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CALLISTER, NEBEKER & MCCULLOUGH 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan NameCALLISTER, NEBEKER & MCCULLOUGH 401(K) PROFIT SHARING PLAN
Plan identification number 001

CALLISTER, NEBEKER & MCCULLOUGH 401(K) PROFIT SHARING 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.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • 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

CALLISTER, NEBEKER & MCCULLOUGH has sponsored the creation of one or more 401k plans.

Company Name:CALLISTER, NEBEKER & MCCULLOUGH
Employer identification number (EIN):870304195
NAIC Classification:541110
NAIC Description:Offices of Lawyers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CALLISTER, NEBEKER & MCCULLOUGH 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012016-01-01BRET J LEIFSON2017-07-12 BRET J LEIFSON2017-07-12
0012015-01-01BRET J LEIFSON BRET J LEIFSON2016-07-20
0012014-01-01BRET LEIFSON BRET LEIFSON2015-08-17
0012014-01-01BRET LEIFSON BRET LEIFSON2016-07-06
0012013-01-01KOREY LOWDER
0012012-01-01D. KOREY LOWDER
0012011-01-01KOREY LOWDER
0012010-01-01KOREY LOWDER
0012009-01-01KOREY LOWDER KOREY LOWDER2010-07-07
0012009-01-01KOREY LOWDER
0012009-01-01KOREY LOWDER

Plan Statistics for CALLISTER, NEBEKER & MCCULLOUGH 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for CALLISTER, NEBEKER & MCCULLOUGH 401(K) PROFIT SHARING PLAN

Measure Date Value
2015: CALLISTER, NEBEKER & MCCULLOUGH 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01128
Total number of active participants reported on line 7a of the Form 55002015-01-0168
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0122
Total of all active and inactive participants2015-01-0190
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0190
Number of participants with account balances2015-01-0184
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: CALLISTER, NEBEKER & MCCULLOUGH 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01112
Total number of active participants reported on line 7a of the Form 55002014-01-0176
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0144
Total of all active and inactive participants2014-01-01120
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01120
Number of participants with account balances2014-01-01116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-012
2013: CALLISTER, NEBEKER & MCCULLOUGH 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01107
Total number of active participants reported on line 7a of the Form 55002013-01-0183
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0129
Total of all active and inactive participants2013-01-01112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01112
Number of participants with account balances2013-01-01110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-012
2012: CALLISTER, NEBEKER & MCCULLOUGH 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01107
Total number of active participants reported on line 7a of the Form 55002012-01-01107
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 participants2012-01-01107
Total participants2012-01-01107
Number of participants with account balances2012-01-01107
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-014
2011: CALLISTER, NEBEKER & MCCULLOUGH 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01107
Total number of active participants reported on line 7a of the Form 55002011-01-0182
Number of retired or separated participants receiving benefits2011-01-0125
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01107
Number of participants with account balances2011-01-01107
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-018
2010: CALLISTER, NEBEKER & MCCULLOUGH 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01109
Total number of active participants reported on line 7a of the Form 55002010-01-01109
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-013
Total of all active and inactive participants2010-01-01112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-01112
Number of participants with account balances2010-01-01112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: CALLISTER, NEBEKER & MCCULLOUGH 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01106
Total number of active participants reported on line 7a of the Form 55002009-01-0185
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0124
Total of all active and inactive participants2009-01-01109
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01109
Number of participants with account balances2009-01-0199
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-013

Financial Data on CALLISTER, NEBEKER & MCCULLOUGH 401(K) PROFIT SHARING PLAN

Measure Date Value
2015 : CALLISTER, NEBEKER & MCCULLOUGH 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$1,003,862
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$2,171,534
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$2,117,211
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$1,086,310
Value of total assets at end of year2015-12-31$23,548,426
Value of total assets at beginning of year2015-12-31$24,716,098
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$54,323
Total interest from all sources2015-12-31$6,384
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$308,525
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$308,525
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$641,225
Participant contributions at end of year2015-12-31$221,114
Participant contributions at beginning of year2015-12-31$171,731
Assets. Other investments not covered elsewhere at end of year2015-12-31$1,384,611
Assets. Other investments not covered elsewhere at beginning of year2015-12-31$2,139,206
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$75,207
Other income not declared elsewhere2015-12-31$5,196
Administrative expenses (other) incurred2015-12-31$54,323
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-1,167,672
Value of net assets at end of year (total assets less liabilities)2015-12-31$23,548,426
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$24,716,098
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$18,984,142
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$19,549,164
Interest on participant loans2015-12-31$6,377
Value of interest in common/collective trusts at end of year2015-12-31$2,887,908
Value of interest in common/collective trusts at beginning of year2015-12-31$2,788,327
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$70,651
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$67,670
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$67,670
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$7
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-425,574
Net investment gain/loss from pooled separate accounts2015-12-31$-18,328
Net investment gain or loss from common/collective trusts2015-12-31$41,349
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$369,878
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$2,117,211
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31WSRP, LLC
Accountancy firm EIN2015-12-31870517754
2014 : CALLISTER, NEBEKER & MCCULLOUGH 401(K) PROFIT SHARING PLAN 2014 401k financial data
Transfers to/from the plan2014-12-31$511,778
Total income from all sources2014-12-31$2,568,931
Expenses. Total of all expenses incurred2014-12-31$1,337,776
Benefits paid (including direct rollovers)2014-12-31$1,294,016
Total plan assets at end of year2014-12-31$24,879,091
Total plan assets at beginning of year2014-12-31$23,136,158
Value of fidelity bond covering the plan2014-12-31$500,000
Total contributions received or receivable from participants2014-12-31$763,554
Expenses. Other expenses not covered elsewhere2014-12-31$43,760
Other income received2014-12-31$1,576,927
Net income (gross income less expenses)2014-12-31$1,231,155
Net plan assets at end of year (total assets less liabilities)2014-12-31$24,879,091
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$23,136,158
Assets. Value of participant loans2014-12-31$171,731
Total contributions received or receivable from employer(s)2014-12-31$228,450
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : CALLISTER, NEBEKER & MCCULLOUGH 401(K) PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources2013-12-31$5,497,739
Expenses. Total of all expenses incurred2013-12-31$1,857,327
Benefits paid (including direct rollovers)2013-12-31$1,821,873
Total plan assets at end of year2013-12-31$23,136,158
Total plan assets at beginning of year2013-12-31$19,495,746
Value of fidelity bond covering the plan2013-12-31$500,000
Total contributions received or receivable from participants2013-12-31$813,084
Expenses. Other expenses not covered elsewhere2013-12-31$35,454
Contributions received from other sources (not participants or employers)2013-12-31$217,699
Other income received2013-12-31$3,454,085
Net income (gross income less expenses)2013-12-31$3,640,412
Net plan assets at end of year (total assets less liabilities)2013-12-31$23,136,158
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$19,495,746
Assets. Value of participant loans2013-12-31$233,346
Total contributions received or receivable from employer(s)2013-12-31$1,012,871
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : CALLISTER, NEBEKER & MCCULLOUGH 401(K) PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources2012-12-31$3,628,293
Expenses. Total of all expenses incurred2012-12-31$2,926,348
Benefits paid (including direct rollovers)2012-12-31$2,923,414
Total plan assets at end of year2012-12-31$19,495,746
Total plan assets at beginning of year2012-12-31$18,793,801
Value of fidelity bond covering the plan2012-12-31$500,000
Total contributions received or receivable from participants2012-12-31$726,850
Other income received2012-12-31$2,088,194
Net income (gross income less expenses)2012-12-31$701,945
Net plan assets at end of year (total assets less liabilities)2012-12-31$19,495,746
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$18,793,801
Assets. Value of participant loans2012-12-31$279,132
Total contributions received or receivable from employer(s)2012-12-31$813,249
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$2,934
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : CALLISTER, NEBEKER & MCCULLOUGH 401(K) PROFIT SHARING PLAN 2011 401k financial data
Total plan liabilities at beginning of year2011-12-31$0
Total income from all sources2011-12-31$1,668,141
Expenses. Total of all expenses incurred2011-12-31$1,389,138
Benefits paid (including direct rollovers)2011-12-31$1,388,562
Total plan assets at end of year2011-12-31$18,793,801
Total plan assets at beginning of year2011-12-31$18,514,798
Value of fidelity bond covering the plan2011-12-31$500,000
Total contributions received or receivable from participants2011-12-31$925,272
Contributions received from other sources (not participants or employers)2011-12-31$281,008
Other income received2011-12-31$-128,640
Net income (gross income less expenses)2011-12-31$279,003
Net plan assets at end of year (total assets less liabilities)2011-12-31$18,793,801
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$18,514,798
Assets. Value of participant loans2011-12-31$136,767
Total contributions received or receivable from employer(s)2011-12-31$590,501
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$576
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : CALLISTER, NEBEKER & MCCULLOUGH 401(K) PROFIT SHARING PLAN 2010 401k financial data
Total plan liabilities at end of year2010-12-31$0
Total plan liabilities at beginning of year2010-12-31$0
Total income from all sources2010-12-31$3,609,757
Expenses. Total of all expenses incurred2010-12-31$450,001
Benefits paid (including direct rollovers)2010-12-31$439,388
Total plan assets at end of year2010-12-31$18,514,798
Total plan assets at beginning of year2010-12-31$15,355,042
Value of fidelity bond covering the plan2010-12-31$500,000
Total contributions received or receivable from participants2010-12-31$718,059
Expenses. Other expenses not covered elsewhere2010-12-31$10,613
Contributions received from other sources (not participants or employers)2010-12-31$257,579
Other income received2010-12-31$1,598,325
Net income (gross income less expenses)2010-12-31$3,159,756
Net plan assets at end of year (total assets less liabilities)2010-12-31$18,514,798
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$15,355,042
Assets. Value of participant loans2010-12-31$92,197
Total contributions received or receivable from employer(s)2010-12-31$1,035,794
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
2009 : CALLISTER, NEBEKER & MCCULLOUGH 401(K) PROFIT SHARING PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for CALLISTER, NEBEKER & MCCULLOUGH 401(K) PROFIT SHARING PLAN

2015: CALLISTER, NEBEKER & MCCULLOUGH 401(K) PROFIT SHARING 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
2015-01-01Plan benefit arrangement - TrustYes
2014: CALLISTER, NEBEKER & MCCULLOUGH 401(K) PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedYes
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: CALLISTER, NEBEKER & MCCULLOUGH 401(K) PROFIT SHARING 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: CALLISTER, NEBEKER & MCCULLOUGH 401(K) PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
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: CALLISTER, NEBEKER & MCCULLOUGH 401(K) PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: CALLISTER, NEBEKER & MCCULLOUGH 401(K) PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: CALLISTER, NEBEKER & MCCULLOUGH 401(K) PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedYes
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

ING USA ANNUITY AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberI155509-0X
Policy instance 1
Insurance contract or identification numberI155509-0X
Number of Individuals Covered5
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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?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?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
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?3
Insurance broker nameLES LEROY BARBER
ING USA ANNUITY AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberI155509-0X
Policy instance 1
Insurance contract or identification numberI155509-0X
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
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?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
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?3
Insurance broker nameLES LEROY BARBER
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number039166
Policy instance 1
Insurance contract or identification number039166
Number of Individuals Covered0
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
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?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?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
ING USA ANNUITY AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberI155509-0X
Policy instance 2
Insurance contract or identification numberI155509-0X
Number of Individuals Covered1
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $224
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?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
Commission paid to Insurance BrokerUSD $56
Insurance broker organization code?3
Insurance broker nameLES LEROY BARBER
ING USA ANNUITY AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number155509-OX
Policy instance 1
Insurance contract or identification number155509-OX
Number of Individuals Covered1
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number039166
Policy instance 2
Insurance contract or identification number039166
Number of Individuals Covered93
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )
Policy contract number62867099
Policy instance 5
Insurance contract or identification number62867099
Number of Individuals Covered1
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
ING USA ANNUITY AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number155509-OX
Policy instance 4
Insurance contract or identification number155509-OX
Number of Individuals Covered1
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number3070597
Policy instance 3
Insurance contract or identification number3070597
Number of Individuals Covered1
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract number38217567
Policy instance 2
Insurance contract or identification number38217567
Number of Individuals Covered1
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number26273
Policy instance 1
Insurance contract or identification number26273
Number of Individuals Covered1
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number039166
Policy instance 6
Insurance contract or identification number039166
Number of Individuals Covered93
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number039166
Policy instance 6
Insurance contract or identification number039166
Number of Individuals Covered90
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )
Policy contract number62867099
Policy instance 5
Insurance contract or identification number62867099
Number of Individuals Covered1
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number3070597
Policy instance 3
Insurance contract or identification number3070597
Number of Individuals Covered1
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract number38217567
Policy instance 2
Insurance contract or identification number38217567
Number of Individuals Covered1
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number26273
Policy instance 1
Insurance contract or identification number26273
Number of Individuals Covered1
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
ING USA ANNUITY AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number155509-OX
Policy instance 4
Insurance contract or identification number155509-OX
Number of Individuals Covered1
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31

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