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ICM 403(B) PLAN 401k Plan overview

Plan NameICM 403(B) PLAN
Plan identification number 002

ICM 403(B) 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.
  • 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 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • 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

INDEPENDENT CASE MANAGEMENT, INC. has sponsored the creation of one or more 401k plans.

Company Name:INDEPENDENT CASE MANAGEMENT, INC.
Employer identification number (EIN):710666268
NAIC Classification:624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ICM 403(B) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022021-08-01
0022020-08-01
0022019-08-01
0022018-08-01
0022017-08-01
0022017-08-01
0022016-08-01CINDY ALBERDING
0022016-08-01
0022015-08-01CINDY ALBERDING
0022015-08-01
0022014-08-01CINDY ALBERDING
0022013-08-01CINDY ALBERDING
0022012-08-01CINDY ALBERDING
0022012-05-01CINDY ALBERDING CINDY ALBERDING2014-09-25
0022011-08-01CINDY ALBERDING2013-04-19

Plan Statistics for ICM 403(B) PLAN

401k plan membership statisitcs for ICM 403(B) PLAN

Measure Date Value
2021: ICM 403(B) PLAN 2021 401k membership
Total participants, beginning-of-year2021-08-0149
Total number of active participants reported on line 7a of the Form 55002021-08-010
Number of retired or separated participants receiving benefits2021-08-010
Number of other retired or separated participants entitled to future benefits2021-08-010
Total of all active and inactive participants2021-08-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-08-010
Total participants2021-08-010
Number of participants with account balances2021-08-010
2020: ICM 403(B) PLAN 2020 401k membership
Total participants, beginning-of-year2020-08-011
Total number of active participants reported on line 7a of the Form 55002020-08-010
Number of retired or separated participants receiving benefits2020-08-010
Number of other retired or separated participants entitled to future benefits2020-08-0149
Total of all active and inactive participants2020-08-0149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-08-010
Total participants2020-08-0149
Number of participants with account balances2020-08-0149
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-08-010
2019: ICM 403(B) PLAN 2019 401k membership
Total participants, beginning-of-year2019-08-0174
Total number of active participants reported on line 7a of the Form 55002019-08-011
Number of retired or separated participants receiving benefits2019-08-0110
Number of other retired or separated participants entitled to future benefits2019-08-0149
Total of all active and inactive participants2019-08-0160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-08-010
Total participants2019-08-0160
Number of participants with account balances2019-08-0160
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-08-010
2018: ICM 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year2018-08-0188
Total number of active participants reported on line 7a of the Form 55002018-08-0170
Number of retired or separated participants receiving benefits2018-08-010
Number of other retired or separated participants entitled to future benefits2018-08-014
Total of all active and inactive participants2018-08-0174
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-08-010
Total participants2018-08-0174
Number of participants with account balances2018-08-0174
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-08-010
2017: ICM 403(B) PLAN 2017 401k membership
Total participants, beginning-of-year2017-08-01197
Total number of active participants reported on line 7a of the Form 55002017-08-01147
Number of retired or separated participants receiving benefits2017-08-010
Number of other retired or separated participants entitled to future benefits2017-08-017
Total of all active and inactive participants2017-08-01154
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-08-013
Total participants2017-08-01157
Number of participants with account balances2017-08-0198
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-08-012
2016: ICM 403(B) PLAN 2016 401k membership
Total participants, beginning-of-year2016-08-01197
Total number of active participants reported on line 7a of the Form 55002016-08-01188
Number of retired or separated participants receiving benefits2016-08-010
Number of other retired or separated participants entitled to future benefits2016-08-0110
Total of all active and inactive participants2016-08-01198
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-08-012
Total participants2016-08-01200
Number of participants with account balances2016-08-01176
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-08-010
2015: ICM 403(B) PLAN 2015 401k membership
Total participants, beginning-of-year2015-08-01165
Total number of active participants reported on line 7a of the Form 55002015-08-01185
Number of retired or separated participants receiving benefits2015-08-010
Number of other retired or separated participants entitled to future benefits2015-08-0110
Total of all active and inactive participants2015-08-01195
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-08-010
Total participants2015-08-01195
Number of participants with account balances2015-08-01180
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-08-010
2014: ICM 403(B) PLAN 2014 401k membership
Total participants, beginning-of-year2014-08-01110
Total number of active participants reported on line 7a of the Form 55002014-08-01165
Number of retired or separated participants receiving benefits2014-08-010
Number of other retired or separated participants entitled to future benefits2014-08-019
Total of all active and inactive participants2014-08-01174
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-08-010
Total participants2014-08-01174
Number of participants with account balances2014-08-01163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-08-010
2013: ICM 403(B) PLAN 2013 401k membership
Total participants, beginning-of-year2013-08-01327
Total number of active participants reported on line 7a of the Form 55002013-08-01101
Number of retired or separated participants receiving benefits2013-08-010
Number of other retired or separated participants entitled to future benefits2013-08-017
Total of all active and inactive participants2013-08-01108
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-08-010
Total participants2013-08-01108
Number of participants with account balances2013-08-0198
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-08-010
2012: ICM 403(B) PLAN 2012 401k membership
Total participants, beginning-of-year2012-08-01327
Total number of active participants reported on line 7a of the Form 55002012-08-01386
Number of retired or separated participants receiving benefits2012-08-010
Number of other retired or separated participants entitled to future benefits2012-08-010
Total of all active and inactive participants2012-08-01386
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-08-010
Total participants2012-08-01386
Number of participants with account balances2012-08-0166
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-08-010
Total participants, beginning-of-year2012-05-01471
Total number of active participants reported on line 7a of the Form 55002012-05-01420
Number of other retired or separated participants entitled to future benefits2012-05-0129
Total of all active and inactive participants2012-05-01449
Total participants2012-05-01449
Number of participants with account balances2012-05-0148

Financial Data on ICM 403(B) PLAN

Measure Date Value
2022 : ICM 403(B) PLAN 2022 401k financial data
Expenses. Total of all expenses incurred2022-06-30$103,342
Benefits paid (including direct rollovers)2022-06-30$103,342
Total plan assets at end of year2022-06-30$0
Total plan assets at beginning of year2022-06-30$103,342
Value of fidelity bond covering the plan2022-06-30$250,000
Net income (gross income less expenses)2022-06-30$-103,342
Net plan assets at end of year (total assets less liabilities)2022-06-30$0
Net plan assets at beginning of year (total assets less liabilities)2022-06-30$103,342
2021 : ICM 403(B) PLAN 2021 401k financial data
Total income from all sources2021-07-31$20,648
Expenses. Total of all expenses incurred2021-07-31$18,141
Benefits paid (including direct rollovers)2021-07-31$17,060
Total plan assets at end of year2021-07-31$103,342
Total plan assets at beginning of year2021-07-31$100,835
Value of fidelity bond covering the plan2021-07-31$250,000
Expenses. Other expenses not covered elsewhere2021-07-31$1,081
Other income received2021-07-31$20,648
Net income (gross income less expenses)2021-07-31$2,507
Net plan assets at end of year (total assets less liabilities)2021-07-31$103,342
Net plan assets at beginning of year (total assets less liabilities)2021-07-31$100,835
Assets. Value of participant loans2021-07-31$1,562
2020 : ICM 403(B) PLAN 2020 401k financial data
Transfers to/from the plan2020-07-31$-3,646
Total income from all sources2020-07-31$15,269
Expenses. Total of all expenses incurred2020-07-31$148,302
Benefits paid (including direct rollovers)2020-07-31$146,886
Total plan assets at end of year2020-07-31$100,835
Total plan assets at beginning of year2020-07-31$237,514
Value of fidelity bond covering the plan2020-07-31$150,000
Expenses. Other expenses not covered elsewhere2020-07-31$1,416
Other income received2020-07-31$15,269
Net income (gross income less expenses)2020-07-31$-133,033
Net plan assets at end of year (total assets less liabilities)2020-07-31$100,835
Net plan assets at beginning of year (total assets less liabilities)2020-07-31$237,514
Assets. Value of participant loans2020-07-31$1,502
2019 : ICM 403(B) PLAN 2019 401k financial data
Total income from all sources2019-07-31$12,022
Expenses. Total of all expenses incurred2019-07-31$133,327
Benefits paid (including direct rollovers)2019-07-31$131,376
Total plan assets at end of year2019-07-31$237,514
Total plan assets at beginning of year2019-07-31$358,819
Value of fidelity bond covering the plan2019-07-31$150,000
Total contributions received or receivable from participants2019-07-31$2,241
Expenses. Other expenses not covered elsewhere2019-07-31$1,951
Other income received2019-07-31$7,805
Net income (gross income less expenses)2019-07-31$-121,305
Net plan assets at end of year (total assets less liabilities)2019-07-31$237,514
Net plan assets at beginning of year (total assets less liabilities)2019-07-31$358,819
Assets. Value of participant loans2019-07-31$1,425
Total contributions received or receivable from employer(s)2019-07-31$1,976
2018 : ICM 403(B) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-07-31$0
Total transfer of assets from this plan2018-07-31$1,171,746
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-07-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-07-31$0
Total income from all sources (including contributions)2018-07-31$291,932
Total loss/gain on sale of assets2018-07-31$0
Total of all expenses incurred2018-07-31$134,726
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-07-31$130,470
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-07-31$191,228
Value of total assets at end of year2018-07-31$358,819
Value of total assets at beginning of year2018-07-31$1,373,359
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-07-31$4,256
Total interest from all sources2018-07-31$2,311
Total dividends received (eg from common stock, registered investment company shares)2018-07-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-07-31No
Was this plan covered by a fidelity bond2018-07-31Yes
Value of fidelity bond cover2018-07-31$150,000
If this is an individual account plan, was there a blackout period2018-07-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-07-31$0
Were there any nonexempt tranactions with any party-in-interest2018-07-31No
Contributions received from participants2018-07-31$136,579
Participant contributions at end of year2018-07-31$2,261
Participant contributions at beginning of year2018-07-31$57,612
Income. Received or receivable in cash from other sources (including rollovers)2018-07-31$1,486
Other income not declared elsewhere2018-07-31$0
Administrative expenses (other) incurred2018-07-31$4,256
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-07-31No
Value of net income/loss2018-07-31$157,206
Value of net assets at end of year (total assets less liabilities)2018-07-31$358,819
Value of net assets at beginning of year (total assets less liabilities)2018-07-31$1,373,359
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-07-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-07-31No
Were any leases to which the plan was party in default or uncollectible2018-07-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-07-31$343,323
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-07-31$1,280,352
Interest on participant loans2018-07-31$1,309
Interest earned on other investments2018-07-31$1,002
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-07-31$13,235
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-07-31$35,395
Net investment gain/loss from pooled separate accounts2018-07-31$98,393
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-07-31No
Was there a failure to transmit to the plan any participant contributions2018-07-31Yes
Has the plan failed to provide any benefit when due under the plan2018-07-31No
Contributions received in cash from employer2018-07-31$53,163
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-07-31$130,470
Did the plan have assets held for investment2018-07-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-07-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-07-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-07-31Yes
Opinion of an independent qualified public accountant for this plan2018-07-31Disclaimer
Accountancy firm name2018-07-31HUDSON CISNE & CO. LLP
Accountancy firm EIN2018-07-31710650689
2017 : ICM 403(B) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-07-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-07-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-07-31$0
Total income from all sources (including contributions)2017-07-31$361,934
Total loss/gain on sale of assets2017-07-31$0
Total of all expenses incurred2017-07-31$190,988
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-07-31$185,970
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-07-31$223,658
Value of total assets at end of year2017-07-31$1,373,359
Value of total assets at beginning of year2017-07-31$1,202,413
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-07-31$5,018
Total interest from all sources2017-07-31$3,416
Total dividends received (eg from common stock, registered investment company shares)2017-07-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-07-31No
Was this plan covered by a fidelity bond2017-07-31Yes
Value of fidelity bond cover2017-07-31$150,000
If this is an individual account plan, was there a blackout period2017-07-31No
Were there any nonexempt tranactions with any party-in-interest2017-07-31No
Contributions received from participants2017-07-31$159,975
Participant contributions at end of year2017-07-31$57,612
Participant contributions at beginning of year2017-07-31$27,414
Administrative expenses (other) incurred2017-07-31$5,018
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-07-31No
Value of net income/loss2017-07-31$170,946
Value of net assets at end of year (total assets less liabilities)2017-07-31$1,373,359
Value of net assets at beginning of year (total assets less liabilities)2017-07-31$1,202,413
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-07-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-07-31No
Were any leases to which the plan was party in default or uncollectible2017-07-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-07-31$1,280,352
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-07-31$1,148,606
Income. Interest from loans (other than to participants)2017-07-31$2,525
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-07-31$891
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-07-31$35,395
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-07-31$26,393
Net investment gain/loss from pooled separate accounts2017-07-31$134,860
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-07-31No
Was there a failure to transmit to the plan any participant contributions2017-07-31No
Has the plan failed to provide any benefit when due under the plan2017-07-31No
Contributions received in cash from employer2017-07-31$63,683
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-07-31$185,970
Did the plan have assets held for investment2017-07-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-07-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-07-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-07-31Yes
Opinion of an independent qualified public accountant for this plan2017-07-31Disclaimer
Accountancy firm name2017-07-31HUDSON CISNE & CO. LLP
Accountancy firm EIN2017-07-31710650689
2016 : ICM 403(B) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-07-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-07-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-07-31$0
Total income from all sources (including contributions)2016-07-31$394,752
Total loss/gain on sale of assets2016-07-31$0
Total of all expenses incurred2016-07-31$84,500
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-07-31$80,040
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-07-31$369,032
Value of total assets at end of year2016-07-31$1,213,007
Value of total assets at beginning of year2016-07-31$902,755
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-07-31$4,460
Total interest from all sources2016-07-31$2,184
Total dividends received (eg from common stock, registered investment company shares)2016-07-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-07-31No
Was this plan covered by a fidelity bond2016-07-31Yes
Value of fidelity bond cover2016-07-31$50,000
If this is an individual account plan, was there a blackout period2016-07-31No
Were there any nonexempt tranactions with any party-in-interest2016-07-31No
Contributions received from participants2016-07-31$201,333
Participant contributions at end of year2016-07-31$38,008
Participant contributions at beginning of year2016-07-31$36,766
Income. Received or receivable in cash from other sources (including rollovers)2016-07-31$94,490
Administrative expenses (other) incurred2016-07-31$4,460
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-07-31No
Value of net income/loss2016-07-31$310,252
Value of net assets at end of year (total assets less liabilities)2016-07-31$1,213,007
Value of net assets at beginning of year (total assets less liabilities)2016-07-31$902,755
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-07-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-07-31No
Were any leases to which the plan was party in default or uncollectible2016-07-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-07-31$1,148,606
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-07-31$845,415
Interest on participant loans2016-07-31$1,493
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-07-31$691
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-07-31$26,393
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-07-31$20,574
Net investment gain/loss from pooled separate accounts2016-07-31$23,536
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-07-31No
Was there a failure to transmit to the plan any participant contributions2016-07-31No
Has the plan failed to provide any benefit when due under the plan2016-07-31No
Contributions received in cash from employer2016-07-31$73,209
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-07-31$80,040
Did the plan have assets held for investment2016-07-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-07-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-07-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-07-31Yes
Opinion of an independent qualified public accountant for this plan2016-07-31Disclaimer
Accountancy firm name2016-07-31HUDSON, CISNE & CO., LLP
Accountancy firm EIN2016-07-31710650689
2015 : ICM 403(B) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-07-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-07-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-07-31$0
Total income from all sources (including contributions)2015-07-31$308,586
Total loss/gain on sale of assets2015-07-31$0
Total of all expenses incurred2015-07-31$38,727
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-07-31$35,223
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-07-31$271,297
Value of total assets at end of year2015-07-31$902,755
Value of total assets at beginning of year2015-07-31$632,896
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-07-31$3,504
Total interest from all sources2015-07-31$1,599
Total dividends received (eg from common stock, registered investment company shares)2015-07-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-07-31No
Was this plan covered by a fidelity bond2015-07-31Yes
Value of fidelity bond cover2015-07-31$50,000
If this is an individual account plan, was there a blackout period2015-07-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-07-31$0
Were there any nonexempt tranactions with any party-in-interest2015-07-31No
Contributions received from participants2015-07-31$194,017
Participant contributions at end of year2015-07-31$36,766
Participant contributions at beginning of year2015-07-31$11,477
Income. Received or receivable in cash from other sources (including rollovers)2015-07-31$4,886
Administrative expenses (other) incurred2015-07-31$3,504
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-07-31No
Value of net income/loss2015-07-31$269,859
Value of net assets at end of year (total assets less liabilities)2015-07-31$902,755
Value of net assets at beginning of year (total assets less liabilities)2015-07-31$632,896
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-07-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-07-31No
Were any leases to which the plan was party in default or uncollectible2015-07-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-07-31$845,415
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-07-31$607,286
Interest on participant loans2015-07-31$1,083
Interest earned on other investments2015-07-31$516
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-07-31$20,574
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-07-31$14,133
Net investment gain/loss from pooled separate accounts2015-07-31$35,690
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-07-31No
Was there a failure to transmit to the plan any participant contributions2015-07-31No
Has the plan failed to provide any benefit when due under the plan2015-07-31No
Contributions received in cash from employer2015-07-31$72,394
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-07-31$35,223
Did the plan have assets held for investment2015-07-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-07-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-07-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-07-31Yes
Opinion of an independent qualified public accountant for this plan2015-07-31Disclaimer
Accountancy firm name2015-07-31HUDSON, CISNE & CO., LLP
Accountancy firm EIN2015-07-31710650689
2014 : ICM 403(B) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-07-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-07-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-07-31$0
Total income from all sources (including contributions)2014-07-31$249,824
Total loss/gain on sale of assets2014-07-31$0
Total of all expenses incurred2014-07-31$21,022
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-07-31$18,782
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-07-31$195,077
Value of total assets at end of year2014-07-31$632,896
Value of total assets at beginning of year2014-07-31$404,094
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-07-31$2,240
Total interest from all sources2014-07-31$847
Total dividends received (eg from common stock, registered investment company shares)2014-07-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-07-31No
Was this plan covered by a fidelity bond2014-07-31Yes
Value of fidelity bond cover2014-07-31$50,000
If this is an individual account plan, was there a blackout period2014-07-31No
Funding deficiency by the employer to the plan for this plan year2014-07-31$0
Minimum employer required contribution for this plan year2014-07-31$0
Amount contributed by the employer to the plan for this plan year2014-07-31$0
Were there any nonexempt tranactions with any party-in-interest2014-07-31No
Contributions received from participants2014-07-31$141,475
Participant contributions at end of year2014-07-31$11,477
Participant contributions at beginning of year2014-07-31$7,002
Administrative expenses (other) incurred2014-07-31$2,240
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-07-31No
Value of net income/loss2014-07-31$228,802
Value of net assets at end of year (total assets less liabilities)2014-07-31$632,896
Value of net assets at beginning of year (total assets less liabilities)2014-07-31$404,094
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-07-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-07-31No
Were any leases to which the plan was party in default or uncollectible2014-07-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-07-31$607,286
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-07-31$387,394
Interest on participant loans2014-07-31$474
Interest earned on other investments2014-07-31$373
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-07-31$14,133
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-07-31$9,698
Net investment gain/loss from pooled separate accounts2014-07-31$53,900
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-07-31No
Was there a failure to transmit to the plan any participant contributions2014-07-31No
Has the plan failed to provide any benefit when due under the plan2014-07-31No
Contributions received in cash from employer2014-07-31$53,602
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-07-31$18,782
Did the plan have assets held for investment2014-07-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-07-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-07-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-07-31Yes
Opinion of an independent qualified public accountant for this plan2014-07-31Disclaimer
Accountancy firm name2014-07-31HUDSON, CISNE & CO., LLP
Accountancy firm EIN2014-07-31710650689
2013 : ICM 403(B) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-07-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-07-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-07-31$0
Total income from all sources (including contributions)2013-07-31$200,869
Total loss/gain on sale of assets2013-07-31$0
Total of all expenses incurred2013-07-31$17,655
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-07-31$16,189
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-07-31$154,841
Value of total assets at end of year2013-07-31$404,094
Value of total assets at beginning of year2013-07-31$220,880
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-07-31$1,466
Total interest from all sources2013-07-31$392
Total dividends received (eg from common stock, registered investment company shares)2013-07-31$0
Was this plan covered by a fidelity bond2013-07-31Yes
Value of fidelity bond cover2013-07-31$50,000
If this is an individual account plan, was there a blackout period2013-07-31No
Funding deficiency by the employer to the plan for this plan year2013-07-31$0
Minimum employer required contribution for this plan year2013-07-31$0
Amount contributed by the employer to the plan for this plan year2013-07-31$0
Were there any nonexempt tranactions with any party-in-interest2013-07-31No
Contributions received from participants2013-07-31$116,022
Participant contributions at end of year2013-07-31$7,002
Participant contributions at beginning of year2013-07-31$5,828
Administrative expenses (other) incurred2013-07-31$1,466
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-07-31No
Value of net income/loss2013-07-31$183,214
Value of net assets at end of year (total assets less liabilities)2013-07-31$404,094
Value of net assets at beginning of year (total assets less liabilities)2013-07-31$220,880
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-07-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-07-31No
Were any leases to which the plan was party in default or uncollectible2013-07-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-07-31$387,394
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-07-31$214,011
Interest on participant loans2013-07-31$217
Interest earned on other investments2013-07-31$175
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-07-31$9,698
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-07-31$1,041
Net investment gain/loss from pooled separate accounts2013-07-31$45,636
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-07-31No
Was there a failure to transmit to the plan any participant contributions2013-07-31Yes
Has the plan failed to provide any benefit when due under the plan2013-07-31No
Contributions received in cash from employer2013-07-31$38,819
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-07-31$16,189
Did the plan have assets held for investment2013-07-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-07-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-07-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-07-31Yes
Opinion of an independent qualified public accountant for this plan2013-07-31Disclaimer
Accountancy firm name2013-07-31HUDSON, CISNE & CO., LLP
Accountancy firm EIN2013-07-31710650689
2012 : ICM 403(B) PLAN 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2012-07-31$-1,562
Total unrealized appreciation/depreciation of assets2012-07-31$-1,562
Total transfer of assets to this plan2012-07-31$207,243
Total income from all sources (including contributions)2012-07-31$13,940
Total of all expenses incurred2012-07-31$303
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-07-31$15,466
Value of total assets at end of year2012-07-31$220,880
Value of total assets at beginning of year2012-07-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-07-31$303
Total interest from all sources2012-07-31$36
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-07-31No
Was this plan covered by a fidelity bond2012-07-31Yes
Value of fidelity bond cover2012-07-31$50,000
If this is an individual account plan, was there a blackout period2012-07-31No
Were there any nonexempt tranactions with any party-in-interest2012-07-31No
Contributions received from participants2012-07-31$11,637
Participant contributions at end of year2012-07-31$5,828
Participant contributions at beginning of year2012-07-31$0
Administrative expenses (other) incurred2012-07-31$303
Total non interest bearing cash at beginning of year2012-07-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-07-31No
Value of net income/loss2012-07-31$13,637
Value of net assets at end of year (total assets less liabilities)2012-07-31$220,880
Value of net assets at beginning of year (total assets less liabilities)2012-07-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-07-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-07-31No
Were any leases to which the plan was party in default or uncollectible2012-07-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-07-31$214,011
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-07-31$0
Value of interest in pooled separate accounts at beginning of year2012-07-31$0
Interest on participant loans2012-07-31$36
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-07-31$1,041
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-07-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-07-31No
Was there a failure to transmit to the plan any participant contributions2012-07-31Yes
Has the plan failed to provide any benefit when due under the plan2012-07-31No
Contributions received in cash from employer2012-07-31$3,829
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-07-31No
Did the plan have assets held for investment2012-07-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-07-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-07-31No

Form 5500 Responses for ICM 403(B) PLAN

2021: ICM 403(B) PLAN 2021 form 5500 responses
2021-08-01Type of plan entitySingle employer plan
2021-08-01This submission is the final filingYes
2021-08-01This return/report is a short plan year return/report (less than 12 months)Yes
2021-08-01Plan funding arrangement – InsuranceYes
2021-08-01Plan funding arrangement – TrustYes
2021-08-01Plan benefit arrangement – InsuranceYes
2021-08-01Plan benefit arrangement - TrustYes
2020: ICM 403(B) PLAN 2020 form 5500 responses
2020-08-01Type of plan entitySingle employer plan
2020-08-01Plan funding arrangement – InsuranceYes
2020-08-01Plan funding arrangement – TrustYes
2020-08-01Plan benefit arrangement – InsuranceYes
2020-08-01Plan benefit arrangement - TrustYes
2019: ICM 403(B) PLAN 2019 form 5500 responses
2019-08-01Type of plan entitySingle employer plan
2019-08-01Plan funding arrangement – InsuranceYes
2019-08-01Plan funding arrangement – TrustYes
2019-08-01Plan benefit arrangement – InsuranceYes
2019-08-01Plan benefit arrangement - TrustYes
2018: ICM 403(B) PLAN 2018 form 5500 responses
2018-08-01Type of plan entitySingle employer plan
2018-08-01Plan funding arrangement – InsuranceYes
2018-08-01Plan funding arrangement – TrustYes
2018-08-01Plan benefit arrangement – InsuranceYes
2018-08-01Plan benefit arrangement - TrustYes
2017: ICM 403(B) PLAN 2017 form 5500 responses
2017-08-01Type of plan entitySingle employer plan
2017-08-01Submission has been amendedNo
2017-08-01This submission is the final filingNo
2017-08-01This return/report is a short plan year return/report (less than 12 months)No
2017-08-01Plan is a collectively bargained planNo
2017-08-01Plan funding arrangement – InsuranceYes
2017-08-01Plan funding arrangement – TrustYes
2017-08-01Plan benefit arrangement – InsuranceYes
2016: ICM 403(B) PLAN 2016 form 5500 responses
2016-08-01Type of plan entitySingle employer plan
2016-08-01Submission has been amendedNo
2016-08-01This submission is the final filingNo
2016-08-01This return/report is a short plan year return/report (less than 12 months)No
2016-08-01Plan is a collectively bargained planNo
2016-08-01Plan funding arrangement – InsuranceYes
2016-08-01Plan funding arrangement – TrustYes
2016-08-01Plan benefit arrangement – InsuranceYes
2015: ICM 403(B) PLAN 2015 form 5500 responses
2015-08-01Type of plan entitySingle employer plan
2015-08-01Submission has been amendedYes
2015-08-01This submission is the final filingNo
2015-08-01This return/report is a short plan year return/report (less than 12 months)No
2015-08-01Plan is a collectively bargained planNo
2015-08-01Plan funding arrangement – InsuranceYes
2015-08-01Plan funding arrangement – TrustYes
2015-08-01Plan benefit arrangement – InsuranceYes
2014: ICM 403(B) PLAN 2014 form 5500 responses
2014-08-01Type of plan entitySingle employer plan
2014-08-01Submission has been amendedNo
2014-08-01This submission is the final filingNo
2014-08-01This return/report is a short plan year return/report (less than 12 months)No
2014-08-01Plan is a collectively bargained planNo
2014-08-01Plan funding arrangement – InsuranceYes
2014-08-01Plan funding arrangement – TrustYes
2014-08-01Plan benefit arrangement – InsuranceYes
2013: ICM 403(B) PLAN 2013 form 5500 responses
2013-08-01Type of plan entitySingle employer plan
2013-08-01Submission has been amendedNo
2013-08-01This submission is the final filingNo
2013-08-01This return/report is a short plan year return/report (less than 12 months)No
2013-08-01Plan is a collectively bargained planNo
2013-08-01Plan funding arrangement – InsuranceYes
2013-08-01Plan funding arrangement – TrustYes
2013-08-01Plan benefit arrangement – InsuranceYes
2012: ICM 403(B) PLAN 2012 form 5500 responses
2012-08-01Type of plan entitySingle employer plan
2012-08-01Submission has been amendedNo
2012-08-01This submission is the final filingNo
2012-08-01This return/report is a short plan year return/report (less than 12 months)No
2012-08-01Plan is a collectively bargained planNo
2012-08-01Plan funding arrangement – InsuranceYes
2012-08-01Plan funding arrangement – TrustYes
2012-08-01Plan benefit arrangement – InsuranceYes
2012-05-01Type of plan entitySingle employer plan
2012-05-01First time form 5500 has been submittedYes
2012-05-01Submission has been amendedYes
2012-05-01This return/report is a short plan year return/report (less than 12 months)Yes
2012-05-01Plan funding arrangement – InsuranceYes
2012-05-01Plan funding arrangement – TrustYes
2012-05-01Plan benefit arrangement – InsuranceYes
2012-05-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGN-750662
Policy instance 1
Insurance contract or identification numberGN-750662
Number of Individuals Covered0
Insurance policy start date2021-08-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
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 numberGN-750662
Policy instance 1
Insurance contract or identification numberGN-750662
Number of Individuals Covered4
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $98
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $98
Insurance broker organization code?3
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-750662
Policy instance 1
Insurance contract or identification numberGA-750662
Number of Individuals Covered5
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $177
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $177
Insurance broker organization code?3
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-750662
Policy instance 1
Insurance contract or identification numberGA-750662
Number of Individuals Covered10
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $302
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $302
Insurance broker organization code?3
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-750662
Policy instance 1
Insurance contract or identification numberGA-750662
Number of Individuals Covered98
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $1,345
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
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-750662
Policy instance 1
Insurance contract or identification numberGA-750662
Number of Individuals Covered163
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $7,900
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 $7,900
Insurance broker organization code?3
Insurance broker nameEDWARD D. JONES & CO LP
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-750662
Policy instance 1
Insurance contract or identification numberGA-750662
Number of Individuals Covered98
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Total amount of commissions paid to insurance brokerUSD $6,013
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 $6,013
Insurance broker organization code?3
Insurance broker nameEDWARD D. JONES & CO LP
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-750662
Policy instance 1
Insurance contract or identification numberGA-750662
Number of Individuals Covered66
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Total amount of commissions paid to insurance brokerUSD $4,339
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 $4,339
Insurance broker organization code?3
Insurance broker nameEDWARD D. JONES & CO.
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-750662
Policy instance 1
Insurance contract or identification numberGA-750662
Number of Individuals Covered48
Insurance policy start date2012-05-01
Insurance policy end date2012-07-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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