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MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION PLAN 401k Plan overview

Plan NameMESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION PLAN
Plan identification number 002

MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION PLAN Benefits

401k Plan TypeDefined Benefit Pension
Plan Features/Benefits
  • Benefits are primarily pay related
  • Frozen Plan - As of the last day of the plan year, the plan provides that no participant will get any new benefit accrual (whether because of service or compensation).
  • 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

MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. has sponsored the creation of one or more 401k plans.

Company Name:MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C.
Employer identification number (EIN):860437624
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022016-01-01
0022015-01-01
0022014-01-01
0022013-01-01
0022012-01-01EARL LABOVITZ EARL LABOVITZ2013-10-03
0022011-01-01EARL LABOVITZ EARL LABOVITZ2012-09-12
0022010-01-01EARL LABOVITZ EARL LABOVITZ2011-09-12
0022009-01-01EARL LABOVITZ EARL LABOVITZ2010-09-07

Plan Statistics for MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION PLAN

401k plan membership statisitcs for MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION PLAN

Measure Date Value
2016: MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION PLAN 2016 401k membership
Market value of plan assets2016-12-312,607,478
Acturial value of plan assets2016-12-312,607,478
Funding target for retired participants and beneficiaries receiving payment2016-12-310
Number of terminated vested participants2016-12-310
Fundng target for terminated vested participants2016-12-310
Active participant vested funding target2016-12-312,529,521
Number of active participants2016-12-316
Total funding liabilities for active participants2016-12-312,529,521
Total participant count2016-12-316
Total funding target for all participants2016-12-312,529,521
Balance at beginning of prior year after applicable adjustments2016-12-310
Prefunding balance at beginning of prior year after applicable adjustments2016-12-311,260
Carryover balanced portion elected for use to offset prior years funding requirement2016-12-310
Prefunding balanced used to offset prior years funding requirement2016-12-310
Amount remaining of carryover balance2016-12-310
Amount remaining of prefunding balance2016-12-311,260
Present value of excess contributions2016-12-3143,673
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2016-12-3143,673
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2016-12-310
Reductions in caryover balances due to elections or deemed elections2016-12-310
Reductions in prefunding balances due to elections or deemed elections2016-12-310
Balance of carryovers at beginning of current year2016-12-310
Balance of prefunding at beginning of current year2016-12-311,238
Total employer contributions2016-12-310
Total employee contributions2016-12-310
Contributions allocated toward unpaid minimum require contributions from prior years2016-12-310
Contributions made to avoid restrictions adjusted to valuation date2016-12-310
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2016-12-310
Liquidity shortfalls end of Q12016-12-310
Liquidity shortfalls end of Q22016-12-310
Liquidity shortfalls end of Q32016-12-310
Liquidity shortfalls end of Q42016-12-310
Unpaid minimum required contributions for all prior years2016-12-310
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2016-12-310
Remaining amount of unpaid minimum required contributions2016-12-310
Minimum required contributions for current year target normal cost2016-12-310
Net shortfall amortization installment of oustanding balance2016-12-310
Waiver amortization installment2016-12-310
Waived amount of outstanding balance2016-12-310
Total funding amount beforereflecting carryover/prefunding balances2016-12-310
Carryover balance elected to use to offset funding requirement2016-12-310
Prefunding balance elected to use to offset funding requirement2016-12-310
Additional cash requirement2016-12-310
Contributions allocatedtoward minimum required contributions for current year2016-12-310
Unpaid minimum required contributions for current year2016-12-310
Unpaid minimum required contributions for all years2016-12-310
Total participants, beginning-of-year2016-01-017
Total number of active participants reported on line 7a of the Form 55002016-01-010
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-017
Total number of active participants reported on line 7a of the Form 55002015-01-017
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-016
Total number of active participants reported on line 7a of the Form 55002014-01-016
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-016
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-016
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-017
Total number of active participants reported on line 7a of the Form 55002013-01-016
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-016
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-016
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-013
Total number of active participants reported on line 7a of the Form 55002012-01-017
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-017
Total number of active participants reported on line 7a of the Form 55002011-01-013
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 participants2011-01-013
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-013
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-018
Total number of active participants reported on line 7a of the Form 55002010-01-013
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-014
Total of all active and inactive participants2010-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-017
Total number of active participants reported on line 7a of the Form 55002009-01-016
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-012
Total of all active and inactive participants2009-01-018
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-018
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION PLAN

Measure Date Value
2016 : MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION PLAN 2016 401k financial data
Total plan liabilities at end of year2016-12-31$0
Total plan liabilities at beginning of year2016-12-31$0
Total income from all sources2016-12-31$51,831
Expenses. Total of all expenses incurred2016-12-31$3,228,199
Benefits paid (including direct rollovers)2016-12-31$3,221,796
Total plan assets at end of year2016-12-31$0
Total plan assets at beginning of year2016-12-31$3,176,368
Value of fidelity bond covering the plan2016-12-31$320,000
Total contributions received or receivable from participants2016-12-31$0
Expenses. Other expenses not covered elsewhere2016-12-31$0
Contributions received from other sources (not participants or employers)2016-12-31$0
Other income received2016-12-31$51,831
Net income (gross income less expenses)2016-12-31$-3,176,368
Net plan assets at end of year (total assets less liabilities)2016-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$3,176,368
Total contributions received or receivable from employer(s)2016-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$6,403
2015 : MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION PLAN 2015 401k financial data
Total income from all sources2015-12-31$-7,299
Expenses. Total of all expenses incurred2015-12-31$16,375
Total plan assets at end of year2015-12-31$3,176,368
Total plan assets at beginning of year2015-12-31$3,200,042
Value of fidelity bond covering the plan2015-12-31$320,000
Total contributions received or receivable from participants2015-12-31$0
Expenses. Other expenses not covered elsewhere2015-12-31$0
Contributions received from other sources (not participants or employers)2015-12-31$0
Other income received2015-12-31$-55,799
Net income (gross income less expenses)2015-12-31$-23,674
Net plan assets at end of year (total assets less liabilities)2015-12-31$3,176,368
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$3,200,042
Assets. Value of assets in partnership/joint-venture interests2015-12-31$78,354
Total contributions received or receivable from employer(s)2015-12-31$48,500
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$16,375
2014 : MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION PLAN 2014 401k financial data
Total income from all sources2014-12-31$261,741
Expenses. Total of all expenses incurred2014-12-31$8,553
Benefits paid (including direct rollovers)2014-12-31$8,553
Total plan assets at end of year2014-12-31$3,200,042
Total plan assets at beginning of year2014-12-31$2,946,854
Value of fidelity bond covering the plan2014-12-31$300,000
Total contributions received or receivable from participants2014-12-31$0
Expenses. Other expenses not covered elsewhere2014-12-31$0
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$191,741
Net income (gross income less expenses)2014-12-31$253,188
Net plan assets at end of year (total assets less liabilities)2014-12-31$3,200,042
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$2,946,854
Assets. Value of assets in partnership/joint-venture interests2014-12-31$386,006
Total contributions received or receivable from employer(s)2014-12-31$70,000
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$0
2013 : MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION PLAN 2013 401k financial data
Total income from all sources2013-12-31$321,686
Expenses. Total of all expenses incurred2013-12-31$1,125
Total plan assets at end of year2013-12-31$2,946,854
Total plan assets at beginning of year2013-12-31$2,626,293
Value of fidelity bond covering the plan2013-12-31$250,000
Total contributions received or receivable from participants2013-12-31$0
Expenses. Other expenses not covered elsewhere2013-12-31$0
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$251,686
Net income (gross income less expenses)2013-12-31$320,561
Net plan assets at end of year (total assets less liabilities)2013-12-31$2,946,854
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$2,626,293
Assets. Value of assets in partnership/joint-venture interests2013-12-31$116,320
Total contributions received or receivable from employer(s)2013-12-31$70,000
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$1,125
2012 : MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION PLAN 2012 401k financial data
Total income from all sources2012-12-31$165,393
Expenses. Total of all expenses incurred2012-12-31$1,396
Total plan assets at end of year2012-12-31$2,626,293
Total plan assets at beginning of year2012-12-31$2,462,296
Value of fidelity bond covering the plan2012-12-31$250,000
Total contributions received or receivable from participants2012-12-31$0
Expenses. Other expenses not covered elsewhere2012-12-31$0
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$39,393
Net income (gross income less expenses)2012-12-31$163,997
Net plan assets at end of year (total assets less liabilities)2012-12-31$2,626,293
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$2,462,296
Assets. Value of assets in partnership/joint-venture interests2012-12-31$198,379
Total contributions received or receivable from employer(s)2012-12-31$126,000
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$1,396
2011 : MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION PLAN 2011 401k financial data
Total income from all sources2011-12-31$-5,544
Expenses. Total of all expenses incurred2011-12-31$82,711
Benefits paid (including direct rollovers)2011-12-31$82,385
Total plan assets at end of year2011-12-31$2,462,296
Total plan assets at beginning of year2011-12-31$2,550,551
Value of fidelity bond covering the plan2011-12-31$250,000
Total contributions received or receivable from participants2011-12-31$0
Expenses. Other expenses not covered elsewhere2011-12-31$0
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-163,544
Net income (gross income less expenses)2011-12-31$-88,255
Net plan assets at end of year (total assets less liabilities)2011-12-31$2,462,296
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$2,550,551
Assets. Value of assets in partnership/joint-venture interests2011-12-31$65,017
Total contributions received or receivable from employer(s)2011-12-31$158,000
Value of certain deemed distributions of participant loans2011-12-31$326
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$0
2010 : MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION PLAN 2010 401k financial data
Total income from all sources2010-12-31$412,948
Expenses. Total of all expenses incurred2010-12-31$12,958
Benefits paid (including direct rollovers)2010-12-31$12,602
Total plan assets at end of year2010-12-31$2,550,551
Total plan assets at beginning of year2010-12-31$2,150,561
Value of fidelity bond covering the plan2010-12-31$250,000
Total contributions received or receivable from participants2010-12-31$0
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$225,948
Net income (gross income less expenses)2010-12-31$399,990
Net plan assets at end of year (total assets less liabilities)2010-12-31$2,550,551
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$2,150,561
Assets. Value of assets in partnership/joint-venture interests2010-12-31$85,374
Total contributions received or receivable from employer(s)2010-12-31$187,000
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$356

Form 5500 Responses for MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION PLAN

2016: MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingYes
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION 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
2014-01-01Plan benefit arrangement - TrustYes
2013: MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION 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
2013-01-01Plan benefit arrangement - TrustYes
2012: MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION 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
2012-01-01Plan benefit arrangement - TrustYes
2011: MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION 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 – TrustYes
2011-01-01Plan benefit arrangement - TrustYes
2010: MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION 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 – TrustYes
2010-01-01Plan benefit arrangement - TrustYes
2009: MESA-TEMPE ALLERGY & ASTHMA CLINIC, P.C. PENSION 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 – TrustYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

JACKSON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65056 )
Policy contract number1012011446
Policy instance 1
Insurance contract or identification number1012011446
Number of Individuals Covered1
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberE1492032
Policy instance 2
Insurance contract or identification numberE1492032
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberE1492032
Policy instance 1
Insurance contract or identification numberE1492032
Number of Individuals Covered1
Insurance policy start date2015-01-01
Insurance policy end date2015-01-01
JACKSON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65056 )
Policy contract number1012011446
Policy instance 2
Insurance contract or identification number1012011446
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberE1492032
Policy instance 1
Insurance contract or identification numberE1492032
Number of Individuals Covered1
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Insurance broker organization code?3
Insurance broker nameDAVID JEFFRESS
JACKSON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65056 )
Policy contract number1012011446
Policy instance 2
Insurance contract or identification number1012011446
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberE1492032
Policy instance 2
Insurance contract or identification numberE1492032
Number of Individuals Covered3
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $20,926
Commission paid to Insurance BrokerUSD $20,926
Insurance broker organization code?3
Insurance broker nameDAVID JEFFRESS
JACKSON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65056 )
Policy contract number1012011446
Policy instance 1
Insurance contract or identification number1012011446
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Insurance broker organization code?3
Insurance broker nameDAVID ALAN JEFFRESS
JACKSON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65056 )
Policy contract number1012011446
Policy instance 3
Insurance contract or identification number1012011446
Number of Individuals Covered3
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
JACKSON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65056 )
Policy contract number1012011446
Policy instance 1
Insurance contract or identification number1012011446
Number of Individuals Covered3
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $700,000
Total amount of fees paid to insurance companyUSD $28,000
Are there contracts with allocated funds for individual policies?Yes
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 $700,000
Amount paid for insurance broker fees28000
Additional information about fees paid to insurance brokerCOMMISSION
Insurance broker organization code?3
Insurance broker nameDAVID ALAN JEFFRESS

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