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EMPLOYEE BENEFIT PLAN OF THE ARC OF QUINEBAUG VALLEY, INC. 401k Plan overview

Plan NameEMPLOYEE BENEFIT PLAN OF THE ARC OF QUINEBAUG VALLEY, INC.
Plan identification number 002

EMPLOYEE BENEFIT PLAN OF THE ARC OF QUINEBAUG VALLEY, INC. 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.
  • 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

THE ARC OF QUINEBAUG VALLEY, INC. has sponsored the creation of one or more 401k plans.

Company Name:THE ARC OF QUINEBAUG VALLEY, INC.
Employer identification number (EIN):060847364
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE BENEFIT PLAN OF THE ARC OF QUINEBAUG VALLEY, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022019-01-01
0022018-01-01
0022017-01-01NANCY MCGEOWAN NANCY MCGEOWAN2018-10-15
0022016-01-01NANCY MCGEOWAN2017-07-14 NANCY MCGEOWAN2017-07-14
0022015-01-01NANCY MCGEOWAN2016-10-14 NANCY MCGEOWAN2016-10-14
0022014-01-01NANCY MCGEOWAN2015-10-08 NANCY MCGEOWAN2015-10-08
0022014-01-01NANCY MCGEOWAN2016-10-25 NANCY MCGEOWAN2016-10-25
0022013-01-01NANCY MCGEOWAN2014-10-09 NANCY MCGEOWAN2014-10-09
0022012-01-01NANCY MCGEOWAN2013-10-11 NANCY MCGEOWAN2013-10-11
0022011-01-01NANCY MCGEOWAN2012-10-09 NANCY MCGEOWAN2012-10-09
0022010-01-01NANCY MCGEOWAN2011-10-12 NANCY MCGEOWAN2011-10-12

Plan Statistics for EMPLOYEE BENEFIT PLAN OF THE ARC OF QUINEBAUG VALLEY, INC.

401k plan membership statisitcs for EMPLOYEE BENEFIT PLAN OF THE ARC OF QUINEBAUG VALLEY, INC.

Measure Date Value
2019: EMPLOYEE BENEFIT PLAN OF THE ARC OF QUINEBAUG VALLEY, INC. 2019 401k membership
Total participants, beginning-of-year2019-01-01157
Total number of active participants reported on line 7a of the Form 55002019-01-010
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-010
Number of participants with account balances2019-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: EMPLOYEE BENEFIT PLAN OF THE ARC OF QUINEBAUG VALLEY, INC. 2018 401k membership
Total participants, beginning-of-year2018-01-01154
Total number of active participants reported on line 7a of the Form 55002018-01-01144
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0113
Total of all active and inactive participants2018-01-01157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01157
Number of participants with account balances2018-01-0145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: EMPLOYEE BENEFIT PLAN OF THE ARC OF QUINEBAUG VALLEY, INC. 2017 401k membership
Total participants, beginning-of-year2017-01-01125
Total number of active participants reported on line 7a of the Form 55002017-01-01143
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0111
Total of all active and inactive participants2017-01-01154
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01154
Number of participants with account balances2017-01-0142
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-011

Financial Data on EMPLOYEE BENEFIT PLAN OF THE ARC OF QUINEBAUG VALLEY, INC.

Measure Date Value
2019 : EMPLOYEE BENEFIT PLAN OF THE ARC OF QUINEBAUG VALLEY, INC. 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$126,940
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$860,696
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$860,360
Expenses. Certain deemed distributions of participant loans2019-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$39,200
Value of total assets at end of year2019-12-31$0
Value of total assets at beginning of year2019-12-31$733,756
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$336
Total interest from all sources2019-12-31$1,360
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2019-12-31$0
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$150,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$30,749
Participant contributions at end of year2019-12-31$0
Participant contributions at beginning of year2019-12-31$4,576
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$64
Other income not declared elsewhere2019-12-31$0
Administrative expenses (other) incurred2019-12-31$336
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$-733,756
Value of net assets at end of year (total assets less liabilities)2019-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$733,756
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$622,581
Interest on participant loans2019-12-31$123
Interest earned on other investments2019-12-31$1,237
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$106,535
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$0
Net investment gain/loss from pooled separate accounts2019-12-31$86,380
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$8,451
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$860,360
Did the plan have assets held for investment2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31APICELLA, TESTA & COMPANY, P.C.
Accountancy firm EIN2019-12-31060876812
2018 : EMPLOYEE BENEFIT PLAN OF THE ARC OF QUINEBAUG VALLEY, INC. 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$20,199
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$110,984
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$108,216
Expenses. Certain deemed distributions of participant loans2018-12-31$2,094
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$74,413
Value of total assets at end of year2018-12-31$733,756
Value of total assets at beginning of year2018-12-31$824,541
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$674
Total interest from all sources2018-12-31$1,248
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$150,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$58,818
Participant contributions at end of year2018-12-31$4,576
Participant contributions at beginning of year2018-12-31$7,940
Participant contributions at end of year2018-12-31$0
Participant contributions at beginning of year2018-12-31$1,317
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$64
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$64
Other income not declared elsewhere2018-12-31$0
Administrative expenses (other) incurred2018-12-31$674
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-90,785
Value of net assets at end of year (total assets less liabilities)2018-12-31$733,756
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$824,541
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$622,581
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$699,618
Interest on participant loans2018-12-31$231
Interest earned on other investments2018-12-31$1,017
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$106,535
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$115,052
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$0
Net investment gain/loss from pooled separate accounts2018-12-31$-55,462
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$15,595
Employer contributions (assets) at end of year2018-12-31$0
Employer contributions (assets) at beginning of year2018-12-31$550
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$108,216
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31APICELLA, TESTA & COMPANY, P.C.
Accountancy firm EIN2018-12-31060876812
2017 : EMPLOYEE BENEFIT PLAN OF THE ARC OF QUINEBAUG VALLEY, INC. 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$162,717
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$12,728
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$11,150
Expenses. Certain deemed distributions of participant loans2017-12-31$925
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$82,010
Value of total assets at end of year2017-12-31$824,541
Value of total assets at beginning of year2017-12-31$674,552
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$653
Total interest from all sources2017-12-31$1,306
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31No
Value of fidelity bond cover2017-12-31$0
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$65,970
Participant contributions at end of year2017-12-31$7,940
Participant contributions at beginning of year2017-12-31$4,935
Participant contributions at end of year2017-12-31$1,317
Participant contributions at beginning of year2017-12-31$1,728
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$64
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$64
Other income not declared elsewhere2017-12-31$0
Administrative expenses (other) incurred2017-12-31$653
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$149,989
Value of net assets at end of year (total assets less liabilities)2017-12-31$824,541
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$674,552
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$699,618
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$563,037
Interest on participant loans2017-12-31$224
Interest earned on other investments2017-12-31$1,082
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$115,052
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$104,172
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$0
Net investment gain/loss from pooled separate accounts2017-12-31$79,401
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$16,040
Employer contributions (assets) at end of year2017-12-31$550
Employer contributions (assets) at beginning of year2017-12-31$616
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$11,150
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31APICELLA, TESTA & COMPANY, P.C.
Accountancy firm EIN2017-12-31060876812

Form 5500 Responses for EMPLOYEE BENEFIT PLAN OF THE ARC OF QUINEBAUG VALLEY, INC.

2019: EMPLOYEE BENEFIT PLAN OF THE ARC OF QUINEBAUG VALLEY, INC. 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingYes
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: EMPLOYEE BENEFIT PLAN OF THE ARC OF QUINEBAUG VALLEY, INC. 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: EMPLOYEE BENEFIT PLAN OF THE ARC OF QUINEBAUG VALLEY, INC. 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number016256E
Policy instance 1
Insurance contract or identification number016256E
Number of Individuals Covered0
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
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
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerINCENTIVE COMP PROGRAM
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number016256E
Policy instance 1
Insurance contract or identification number016256E
Number of Individuals Covered45
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $421
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
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
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees421
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number016256E
Policy instance 1
Insurance contract or identification number016256E
Number of Individuals Covered42
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $201
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
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
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees201
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP PROGRAM
Insurance broker organization code?3
Insurance broker nameHARTFORD REGIONAL OFFICE

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