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CHURCHILL ADMINISTRATIVE SERVICES, LLC 401(K) PROFIT SHARING PLAN & TRUST 401k Plan overview

Plan NameCHURCHILL ADMINISTRATIVE SERVICES, LLC 401(K) PROFIT SHARING PLAN & TRUST
Plan identification number 001

CHURCHILL ADMINISTRATIVE SERVICES, LLC 401(K) PROFIT SHARING PLAN & TRUST Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • 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.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • 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.
  • Plan sponsor(s) received services of leased employees, as defined in Code section 414(n), during the plan year.

401k Sponsoring company profile

CHURCHILL ADMINISTRATIVE SERVICES, LLC has sponsored the creation of one or more 401k plans.

Company Name:CHURCHILL ADMINISTRATIVE SERVICES, LLC
Employer identification number (EIN):811093064
NAIC Classification:531110
NAIC Description:Lessors of Residential Buildings and Dwellings

Additional information about CHURCHILL ADMINISTRATIVE SERVICES, LLC

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2016-01-08
Company Identification Number: 0802365326
Legal Registered Office Address: 5605 N MACARTHUR BLVD STE 580

IRVING
United States of America (USA)
75038

More information about CHURCHILL ADMINISTRATIVE SERVICES, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CHURCHILL ADMINISTRATIVE SERVICES, LLC 401(K) PROFIT SHARING PLAN & TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01BRAD FORSLUND2023-05-15
0012021-01-01BRADLEY FORSLUND2022-07-14
0012020-01-01BRADLEY FORSLUND2021-06-02 BRADLEY FORSLUND2021-06-02
0012019-01-01
0012018-01-01
0012017-01-01SANDY KLIDAS
0012016-01-01SANDY KLIDAS2017-09-14

Plan Statistics for CHURCHILL ADMINISTRATIVE SERVICES, LLC 401(K) PROFIT SHARING PLAN & TRUST

401k plan membership statisitcs for CHURCHILL ADMINISTRATIVE SERVICES, LLC 401(K) PROFIT SHARING PLAN & TRUST

Measure Date Value
2019: CHURCHILL ADMINISTRATIVE SERVICES, LLC 401(K) PROFIT SHARING PLAN & TRUST 2019 401k membership
Total participants, beginning-of-year2019-01-01103
Total number of active participants reported on line 7a of the Form 55002019-01-0179
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0112
Total of all active and inactive participants2019-01-0191
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0191
Number of participants with account balances2019-01-0176
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: CHURCHILL ADMINISTRATIVE SERVICES, LLC 401(K) PROFIT SHARING PLAN & TRUST 2018 401k membership
Total participants, beginning-of-year2018-01-01127
Total number of active participants reported on line 7a of the Form 55002018-01-0178
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0118
Total of all active and inactive participants2018-01-0196
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0196
Number of participants with account balances2018-01-0178
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: CHURCHILL ADMINISTRATIVE SERVICES, LLC 401(K) PROFIT SHARING PLAN & TRUST 2017 401k membership
Total participants, beginning-of-year2017-01-01128
Total number of active participants reported on line 7a of the Form 55002017-01-01106
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-014
Total of all active and inactive participants2017-01-01110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01110
Number of participants with account balances2017-01-0181
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010

Financial Data on CHURCHILL ADMINISTRATIVE SERVICES, LLC 401(K) PROFIT SHARING PLAN & TRUST

Measure Date Value
2019 : CHURCHILL ADMINISTRATIVE SERVICES, LLC 401(K) PROFIT SHARING PLAN & TRUST 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$1,106,707
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$171,198
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$167,710
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$593,783
Value of total assets at end of year2019-12-31$3,555,283
Value of total assets at beginning of year2019-12-31$2,619,774
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$3,488
Total interest from all sources2019-12-31$9,108
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$1,000,000
If this is an individual account plan, was there a blackout period2019-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$309,357
Participant contributions at end of year2019-12-31$122,082
Participant contributions at beginning of year2019-12-31$78,432
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$126,512
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$935,509
Value of net assets at end of year (total assets less liabilities)2019-12-31$3,555,283
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$2,619,774
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in pooled separate accounts at end of year2019-12-31$3,433,201
Value of interest in pooled separate accounts at beginning of year2019-12-31$2,541,342
Interest on participant loans2019-12-31$9,108
Net investment gain/loss from pooled separate accounts2019-12-31$503,816
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$157,914
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$167,710
Contract administrator fees2019-12-31$3,488
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31LANE GORMAN TRUBITT, LLC
Accountancy firm EIN2019-12-31751044330
2018 : CHURCHILL ADMINISTRATIVE SERVICES, LLC 401(K) PROFIT SHARING PLAN & TRUST 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$323,139
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$303,295
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$295,911
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$435,750
Value of total assets at end of year2018-12-31$2,619,774
Value of total assets at beginning of year2018-12-31$2,599,930
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$7,384
Total interest from all sources2018-12-31$4,619
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$1,000,000
If this is an individual account plan, was there a blackout period2018-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$270,064
Participant contributions at end of year2018-12-31$78,432
Participant contributions at beginning of year2018-12-31$105,736
Assets. Other investments not covered elsewhere at beginning of year2018-12-31$239,096
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$19,362
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$19,844
Value of net assets at end of year (total assets less liabilities)2018-12-31$2,619,774
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$2,599,930
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Investment advisory and management fees2018-12-31$7,384
Value of interest in pooled separate accounts at end of year2018-12-31$2,541,342
Value of interest in pooled separate accounts at beginning of year2018-12-31$2,130,002
Interest on participant loans2018-12-31$4,619
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$125,096
Net investment gain/loss from pooled separate accounts2018-12-31$-117,230
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$146,324
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$295,911
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31Yes
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31LANE GORMAN TRUBITT, LLC
Accountancy firm EIN2018-12-31751044330
2017 : CHURCHILL ADMINISTRATIVE SERVICES, LLC 401(K) PROFIT SHARING PLAN & TRUST 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$743,991
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$307,908
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$305,308
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$455,168
Value of total assets at end of year2017-12-31$2,599,930
Value of total assets at beginning of year2017-12-31$2,163,847
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$2,600
Total interest from all sources2017-12-31$5,490
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$1,000,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$293,371
Participant contributions at end of year2017-12-31$105,736
Participant contributions at beginning of year2017-12-31$121,658
Assets. Other investments not covered elsewhere at end of year2017-12-31$239,096
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$1,833
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$436,083
Value of net assets at end of year (total assets less liabilities)2017-12-31$2,599,930
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$2,163,847
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in pooled separate accounts at end of year2017-12-31$2,130,002
Value of interest in pooled separate accounts at beginning of year2017-12-31$1,749,569
Interest on participant loans2017-12-31$5,001
Income. Interest from loans (other than to participants)2017-12-31$0
Interest earned on other investments2017-12-31$489
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$125,096
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$292,620
Net investment gain/loss from pooled separate accounts2017-12-31$283,333
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$159,964
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$305,308
Contract administrator fees2017-12-31$2,600
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31LANE GORMAN TRUBITT, LLC
Accountancy firm EIN2017-12-31751044330

Form 5500 Responses for CHURCHILL ADMINISTRATIVE SERVICES, LLC 401(K) PROFIT SHARING PLAN & TRUST

2019: CHURCHILL ADMINISTRATIVE SERVICES, LLC 401(K) PROFIT SHARING PLAN & TRUST 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: CHURCHILL ADMINISTRATIVE SERVICES, LLC 401(K) PROFIT SHARING PLAN & TRUST 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: CHURCHILL ADMINISTRATIVE SERVICES, LLC 401(K) PROFIT SHARING PLAN & TRUST 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number339311
Policy instance 1
Insurance contract or identification number339311
Number of Individuals Covered76
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
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?No
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
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number339311
Policy instance 1
Insurance contract or identification number339311
Number of Individuals Covered81
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
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?No
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
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number21527
Policy instance 2
Insurance contract or identification number21527
Number of Individuals Covered0
Insurance policy start date2018-01-01
Insurance policy end date2018-10-18
Total amount of commissions paid to insurance brokerUSD $0
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?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
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?Yes
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number21527
Policy instance 1
Insurance contract or identification number21527
Number of Individuals Covered81
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,677
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?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
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
Amount paid for insurance broker fees3677
Additional information about fees paid to insurance brokerSERVICE FEES
Insurance broker organization code?3
Insurance broker name401K GENERATION INC.

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