of year (total assets less liabilities)2011-12-31$1,663,300
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$1,779,416
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
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$15,540
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : TOCO HILL, INC. RETIREMENT TRUST 2010 401k financial data
Transfers to/from the plan2010-12-31$0
Total plan liabilities at beginning of year2010-12-31$0
Total income from all sources2010-12-31$158,325
Expenses. Total of all expenses incurred2010-12-31$436,826
Benefits paid (including direct rollovers)2010-12-31$389,640
Total plan assets at end of year2010-12-31$1,779,416
Total plan assets at beginning of year2010-12-31$2,057,917
Value of fidelity bond covering the plan2010-12-31$1,500,000
Assets. Value of tangible personal property2010-12-31$388,328
Total contributions received or receivable from participants2010-12-31$0
Expenses. Other expenses not covered elsewhere2010-12-31$24,189
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$158,325
Noncash contributions received2010-12-31$0
Net income (gross income less expenses)2010-12-31$-278,501
Net plan assets at end of year (total assets less liabilities)2010-12-31$1,779,416
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$2,057,917
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$0
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$22,997
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0

Form 5500 Responses for TOCO HILL, INC. RETIREMENT TRUST

2021: TOCO HILL, INC. RETIREMENT TRUST 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement - TrustYes
2020: TOCO HILL, INC. RETIREMENT TRUST 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement - TrustYes
2019: TOCO HILL, INC. RETIREMENT TRUST 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 - TrustYes
2018: TOCO HILL, INC. RETIREMENT TRUST 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 - TrustYes
2017: TOCO HILL, INC. RETIREMENT TRUST 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 - TrustYes
2016: TOCO HILL, INC. RETIREMENT TRUST 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 - TrustYes
2015: TOCO HILL, INC. RETIREMENT TRUST 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 - TrustYes
2014: TOCO HILL, INC. RETIREMENT TRUST 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 - TrustYes
2013: TOCO HILL, INC. RETIREMENT TRUST 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 - TrustYes
2012: TOCO HILL, INC. RETIREMENT TRUST 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedYes
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 - TrustYes
2011: TOCO HILL, INC. RETIREMENT TRUST 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedYes
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 - TrustYes
2009: TOCO HILL, INC. RETIREMENT TRUST 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 - TrustYes

Insurance Providers Used on plan

WAHINGTON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65900 )
Policy contract number1090379592
Policy instance 2
Insurance contract or identification number1090379592
Number of Individuals Covered1
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?1
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?Yes
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract number1A22463550
Policy instance 1
Insurance contract or identification number1A22463550
Number of Individuals Covered1
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?1
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
WAHINGTON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65900 )
Policy contract number1090379592
Policy instance 3
Insurance contract or identification number1090379592
Number of Individuals Covered2
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?1
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?Yes
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract number1A22463550
Policy instance 2
Insurance contract or identification number1A22463550
Number of Individuals Covered1
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?1
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
THE LAFAYETTE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65242 )
Policy contract number0894856-87
Policy instance 1
Insurance contract or identification number0894856-87
Number of Individuals Covered1
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?1
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
Insurance broker organization code?3
THE LAFAYETTE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65242 )
Policy contract number0894856-87
Policy instance 1
Insurance contract or identification number0894856-87
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?1
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
Insurance broker organization code?3
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract number
Policy instance 2
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?1
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
WAHINGTON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65900 )
Policy contract number1090379592
Policy instance 3
Insurance contract or identification number1090379592
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?1
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?Yes
WAHINGTON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65900 )
Policy contract number1090379592
Policy instance 3
Insurance contract or identification number1090379592
Number of Individuals Covered3
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?1
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?Yes
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract number
Policy instance 2
Number of Individuals Covered1
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?1
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
THE LAFAYETTE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65242 )
Policy contract number0894856-87
Policy instance 1
Insurance contract or identification number0894856-87
Number of Individuals Covered2
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $166
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?1
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 $166
Amount paid for insurance broker fees0
Insurance broker organization code?3
WAHINGTON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65900 )
Policy contract number1090379592
Policy instance 3
Insurance contract or identification number1090379592
Number of Individuals Covered3
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?1
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?Yes
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract number
Policy instance 2
Number of Individuals Covered2
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?1
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?Yes
THE LAFAYETTE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65242 )
Policy contract number0894856-87
Policy instance 1
Insurance contract or identification number0894856-87
Number of Individuals Covered2
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $331
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?1
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 $331
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameBRIAN J. BENSON
THE LAFAYETTE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65242 )
Policy contract number0894586-87
Policy instance 1
Insurance contract or identification number0894586-87
Number of Individuals Covered2
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare 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?Yes
WAHINGTON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65900 )
Policy contract number1090379592
Policy instance 2
Insurance contract or identification number1090379592
Number of Individuals Covered3
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare 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?Yes
THE LAFAYETTE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65242 )
Policy contract number0894586-87
Policy instance 1
Insurance contract or identification number0894586-87
Number of Individuals Covered2
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?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 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?Yes
Insurance broker organization code?3
Insurance broker nameBRIAN BENSON
WAHINGTON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65900 )
Policy contract number1090379592
Policy instance 2
Insurance contract or identification number1090379592
Number of Individuals Covered3
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $2,893
Total amount of fees paid to insurance companyUSD $0
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 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?Yes
Commission paid to Insurance BrokerUSD $2,893
Insurance broker organization code?3
Insurance broker nameMICHAEL G. COX
THE LAFAYETTE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65242 )
Policy contract number0894586-87
Policy instance 1
Insurance contract or identification number0894586-87
Number of Individuals Covered1
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?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 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?Yes
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?3
Insurance broker nameBRIAN BENSON
WAHINGTON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65900 )
Policy contract number1090379592
Policy instance 2
Insurance contract or identification number1090379592
Number of Individuals Covered3
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2,893
Total amount of fees paid to insurance companyUSD $0
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 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?Yes
Commission paid to Insurance BrokerUSD $2,893
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameMICHAEL G. COX
WAHINGTON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65900 )
Policy contract number1090379592
Policy instance 2
Insurance contract or identification number1090379592
Number of Individuals Covered3
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $353
Total amount of fees paid to insurance companyUSD $0
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 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?Yes
Commission paid to Insurance BrokerUSD $353
Insurance broker organization code?3
Insurance broker nameMICHAEL G. COX
THE LAFAYETTE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65242 )
Policy contract number0894586-87
Policy instance 1
Insurance contract or identification number0894586-87
Number of Individuals Covered2
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $585
Total amount of fees paid to insurance companyUSD $0
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 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?Yes
Commission paid to Insurance BrokerUSD $585
Insurance broker organization code?3
Insurance broker nameBRIAN BENSON
WAHINGTON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65900 )
Policy contract number1090379592
Policy instance 2
Insurance contract or identification number1090379592
Number of Individuals Covered3
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?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 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
THE LAFAYETTE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65242 )
Policy contract number0894586-87
Policy instance 1
Insurance contract or identification number0894586-87
Number of Individuals Covered2
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?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 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
THE LAFAYETTE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65242 )
Policy contract number0894586-87
Policy instance 1
Insurance contract or identification number0894586-87
Number of Individuals Covered2
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $357
Total amount of fees paid to insurance companyUSD $0
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $357
Insurance broker organization code?3
Insurance broker name
WAHINGTON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65900 )
Policy contract number1090379592
Policy instance 2
Insurance contract or identification number1090379592
Number of Individuals Covered3
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $461
Total amount of fees paid to insurance companyUSD $0
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $461
Insurance broker organization code?3
Insurance broker nameMICHAEL G. COX

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