L & W MEDICAL CARE, P.C. has sponsored the creation of one or more 401k plans.
Additional information about L & W MEDICAL CARE, P.C.
Submission information for form 5500 for 401k plan L & W MEDICAL CARE, P.C. PROFIT SHARING PLAN
401k plan membership statisitcs for L & W MEDICAL CARE, P.C. PROFIT SHARING PLAN
| Measure | Date | Value |
|---|
| 2014: L & W MEDICAL CARE, P.C. PROFIT SHARING PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 3 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 3 |
| 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 | 0 |
| Total of all active and inactive participants | 2014-01-01 | 3 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-01-01 | 0 |
| Total participants | 2014-01-01 | 3 |
| Number of participants with account balances | 2014-01-01 | 3 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2014-01-01 | 0 |
| 2013: L & W MEDICAL CARE, P.C. PROFIT SHARING PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 3 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 3 |
| 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 | 0 |
| Total of all active and inactive participants | 2013-01-01 | 3 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-01-01 | 0 |
| Total participants | 2013-01-01 | 3 |
| Number of participants with account balances | 2013-01-01 | 3 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-01-01 | 0 |
| 2012: L & W MEDICAL CARE, P.C. PROFIT SHARING PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 3 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 3 |
| 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 | 0 |
| Total of all active and inactive participants | 2012-01-01 | 3 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-01-01 | 0 |
| Total participants | 2012-01-01 | 3 |
| Number of participants with account balances | 2012-01-01 | 3 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-01-01 | 0 |
| 2011: L & W MEDICAL CARE, P.C. PROFIT SHARING PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 3 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 3 |
| 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 | 3 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-01-01 | 0 |
| Total participants | 2011-01-01 | 3 |
| Number of participants with account balances | 2011-01-01 | 3 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2011-01-01 | 0 |
| 2010: L & W MEDICAL CARE, P.C. PROFIT SHARING PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 4 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 3 |
| Number of retired or separated participants receiving benefits | 2010-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2010-01-01 | 0 |
| Total of all active and inactive participants | 2010-01-01 | 3 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2010-01-01 | 0 |
| Total participants | 2010-01-01 | 3 |
| Number of participants with account balances | 2010-01-01 | 3 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2010-01-01 | 0 |
| 2009: L & W MEDICAL CARE, P.C. PROFIT SHARING PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 4 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 3 |
| 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 | 1 |
| Total of all active and inactive participants | 2009-01-01 | 4 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-01-01 | 0 |
| Total participants | 2009-01-01 | 4 |
| Number of participants with account balances | 2009-01-01 | 4 |
| 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 : L & W MEDICAL CARE, P.C. PROFIT SHARING PLAN 2014 401k financial data |
|---|
| Transfers to/from the plan | 2014-12-31 | $0 |
| Total plan liabilities at end of year | 2014-12-31 | $0 |
| Total plan liabilities at beginning of year | 2014-12-31 | $0 |
| Total income from all sources | 2014-12-31 | $123,045 |
| Expenses. Total of all expenses incurred | 2014-12-31 | $22,121 |
| Benefits paid (including direct rollovers) | 2014-12-31 | $0 |
| Total plan assets at end of year | 2014-12-31 | $554,915 |
| Total plan assets at beginning of year | 2014-12-31 | $453,991 |
| Total contributions received or receivable from participants | 2014-12-31 | $41,700 |
| Expenses. Other expenses not covered elsewhere | 2014-12-31 | $22,121 |
| Contributions received from other sources (not participants or employers) | 2014-12-31 | $0 |
| Other income received | 2014-12-31 | $65,740 |
| Noncash contributions received | 2014-12-31 | $0 |
| Net income (gross income less expenses) | 2014-12-31 | $100,924 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $554,915 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $453,991 |
| Total contributions received or receivable from employer(s) | 2014-12-31 | $15,605 |
| Value of certain deemed distributions of participant loans | 2014-12-31 | $0 |
| Value of corrective distributions | 2014-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2014-12-31 | $0 |
| 2013 : L & W MEDICAL CARE, P.C. PROFIT SHARING PLAN 2013 401k financial data |
|---|
| Transfers to/from the plan | 2013-12-31 | $0 |
| Total plan liabilities at end of year | 2013-12-31 | $0 |
| Total plan liabilities at beginning of year | 2013-12-31 | $0 |
| Total income from all sources | 2013-12-31 | $114,161 |
| Expenses. Total of all expenses incurred | 2013-12-31 | $22,121 |
| Benefits paid (including direct rollovers) | 2013-12-31 | $0 |
| Total plan assets at end of year | 2013-12-31 | $453,991 |
| Total plan assets at beginning of year | 2013-12-31 | $361,951 |
| Total contributions received or receivable from participants | 2013-12-31 | $41,700 |
| Expenses. Other expenses not covered elsewhere | 2013-12-31 | $22,121 |
| Contributions received from other sources (not participants or employers) | 2013-12-31 | $13,800 |
| Other income received | 2013-12-31 | $32,566 |
| Noncash contributions received | 2013-12-31 | $0 |
| Net income (gross income less expenses) | 2013-12-31 | $92,040 |
| Net plan assets at end of year (total assets less liabilities) | 2013-12-31 | $453,991 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-12-31 | $361,951 |
| Total contributions received or receivable from employer(s) | 2013-12-31 | $26,095 |
| Value of certain deemed distributions of participant loans | 2013-12-31 | $0 |
| Value of corrective distributions | 2013-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2013-12-31 | $0 |
| 2012 : L & W MEDICAL CARE, P.C. PROFIT SHARING PLAN 2012 401k financial data |
|---|
| Transfers to/from the plan | 2012-12-31 | $0 |
| Total plan liabilities at end of year | 2012-12-31 | $0 |
| Total plan liabilities at beginning of year | 2012-12-31 | $0 |
| Total income from all sources | 2012-12-31 | $75,195 |
| Expenses. Total of all expenses incurred | 2012-12-31 | $22,121 |
| Benefits paid (including direct rollovers) | 2012-12-31 | $0 |
| Total plan assets at end of year | 2012-12-31 | $361,951 |
| Total plan assets at beginning of year | 2012-12-31 | $308,877 |
| Total contributions received or receivable from participants | 2012-12-31 | $40,700 |
| Expenses. Other expenses not covered elsewhere | 2012-12-31 | $22,121 |
| Contributions received from other sources (not participants or employers) | 2012-12-31 | $0 |
| Other income received | 2012-12-31 | $18,583 |
| Noncash contributions received | 2012-12-31 | $0 |
| Net income (gross income less expenses) | 2012-12-31 | $53,074 |
| Net plan assets at end of year (total assets less liabilities) | 2012-12-31 | $361,951 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-12-31 | $308,877 |
| Total contributions received or receivable from employer(s) | 2012-12-31 | $15,912 |
| Value of certain deemed distributions of participant loans | 2012-12-31 | $0 |
| Value of corrective distributions | 2012-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2012-12-31 | $0 |
| 2011 : L & W MEDICAL CARE, P.C. PROFIT SHARING PLAN 2011 401k financial data |
|---|
| Transfers to/from the plan | 2011-12-31 | $0 |
| Total plan liabilities at end of year | 2011-12-31 | $0 |
| Total plan liabilities at beginning of year | 2011-12-31 | $0 |
| Total income from all sources | 2011-12-31 | $63,879 |
| Expenses. Total of all expenses incurred | 2011-12-31 | $36,441 |
| Benefits paid (including direct rollovers) | 2011-12-31 | $0 |
| Total plan assets at end of year | 2011-12-31 | $308,877 |
| Total plan assets at beginning of year | 2011-12-31 | $281,439 |
| Total contributions received or receivable from participants | 2011-12-31 | $9,300 |
| Expenses. Other expenses not covered elsewhere | 2011-12-31 | $36,441 |
| Contributions received from other sources (not participants or employers) | 2011-12-31 | $0 |
| Other income received | 2011-12-31 | $2,561 |
| Noncash contributions received | 2011-12-31 | $0 |
| Net income (gross income less expenses) | 2011-12-31 | $27,438 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-31 | $308,877 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-31 | $281,439 |
| Total contributions received or receivable from employer(s) | 2011-12-31 | $52,018 |
| Value of certain deemed distributions of participant loans | 2011-12-31 | $0 |
| Value of corrective distributions | 2011-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2011-12-31 | $0 |
| 2010 : L & W MEDICAL CARE, P.C. PROFIT SHARING PLAN 2010 401k financial data |
|---|
| Transfers to/from the plan | 2010-12-31 | $0 |
| Total plan liabilities at end of year | 2010-12-31 | $0 |
| Total plan liabilities at beginning of year | 2010-12-31 | $0 |
| Total income from all sources | 2010-12-31 | $58,565 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $29,398 |
| Benefits paid (including direct rollovers) | 2010-12-31 | $21,384 |
| Total plan assets at end of year | 2010-12-31 | $281,439 |
| Total plan assets at beginning of year | 2010-12-31 | $252,272 |
| Total contributions received or receivable from participants | 2010-12-31 | $9,300 |
| Expenses. Other expenses not covered elsewhere | 2010-12-31 | $8,014 |
| Contributions received from other sources (not participants or employers) | 2010-12-31 | $0 |
| Other income received | 2010-12-31 | $12,868 |
| Noncash contributions received | 2010-12-31 | $0 |
| Net income (gross income less expenses) | 2010-12-31 | $29,167 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $281,439 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $252,272 |
| Total contributions received or receivable from employer(s) | 2010-12-31 | $36,397 |
| Value of certain deemed distributions of participant loans | 2010-12-31 | $0 |
| Value of corrective distributions | 2010-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2010-12-31 | $0 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2010-12-31 | $0 |
| 2014: L & W MEDICAL CARE, P.C. PROFIT SHARING 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 |
| 2014-01-01 | Plan benefit arrangement - Trust | Yes |
| 2013: L & W MEDICAL CARE, P.C. PROFIT SHARING 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 |
| 2013-01-01 | Plan benefit arrangement - Trust | Yes |
| 2012: L & W MEDICAL CARE, P.C. PROFIT SHARING PLAN 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 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 |
| 2012-01-01 | Plan benefit arrangement - Trust | Yes |
| 2011: L & W MEDICAL CARE, P.C. PROFIT SHARING 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 |
| 2011-01-01 | Plan benefit arrangement - Trust | Yes |
| 2010: L & W MEDICAL CARE, P.C. PROFIT SHARING PLAN 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Submission has been amended | No |
| 2010-01-01 | This submission is the final filing | No |
| 2010-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-01-01 | Plan is a collectively bargained plan | No |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan funding arrangement – Trust | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement - Trust | Yes |
| 2009: L & W MEDICAL CARE, P.C. PROFIT SHARING 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 – Insurance | Yes |
| 2009-01-01 | Plan funding arrangement – Trust | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement - Trust | Yes |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | GPT PR340 |
| Policy instance | 1 |
| Insurance contract or identification number | GPT PR340 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $1,411 | | Total amount of fees paid to insurance company | USD $0 | | 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 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 | Yes | | 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 $1,411 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | 3 | | Insurance broker organization code? | 3 | | Insurance broker name | JOSEPH LAZERSON C/0 THE GUARDIAN |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | GPT PR340 |
| Policy instance | 1 |
| Insurance contract or identification number | GPT PR340 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $1,411 | | Total amount of fees paid to insurance company | USD $0 | | 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 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 | Yes | | 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 $1,411 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | 3 | | Insurance broker organization code? | 3 | | Insurance broker name | JOSEPH LAZERSON C/0 THE GUARDIAN |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | GPT PR340 |
| Policy instance | 1 |
| Insurance contract or identification number | GPT PR340 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $1,411 | | Total amount of fees paid to insurance company | USD $0 | | 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 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 | Yes | | 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 $1,411 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | 3 | | Insurance broker organization code? | 3 | | Insurance broker name | JOSEPH LAZERSON C/0 THE GUARDIAN |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | GPT PR340 |
| Policy instance | 1 |
| Insurance contract or identification number | GPT PR340 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $7,294 | | Total amount of fees paid to insurance company | USD $0 | | 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 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 | Yes | | 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 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | GPT PR340 |
| Policy instance | 1 |
| Insurance contract or identification number | GPT PR340 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $801 | | Total amount of fees paid to insurance company | USD $0 | | 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 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 | Yes | | 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 $801 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | 3 | | Insurance broker organization code? | 3 | | Insurance broker name | JOSEPH LAZERSON C/0 THE GUARDIAN |
|
