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GATEWAY REGIONAL HEALTH SYSTEM, INC. RETIREMENT PLAN 401k Plan overview

Plan NameGATEWAY REGIONAL HEALTH SYSTEM, INC. RETIREMENT PLAN
Plan identification number 001

GATEWAY REGIONAL HEALTH SYSTEM, INC. RETIREMENT PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Stock bonus
  • Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.

401k Sponsoring company profile

GATEWAY REGIONAL HEALTH SYSTEM, INC has sponsored the creation of one or more 401k plans.

Company Name:GATEWAY REGIONAL HEALTH SYSTEM, INC
Employer identification number (EIN):610475281
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GATEWAY REGIONAL HEALTH SYSTEM, INC. RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012019-10-01TROY LINDON2020-03-04
0012018-10-01TROY LINDON2019-12-10
0012017-10-01TROY LINDON2019-01-10
0012016-10-01TROY LINDON2018-01-19
0012015-10-01TROY LINDON2017-01-24
0012014-10-01TROY LINDON2016-01-26 TROY LINDON2016-01-26
0012013-10-01TROY LINDON TROY LINDON2015-07-13
0012012-10-01TROY LINDON TROY LINDON2014-07-08
0012011-10-01TROY LINDON TROY LINDON2013-07-12
0012009-10-01TROY LINDON TROY LINDON2011-07-06

Plan Statistics for GATEWAY REGIONAL HEALTH SYSTEM, INC. RETIREMENT PLAN

401k plan membership statisitcs for GATEWAY REGIONAL HEALTH SYSTEM, INC. RETIREMENT PLAN

Measure Date Value
2013: GATEWAY REGIONAL HEALTH SYSTEM, INC. RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year2013-10-01114
Total number of active participants reported on line 7a of the Form 55002013-10-0190
Number of retired or separated participants receiving benefits2013-10-010
Number of other retired or separated participants entitled to future benefits2013-10-010
Total of all active and inactive participants2013-10-0190
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-10-010
Total participants2013-10-0190
Number of participants with account balances2013-10-0190
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-10-010
2012: GATEWAY REGIONAL HEALTH SYSTEM, INC. RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year2012-10-01121
Total number of active participants reported on line 7a of the Form 55002012-10-01114
Number of retired or separated participants receiving benefits2012-10-010
Number of other retired or separated participants entitled to future benefits2012-10-010
Total of all active and inactive participants2012-10-01114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-10-010
Total participants2012-10-01114
Number of participants with account balances2012-10-01114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-10-010
2011: GATEWAY REGIONAL HEALTH SYSTEM, INC. RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year2011-10-01130
Total number of active participants reported on line 7a of the Form 55002011-10-01121
Number of other retired or separated participants entitled to future benefits2011-10-019
Total of all active and inactive participants2011-10-01130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-10-010
Total participants2011-10-01130
Number of participants with account balances2011-10-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-10-010
2009: GATEWAY REGIONAL HEALTH SYSTEM, INC. RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year2009-10-01259
Total number of active participants reported on line 7a of the Form 55002009-10-01104
Number of retired or separated participants receiving benefits2009-10-010
Number of other retired or separated participants entitled to future benefits2009-10-01120
Total of all active and inactive participants2009-10-01224
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-10-010
Total participants2009-10-01224
Number of participants with account balances2009-10-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-10-010

Financial Data on GATEWAY REGIONAL HEALTH SYSTEM, INC. RETIREMENT PLAN

Measure Date Value
2014 : GATEWAY REGIONAL HEALTH SYSTEM, INC. RETIREMENT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-09-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-09-30$0
Total income from all sources (including contributions)2014-09-30$158,252
Total loss/gain on sale of assets2014-09-30$0
Total of all expenses incurred2014-09-30$324,852
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-09-30$320,833
Expenses. Certain deemed distributions of participant loans2014-09-30$-478
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-09-30$0
Value of total assets at end of year2014-09-30$2,114,697
Value of total assets at beginning of year2014-09-30$2,281,297
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-09-30$4,497
Total interest from all sources2014-09-30$31,080
Total dividends received (eg from common stock, registered investment company shares)2014-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-09-30No
Was this plan covered by a fidelity bond2014-09-30Yes
Value of fidelity bond cover2014-09-30$10,000,000
If this is an individual account plan, was there a blackout period2014-09-30No
Were there any nonexempt tranactions with any party-in-interest2014-09-30No
Participant contributions at end of year2014-09-30$2,141
Participant contributions at beginning of year2014-09-30$5,620
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-09-30No
Value of net income/loss2014-09-30$-166,600
Value of net assets at end of year (total assets less liabilities)2014-09-30$2,114,697
Value of net assets at beginning of year (total assets less liabilities)2014-09-30$2,281,297
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2014-09-30No
Were any leases to which the plan was party in default or uncollectible2014-09-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-09-30$1,242,858
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-09-30$1,342,331
Interest on participant loans2014-09-30$130
Interest earned on other investments2014-09-30$30,950
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-09-30$869,698
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-09-30$933,346
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-09-30$127,172
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-09-30No
Was there a failure to transmit to the plan any participant contributions2014-09-30No
Has the plan failed to provide any benefit when due under the plan2014-09-30No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-09-30$320,833
Contract administrator fees2014-09-30$4,497
Did the plan have assets held for investment2014-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-09-30Yes
Opinion of an independent qualified public accountant for this plan2014-09-30Disclaimer
Accountancy firm name2014-09-30ERNST & YOUNG LLP
Accountancy firm EIN2014-09-30346565596
2013 : GATEWAY REGIONAL HEALTH SYSTEM, INC. RETIREMENT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-09-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-09-30$0
Total income from all sources (including contributions)2013-09-30$232,752
Total loss/gain on sale of assets2013-09-30$0
Total of all expenses incurred2013-09-30$117,394
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-09-30$113,062
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-09-30$0
Value of total assets at end of year2013-09-30$2,281,297
Value of total assets at beginning of year2013-09-30$2,165,939
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-09-30$4,332
Total interest from all sources2013-09-30$31,815
Total dividends received (eg from common stock, registered investment company shares)2013-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-09-30No
Was this plan covered by a fidelity bond2013-09-30Yes
Value of fidelity bond cover2013-09-30$10,000,000
If this is an individual account plan, was there a blackout period2013-09-30No
Were there any nonexempt tranactions with any party-in-interest2013-09-30No
Participant contributions at end of year2013-09-30$5,620
Participant contributions at beginning of year2013-09-30$7,708
Administrative expenses (other) incurred2013-09-30$4,016
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-09-30No
Value of net income/loss2013-09-30$115,358
Value of net assets at end of year (total assets less liabilities)2013-09-30$2,281,297
Value of net assets at beginning of year (total assets less liabilities)2013-09-30$2,165,939
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2013-09-30No
Were any leases to which the plan was party in default or uncollectible2013-09-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-09-30$1,342,331
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-09-30$1,213,471
Interest on participant loans2013-09-30$192
Interest earned on other investments2013-09-30$31,623
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-09-30$933,346
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-09-30$944,760
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-09-30$200,937
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-09-30No
Was there a failure to transmit to the plan any participant contributions2013-09-30No
Has the plan failed to provide any benefit when due under the plan2013-09-30No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-09-30$113,062
Contract administrator fees2013-09-30$316
Did the plan have assets held for investment2013-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-09-30Yes
Opinion of an independent qualified public accountant for this plan2013-09-30Disclaimer
Accountancy firm name2013-09-30ERNST & YOUNG LLP
Accountancy firm EIN2013-09-30346565596
2012 : GATEWAY REGIONAL HEALTH SYSTEM, INC. RETIREMENT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-09-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-09-30$0
Total income from all sources (including contributions)2012-09-30$251,482
Total loss/gain on sale of assets2012-09-30$0
Total of all expenses incurred2012-09-30$222,237
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-09-30$218,238
Expenses. Certain deemed distributions of participant loans2012-09-30$-263
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-09-30$0
Value of total assets at end of year2012-09-30$2,165,939
Value of total assets at beginning of year2012-09-30$2,136,694
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-09-30$4,262
Total interest from all sources2012-09-30$33,241
Total dividends received (eg from common stock, registered investment company shares)2012-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-09-30No
Was this plan covered by a fidelity bond2012-09-30Yes
Value of fidelity bond cover2012-09-30$10,000,000
If this is an individual account plan, was there a blackout period2012-09-30No
Were there any nonexempt tranactions with any party-in-interest2012-09-30No
Participant contributions at end of year2012-09-30$7,708
Participant contributions at beginning of year2012-09-30$25,080
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-09-30No
Value of net income/loss2012-09-30$29,245
Value of net assets at end of year (total assets less liabilities)2012-09-30$2,165,939
Value of net assets at beginning of year (total assets less liabilities)2012-09-30$2,136,694
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2012-09-30No
Were any leases to which the plan was party in default or uncollectible2012-09-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-09-30$1,213,471
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-09-30$1,111,947
Interest on participant loans2012-09-30$405
Interest earned on other investments2012-09-30$32,836
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-09-30$944,760
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-09-30$999,667
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-09-30$218,241
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-09-30No
Was there a failure to transmit to the plan any participant contributions2012-09-30No
Has the plan failed to provide any benefit when due under the plan2012-09-30No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-09-30$218,238
Contract administrator fees2012-09-30$4,262
Did the plan have assets held for investment2012-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-09-30Yes
Opinion of an independent qualified public accountant for this plan2012-09-30Disclaimer
Accountancy firm name2012-09-30ERNST & YOUNG LLP
Accountancy firm EIN2012-09-30346565596
2011 : GATEWAY REGIONAL HEALTH SYSTEM, INC. RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-09-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-09-30$0
Total income from all sources (including contributions)2011-09-30$26,382
Total loss/gain on sale of assets2011-09-30$0
Total of all expenses incurred2011-09-30$294,606
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-09-30$289,337
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-09-30$0
Value of total assets at end of year2011-09-30$2,136,694
Value of total assets at beginning of year2011-09-30$2,404,918
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-09-30$5,269
Total interest from all sources2011-09-30$37,957
Total dividends received (eg from common stock, registered investment company shares)2011-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-09-30No
Was this plan covered by a fidelity bond2011-09-30Yes
Value of fidelity bond cover2011-09-30$10,000,000
If this is an individual account plan, was there a blackout period2011-09-30No
Were there any nonexempt tranactions with any party-in-interest2011-09-30No
Participant contributions at end of year2011-09-30$25,080
Participant contributions at beginning of year2011-09-30$37,823
Administrative expenses (other) incurred2011-09-30$56
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-09-30No
Value of net income/loss2011-09-30$-268,224
Value of net assets at end of year (total assets less liabilities)2011-09-30$2,136,694
Value of net assets at beginning of year (total assets less liabilities)2011-09-30$2,404,918
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2011-09-30No
Were any leases to which the plan was party in default or uncollectible2011-09-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-09-30$1,111,947
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-09-30$1,289,381
Interest on participant loans2011-09-30$927
Interest earned on other investments2011-09-30$37,030
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-09-30$999,667
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-09-30$1,077,714
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-09-30$-11,575
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-09-30No
Was there a failure to transmit to the plan any participant contributions2011-09-30No
Has the plan failed to provide any benefit when due under the plan2011-09-30No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-09-30$289,337
Contract administrator fees2011-09-30$5,213
Did the plan have assets held for investment2011-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-09-30Yes
Opinion of an independent qualified public accountant for this plan2011-09-30Disclaimer
Accountancy firm name2011-09-30ERNST & YOUNG LLP
Accountancy firm EIN2011-09-30346565596

Form 5500 Responses for GATEWAY REGIONAL HEALTH SYSTEM, INC. RETIREMENT PLAN

2013: GATEWAY REGIONAL HEALTH SYSTEM, INC. RETIREMENT PLAN 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Submission has been amendedNo
2013-10-01This submission is the final filingNo
2013-10-01This return/report is a short plan year return/report (less than 12 months)No
2013-10-01Plan is a collectively bargained planNo
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan benefit arrangement – InsuranceYes
2012: GATEWAY REGIONAL HEALTH SYSTEM, INC. RETIREMENT PLAN 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Submission has been amendedNo
2012-10-01This submission is the final filingNo
2012-10-01This return/report is a short plan year return/report (less than 12 months)No
2012-10-01Plan is a collectively bargained planNo
2012-10-01Plan funding arrangement – InsuranceYes
2012-10-01Plan benefit arrangement – InsuranceYes
2011: GATEWAY REGIONAL HEALTH SYSTEM, INC. RETIREMENT PLAN 2011 form 5500 responses
2011-10-01Type of plan entitySingle employer plan
2011-10-01Submission has been amendedNo
2011-10-01This submission is the final filingNo
2011-10-01This return/report is a short plan year return/report (less than 12 months)No
2011-10-01Plan is a collectively bargained planNo
2011-10-01Plan funding arrangement – InsuranceYes
2011-10-01Plan benefit arrangement – InsuranceYes
2009: GATEWAY REGIONAL HEALTH SYSTEM, INC. RETIREMENT PLAN 2009 form 5500 responses
2009-10-01Type of plan entitySingle employer plan
2009-10-01Submission has been amendedNo
2009-10-01This submission is the final filingNo
2009-10-01This return/report is a short plan year return/report (less than 12 months)No
2009-10-01Plan is a collectively bargained planNo
2009-10-01Plan funding arrangement – InsuranceYes
2009-10-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number43808
Policy instance 1
Insurance contract or identification number43808
Number of Individuals Covered90
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Total amount of commissions paid to insurance brokerUSD $872
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 Administration1
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?No
Commission paid to Insurance BrokerUSD $566
Insurance broker organization code?3
Insurance broker nameMARTYN, JACK E
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number43808
Policy instance 1
Insurance contract or identification number43808
Number of Individuals Covered114
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Total amount of commissions paid to insurance brokerUSD $864
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 Administration1
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?No
Commission paid to Insurance BrokerUSD $585
Insurance broker organization code?3
Insurance broker nameMARTYN, JACK E
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number43808
Policy instance 1
Insurance contract or identification number43808
Number of Individuals Covered121
Insurance policy start date2011-10-01
Insurance policy end date2012-09-30
Total amount of commissions paid to insurance brokerUSD $949
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 Administration1
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?No
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number43808
Policy instance 1
Insurance contract or identification number43808
Number of Individuals Covered130
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Total amount of commissions paid to insurance brokerUSD $846
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 Administration1
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?No

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