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PEAK SPORTS, INC. PENSION PLAN 401k Plan overview

Plan NamePEAK SPORTS, INC. PENSION PLAN
Plan identification number 001

PEAK SPORTS, INC. PENSION PLAN Benefits

401k Plan TypeDefined Benefit Pension
Plan Features/Benefits
  • Benefits are primarily pay related
  • Covered by PBGC - Plan is covered under the PBGC insurance program (see ERISA section 4021).
  • 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.
  • 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

PEAK SPORTS, INC. has sponsored the creation of one or more 401k plans.

Company Name:PEAK SPORTS, INC.
Employer identification number (EIN):930636888
NAIC Classification:451110
NAIC Description:Sporting Goods Stores

Additional information about PEAK SPORTS, INC.

Jurisdiction of Incorporation: Oregon Secretary of State Corporations Division
Incorporation Date: 1972-09-28
Company Identification Number: 9881814
Legal Registered Office Address: 745 NW VAN BUREN AVENUE

CORVALLIS
United States of America (USA)
97330

More information about PEAK SPORTS, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PEAK SPORTS, INC. PENSION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012015-10-01JEFFREY KATZ
0012014-10-01JEFFREY KATZ
0012014-10-01JEFFREY KATZ
0012013-10-01JEFFREY KATZ
0012012-10-01JEFFREY KATZ
0012011-10-01JEFFREY KATZ
0012010-10-01JEFFREY KATZ
0012009-09-30JEFFREY KATZ
0012008-09-30JEFFREY KATZ

Plan Statistics for PEAK SPORTS, INC. PENSION PLAN

401k plan membership statisitcs for PEAK SPORTS, INC. PENSION PLAN

Measure Date Value
2015: PEAK SPORTS, INC. PENSION PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-017
Total number of active participants reported on line 7a of the Form 55002015-10-010
Number of retired or separated participants receiving benefits2015-10-010
Number of other retired or separated participants entitled to future benefits2015-10-010
Total of all active and inactive participants2015-10-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-10-010
Total participants2015-10-010
Number of participants with account balances2015-10-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-10-010
2014: PEAK SPORTS, INC. PENSION PLAN 2014 401k membership
Total participants, beginning-of-year2014-10-017
Total number of active participants reported on line 7a of the Form 55002014-10-016
Number of retired or separated participants receiving benefits2014-10-010
Number of other retired or separated participants entitled to future benefits2014-10-011
Total of all active and inactive participants2014-10-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-10-010
Total participants2014-10-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-10-010
2013: PEAK SPORTS, INC. PENSION PLAN 2013 401k membership
Total participants, beginning-of-year2013-10-018
Total number of active participants reported on line 7a of the Form 55002013-10-016
Number of retired or separated participants receiving benefits2013-10-010
Number of other retired or separated participants entitled to future benefits2013-10-011
Total of all active and inactive participants2013-10-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-10-010
Total participants2013-10-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-10-010
2012: PEAK SPORTS, INC. PENSION PLAN 2012 401k membership
Total participants, beginning-of-year2012-10-019
Total number of active participants reported on line 7a of the Form 55002012-10-016
Number of retired or separated participants receiving benefits2012-10-010
Number of other retired or separated participants entitled to future benefits2012-10-012
Total of all active and inactive participants2012-10-018
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-10-010
Total participants2012-10-018
2011: PEAK SPORTS, INC. PENSION PLAN 2011 401k membership
Total participants, beginning-of-year2011-10-019
Total number of active participants reported on line 7a of the Form 55002011-10-016
Number of retired or separated participants receiving benefits2011-10-010
Number of other retired or separated participants entitled to future benefits2011-10-013
Total of all active and inactive participants2011-10-019
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-10-010
Total participants2011-10-019
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-10-010
2010: PEAK SPORTS, INC. PENSION PLAN 2010 401k membership
Total participants, beginning-of-year2010-10-019
Total number of active participants reported on line 7a of the Form 55002010-10-016
Number of retired or separated participants receiving benefits2010-10-010
Number of other retired or separated participants entitled to future benefits2010-10-013
Total of all active and inactive participants2010-10-019
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-10-010
Total participants2010-10-019
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-10-010
2009: PEAK SPORTS, INC. PENSION PLAN 2009 401k membership
Total participants, beginning-of-year2009-09-309
Total number of active participants reported on line 7a of the Form 55002009-09-307
Number of retired or separated participants receiving benefits2009-09-300
Number of other retired or separated participants entitled to future benefits2009-09-302
Total of all active and inactive participants2009-09-309
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-09-300
Total participants2009-09-309
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-09-300
2008: PEAK SPORTS, INC. PENSION PLAN 2008 401k membership
Total participants, beginning-of-year2008-09-309
Total number of active participants reported on line 7a of the Form 55002008-09-307
Number of retired or separated participants receiving benefits2008-09-300
Number of other retired or separated participants entitled to future benefits2008-09-302
Total of all active and inactive participants2008-09-309
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2008-09-300
Total participants2008-09-309
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2008-09-300

Financial Data on PEAK SPORTS, INC. PENSION PLAN

Measure Date Value
2016 : PEAK SPORTS, INC. PENSION PLAN 2016 401k financial data
Total plan liabilities at end of year2016-05-31$0
Total plan liabilities at beginning of year2016-05-31$172
Total income from all sources2016-05-31$50,257
Expenses. Total of all expenses incurred2016-05-31$2,143,764
Benefits paid (including direct rollovers)2016-05-31$2,138,272
Total plan assets at end of year2016-05-31$0
Total plan assets at beginning of year2016-05-31$2,093,679
Value of fidelity bond covering the plan2016-05-31$115,000
Other income received2016-05-31$50,257
Net income (gross income less expenses)2016-05-31$-2,093,507
Net plan assets at end of year (total assets less liabilities)2016-05-31$0
Net plan assets at beginning of year (total assets less liabilities)2016-05-31$2,093,507
Expenses. Administrative service providers (salaries,fees and commissions)2016-05-31$5,492
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-05-31$0
2015 : PEAK SPORTS, INC. PENSION PLAN 2015 401k financial data
Total plan liabilities at end of year2015-09-30$172
Total plan liabilities at beginning of year2015-09-30$172
Total income from all sources2015-09-30$-40,532
Expenses. Total of all expenses incurred2015-09-30$42,412
Total plan assets at end of year2015-09-30$2,093,679
Total plan assets at beginning of year2015-09-30$2,176,623
Value of fidelity bond covering the plan2015-09-30$115,000
Other income received2015-09-30$-40,532
Net income (gross income less expenses)2015-09-30$-82,944
Net plan assets at end of year (total assets less liabilities)2015-09-30$2,093,679
Net plan assets at beginning of year (total assets less liabilities)2015-09-30$2,176,623
Expenses. Administrative service providers (salaries,fees and commissions)2015-09-30$42,412
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-09-30$0
2014 : PEAK SPORTS, INC. PENSION PLAN 2014 401k financial data
Total plan liabilities at end of year2014-09-30$172
Total plan liabilities at beginning of year2014-09-30$172
Total income from all sources2014-09-30$257,945
Expenses. Total of all expenses incurred2014-09-30$43,595
Benefits paid (including direct rollovers)2014-09-30$11,489
Total plan assets at end of year2014-09-30$2,176,623
Total plan assets at beginning of year2014-09-30$1,962,273
Value of fidelity bond covering the plan2014-09-30$115,000
Total contributions received or receivable from participants2014-09-30$0
Expenses. Other expenses not covered elsewhere2014-09-30$1,583
Contributions received from other sources (not participants or employers)2014-09-30$0
Other income received2014-09-30$234,363
Net income (gross income less expenses)2014-09-30$214,350
Net plan assets at end of year (total assets less liabilities)2014-09-30$2,176,451
Net plan assets at beginning of year (total assets less liabilities)2014-09-30$1,962,101
Total contributions received or receivable from employer(s)2014-09-30$23,582
Value of certain deemed distributions of participant loans2014-09-30$0
Value of corrective distributions2014-09-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2014-09-30$30,523
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-09-30$0
2013 : PEAK SPORTS, INC. PENSION PLAN 2013 401k financial data
Transfers to/from the plan2013-09-30$0
Total plan liabilities at end of year2013-09-30$172
Total plan liabilities at beginning of year2013-09-30$0
Total income from all sources2013-09-30$407,115
Expenses. Total of all expenses incurred2013-09-30$27,267
Benefits paid (including direct rollovers)2013-09-30$792
Total plan assets at end of year2013-09-30$1,962,273
Total plan assets at beginning of year2013-09-30$1,582,253
Value of fidelity bond covering the plan2013-09-30$115,000
Total contributions received or receivable from participants2013-09-30$0
Expenses. Other expenses not covered elsewhere2013-09-30$1,648
Contributions received from other sources (not participants or employers)2013-09-30$0
Other income received2013-09-30$257,467
Net income (gross income less expenses)2013-09-30$379,848
Net plan assets at end of year (total assets less liabilities)2013-09-30$1,962,101
Net plan assets at beginning of year (total assets less liabilities)2013-09-30$1,582,253
Total contributions received or receivable from employer(s)2013-09-30$149,648
Value of certain deemed distributions of participant loans2013-09-30$0
Value of corrective distributions2013-09-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2013-09-30$24,827
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-09-30$0
2012 : PEAK SPORTS, INC. PENSION PLAN 2012 401k financial data
Total plan liabilities at end of year2012-09-30$0
Total plan liabilities at beginning of year2012-09-30$0
Total income from all sources2012-09-30$369,621
Expenses. Total of all expenses incurred2012-09-30$25,287
Total plan assets at end of year2012-09-30$1,582,253
Total plan assets at beginning of year2012-09-30$1,237,919
Value of fidelity bond covering the plan2012-09-30$115,000
Total contributions received or receivable from participants2012-09-30$0
Other income received2012-09-30$261,589
Net income (gross income less expenses)2012-09-30$344,334
Net plan assets at end of year (total assets less liabilities)2012-09-30$1,582,253
Net plan assets at beginning of year (total assets less liabilities)2012-09-30$1,237,919
Total contributions received or receivable from employer(s)2012-09-30$108,032
Expenses. Administrative service providers (salaries,fees and commissions)2012-09-30$25,287
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-09-30$0
2011 : PEAK SPORTS, INC. PENSION PLAN 2011 401k financial data
Transfers to/from the plan2011-09-30$0
Total plan liabilities at end of year2011-09-30$0
Total plan liabilities at beginning of year2011-09-30$0
Total income from all sources2011-09-30$47,173
Expenses. Total of all expenses incurred2011-09-30$17,897
Benefits paid (including direct rollovers)2011-09-30$0
Total plan assets at end of year2011-09-30$1,237,919
Total plan assets at beginning of year2011-09-30$1,208,643
Value of fidelity bond covering the plan2011-09-30$115,000
Total contributions received or receivable from participants2011-09-30$0
Expenses. Other expenses not covered elsewhere2011-09-30$0
Contributions received from other sources (not participants or employers)2011-09-30$0
Other income received2011-09-30$-24,475
Noncash contributions received2011-09-30$0
Net income (gross income less expenses)2011-09-30$29,276
Net plan assets at end of year (total assets less liabilities)2011-09-30$1,237,919
Net plan assets at beginning of year (total assets less liabilities)2011-09-30$1,208,643
Total contributions received or receivable from employer(s)2011-09-30$71,648
Value of certain deemed distributions of participant loans2011-09-30$0
Value of corrective distributions2011-09-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2011-09-30$17,897
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-09-30$0
2010 : PEAK SPORTS, INC. PENSION PLAN 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-09-30$0

Form 5500 Responses for PEAK SPORTS, INC. PENSION PLAN

2015: PEAK SPORTS, INC. PENSION PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Submission has been amendedNo
2015-10-01This submission is the final filingYes
2015-10-01This return/report is a short plan year return/report (less than 12 months)Yes
2015-10-01Plan is a collectively bargained planNo
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan funding arrangement – TrustYes
2015-10-01Plan benefit arrangement – InsuranceYes
2015-10-01Plan benefit arrangement - TrustYes
2014: PEAK SPORTS, INC. PENSION PLAN 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Submission has been amendedYes
2014-10-01This submission is the final filingNo
2014-10-01This return/report is a short plan year return/report (less than 12 months)No
2014-10-01Plan is a collectively bargained planNo
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan funding arrangement – TrustYes
2014-10-01Plan benefit arrangement – InsuranceYes
2014-10-01Plan benefit arrangement - TrustYes
2013: PEAK SPORTS, INC. PENSION PLAN 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Submission has been amendedNo
2013-10-01This submission is the final filingNo
2013-10-01This return/report is a short plan year return/report (less than 12 months)No
2013-10-01Plan is a collectively bargained planNo
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan funding arrangement – TrustYes
2013-10-01Plan benefit arrangement – InsuranceYes
2013-10-01Plan benefit arrangement - TrustYes
2012: PEAK SPORTS, INC. PENSION PLAN 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Submission has been amendedNo
2012-10-01This submission is the final filingNo
2012-10-01This return/report is a short plan year return/report (less than 12 months)No
2012-10-01Plan is a collectively bargained planNo
2012-10-01Plan funding arrangement – InsuranceYes
2012-10-01Plan funding arrangement – TrustYes
2012-10-01Plan benefit arrangement – InsuranceYes
2012-10-01Plan benefit arrangement - TrustYes
2011: PEAK SPORTS, INC. PENSION PLAN 2011 form 5500 responses
2011-10-01Type of plan entitySingle employer plan
2011-10-01Submission has been amendedNo
2011-10-01This submission is the final filingNo
2011-10-01This return/report is a short plan year return/report (less than 12 months)No
2011-10-01Plan is a collectively bargained planNo
2011-10-01Plan funding arrangement – InsuranceYes
2011-10-01Plan funding arrangement – TrustYes
2011-10-01Plan benefit arrangement – InsuranceYes
2011-10-01Plan benefit arrangement - TrustYes
2010: PEAK SPORTS, INC. PENSION PLAN 2010 form 5500 responses
2010-10-01Type of plan entitySingle employer plan
2010-10-01Submission has been amendedNo
2010-10-01This submission is the final filingNo
2010-10-01This return/report is a short plan year return/report (less than 12 months)No
2010-10-01Plan is a collectively bargained planNo
2010-10-01Plan funding arrangement – InsuranceYes
2010-10-01Plan funding arrangement – TrustYes
2010-10-01Plan benefit arrangement – InsuranceYes
2010-10-01Plan benefit arrangement - TrustYes
2009: PEAK SPORTS, INC. PENSION PLAN 2009 form 5500 responses
2009-09-30Type of plan entitySingle employer plan
2009-09-30Submission has been amendedNo
2009-09-30This submission is the final filingNo
2009-09-30This return/report is a short plan year return/report (less than 12 months)No
2009-09-30Plan is a collectively bargained planNo
2009-09-30Plan funding arrangement – InsuranceYes
2009-09-30Plan funding arrangement – TrustYes
2009-09-30Plan benefit arrangement – InsuranceYes
2009-09-30Plan benefit arrangement - TrustYes
2008: PEAK SPORTS, INC. PENSION PLAN 2008 form 5500 responses
2008-09-30Type of plan entitySingle employer plan
2008-09-30Submission has been amendedNo
2008-09-30This submission is the final filingNo
2008-09-30This return/report is a short plan year return/report (less than 12 months)No
2008-09-30Plan is a collectively bargained planNo
2008-09-30Plan funding arrangement – InsuranceYes
2008-09-30Plan funding arrangement – TrustYes
2008-09-30Plan benefit arrangement – InsuranceYes
2008-09-30Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

CONSECO LIFE (National Association of Insurance Commissioners NAIC id number: 00716 )
Policy contract number10P0274910
Policy instance 1
Insurance contract or identification number10P0274910
Number of Individuals Covered0
Insurance policy start date2015-10-01
Insurance policy end date2016-05-31
Are there contracts with allocated funds for individual policies?Yes
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
CONSECO LIFE (National Association of Insurance Commissioners NAIC id number: 00716 )
Policy contract number10P0274910
Policy instance 1
Insurance contract or identification number10P0274910
Number of Individuals Covered3
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Are there contracts with allocated funds for individual policies?Yes
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
CONSECO LIFE (National Association of Insurance Commissioners NAIC id number: 00716 )
Policy contract number10P0274910
Policy instance 1
Insurance contract or identification number10P0274910
Number of Individuals Covered3
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Are there contracts with allocated funds for individual policies?Yes
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
CONSECO LIFE (National Association of Insurance Commissioners NAIC id number: 00716 )
Policy contract number10P0274910
Policy instance 1
Insurance contract or identification number10P0274910
Number of Individuals Covered3
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Are there contracts with allocated funds for individual policies?Yes
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
CONSECO LIFE (National Association of Insurance Commissioners NAIC id number: 00716 )
Policy contract number10P0274910
Policy instance 1
Insurance contract or identification number10P0274910
Number of Individuals Covered3
Insurance policy start date2011-10-01
Insurance policy end date2012-09-30
Are there contracts with allocated funds for individual policies?Yes
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
CONSECO LIFE (National Association of Insurance Commissioners NAIC id number: 00716 )
Policy contract number10P0274910
Policy instance 1
Insurance contract or identification number10P0274910
Number of Individuals Covered3
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Are there contracts with allocated funds for individual policies?Yes
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

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