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MALLETTE BROTHERS EMPLOYEE PROFIT SHARING PLAN 401k Plan overview

Plan NameMALLETTE BROTHERS EMPLOYEE PROFIT SHARING PLAN
Plan identification number 001

MALLETTE BROTHERS EMPLOYEE PROFIT SHARING 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.
  • 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

MALLETTE BROTHERS CONSTRUCTION has sponsored the creation of one or more 401k plans.

Company Name:MALLETTE BROTHERS CONSTRUCTION
Employer identification number (EIN):640473970
NAIC Classification:238100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MALLETTE BROTHERS EMPLOYEE PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012021-07-01CASSIE FORSHEE2022-07-26
0012020-07-01GLYNN MALLETTE2021-11-10
0012019-07-01GLYNN MALLETTE2020-11-23 GLYNN MALLETTE2020-11-23
0012018-07-01GLYNN MALLETTE2019-12-06 GLYNN MALLETTE2019-12-06
0012017-07-01GLYNN MALLETTE2018-11-28 GLYNN MALLETTE2018-11-28
0012016-07-01GLYNN MALLETTE2017-11-07 GLYNN MALLETTE2017-11-07
0012015-07-01GLYNN MALLETTE2016-11-02 GLYNN MALLETTE2016-11-02
0012014-07-01GLYNN MALLETTE GLYNN MALLETTE2015-11-11
0012013-07-01GLYNN MALLETTE GLYNN MALLETTE2014-11-24
0012012-07-01GLYNN MALLETTE GLYNN MALLETTE2013-12-19
0012011-07-01GLYNN MALLETTE
0012010-07-01GLYNN MALLETTE
0012009-07-01GLYNN MALLETTE

Plan Statistics for MALLETTE BROTHERS EMPLOYEE PROFIT SHARING PLAN

401k plan membership statisitcs for MALLETTE BROTHERS EMPLOYEE PROFIT SHARING PLAN

Measure Date Value
2014: MALLETTE BROTHERS EMPLOYEE PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-0147
Total number of active participants reported on line 7a of the Form 55002014-07-0140
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-017
Total of all active and inactive participants2014-07-0147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-07-011
Total participants2014-07-0148
Number of participants with account balances2014-07-0141
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-07-010
2013: MALLETTE BROTHERS EMPLOYEE PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-0150
Total number of active participants reported on line 7a of the Form 55002013-07-0136
Number of retired or separated participants receiving benefits2013-07-010
Number of other retired or separated participants entitled to future benefits2013-07-018
Total of all active and inactive participants2013-07-0144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-07-010
Total participants2013-07-0144
Number of participants with account balances2013-07-0121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-07-010
2012: MALLETTE BROTHERS EMPLOYEE PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-07-0149
Total number of active participants reported on line 7a of the Form 55002012-07-0143
Number of retired or separated participants receiving benefits2012-07-010
Number of other retired or separated participants entitled to future benefits2012-07-0110
Total of all active and inactive participants2012-07-0153
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-07-010
Total participants2012-07-0153
Number of participants with account balances2012-07-0143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-07-012
2011: MALLETTE BROTHERS EMPLOYEE PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-07-0153
Total number of active participants reported on line 7a of the Form 55002011-07-0141
Number of retired or separated participants receiving benefits2011-07-010
Number of other retired or separated participants entitled to future benefits2011-07-0110
Total of all active and inactive participants2011-07-0151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-07-010
Total participants2011-07-0151
Number of participants with account balances2011-07-0141
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-07-012
2010: MALLETTE BROTHERS EMPLOYEE PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year2010-07-0147
Total number of active participants reported on line 7a of the Form 55002010-07-0136
Number of retired or separated participants receiving benefits2010-07-010
Number of other retired or separated participants entitled to future benefits2010-07-010
Total of all active and inactive participants2010-07-0136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-07-010
Total participants2010-07-0136
Number of participants with account balances2010-07-0124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-07-010
2009: MALLETTE BROTHERS EMPLOYEE PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-07-0143
Total number of active participants reported on line 7a of the Form 55002009-07-0132
Number of retired or separated participants receiving benefits2009-07-010
Number of other retired or separated participants entitled to future benefits2009-07-0111
Total of all active and inactive participants2009-07-0143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-07-010
Total participants2009-07-0143
Number of participants with account balances2009-07-0125
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-07-010

Financial Data on MALLETTE BROTHERS EMPLOYEE PROFIT SHARING PLAN

Measure Date Value
2015 : MALLETTE BROTHERS EMPLOYEE PROFIT SHARING PLAN 2015 401k financial data
Transfers to/from the plan2015-06-30$0
Total income from all sources2015-06-30$3,753
Expenses. Total of all expenses incurred2015-06-30$2,534
Benefits paid (including direct rollovers)2015-06-30$2,534
Total plan assets at end of year2015-06-30$123,793
Total plan assets at beginning of year2015-06-30$122,574
Value of fidelity bond covering the plan2015-06-30$250,000
Total contributions received or receivable from participants2015-06-30$0
Expenses. Other expenses not covered elsewhere2015-06-30$0
Contributions received from other sources (not participants or employers)2015-06-30$0
Other income received2015-06-30$3,753
Net income (gross income less expenses)2015-06-30$1,219
Net plan assets at end of year (total assets less liabilities)2015-06-30$123,793
Net plan assets at beginning of year (total assets less liabilities)2015-06-30$122,574
Assets. Value of participant loans2015-06-30$0
Total contributions received or receivable from employer(s)2015-06-30$0
Value of certain deemed distributions of participant loans2015-06-30$0
Value of corrective distributions2015-06-30$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-06-30$0
Funding deficiency by the employer to the plan for this plan year2015-06-30$0
Minimum employer required contribution for this plan year2015-06-30$0
Amount contributed by the employer to the plan for this plan year2015-06-30$0
2014 : MALLETTE BROTHERS EMPLOYEE PROFIT SHARING PLAN 2014 401k financial data
Transfers to/from the plan2014-06-30$0
Total income from all sources2014-06-30$19,278
Expenses. Total of all expenses incurred2014-06-30$2,842
Benefits paid (including direct rollovers)2014-06-30$2,842
Total plan assets at end of year2014-06-30$122,574
Total plan assets at beginning of year2014-06-30$106,138
Value of fidelity bond covering the plan2014-06-30$250,000
Total contributions received or receivable from participants2014-06-30$0
Expenses. Other expenses not covered elsewhere2014-06-30$0
Contributions received from other sources (not participants or employers)2014-06-30$0
Other income received2014-06-30$19,278
Net income (gross income less expenses)2014-06-30$16,436
Net plan assets at end of year (total assets less liabilities)2014-06-30$122,574
Net plan assets at beginning of year (total assets less liabilities)2014-06-30$106,138
Assets. Value of participant loans2014-06-30$0
Total contributions received or receivable from employer(s)2014-06-30$0
Value of certain deemed distributions of participant loans2014-06-30$0
Value of corrective distributions2014-06-30$0
Funding deficiency by the employer to the plan for this plan year2014-06-30$0
Minimum employer required contribution for this plan year2014-06-30$0
Amount contributed by the employer to the plan for this plan year2014-06-30$0
2013 : MALLETTE BROTHERS EMPLOYEE PROFIT SHARING PLAN 2013 401k financial data
Transfers to/from the plan2013-06-30$0
Total income from all sources2013-06-30$14,318
Expenses. Total of all expenses incurred2013-06-30$3,023
Benefits paid (including direct rollovers)2013-06-30$3,023
Total plan assets at end of year2013-06-30$106,138
Total plan assets at beginning of year2013-06-30$94,843
Value of fidelity bond covering the plan2013-06-30$250,000
Total contributions received or receivable from participants2013-06-30$0
Expenses. Other expenses not covered elsewhere2013-06-30$0
Contributions received from other sources (not participants or employers)2013-06-30$0
Other income received2013-06-30$14,318
Net income (gross income less expenses)2013-06-30$11,295
Net plan assets at end of year (total assets less liabilities)2013-06-30$106,138
Net plan assets at beginning of year (total assets less liabilities)2013-06-30$94,843
Assets. Value of participant loans2013-06-30$0
Total contributions received or receivable from employer(s)2013-06-30$0
Value of certain deemed distributions of participant loans2013-06-30$0
Value of corrective distributions2013-06-30$0
Funding deficiency by the employer to the plan for this plan year2013-06-30$0
Minimum employer required contribution for this plan year2013-06-30$0
Amount contributed by the employer to the plan for this plan year2013-06-30$0
2012 : MALLETTE BROTHERS EMPLOYEE PROFIT SHARING PLAN 2012 401k financial data
Transfers to/from the plan2012-06-30$0
Total income from all sources2012-06-30$1,277
Expenses. Total of all expenses incurred2012-06-30$3,444
Benefits paid (including direct rollovers)2012-06-30$3,444
Total plan assets at end of year2012-06-30$94,843
Total plan assets at beginning of year2012-06-30$97,010
Value of fidelity bond covering the plan2012-06-30$250,000
Total contributions received or receivable from participants2012-06-30$0
Expenses. Other expenses not covered elsewhere2012-06-30$0
Contributions received from other sources (not participants or employers)2012-06-30$0
Other income received2012-06-30$1,277
Net income (gross income less expenses)2012-06-30$-2,167
Net plan assets at end of year (total assets less liabilities)2012-06-30$94,843
Net plan assets at beginning of year (total assets less liabilities)2012-06-30$97,010
Assets. Value of participant loans2012-06-30$0
Total contributions received or receivable from employer(s)2012-06-30$0
Value of certain deemed distributions of participant loans2012-06-30$0
Value of corrective distributions2012-06-30$0
Funding deficiency by the employer to the plan for this plan year2012-06-30$0
Minimum employer required contribution for this plan year2012-06-30$0
Amount contributed by the employer to the plan for this plan year2012-06-30$0
2011 : MALLETTE BROTHERS EMPLOYEE PROFIT SHARING PLAN 2011 401k financial data
Transfers to/from the plan2011-06-30$0
Total income from all sources2011-06-30$17,350
Expenses. Total of all expenses incurred2011-06-30$2,681
Benefits paid (including direct rollovers)2011-06-30$2,681
Total plan assets at end of year2011-06-30$97,010
Total plan assets at beginning of year2011-06-30$82,341
Value of fidelity bond covering the plan2011-06-30$250,000
Total contributions received or receivable from participants2011-06-30$0
Expenses. Other expenses not covered elsewhere2011-06-30$0
Contributions received from other sources (not participants or employers)2011-06-30$0
Other income received2011-06-30$17,350
Net income (gross income less expenses)2011-06-30$14,669
Net plan assets at end of year (total assets less liabilities)2011-06-30$97,010
Net plan assets at beginning of year (total assets less liabilities)2011-06-30$82,341
Assets. Value of participant loans2011-06-30$0
Total contributions received or receivable from employer(s)2011-06-30$0
Value of certain deemed distributions of participant loans2011-06-30$0
Value of corrective distributions2011-06-30$0
Funding deficiency by the employer to the plan for this plan year2011-06-30$0
Minimum employer required contribution for this plan year2011-06-30$0
Amount contributed by the employer to the plan for this plan year2011-06-30$0
2010 : MALLETTE BROTHERS EMPLOYEE PROFIT SHARING PLAN 2010 401k financial data
Transfers to/from the plan2010-06-30$0
Total income from all sources2010-06-30$7,475
Expenses. Total of all expenses incurred2010-06-30$0
Benefits paid (including direct rollovers)2010-06-30$0
Total plan assets at end of year2010-06-30$82,341
Total plan assets at beginning of year2010-06-30$74,866
Value of fidelity bond covering the plan2010-06-30$250,000
Total contributions received or receivable from participants2010-06-30$0
Expenses. Other expenses not covered elsewhere2010-06-30$0
Contributions received from other sources (not participants or employers)2010-06-30$0
Other income received2010-06-30$7,475
Net income (gross income less expenses)2010-06-30$7,475
Net plan assets at end of year (total assets less liabilities)2010-06-30$82,341
Net plan assets at beginning of year (total assets less liabilities)2010-06-30$74,866
Assets. Value of participant loans2010-06-30$0
Total contributions received or receivable from employer(s)2010-06-30$0
Value of certain deemed distributions of participant loans2010-06-30$0
Value of corrective distributions2010-06-30$0

Form 5500 Responses for MALLETTE BROTHERS EMPLOYEE PROFIT SHARING PLAN

2014: MALLETTE BROTHERS EMPLOYEE PROFIT SHARING PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan funding arrangement – TrustYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: MALLETTE BROTHERS EMPLOYEE PROFIT SHARING PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan funding arrangement – TrustYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: MALLETTE BROTHERS EMPLOYEE PROFIT SHARING PLAN 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan funding arrangement – TrustYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: MALLETTE BROTHERS EMPLOYEE PROFIT SHARING PLAN 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan funding arrangement – TrustYes
2011-07-01Plan benefit arrangement – InsuranceYes
2010: MALLETTE BROTHERS EMPLOYEE PROFIT SHARING PLAN 2010 form 5500 responses
2010-07-01Type of plan entitySingle employer plan
2010-07-01Submission has been amendedNo
2010-07-01This submission is the final filingNo
2010-07-01This return/report is a short plan year return/report (less than 12 months)No
2010-07-01Plan is a collectively bargained planNo
2010-07-01Plan funding arrangement – InsuranceYes
2010-07-01Plan funding arrangement – TrustYes
2010-07-01Plan benefit arrangement – InsuranceYes
2009: MALLETTE BROTHERS EMPLOYEE PROFIT SHARING PLAN 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan funding arrangement – TrustYes
2009-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-007830
Policy instance 1
Insurance contract or identification numberGA-007830
Number of Individuals Covered41
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $490
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $490
Insurance broker organization code?3
Insurance broker nameLPL FINANCIAL CORPORATION
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-007830
Policy instance 1
Insurance contract or identification numberGA-007830
Number of Individuals Covered21
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $448
Total amount of fees paid to insurance companyUSD $19
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $448
Insurance broker organization code?3
Amount paid for insurance broker fees19
Additional information about fees paid to insurance brokerSALES/MARKETING
Insurance broker nameLPL FINANCIAL CORPORATION
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-007830
Policy instance 1
Insurance contract or identification numberGA-007830
Number of Individuals Covered43
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $394
Total amount of fees paid to insurance companyUSD $67
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $394
Insurance broker organization code?3
Amount paid for insurance broker fees67
Additional information about fees paid to insurance brokerSALES/MARKETING
Insurance broker nameLPL FINANCIAL LLC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-007830
Policy instance 1
Insurance contract or identification numberGA-007830
Number of Individuals Covered41
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $374
Total amount of fees paid to insurance companyUSD $42
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-007830
Policy instance 1
Insurance contract or identification numberGA-007830
Number of Individuals Covered24
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $360
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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