401k Plan data: EMPLOYEE BENEFIT PLAN OF MONTGOMERY COUNTY COLLABORATION COUNCIL FOR CHILDR plan

EMPLOYEE BENEFIT PLAN OF MONTGOMERY COUNTY COLLABORATION COUNCIL FOR CHILDR 401k Plan overview

Plan Name	EMPLOYEE BENEFIT PLAN OF MONTGOMERY COUNTY COLLABORATION COUNCIL FOR CHILDR
Plan identification number	001

EMPLOYEE BENEFIT PLAN OF MONTGOMERY COUNTY COLLABORATION COUNCIL FOR CHILDR 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

MONTGOMERY COUNTY COLLABORATIO has sponsored the creation of one or more 401k plans.

Company Name: MONTGOMERY COUNTY COLLABORATIO

Employer identification number (EIN): 141904589

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 MONTGOMERY COUNTY COLLABORATION COUNCIL FOR CHILDR

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 LISE ROBINSON 2023-07-03 LISE ROBINSON 2023-07-03
001 2022-01-01 KYLE GOOD 2023-10-12
001 2021-01-01 SANDRA LOMBARDO 2022-04-06
001 2020-01-01 SANDRA LOMBARDO 2021-07-13
001 2019-01-01 LISE ROBINSON 2020-07-16
001 2019-01-01
001 2018-01-01 LISE ROBINSON 2020-06-02 LISE ROBINSON 2020-06-04
001 2017-01-01 CHARLOTTE GIRONDA 2018-05-30 CHARLOTTE GIRONDA 2018-05-30
001 2016-01-01 MEG BREITENBACH 2017-07-28 MEG BREITENBACH 2017-07-28
001 2016-01-01 MEG BREITENBACH 2017-07-27 MEG BREITENBACH 2017-07-27
001 2015-01-01 MEG BREITENBACH 2016-06-02 MEG BREITENBACH 2016-06-02
001 2014-01-01 MEG BREITENBACH 2015-06-02 MEG BREITENBACH 2015-06-02
001 2013-01-01 MEG BREITENBACH 2014-10-13 MEG BREITENBACH 2014-10-13
001 2012-01-01 JOHN DABROWSKI JOHN DABROWSKI 2013-06-18
001 2011-01-01 JOHN DABROWSKI
001 2009-01-01 CAROL A. WALSH CAROL A. WALSH 2010-07-22

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01	LISE ROBINSON	2023-07-03	LISE ROBINSON	2023-07-03
001	2022-01-01	KYLE GOOD	2023-10-12
001	2021-01-01	SANDRA LOMBARDO	2022-04-06
001	2020-01-01	SANDRA LOMBARDO	2021-07-13
001	2019-01-01	LISE ROBINSON	2020-07-16
001	2019-01-01
001	2018-01-01	LISE ROBINSON	2020-06-02	LISE ROBINSON	2020-06-04
001	2017-01-01	CHARLOTTE GIRONDA	2018-05-30	CHARLOTTE GIRONDA	2018-05-30
001	2016-01-01	MEG BREITENBACH	2017-07-28	MEG BREITENBACH	2017-07-28
001	2016-01-01	MEG BREITENBACH	2017-07-27	MEG BREITENBACH	2017-07-27
001	2015-01-01	MEG BREITENBACH	2016-06-02	MEG BREITENBACH	2016-06-02
001	2014-01-01	MEG BREITENBACH	2015-06-02	MEG BREITENBACH	2015-06-02
001	2013-01-01	MEG BREITENBACH	2014-10-13	MEG BREITENBACH	2014-10-13
001	2012-01-01	JOHN DABROWSKI		JOHN DABROWSKI	2013-06-18
001	2011-01-01	JOHN DABROWSKI
001	2009-01-01	CAROL A. WALSH		CAROL A. WALSH	2010-07-22

Plan Statistics for EMPLOYEE BENEFIT PLAN OF MONTGOMERY COUNTY COLLABORATION COUNCIL FOR CHILDR

401k plan membership statisitcs for EMPLOYEE BENEFIT PLAN OF MONTGOMERY COUNTY COLLABORATION COUNCIL FOR CHILDR

Measure Date Value
2019: EMPLOYEE BENEFIT PLAN OF MONTGOMERY COUNTY COLLABORATION COUNCIL FOR CHILDR 2019 401k membership
Total participants, beginning-of-year 2019-01-01 14
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 18
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 6
Total of all active and inactive participants 2019-01-01 24
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 24
Number of participants with account balances 2019-01-01 24
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 1
2012: EMPLOYEE BENEFIT PLAN OF MONTGOMERY COUNTY COLLABORATION COUNCIL FOR CHILDR 2012 401k membership
Total participants, beginning-of-year 2012-01-01 16
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 11
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 7
Total of all active and inactive participants 2012-01-01 18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 18
Number of participants with account balances 2012-01-01 11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 12
2011: EMPLOYEE BENEFIT PLAN OF MONTGOMERY COUNTY COLLABORATION COUNCIL FOR CHILDR 2011 401k membership
Total participants, beginning-of-year 2011-01-01 17
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 11
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 8
Total of all active and inactive participants 2011-01-01 19
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 19
Number of participants with account balances 2011-01-01 19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: EMPLOYEE BENEFIT PLAN OF MONTGOMERY COUNTY COLLABORATION COUNCIL FOR CHILDR 2009 401k membership
Total participants, beginning-of-year 2009-01-01 18
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 14
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 4
Total of all active and inactive participants 2009-01-01 18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 18
Number of participants with account balances 2009-01-01 18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 2

Measure	Date	Value
2019: EMPLOYEE BENEFIT PLAN OF MONTGOMERY COUNTY COLLABORATION COUNCIL FOR CHILDR 2019 401k membership
Total participants, beginning-of-year	2019-01-01	14
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	18
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	6
Total of all active and inactive participants	2019-01-01	24
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	24
Number of participants with account balances	2019-01-01	24
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	1
2012: EMPLOYEE BENEFIT PLAN OF MONTGOMERY COUNTY COLLABORATION COUNCIL FOR CHILDR 2012 401k membership
Total participants, beginning-of-year	2012-01-01	16
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	11
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	7
Total of all active and inactive participants	2012-01-01	18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	18
Number of participants with account balances	2012-01-01	11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	12
2011: EMPLOYEE BENEFIT PLAN OF MONTGOMERY COUNTY COLLABORATION COUNCIL FOR CHILDR 2011 401k membership
Total participants, beginning-of-year	2011-01-01	17
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	11
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	8
Total of all active and inactive participants	2011-01-01	19
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	19
Number of participants with account balances	2011-01-01	19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: EMPLOYEE BENEFIT PLAN OF MONTGOMERY COUNTY COLLABORATION COUNCIL FOR CHILDR 2009 401k membership
Total participants, beginning-of-year	2009-01-01	18
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	14
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	4
Total of all active and inactive participants	2009-01-01	18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	18
Number of participants with account balances	2009-01-01	18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	2

Financial Data on EMPLOYEE BENEFIT PLAN OF MONTGOMERY COUNTY COLLABORATION COUNCIL FOR CHILDR

Measure	Date	Value
2019 : EMPLOYEE BENEFIT PLAN OF MONTGOMERY COUNTY COLLABORATION COUNCIL FOR CHILDR 2019 401k financial data
Transfers to/from the plan	2019-12-31	$0
Total plan liabilities at end of year	2019-12-31	$0
Total plan liabilities at beginning of year	2019-12-31	$0
Total income from all sources	2019-12-31	$722,475
Expenses. Total of all expenses incurred	2019-12-31	$2,862
Benefits paid (including direct rollovers)	2019-12-31	$2,000
Total plan assets at end of year	2019-12-31	$719,613
Total plan assets at beginning of year	2019-12-31	$0
Value of fidelity bond covering the plan	2019-12-31	$0
Total contributions received or receivable from participants	2019-12-31	$38,480
Expenses. Other expenses not covered elsewhere	2019-12-31	$0
Contributions received from other sources (not participants or employers)	2019-12-31	$69,916
Other income received	2019-12-31	$608,566
Net income (gross income less expenses)	2019-12-31	$719,613
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$719,613
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$0
Assets. Value of participant loans	2019-12-31	$9,064
Total contributions received or receivable from employer(s)	2019-12-31	$5,513
Value of certain deemed distributions of participant loans	2019-12-31	$0
Value of corrective distributions	2019-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2019-12-31	$862
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2019-12-31	$0
Minimum employer required contribution for this plan year	2019-12-31	$0
Amount contributed by the employer to the plan for this plan year	2019-12-31	$0
2012 : EMPLOYEE BENEFIT PLAN OF MONTGOMERY COUNTY COLLABORATION COUNCIL FOR CHILDR 2012 401k financial data
Transfers to/from the plan	2012-12-31	$0
Total income from all sources	2012-12-31	$147,926
Expenses. Total of all expenses incurred	2012-12-31	$2,452
Benefits paid (including direct rollovers)	2012-12-31	$2,312
Total plan assets at end of year	2012-12-31	$831,269
Total plan assets at beginning of year	2012-12-31	$685,795
Value of fidelity bond covering the plan	2012-12-31	$75,000
Total contributions received or receivable from participants	2012-12-31	$58,352
Expenses. Other expenses not covered elsewhere	2012-12-31	$140
Contributions received from other sources (not participants or employers)	2012-12-31	$0
Other income received	2012-12-31	$82,844
Net income (gross income less expenses)	2012-12-31	$145,474
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$831,269
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$685,795
Assets. Value of participant loans	2012-12-31	$39,356
Total contributions received or receivable from employer(s)	2012-12-31	$6,730
Value of certain deemed distributions of participant loans	2012-12-31	$0
Value of corrective distributions	2012-12-31	$0
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 : EMPLOYEE BENEFIT PLAN OF MONTGOMERY COUNTY COLLABORATION COUNCIL FOR CHILDR 2011 401k financial data
Transfers to/from the plan	2011-12-31	$0
Total income from all sources	2011-12-31	$48,102
Expenses. Total of all expenses incurred	2011-12-31	$0
Benefits paid (including direct rollovers)	2011-12-31	$0
Total plan assets at end of year	2011-12-31	$685,795
Total plan assets at beginning of year	2011-12-31	$637,693
Value of fidelity bond covering the plan	2011-12-31	$75,000
Total contributions received or receivable from participants	2011-12-31	$64,619
Expenses. Other expenses not covered elsewhere	2011-12-31	$0
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$-23,546
Net income (gross income less expenses)	2011-12-31	$48,102
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$685,795
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$637,693
Assets. Value of participant loans	2011-12-31	$8,987
Total contributions received or receivable from employer(s)	2011-12-31	$7,029
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$0
2010 : EMPLOYEE BENEFIT PLAN OF MONTGOMERY COUNTY COLLABORATION COUNCIL FOR CHILDR 2010 401k financial data
Transfers to/from the plan	2010-12-31	$0
Total income from all sources	2010-12-31	$142,619
Expenses. Total of all expenses incurred	2010-12-31	$12,991
Benefits paid (including direct rollovers)	2010-12-31	$12,851
Total plan assets at end of year	2010-12-31	$637,693
Total plan assets at beginning of year	2010-12-31	$508,065
Value of fidelity bond covering the plan	2010-12-31	$50,000
Total contributions received or receivable from participants	2010-12-31	$66,002
Expenses. Other expenses not covered elsewhere	2010-12-31	$140
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$69,772
Net income (gross income less expenses)	2010-12-31	$129,628
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$637,693
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$508,065
Assets. Value of participant loans	2010-12-31	$13,818
Total contributions received or receivable from employer(s)	2010-12-31	$6,845
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2010-12-31	$0
Minimum employer required contribution for this plan year	2010-12-31	$0
Amount contributed by the employer to the plan for this plan year	2010-12-31	$0

Form 5500 Responses for EMPLOYEE BENEFIT PLAN OF MONTGOMERY COUNTY COLLABORATION COUNCIL FOR CHILDR

2019: EMPLOYEE BENEFIT PLAN OF MONTGOMERY COUNTY COLLABORATION COUNCIL FOR CHILDR 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2012: EMPLOYEE BENEFIT PLAN OF MONTGOMERY COUNTY COLLABORATION COUNCIL FOR CHILDR 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
2011: EMPLOYEE BENEFIT PLAN OF MONTGOMERY COUNTY COLLABORATION COUNCIL FOR CHILDR 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: EMPLOYEE BENEFIT PLAN OF MONTGOMERY COUNTY COLLABORATION COUNCIL FOR CHILDR 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

Insurance Providers Used on plan

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

Policy contract number

GA-026154

Policy instance

Insurance contract or identification number	GA-026154
Number of Individuals Covered	11
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $2,854
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 $2,854
Insurance broker organization code?	3
Insurance broker name	MERRILL LYNCH LIFE AGENCY

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

Policy contract number

GA-026154

Policy instance

Insurance contract or identification number	GA-026154
Number of Individuals Covered	19
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $2,592
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

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

Policy contract number

GA-026154

Policy instance

Insurance contract or identification number	GA-026154
Number of Individuals Covered	17
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $2,076
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 $2,076
Insurance broker organization code?	3
Insurance broker name	MERRILL LYNCH LIFE AGENCY

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Company Name:	MONTGOMERY COUNTY COLLABORATIO
Employer identification number (EIN):	141904589
NAIC Classification:	813000
NAIC Description:	Religious, Grantmaking, Civic, Professional, and Similar Organizations