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SAFETY COUNCIL OF SWLA 401(K) PLAN 401k Plan overview

Plan NameSAFETY COUNCIL OF SWLA 401(K) PLAN
Plan identification number 001

SAFETY COUNCIL OF SWLA 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.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • 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.
  • Prototype plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion or notification letter; and under which a seperate funding medium (for example, a seperate trust or custodial account) is established for the use of each adopting employer.

401k Sponsoring company profile

SAFETY COUNCIL OF SWLA has sponsored the creation of one or more 401k plans.

Company Name:SAFETY COUNCIL OF SWLA
Employer identification number (EIN):720506995
NAIC Classification:611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SAFETY COUNCIL OF SWLA 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012023-01-01ROBERT SCHAFFERNOTH2024-10-04
0012022-01-01CHRISTINA DETIVEAUX2023-10-04
0012021-01-01CHRISTINA DETIVEAUX2022-06-27
0012020-01-01DARRYL BLUNT2021-09-17
0012019-01-01DARRYL BLUNT2020-10-13 CHRISTINA DETIVEAUX2020-10-13
0012018-01-01DARRYL BLUNT2019-06-25 DARRYL DREWETT2019-06-27
0012016-01-01JONI FONTENOT2017-08-09 JONI FONTENOT2017-08-09
0012015-01-01JONI G FONTENOT2016-07-29 JONI G FONTENOT2016-07-29
0012014-01-01JONI FONTENOT JONI FONTENOT2015-07-29
0012013-01-01JONI FONTENOT JONI FONTENOT2014-07-31
0012012-01-01JONI FONTENOT
0012011-01-01JONI FONTENOT
0012010-01-01JONI FONTENOT
0012009-01-01JONI FONTENOT
0012008-01-01JONI FONTENOT

Plan Statistics for SAFETY COUNCIL OF SWLA 401(K) PLAN

401k plan membership statisitcs for SAFETY COUNCIL OF SWLA 401(K) PLAN

Measure Date Value
2014: SAFETY COUNCIL OF SWLA 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0113
Total number of active participants reported on line 7a of the Form 55002014-01-019
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-014
Total of all active and inactive participants2014-01-0113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0113
Number of participants with account balances2014-01-0113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: SAFETY COUNCIL OF SWLA 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0112
Total number of active participants reported on line 7a of the Form 55002013-01-0110
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-014
Total of all active and inactive participants2013-01-0114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0114
Number of participants with account balances2013-01-0114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: SAFETY COUNCIL OF SWLA 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0114
Total number of active participants reported on line 7a of the Form 55002012-01-018
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-016
Total of all active and inactive participants2012-01-0114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0114
Number of participants with account balances2012-01-018
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: SAFETY COUNCIL OF SWLA 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0117
Total number of active participants reported on line 7a of the Form 55002011-01-0116
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 participants2011-01-0116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0116
Number of participants with account balances2011-01-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: SAFETY COUNCIL OF SWLA 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0116
Total number of active participants reported on line 7a of the Form 55002010-01-0116
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 participants2010-01-0116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0116
Number of participants with account balances2010-01-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: SAFETY COUNCIL OF SWLA 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0117
Total number of active participants reported on line 7a of the Form 55002009-01-0116
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 participants2009-01-0117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0117
Number of participants with account balances2009-01-0117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010
2008: SAFETY COUNCIL OF SWLA 401(K) PLAN 2008 401k membership
Total participants, beginning-of-year2008-01-0113
Total number of active participants reported on line 7a of the Form 55002008-01-0114
Number of retired or separated participants receiving benefits2008-01-010
Number of other retired or separated participants entitled to future benefits2008-01-012
Total of all active and inactive participants2008-01-0116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2008-01-010
Total participants2008-01-0116
Number of participants with account balances2008-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2008-01-011

Financial Data on SAFETY COUNCIL OF SWLA 401(K) PLAN

Measure Date Value
2014 : SAFETY COUNCIL OF SWLA 401(K) PLAN 2014 401k financial data
Transfers to/from the plan2014-12-31$0
Total income from all sources2014-12-31$161,518
Expenses. Total of all expenses incurred2014-12-31$69,606
Benefits paid (including direct rollovers)2014-12-31$69,507
Total plan assets at end of year2014-12-31$1,310,603
Total plan assets at beginning of year2014-12-31$1,218,691
Value of fidelity bond covering the plan2014-12-31$60,000
Total contributions received or receivable from participants2014-12-31$68,545
Expenses. Other expenses not covered elsewhere2014-12-31$99
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$63,189
Net income (gross income less expenses)2014-12-31$91,912
Net plan assets at end of year (total assets less liabilities)2014-12-31$1,310,603
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$1,218,691
Assets. Value of participant loans2014-12-31$24,944
Total contributions received or receivable from employer(s)2014-12-31$29,784
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 : SAFETY COUNCIL OF SWLA 401(K) PLAN 2013 401k financial data
Transfers to/from the plan2013-12-31$0
Total income from all sources2013-12-31$265,783
Expenses. Total of all expenses incurred2013-12-31$53,848
Benefits paid (including direct rollovers)2013-12-31$53,724
Total plan assets at end of year2013-12-31$1,218,691
Total plan assets at beginning of year2013-12-31$1,006,756
Value of fidelity bond covering the plan2013-12-31$60,000
Total contributions received or receivable from participants2013-12-31$65,189
Expenses. Other expenses not covered elsewhere2013-12-31$124
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$172,092
Net income (gross income less expenses)2013-12-31$211,935
Net plan assets at end of year (total assets less liabilities)2013-12-31$1,218,691
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$1,006,756
Assets. Value of participant loans2013-12-31$32,089
Total contributions received or receivable from employer(s)2013-12-31$28,502
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 : SAFETY COUNCIL OF SWLA 401(K) PLAN 2012 401k financial data
Transfers to/from the plan2012-12-31$0
Total income from all sources2012-12-31$231,195
Expenses. Total of all expenses incurred2012-12-31$166,854
Benefits paid (including direct rollovers)2012-12-31$166,796
Total plan assets at end of year2012-12-31$1,006,756
Total plan assets at beginning of year2012-12-31$942,415
Value of fidelity bond covering the plan2012-12-31$60,000
Total contributions received or receivable from participants2012-12-31$74,870
Expenses. Other expenses not covered elsewhere2012-12-31$58
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$123,202
Net income (gross income less expenses)2012-12-31$64,341
Net plan assets at end of year (total assets less liabilities)2012-12-31$1,006,756
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$942,415
Assets. Value of participant loans2012-12-31$11,487
Total contributions received or receivable from employer(s)2012-12-31$33,123
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$0
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 : SAFETY COUNCIL OF SWLA 401(K) PLAN 2011 401k financial data
Transfers to/from the plan2011-12-31$1,146
Total income from all sources2011-12-31$130,533
Expenses. Total of all expenses incurred2011-12-31$252,147
Benefits paid (including direct rollovers)2011-12-31$252,089
Total plan assets at end of year2011-12-31$942,415
Total plan assets at beginning of year2011-12-31$1,062,883
Value of fidelity bond covering the plan2011-12-31$60,000
Total contributions received or receivable from participants2011-12-31$104,726
Expenses. Other expenses not covered elsewhere2011-12-31$58
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-28,063
Net income (gross income less expenses)2011-12-31$-121,614
Net plan assets at end of year (total assets less liabilities)2011-12-31$942,415
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$1,062,883
Assets. Value of participant loans2011-12-31$14,166
Total contributions received or receivable from employer(s)2011-12-31$53,870
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 : SAFETY COUNCIL OF SWLA 401(K) PLAN 2010 401k financial data
Transfers to/from the plan2010-12-31$0
Total income from all sources2010-12-31$254,162
Expenses. Total of all expenses incurred2010-12-31$38,449
Benefits paid (including direct rollovers)2010-12-31$38,449
Total plan assets at end of year2010-12-31$1,062,883
Total plan assets at beginning of year2010-12-31$847,170
Value of fidelity bond covering the plan2010-12-31$60,000
Total contributions received or receivable from participants2010-12-31$95,387
Expenses. Other expenses not covered elsewhere2010-12-31$0
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$112,406
Net income (gross income less expenses)2010-12-31$215,713
Net plan assets at end of year (total assets less liabilities)2010-12-31$1,062,883
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$847,170
Assets. Value of participant loans2010-12-31$0
Total contributions received or receivable from employer(s)2010-12-31$46,369
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 : SAFETY COUNCIL OF SWLA 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
2008 : SAFETY COUNCIL OF SWLA 401(K) PLAN 2008 401k financial data
Transfers to/from the plan2008-12-31$0
Total income from all sources2008-12-31$39,452
Expenses. Total of all expenses incurred2008-12-31$3,016
Benefits paid (including direct rollovers)2008-12-31$3,000
Total plan assets at end of year2008-12-31$438,081
Total plan assets at beginning of year2008-12-31$401,645
Value of fidelity bond covering the plan2008-12-31$60,000
Total contributions received or receivable from participants2008-12-31$86,163
Expenses. Other expenses not covered elsewhere2008-12-31$16
Contributions received from other sources (not participants or employers)2008-12-31$0
Other income received2008-12-31$-171,779
Net income (gross income less expenses)2008-12-31$36,436
Net plan assets at end of year (total assets less liabilities)2008-12-31$438,081
Net plan assets at beginning of year (total assets less liabilities)2008-12-31$401,645
Total contributions received or receivable from employer(s)2008-12-31$125,068
Value of certain deemed distributions of participant loans2008-12-31$0
Value of corrective distributions2008-12-31$0
Funding deficiency by the employer to the plan for this plan year2008-12-31$0
Minimum employer required contribution for this plan year2008-12-31$0
Amount contributed by the employer to the plan for this plan year2008-12-31$0

Form 5500 Responses for SAFETY COUNCIL OF SWLA 401(K) PLAN

2014: SAFETY COUNCIL OF SWLA 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: SAFETY COUNCIL OF SWLA 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: SAFETY COUNCIL OF SWLA 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: SAFETY COUNCIL OF SWLA 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: SAFETY COUNCIL OF SWLA 401(K) PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
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: SAFETY COUNCIL OF SWLA 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
2008: SAFETY COUNCIL OF SWLA 401(K) PLAN 2008 form 5500 responses
2008-01-01Type of plan entitySingle employer plan
2008-01-01Submission has been amendedNo
2008-01-01This submission is the final filingNo
2008-01-01This return/report is a short plan year return/report (less than 12 months)No
2008-01-01Plan is a collectively bargained planNo
2008-01-01Plan funding arrangement – InsuranceYes
2008-01-01Plan funding arrangement – TrustYes
2008-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-831898
Policy instance 1
Insurance contract or identification numberGA-831898
Number of Individuals Covered13
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $5,340
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 $5,340
Insurance broker organization code?3
Insurance broker nameWOODBURY FIN SVCS INC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-831898
Policy instance 1
Insurance contract or identification numberGA-831898
Number of Individuals Covered14
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,646
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 $4,646
Insurance broker organization code?3
Insurance broker nameWOODBURY FINANCIAL SVCS INC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-831898
Policy instance 1
Insurance contract or identification numberGA-831898
Number of Individuals Covered8
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $4,557
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 $4,557
Insurance broker organization code?3
Insurance broker nameWOODBURY FINANCIAL SVCS INC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-800774
Policy instance 1
Insurance contract or identification numberGA-800774
Number of Individuals Covered16
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $4,966
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-800774
Policy instance 1
Insurance contract or identification numberGA-800774
Number of Individuals Covered16
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $4,139
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 $4,139
Insurance broker organization code?3
Insurance broker nameWOODBURY FINANCIAL SVCS INC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA800774
Policy instance 1
Insurance contract or identification numberGA800774
Number of Individuals Covered16
Insurance policy start date2008-01-01
Insurance policy end date2008-12-31
Total amount of commissions paid to insurance brokerUSD $2,852
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Commission paid to Insurance BrokerUSD $2,852
Insurance broker organization code?3
Insurance broker nameWOODBURY FINANCIAL SERVICES INC

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