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ANKOD, INC. 401(K) PLAN 401k Plan overview

Plan NameANKOD, INC. 401(K) PLAN
Plan identification number 001

ANKOD, INC. 401(K) 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

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

Company Name:ANKOD, INC.
Employer identification number (EIN):650967246
NAIC Classification:621610
NAIC Description:Home Health Care Services

Additional information about ANKOD, INC.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations
Incorporation Date: 1999-12-01
Company Identification Number: P99000105124
Legal Registered Office Address: 4960 N. PINE ISLAND ROAD

LAUDERHILL

33351

More information about ANKOD, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ANKOD, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012015-01-01NEOLA OCCENAD NEOLA OCCENAD2015-10-20
0012014-01-01NEOLA OCCENAD
0012013-01-01NEOLA OCCENAD
0012012-01-01NEOLA OCCENAD
0012011-01-01NEOLA OCCENAD
0012010-01-01NEOLA OCCENAD
0012009-01-01MARGARETTE OCCENAD

Plan Statistics for ANKOD, INC. 401(K) PLAN

401k plan membership statisitcs for ANKOD, INC. 401(K) PLAN

Measure Date Value
2015: ANKOD, INC. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-017
Total number of active participants reported on line 7a of the Form 55002015-01-010
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-010
Number of participants with account balances2015-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: ANKOD, INC. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-017
Total number of active participants reported on line 7a of the Form 55002014-01-017
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-017
Number of participants with account balances2014-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: ANKOD, INC. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0110
Total number of active participants reported on line 7a of the Form 55002013-01-017
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-012
Total of all active and inactive participants2013-01-019
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-019
Number of participants with account balances2013-01-019
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: ANKOD, INC. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-019
Total number of active participants reported on line 7a of the Form 55002012-01-0110
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-0110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0110
Number of participants with account balances2012-01-0110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: ANKOD, INC. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-019
Total number of active participants reported on line 7a of the Form 55002011-01-019
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-019
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-019
Number of participants with account balances2011-01-019
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: ANKOD, INC. 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-017
Total number of active participants reported on line 7a of the Form 55002010-01-019
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-019
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-019
Number of participants with account balances2010-01-019
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: ANKOD, INC. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0110
Total number of active participants reported on line 7a of the Form 55002009-01-017
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 participants2009-01-018
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-018
Number of participants with account balances2009-01-018
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-011

Financial Data on ANKOD, INC. 401(K) PLAN

Measure Date Value
2015 : ANKOD, INC. 401(K) PLAN 2015 401k financial data
Total plan liabilities at end of year2015-04-30$0
Total income from all sources2015-04-30$29,137
Expenses. Total of all expenses incurred2015-04-30$306,018
Benefits paid (including direct rollovers)2015-04-30$306,018
Total plan assets at end of year2015-04-30$0
Total plan assets at beginning of year2015-04-30$276,881
Value of fidelity bond covering the plan2015-04-30$5,000
Total contributions received or receivable from participants2015-04-30$14,521
Expenses. Other expenses not covered elsewhere2015-04-30$0
Contributions received from other sources (not participants or employers)2015-04-30$0
Other income received2015-04-30$14,616
Net income (gross income less expenses)2015-04-30$-276,881
Net plan assets at end of year (total assets less liabilities)2015-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2015-04-30$276,881
Assets. Value of participant loans2015-04-30$0
Total contributions received or receivable from employer(s)2015-04-30$0
Value of certain deemed distributions of participant loans2015-04-30$0
Value of corrective distributions2015-04-30$0
Funding deficiency by the employer to the plan for this plan year2015-04-30$0
Minimum employer required contribution for this plan year2015-04-30$0
Amount contributed by the employer to the plan for this plan year2015-04-30$0
2014 : ANKOD, INC. 401(K) PLAN 2014 401k financial data
Transfers to/from the plan2014-12-31$536
Total income from all sources2014-12-31$26,811
Expenses. Total of all expenses incurred2014-12-31$35,929
Benefits paid (including direct rollovers)2014-12-31$35,741
Total plan assets at end of year2014-12-31$276,881
Total plan assets at beginning of year2014-12-31$285,463
Value of fidelity bond covering the plan2014-12-31$5,000
Total contributions received or receivable from participants2014-12-31$6,456
Expenses. Other expenses not covered elsewhere2014-12-31$188
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$17,110
Net income (gross income less expenses)2014-12-31$-9,118
Net plan assets at end of year (total assets less liabilities)2014-12-31$276,881
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$285,463
Assets. Value of participant loans2014-12-31$0
Total contributions received or receivable from employer(s)2014-12-31$3,245
Value of certain deemed distributions of participant loans2014-12-31$0
Value of corrective distributions2014-12-31$0
Funding deficiency by the employer to the plan for this plan year2014-12-31$0
Minimum employer required contribution for this plan year2014-12-31$0
Amount contributed by the employer to the plan for this plan year2014-12-31$0
2013 : ANKOD, INC. 401(K) PLAN 2013 401k financial data
Transfers to/from the plan2013-12-31$0
Total income from all sources2013-12-31$52,839
Expenses. Total of all expenses incurred2013-12-31$9,456
Benefits paid (including direct rollovers)2013-12-31$9,218
Total plan assets at end of year2013-12-31$285,463
Total plan assets at beginning of year2013-12-31$242,080
Value of fidelity bond covering the plan2013-12-31$5,000
Total contributions received or receivable from participants2013-12-31$15,999
Expenses. Other expenses not covered elsewhere2013-12-31$238
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$28,812
Net income (gross income less expenses)2013-12-31$43,383
Net plan assets at end of year (total assets less liabilities)2013-12-31$285,463
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$242,080
Assets. Value of participant loans2013-12-31$0
Total contributions received or receivable from employer(s)2013-12-31$8,028
Value of certain deemed distributions of participant loans2013-12-31$0
Value of corrective distributions2013-12-31$0
Funding deficiency by the employer to the plan for this plan year2013-12-31$0
Minimum employer required contribution for this plan year2013-12-31$0
Amount contributed by the employer to the plan for this plan year2013-12-31$0
2012 : ANKOD, INC. 401(K) PLAN 2012 401k financial data
Transfers to/from the plan2012-12-31$0
Total income from all sources2012-12-31$86,079
Expenses. Total of all expenses incurred2012-12-31$1,893
Benefits paid (including direct rollovers)2012-12-31$0
Total plan assets at end of year2012-12-31$242,080
Total plan assets at beginning of year2012-12-31$157,894
Value of fidelity bond covering the plan2012-12-31$5,000
Total contributions received or receivable from participants2012-12-31$42,503
Expenses. Other expenses not covered elsewhere2012-12-31$238
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$21,452
Net income (gross income less expenses)2012-12-31$84,186
Net plan assets at end of year (total assets less liabilities)2012-12-31$242,080
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$157,894
Assets. Value of participant loans2012-12-31$0
Total contributions received or receivable from employer(s)2012-12-31$22,124
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$1,655
Funding deficiency by the employer to the plan for this plan year2012-12-31$0
Minimum employer required contribution for this plan year2012-12-31$0
Amount contributed by the employer to the plan for this plan year2012-12-31$0
2011 : ANKOD, INC. 401(K) PLAN 2011 401k financial data
Transfers to/from the plan2011-12-31$0
Total income from all sources2011-12-31$59,369
Expenses. Total of all expenses incurred2011-12-31$3,376
Benefits paid (including direct rollovers)2011-12-31$3,151
Total plan assets at end of year2011-12-31$157,894
Total plan assets at beginning of year2011-12-31$101,901
Value of fidelity bond covering the plan2011-12-31$5,000
Total contributions received or receivable from participants2011-12-31$40,249
Expenses. Other expenses not covered elsewhere2011-12-31$225
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-2,333
Net income (gross income less expenses)2011-12-31$55,993
Net plan assets at end of year (total assets less liabilities)2011-12-31$157,894
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$101,901
Assets. Value of participant loans2011-12-31$0
Total contributions received or receivable from employer(s)2011-12-31$21,453
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$0
Funding deficiency by the employer to the plan for this plan year2011-12-31$0
Minimum employer required contribution for this plan year2011-12-31$0
Amount contributed by the employer to the plan for this plan year2011-12-31$0
2010 : ANKOD, INC. 401(K) PLAN 2010 401k financial data
Transfers to/from the plan2010-12-31$0
Total income from all sources2010-12-31$57,083
Expenses. Total of all expenses incurred2010-12-31$1,706
Benefits paid (including direct rollovers)2010-12-31$1,475
Total plan assets at end of year2010-12-31$101,901
Total plan assets at beginning of year2010-12-31$46,524
Value of fidelity bond covering the plan2010-12-31$5,000
Total contributions received or receivable from participants2010-12-31$31,666
Expenses. Other expenses not covered elsewhere2010-12-31$231
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$7,191
Net income (gross income less expenses)2010-12-31$55,377
Net plan assets at end of year (total assets less liabilities)2010-12-31$101,901
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$46,524
Assets. Value of participant loans2010-12-31$0
Total contributions received or receivable from employer(s)2010-12-31$18,226
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$0
Funding deficiency by the employer to the plan for this plan year2010-12-31$0
Minimum employer required contribution for this plan year2010-12-31$0
Amount contributed by the employer to the plan for this plan year2010-12-31$0
2009 : ANKOD, INC. 401(K) PLAN 2009 401k financial data
Funding deficiency by the employer to the plan for this plan year2009-12-31$0
Minimum employer required contribution for this plan year2009-12-31$0
Amount contributed by the employer to the plan for this plan year2009-12-31$0

Form 5500 Responses for ANKOD, INC. 401(K) PLAN

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

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-810283
Policy instance 1
Insurance contract or identification numberGA-810283
Number of Individuals Covered0
Insurance policy start date2015-01-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $562
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 $562
Insurance broker organization code?3
Insurance broker namePARKLAND SECURITIES, LLC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-810283
Policy instance 1
Insurance contract or identification numberGA-810283
Number of Individuals Covered7
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,109
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,109
Insurance broker organization code?3
Insurance broker namePARKLAND SECURITIES, LLC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-810283
Policy instance 1
Insurance contract or identification numberGA-810283
Number of Individuals Covered9
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,004
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,004
Insurance broker organization code?3
Insurance broker nameSAMMONS SECURITIES
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-810283
Policy instance 1
Insurance contract or identification numberGA-810283
Number of Individuals Covered10
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $713
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 $505
Insurance broker organization code?3
Insurance broker nameSAMMONS SECURITIES
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-810283
Policy instance 1
Insurance contract or identification numberGA-810283
Number of Individuals Covered9
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $469
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-810283
Policy instance 1
Insurance contract or identification numberGA-810283
Number of Individuals Covered9
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $230
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 $230
Insurance broker organization code?3
Insurance broker nameWOODBURY FINANCIAL SVCS INC

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