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FAMILY ALLERGY AND ASTHMA SAFE HARBOR 401K PLAN 401k Plan overview

Plan NameFAMILY ALLERGY AND ASTHMA SAFE HARBOR 401K PLAN
Plan identification number 001

FAMILY ALLERGY AND ASTHMA SAFE HARBOR 401K PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Plan covering Self-Employed individuals.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

PSF, PLLC D/B/A FAMILY ALLERGY AND ASTHMA has sponsored the creation of one or more 401k plans.

Company Name:PSF, PLLC D/B/A FAMILY ALLERGY AND ASTHMA
Employer identification number (EIN):611389493
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FAMILY ALLERGY AND ASTHMA SAFE HARBOR 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012017-01-01KAY TYLER
0012016-01-01JAMES L. SUBLETT
0012015-01-01JAMES SUBLETT
0012014-01-01JAMES SUBLETT
0012013-01-01JAMES SUBLETT2014-06-24
0012012-01-01JAMES SUBLETT2013-07-17
0012011-01-01JAMES SUBLETT2012-03-16
0012010-01-01JAMES SUBLETT2011-09-01

Plan Statistics for FAMILY ALLERGY AND ASTHMA SAFE HARBOR 401K PLAN

401k plan membership statisitcs for FAMILY ALLERGY AND ASTHMA SAFE HARBOR 401K PLAN

Measure Date Value
2017: FAMILY ALLERGY AND ASTHMA SAFE HARBOR 401K PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01153
Total number of active participants reported on line 7a of the Form 55002017-01-01138
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0131
Total of all active and inactive participants2017-01-01169
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01169
Number of participants with account balances2017-01-01163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-016
2016: FAMILY ALLERGY AND ASTHMA SAFE HARBOR 401K PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01147
Total number of active participants reported on line 7a of the Form 55002016-01-01134
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0118
Total of all active and inactive participants2016-01-01152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-011
Total participants2016-01-01153
Number of participants with account balances2016-01-01143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-012
2015: FAMILY ALLERGY AND ASTHMA SAFE HARBOR 401K PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01140
Total number of active participants reported on line 7a of the Form 55002015-01-01118
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0124
Total of all active and inactive participants2015-01-01142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01142
Number of participants with account balances2015-01-01141
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-0112
2014: FAMILY ALLERGY AND ASTHMA SAFE HARBOR 401K PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01128
Total number of active participants reported on line 7a of the Form 55002014-01-01112
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0120
Total of all active and inactive participants2014-01-01132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01132
Number of participants with account balances2014-01-01132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-0111

Financial Data on FAMILY ALLERGY AND ASTHMA SAFE HARBOR 401K PLAN

Measure Date Value
2017 : FAMILY ALLERGY AND ASTHMA SAFE HARBOR 401K PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$1,866
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$2,141
Total income from all sources (including contributions)2017-12-31$4,369,364
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$534,425
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$502,020
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$2,089,121
Value of total assets at end of year2017-12-31$16,624,746
Value of total assets at beginning of year2017-12-31$12,790,082
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$32,405
Total interest from all sources2017-12-31$8,090
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$644,862
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$644,862
Administrative expenses professional fees incurred2017-12-31$9,100
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$699,893
Participant contributions at end of year2017-12-31$186,919
Participant contributions at beginning of year2017-12-31$157,798
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$190,908
Liabilities. Value of operating payables at end of year2017-12-31$1,866
Liabilities. Value of operating payables at beginning of year2017-12-31$2,141
Total non interest bearing cash at end of year2017-12-31$10,649
Total non interest bearing cash at beginning of year2017-12-31$2,141
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$3,834,939
Value of net assets at end of year (total assets less liabilities)2017-12-31$16,622,880
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$12,787,941
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Investment advisory and management fees2017-12-31$5,160
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$15,147,006
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$11,682,824
Interest on participant loans2017-12-31$8,090
Value of interest in common/collective trusts at end of year2017-12-31$465,414
Value of interest in common/collective trusts at beginning of year2017-12-31$241,330
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$1,620,775
Net investment gain or loss from common/collective trusts2017-12-31$6,516
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$1,198,320
Employer contributions (assets) at end of year2017-12-31$814,758
Employer contributions (assets) at beginning of year2017-12-31$705,989
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$502,020
Contract administrator fees2017-12-31$18,145
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31DEMING MALONE LIVESAY & OSTROFF
Accountancy firm EIN2017-12-31611064249
2016 : FAMILY ALLERGY AND ASTHMA SAFE HARBOR 401K PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$2,141
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total income from all sources (including contributions)2016-12-31$2,615,308
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$797,241
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$774,670
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$1,756,728
Value of total assets at end of year2016-12-31$12,790,082
Value of total assets at beginning of year2016-12-31$10,969,874
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$22,571
Total interest from all sources2016-12-31$9,228
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$230,337
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$230,337
Administrative expenses professional fees incurred2016-12-31$8,800
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$612,505
Participant contributions at end of year2016-12-31$157,798
Participant contributions at beginning of year2016-12-31$179,819
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$93,434
Liabilities. Value of operating payables at end of year2016-12-31$2,141
Liabilities. Value of operating payables at beginning of year2016-12-31$0
Total non interest bearing cash at end of year2016-12-31$2,141
Total non interest bearing cash at beginning of year2016-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$1,818,067
Value of net assets at end of year (total assets less liabilities)2016-12-31$12,787,941
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$10,969,874
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Investment advisory and management fees2016-12-31$4,928
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$11,682,824
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$10,133,085
Interest on participant loans2016-12-31$9,228
Value of interest in common/collective trusts at end of year2016-12-31$241,330
Value of interest in common/collective trusts at beginning of year2016-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$617,198
Net investment gain or loss from common/collective trusts2016-12-31$1,817
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$1,050,789
Employer contributions (assets) at end of year2016-12-31$705,989
Employer contributions (assets) at beginning of year2016-12-31$656,970
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$774,670
Contract administrator fees2016-12-31$8,843
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31Yes
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31DEMING MALONE LIVESAY & OSTROFF
Accountancy firm EIN2016-12-31611064249
2015 : FAMILY ALLERGY AND ASTHMA SAFE HARBOR 401K PLAN 2015 401k financial data
Total income from all sources (including contributions)2015-12-31$1,249,989
Total of all expenses incurred2015-12-31$551,587
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$541,604
Expenses. Certain deemed distributions of participant loans2015-12-31$1,554
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$1,515,752
Value of total assets at end of year2015-12-31$10,969,874
Value of total assets at beginning of year2015-12-31$10,271,472
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$8,429
Total interest from all sources2015-12-31$9,343
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$546,642
Participant contributions at end of year2015-12-31$179,819
Participant contributions at beginning of year2015-12-31$170,020
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$14,842
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$698,402
Value of net assets at end of year (total assets less liabilities)2015-12-31$10,969,874
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$10,271,472
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Investment advisory and management fees2015-12-31$8,429
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$10,133,085
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$9,507,387
Interest on participant loans2015-12-31$9,328
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$15
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-275,106
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$954,268
Employer contributions (assets) at end of year2015-12-31$656,970
Employer contributions (assets) at beginning of year2015-12-31$594,065
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$541,604
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31DEMING MALONE LIVESAY & OSTROFF
Accountancy firm EIN2015-12-31611064249
2014 : FAMILY ALLERGY AND ASTHMA SAFE HARBOR 401K PLAN 2014 401k financial data
Total income from all sources (including contributions)2014-12-31$1,866,638
Total of all expenses incurred2014-12-31$572,935
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$564,316
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$1,407,430
Value of total assets at end of year2014-12-31$10,271,472
Value of total assets at beginning of year2014-12-31$8,977,769
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$8,619
Total interest from all sources2014-12-31$7,508
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$523,298
Participant contributions at end of year2014-12-31$170,020
Participant contributions at beginning of year2014-12-31$133,670
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$2,489
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$1,293,703
Value of net assets at end of year (total assets less liabilities)2014-12-31$10,271,472
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$8,977,769
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Investment advisory and management fees2014-12-31$8,619
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$9,507,387
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$8,314,085
Interest on participant loans2014-12-31$7,478
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$30
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$451,700
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$881,643
Employer contributions (assets) at end of year2014-12-31$594,065
Employer contributions (assets) at beginning of year2014-12-31$530,014
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$564,316
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31DEMING MALONE LIVESAY & OSTROFF
Accountancy firm EIN2014-12-31611064249

Form 5500 Responses for FAMILY ALLERGY AND ASTHMA SAFE HARBOR 401K PLAN

2017: FAMILY ALLERGY AND ASTHMA SAFE HARBOR 401K PLAN 2017 form 5500 responses
2017-01-01Type of plan entityMulitple employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: FAMILY ALLERGY AND ASTHMA SAFE HARBOR 401K PLAN 2016 form 5500 responses
2016-01-01Type of plan entityMulitple employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: FAMILY ALLERGY AND ASTHMA SAFE HARBOR 401K PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: FAMILY ALLERGY AND ASTHMA SAFE HARBOR 401K PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-823685
Policy instance 1
Insurance contract or identification numberGA-823685
Number of Individuals Covered139
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $38,098
Total amount of fees paid to insurance companyUSD $0
Commission paid to Insurance BrokerUSD $33,336
Insurance broker organization code?3
Insurance broker nameMOUNTJOY CHILTON MEDLEY LLP
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-823685
Policy instance 1
Insurance contract or identification numberGA-823685
Number of Individuals Covered128
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $32,943
Total amount of fees paid to insurance companyUSD $0
Commission paid to Insurance BrokerUSD $28,825
Insurance broker organization code?3
Insurance broker nameMOUNTJOY CHILTON MEDLEY LLP

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