401k Plan data: HAYWARD, TILTON & ROLAPP PLAN plan

HAYWARD, TILTON & ROLAPP PLAN 401k Plan overview

Plan Name	HAYWARD, TILTON & ROLAPP PLAN
Plan identification number	001

HAYWARD, TILTON & ROLAPP PLAN Benefits

401k Plan Type

Defined 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.
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.

401k Sponsoring company profile

HAYWARD, TILTON, & ROLAPP INSURANCE has sponsored the creation of one or more 401k plans.

Company Name: HAYWARD, TILTON, & ROLAPP INSURANCE

Employer identification number (EIN): 952680888

NAIC Classification: 524210
NAIC Description: Insurance Agencies and Brokerages

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HAYWARD, TILTON & ROLAPP PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2017-01-01 ROGER W ROLAPP 2018-06-22
001 2016-01-01 ROGER W ROLAPP 2017-06-02 ROGER W ROLAPP 2017-06-02
001 2015-01-01 ROGER W ROLAPP 2016-06-16
001 2014-01-01 ROGER ROLAPP
001 2013-01-01 ROGER ROLAPP
001 2012-01-01 ROGER ROLAPP
001 2011-01-01 CRYSTAL MATTHIESSEN
001 2010-01-01 ROGER ROLAPP 2011-07-29
001 2009-01-01 ROGER ROLAPP

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2017-01-01	ROGER W ROLAPP	2018-06-22
001	2016-01-01	ROGER W ROLAPP	2017-06-02	ROGER W ROLAPP	2017-06-02
001	2015-01-01	ROGER W ROLAPP	2016-06-16
001	2014-01-01	ROGER ROLAPP
001	2013-01-01	ROGER ROLAPP
001	2012-01-01	ROGER ROLAPP
001	2011-01-01	CRYSTAL MATTHIESSEN
001	2010-01-01	ROGER ROLAPP	2011-07-29
001	2009-01-01	ROGER ROLAPP

Plan Statistics for HAYWARD, TILTON & ROLAPP PLAN

401k plan membership statisitcs for HAYWARD, TILTON & ROLAPP PLAN

Measure Date Value
2014: HAYWARD, TILTON & ROLAPP PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 48
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 38
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 10
Total of all active and inactive participants 2014-01-01 48
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 1
Total participants 2014-01-01 49
Number of participants with account balances 2014-01-01 39
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: HAYWARD, TILTON & ROLAPP PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 48
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 42
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 9
Total of all active and inactive participants 2013-01-01 51
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 51
Number of participants with account balances 2013-01-01 39
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 1
2012: HAYWARD, TILTON & ROLAPP PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 52
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 42
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 9
Total of all active and inactive participants 2012-01-01 51
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 51
Number of participants with account balances 2012-01-01 42
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: HAYWARD, TILTON & ROLAPP PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 56
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 47
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 47
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 47
Number of participants with account balances 2011-01-01 43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: HAYWARD, TILTON & ROLAPP PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 68
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 57
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 5
Total of all active and inactive participants 2009-01-01 62
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 62
Number of participants with account balances 2009-01-01 44
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2014: HAYWARD, TILTON & ROLAPP PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	48
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	38
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	10
Total of all active and inactive participants	2014-01-01	48
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	1
Total participants	2014-01-01	49
Number of participants with account balances	2014-01-01	39
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: HAYWARD, TILTON & ROLAPP PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	48
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	42
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	9
Total of all active and inactive participants	2013-01-01	51
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	51
Number of participants with account balances	2013-01-01	39
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	1
2012: HAYWARD, TILTON & ROLAPP PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	52
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	42
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	9
Total of all active and inactive participants	2012-01-01	51
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	51
Number of participants with account balances	2012-01-01	42
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: HAYWARD, TILTON & ROLAPP PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	56
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	47
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	47
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	47
Number of participants with account balances	2011-01-01	43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: HAYWARD, TILTON & ROLAPP PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	68
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	57
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	5
Total of all active and inactive participants	2009-01-01	62
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	62
Number of participants with account balances	2009-01-01	44
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on HAYWARD, TILTON & ROLAPP PLAN

Measure	Date	Value
2014 : HAYWARD, TILTON & ROLAPP PLAN 2014 401k financial data
Transfers to/from the plan	2014-12-31	$0
Total income from all sources	2014-12-31	$520,533
Expenses. Total of all expenses incurred	2014-12-31	$351,989
Benefits paid (including direct rollovers)	2014-12-31	$351,648
Total plan assets at end of year	2014-12-31	$4,690,170
Total plan assets at beginning of year	2014-12-31	$4,521,626
Value of fidelity bond covering the plan	2014-12-31	$500,000
Total contributions received or receivable from participants	2014-12-31	$177,325
Expenses. Other expenses not covered elsewhere	2014-12-31	$341
Contributions received from other sources (not participants or employers)	2014-12-31	$76,316
Other income received	2014-12-31	$258,652
Net income (gross income less expenses)	2014-12-31	$168,544
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$4,690,170
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$4,521,626
Assets. Value of participant loans	2014-12-31	$109,203
Total contributions received or receivable from employer(s)	2014-12-31	$8,240
Value of certain deemed distributions of participant loans	2014-12-31	$0
Value of corrective distributions	2014-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2014-12-31	$0
Minimum employer required contribution for this plan year	2014-12-31	$0
Amount contributed by the employer to the plan for this plan year	2014-12-31	$0
2013 : HAYWARD, TILTON & ROLAPP PLAN 2013 401k financial data
Transfers to/from the plan	2013-12-31	$5
Total income from all sources	2013-12-31	$1,367,275
Expenses. Total of all expenses incurred	2013-12-31	$499,273
Benefits paid (including direct rollovers)	2013-12-31	$498,912
Total plan assets at end of year	2013-12-31	$4,521,626
Total plan assets at beginning of year	2013-12-31	$3,653,619
Value of fidelity bond covering the plan	2013-12-31	$500,000
Total contributions received or receivable from participants	2013-12-31	$125,196
Expenses. Other expenses not covered elsewhere	2013-12-31	$361
Contributions received from other sources (not participants or employers)	2013-12-31	$575,391
Other income received	2013-12-31	$660,062
Net income (gross income less expenses)	2013-12-31	$868,002
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$4,521,626
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$3,653,619
Assets. Value of participant loans	2013-12-31	$114,315
Total contributions received or receivable from employer(s)	2013-12-31	$6,626
Value of certain deemed distributions of participant loans	2013-12-31	$0
Value of corrective distributions	2013-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2013-12-31	$0
Minimum employer required contribution for this plan year	2013-12-31	$0
Amount contributed by the employer to the plan for this plan year	2013-12-31	$0
2012 : HAYWARD, TILTON & ROLAPP PLAN 2012 401k financial data
Transfers to/from the plan	2012-12-31	$23
Total income from all sources	2012-12-31	$577,918
Expenses. Total of all expenses incurred	2012-12-31	$65,955
Benefits paid (including direct rollovers)	2012-12-31	$44,586
Total plan assets at end of year	2012-12-31	$3,653,619
Total plan assets at beginning of year	2012-12-31	$3,141,633
Value of fidelity bond covering the plan	2012-12-31	$500,000
Total contributions received or receivable from participants	2012-12-31	$166,740
Expenses. Other expenses not covered elsewhere	2012-12-31	$377
Contributions received from other sources (not participants or employers)	2012-12-31	$18,176
Other income received	2012-12-31	$383,932
Net income (gross income less expenses)	2012-12-31	$511,963
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$3,653,619
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$3,141,633
Assets. Value of participant loans	2012-12-31	$122,226
Total contributions received or receivable from employer(s)	2012-12-31	$9,070
Value of certain deemed distributions of participant loans	2012-12-31	$0
Value of corrective distributions	2012-12-31	$20,992
Funding deficiency by the employer to the plan for this plan year	2012-12-31	$0
Minimum employer required contribution for this plan year	2012-12-31	$0
Amount contributed by the employer to the plan for this plan year	2012-12-31	$0
2011 : HAYWARD, TILTON & ROLAPP PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$117,862
Expenses. Total of all expenses incurred	2011-12-31	$113,151
Benefits paid (including direct rollovers)	2011-12-31	$92,232
Total plan assets at end of year	2011-12-31	$3,141,632
Total plan assets at beginning of year	2011-12-31	$3,141,310
Value of fidelity bond covering the plan	2011-12-31	$500,000
Total contributions received or receivable from participants	2011-12-31	$199,138
Expenses. Other expenses not covered elsewhere	2011-12-31	$123
Contributions received from other sources (not participants or employers)	2011-12-31	$10,800
Other income received	2011-12-31	$-100,074
Net income (gross income less expenses)	2011-12-31	$4,711
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$3,141,632
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$3,141,310
Assets. Value of participant loans	2011-12-31	$115,809
Total contributions received or receivable from employer(s)	2011-12-31	$7,998
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$20,796
Funding deficiency by the employer to the plan for this plan year	2011-12-31	$0
Minimum employer required contribution for this plan year	2011-12-31	$0
Amount contributed by the employer to the plan for this plan year	2011-12-31	$0
2009 : HAYWARD, TILTON & ROLAPP PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for HAYWARD, TILTON & ROLAPP PLAN

2014: HAYWARD, TILTON & ROLAPP PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: HAYWARD, TILTON & ROLAPP PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: HAYWARD, TILTON & ROLAPP PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	First time form 5500 has been submitted	Yes
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: HAYWARD, TILTON & ROLAPP PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: HAYWARD, TILTON & ROLAPP PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-824356

Policy instance

Insurance contract or identification number	GA-824356
Number of Individuals Covered	39
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $6,633
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,906
Insurance broker organization code?	3
Insurance broker name	NFP INSURANCE SERVICES INC

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-824356

Policy instance

Insurance contract or identification number	GA-824356
Number of Individuals Covered	39
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $5,416
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,416
Insurance broker organization code?	3
Insurance broker name	JHW FINANCIAL SERVICES INC

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-824356

Policy instance

Insurance contract or identification number	GA-824356
Number of Individuals Covered	42
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $4,808
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,808
Insurance broker organization code?	3
Insurance broker name	JHW FINANCIAL SERVICES INC.

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-824356

Policy instance

Insurance contract or identification number	GA-824356
Number of Individuals Covered	43
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $2,919
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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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Company Name:	HAYWARD, TILTON, & ROLAPP INSURANCE
Employer identification number (EIN):	952680888
NAIC Classification:	524210
NAIC Description:	Insurance Agencies and Brokerages