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EAST CAROLINA ANESTHESIA ASSOCIATES, PLLC CASH BALANCE PENSION PLAN 401k Plan overview

Plan NameEAST CAROLINA ANESTHESIA ASSOCIATES, PLLC CASH BALANCE PENSION PLAN
Plan identification number 002

EAST CAROLINA ANESTHESIA ASSOCIATES, PLLC CASH BALANCE PENSION PLAN Benefits

401k Plan TypeDefined Benefit Pension
Plan Features/Benefits
  • Cash balance or similar plan - Plan has a "cash balance" formula. For this purpose, a "cash balance" formula is a benefit formula in a defined benefit plan by whatever name (for example, personal account plan, pension equity plan, life cycle plan, cash account plan, etc.) that rather than, or in addition to, expressing the accrued benefit as a life annuity commencing at normal retirement age, defines benefits for each employee in terms more common to a defined contribution plan such as a single sum distribution amount (for example, 10 percent of final average pay times years of service, or the amount of the employee's hypothetical account balance).
  • Covered by PBGC - Plan is covered under the PBGC insurance program (see ERISA section 4021).
  • Plan covered by PBGC that was terminated and closed out for PBGC purposes - Before the end of the plan year (or a prior plan year), (1) the plan terminated in a standard (or distress) termination and completed the distribution of plan assets in satisfaction of all benefit liabilities (or all ERISA Title IV benefits for distress termination); or (2) a trustee was appointed for a terminated plan pursuant to ERISA section 4042.
  • Frozen Plan - As of the last day of the plan year, the plan provides that no participant will get any new benefit accrual (whether because of service or compensation).
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

EAST CAROLINA ANESTHESIA ASSOCIATES, PLLC has sponsored the creation of one or more 401k plans.

Company Name:EAST CAROLINA ANESTHESIA ASSOCIATES, PLLC
Employer identification number (EIN):201442673
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EAST CAROLINA ANESTHESIA ASSOCIATES, PLLC CASH BALANCE PENSION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022022-01-01
0022021-01-01DOUGLAS D. FRANKEY2023-02-21
0022020-01-01DOUGLAS D. FRANKEY2021-10-15 DOUGLAS D. FRANKEY2021-10-15
0022019-01-01JOSHUA SCHWARTZ2020-10-15 AMY CHERNAULT2020-10-15
0022019-01-01GARY MULLEN2021-05-19
0022018-01-01
0022017-01-01
0022016-01-01JOSHUA SCHWARTZ2018-01-16
0022015-01-01JOSHUA SCHWARTZ2016-10-17
0022014-01-01JOSHUA SCWARTZ2015-10-12
0022013-01-01JOSHUA SCWARTZ2014-10-10
0022012-01-01JOSHUA SCWARTZ2013-10-09
0022011-01-01DR. JOSHUA SCHWARTZ2012-10-12
0022010-01-01DR. JOSHUA SCHWARTZ2011-10-03

Plan Statistics for EAST CAROLINA ANESTHESIA ASSOCIATES, PLLC CASH BALANCE PENSION PLAN

401k plan membership statisitcs for EAST CAROLINA ANESTHESIA ASSOCIATES, PLLC CASH BALANCE PENSION PLAN

Measure Date Value
2021: EAST CAROLINA ANESTHESIA ASSOCIATES, PLLC CASH BALANCE PENSION PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01155
Total number of active participants reported on line 7a of the Form 55002021-01-0119
Number of retired or separated participants receiving benefits2021-01-0119
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-0138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-0138
Number of participants with account balances2021-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: EAST CAROLINA ANESTHESIA ASSOCIATES, PLLC CASH BALANCE PENSION PLAN 2020 401k membership
Market value of plan assets2020-12-3127,386,111
Acturial value of plan assets2020-12-3127,386,111
Funding target for retired participants and beneficiaries receiving payment2020-12-310
Number of terminated vested participants2020-12-3122
Fundng target for terminated vested participants2020-12-31710,085
Active participant vested funding target2020-12-3122,809,732
Number of active participants2020-12-31140
Total funding liabilities for active participants2020-12-3122,864,637
Total participant count2020-12-31162
Total funding target for all participants2020-12-3123,574,722
Balance at beginning of prior year after applicable adjustments2020-12-310
Prefunding balance at beginning of prior year after applicable adjustments2020-12-310
Carryover balanced portion elected for use to offset prior years funding requirement2020-12-310
Prefunding balanced used to offset prior years funding requirement2020-12-310
Amount remaining of carryover balance2020-12-310
Amount remaining of prefunding balance2020-12-310
Present value of excess contributions2020-12-312,544,919
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2020-12-312,673,437
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2020-12-310
Reductions in caryover balances due to elections or deemed elections2020-12-310
Reductions in prefunding balances due to elections or deemed elections2020-12-310
Balance of carryovers at beginning of current year2020-12-310
Balance of prefunding at beginning of current year2020-12-310
Total employer contributions2020-12-314,396,699
Total employee contributions2020-12-310
Contributions allocated toward unpaid minimum require contributions from prior years2020-12-310
Contributions made to avoid restrictions adjusted to valuation date2020-12-310
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2020-12-314,207,774
Unpaid minimum required contributions for all prior years2020-12-310
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2020-12-310
Remaining amount of unpaid minimum required contributions2020-12-310
Minimum required contributions for current year target normal cost2020-12-310
Net shortfall amortization installment of oustanding balance2020-12-310
Waiver amortization installment2020-12-310
Total funding amount beforereflecting carryover/prefunding balances2020-12-310
Carryover balance elected to use to offset funding requirement2020-12-310
Prefunding balance elected to use to offset funding requirement2020-12-310
Additional cash requirement2020-12-310
Contributions allocatedtoward minimum required contributions for current year2020-12-314,207,774
Unpaid minimum required contributions for current year2020-12-310
Unpaid minimum required contributions for all years2020-12-310
Total participants, beginning-of-year2020-01-01162
Total number of active participants reported on line 7a of the Form 55002020-01-01124
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0131
Total of all active and inactive participants2020-01-01155
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01155
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-011
2019: EAST CAROLINA ANESTHESIA ASSOCIATES, PLLC CASH BALANCE PENSION PLAN 2019 401k membership
Market value of plan assets2019-12-3119,787,090
Acturial value of plan assets2019-12-3119,787,090
Funding target for retired participants and beneficiaries receiving payment2019-12-310
Number of terminated vested participants2019-12-3129
Fundng target for terminated vested participants2019-12-31786,195
Active participant vested funding target2019-12-3118,264,741
Number of active participants2019-12-31117
Total funding liabilities for active participants2019-12-3118,847,773
Total participant count2019-12-31146
Total funding target for all participants2019-12-3119,633,968
Balance at beginning of prior year after applicable adjustments2019-12-310
Prefunding balance at beginning of prior year after applicable adjustments2019-12-310
Carryover balanced portion elected for use to offset prior years funding requirement2019-12-310
Prefunding balanced used to offset prior years funding requirement2019-12-310
Amount remaining of carryover balance2019-12-310
Amount remaining of prefunding balance2019-12-310
Present value of excess contributions2019-12-313,003,509
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2019-12-313,163,296
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2019-12-310
Reductions in caryover balances due to elections or deemed elections2019-12-310
Reductions in prefunding balances due to elections or deemed elections2019-12-310
Balance of carryovers at beginning of current year2019-12-310
Balance of prefunding at beginning of current year2019-12-310
Total employer contributions2019-12-314,837,042
Total employee contributions2019-12-310
Contributions allocated toward unpaid minimum require contributions from prior years2019-12-310
Contributions made to avoid restrictions adjusted to valuation date2019-12-310
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2019-12-314,699,051
Unpaid minimum required contributions for all prior years2019-12-310
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2019-12-310
Remaining amount of unpaid minimum required contributions2019-12-310
Minimum required contributions for current year target normal cost2019-12-312,307,254
Net shortfall amortization installment of oustanding balance2019-12-310
Waiver amortization installment2019-12-310
Total funding amount beforereflecting carryover/prefunding balances2019-12-312,154,132
Carryover balance elected to use to offset funding requirement2019-12-310
Prefunding balance elected to use to offset funding requirement2019-12-310
Additional cash requirement2019-12-312,154,132
Contributions allocatedtoward minimum required contributions for current year2019-12-314,699,051
Unpaid minimum required contributions for current year2019-12-310
Unpaid minimum required contributions for all years2019-12-310
Total participants, beginning-of-year2019-01-01146
Total number of active participants reported on line 7a of the Form 55002019-01-01131
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0122
Total of all active and inactive participants2019-01-01153
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01153
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-013
2018: EAST CAROLINA ANESTHESIA ASSOCIATES, PLLC CASH BALANCE PENSION PLAN 2018 401k membership
Market value of plan assets2018-12-3117,682,915
Acturial value of plan assets2018-12-3117,682,915
Funding target for retired participants and beneficiaries receiving payment2018-12-310
Number of terminated vested participants2018-12-3115
Fundng target for terminated vested participants2018-12-3199,438
Active participant vested funding target2018-12-311,434,128
Number of active participants2018-12-3192
Total funding liabilities for active participants2018-12-3115,114,861
Total participant count2018-12-31107
Total funding target for all participants2018-12-3115,214,299
Balance at beginning of prior year after applicable adjustments2018-12-310
Prefunding balance at beginning of prior year after applicable adjustments2018-12-310
Carryover balanced portion elected for use to offset prior years funding requirement2018-12-310
Prefunding balanced used to offset prior years funding requirement2018-12-310
Amount remaining of carryover balance2018-12-310
Amount remaining of prefunding balance2018-12-310
Present value of excess contributions2018-12-311,676,494
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2018-12-311,676,494
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2018-12-310
Reductions in caryover balances due to elections or deemed elections2018-12-310
Reductions in prefunding balances due to elections or deemed elections2018-12-310
Balance of carryovers at beginning of current year2018-12-310
Balance of prefunding at beginning of current year2018-12-310
Total employer contributions2018-12-313,089,234
Total employee contributions2018-12-310
Contributions allocated toward unpaid minimum require contributions from prior years2018-12-310
Contributions made to avoid restrictions adjusted to valuation date2018-12-310
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2018-12-313,003,509
Unpaid minimum required contributions for all prior years2018-12-310
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2018-12-310
Remaining amount of unpaid minimum required contributions2018-12-310
Minimum required contributions for current year target normal cost2018-12-312,434,800
Net shortfall amortization installment of oustanding balance2018-12-310
Waiver amortization installment2018-12-310
Total funding amount beforereflecting carryover/prefunding balances2018-12-310
Carryover balance elected to use to offset funding requirement2018-12-310
Prefunding balance elected to use to offset funding requirement2018-12-310
Additional cash requirement2018-12-310
Contributions allocatedtoward minimum required contributions for current year2018-12-313,003,509
Unpaid minimum required contributions for current year2018-12-310
Unpaid minimum required contributions for all years2018-12-310
2017: EAST CAROLINA ANESTHESIA ASSOCIATES, PLLC CASH BALANCE PENSION PLAN 2017 401k membership
Market value of plan assets2017-12-3114,716,846
Acturial value of plan assets2017-12-3114,716,846
Funding target for retired participants and beneficiaries receiving payment2017-12-310
Number of terminated vested participants2017-12-3114
Fundng target for terminated vested participants2017-12-3186,570
Active participant vested funding target2017-12-3112,311,078
Number of active participants2017-12-3169
Total funding liabilities for active participants2017-12-3112,388,104
Total participant count2017-12-3183
Total funding target for all participants2017-12-3112,474,674
Balance at beginning of prior year after applicable adjustments2017-12-310
Prefunding balance at beginning of prior year after applicable adjustments2017-12-310
Carryover balanced portion elected for use to offset prior years funding requirement2017-12-310
Prefunding balanced used to offset prior years funding requirement2017-12-310
Amount remaining of carryover balance2017-12-310
Amount remaining of prefunding balance2017-12-310
Present value of excess contributions2017-12-311,139,492
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2017-12-311,211,166
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2017-12-310
Reductions in caryover balances due to elections or deemed elections2017-12-310
Reductions in prefunding balances due to elections or deemed elections2017-12-310
Balance of carryovers at beginning of current year2017-12-310
Balance of prefunding at beginning of current year2017-12-310
Total employer contributions2017-12-311,728,619
Total employee contributions2017-12-310
Contributions allocated toward unpaid minimum require contributions from prior years2017-12-310
Contributions made to avoid restrictions adjusted to valuation date2017-12-310
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2017-12-311,676,494
Unpaid minimum required contributions for all prior years2017-12-310
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2017-12-310
Remaining amount of unpaid minimum required contributions2017-12-310
Minimum required contributions for current year target normal cost2017-12-311,673,507
Net shortfall amortization installment of oustanding balance2017-12-310
Waiver amortization installment2017-12-310
Total funding amount beforereflecting carryover/prefunding balances2017-12-310
Carryover balance elected to use to offset funding requirement2017-12-310
Prefunding balance elected to use to offset funding requirement2017-12-310
Additional cash requirement2017-12-310
Contributions allocatedtoward minimum required contributions for current year2017-12-311,676,494
Unpaid minimum required contributions for current year2017-12-310
Unpaid minimum required contributions for all years2017-12-310
2016: EAST CAROLINA ANESTHESIA ASSOCIATES, PLLC CASH BALANCE PENSION PLAN 2016 401k membership
Market value of plan assets2016-12-3112,433,461
Acturial value of plan assets2016-12-3112,433,461
Funding target for retired participants and beneficiaries receiving payment2016-12-310
Number of terminated vested participants2016-12-3114
Fundng target for terminated vested participants2016-12-31722,524
Active participant vested funding target2016-12-3111,843,797
Number of active participants2016-12-3153
Total funding liabilities for active participants2016-12-3111,845,057
Total participant count2016-12-3168
Total funding target for all participants2016-12-3112,567,581
Balance at beginning of prior year after applicable adjustments2016-12-310
Prefunding balance at beginning of prior year after applicable adjustments2016-12-310
Amount remaining of carryover balance2016-12-310
Amount remaining of prefunding balance2016-12-310
Present value of excess contributions2016-12-311,023,110
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2016-12-311,089,612
Balance of carryovers at beginning of current year2016-12-310
Balance of prefunding at beginning of current year2016-12-310
Total employer contributions2016-12-312,364,653
Total employee contributions2016-12-310
Contributions allocated toward unpaid minimum require contributions from prior years2016-12-310
Contributions made to avoid restrictions adjusted to valuation date2016-12-310
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2016-12-312,273,271
Unpaid minimum required contributions for all prior years2016-12-310
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2016-12-310
Remaining amount of unpaid minimum required contributions2016-12-310
Minimum required contributions for current year target normal cost2016-12-311,111,619
Net shortfall amortization installment of oustanding balance2016-12-31134,120
Total funding amount beforereflecting carryover/prefunding balances2016-12-311,133,779
Additional cash requirement2016-12-311,133,779
Contributions allocatedtoward minimum required contributions for current year2016-12-312,273,271
Unpaid minimum required contributions for current year2016-12-310
Unpaid minimum required contributions for all years2016-12-310

Financial Data on EAST CAROLINA ANESTHESIA ASSOCIATES, PLLC CASH BALANCE PENSION PLAN

Measure Date Value
2021 : EAST CAROLINA ANESTHESIA ASSOCIATES, PLLC CASH BALANCE PENSION PLAN 2021 401k financial data
Unrealized appreciation/depreciation of real estate assets2021-12-31$4,405
Total unrealized appreciation/depreciation of assets2021-12-31$4,405
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$17,910
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$27,200,847
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$27,087,846
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$0
Value of total assets at end of year2021-12-31$1,309,345
Value of total assets at beginning of year2021-12-31$28,492,282
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$113,001
Total interest from all sources2021-12-31$13,505
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2021-12-31$0
Administrative expenses professional fees incurred2021-12-31$47,614
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Assets. Other investments not covered elsewhere at end of year2021-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2021-12-31$242,317
Total non interest bearing cash at end of year2021-12-31$0
Total non interest bearing cash at beginning of year2021-12-31$36,961
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$-27,182,937
Value of net assets at end of year (total assets less liabilities)2021-12-31$1,309,345
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$28,492,282
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Investment advisory and management fees2021-12-31$11,850
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$172,676
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$0
Income. Interest from US Government securities2021-12-31$13,468
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$1,136,669
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$26,008,177
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$26,008,177
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$37
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$61,936
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Employer contributions (assets) at end of year2021-12-31$0
Employer contributions (assets) at beginning of year2021-12-31$2,142,891
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$27,087,846
Contract administrator fees2021-12-31$53,537
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Disclaimer
Accountancy firm name2021-12-31DIXON HUGHES GOODMAN
Accountancy firm EIN2021-12-31560747981
2020 : EAST CAROLINA ANESTHESIA ASSOCIATES, PLLC CASH BALANCE PENSION PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$3,877,006
Total loss/gain on sale of assets2020-12-31$619,150
Total of all expenses incurred2020-12-31$2,814,805
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$2,585,071
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$4,396,699
Value of total assets at end of year2020-12-31$28,492,282
Value of total assets at beginning of year2020-12-31$27,430,081
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$229,734
Total interest from all sources2020-12-31$138,403
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$57,658
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2020-12-31$0
Administrative expenses professional fees incurred2020-12-31$148,112
Assets. Corporate prefeered stocks other than exployer securities at end of year2020-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2020-12-31$0
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Assets. Other investments not covered elsewhere at end of year2020-12-31$242,317
Assets. Other investments not covered elsewhere at beginning of year2020-12-31$1,289,039
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$22,965
Other income not declared elsewhere2020-12-31$135,827
Administrative expenses (other) incurred2020-12-31$1,019
Total non interest bearing cash at end of year2020-12-31$36,961
Total non interest bearing cash at beginning of year2020-12-31$36,961
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$1,062,201
Value of net assets at end of year (total assets less liabilities)2020-12-31$28,492,282
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$27,430,081
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Assets. partnership/joint venture interests at end of year2020-12-31$0
Assets. partnership/joint venture interests at beginning of year2020-12-31$15,980
Investment advisory and management fees2020-12-31$65,384
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$0
Interest earned on other investments2020-12-31$24,863
Income. Interest from US Government securities2020-12-31$33,671
Income. Interest from corporate debt instruments2020-12-31$73,024
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$26,008,177
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$4,563,241
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$4,563,241
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$6,845
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$61,936
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$5,959,329
Asset value of US Government securities at end of year2020-12-31$0
Asset value of US Government securities at beginning of year2020-12-31$1,008,294
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$-1,470,731
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31Yes
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$4,396,699
Employer contributions (assets) at end of year2020-12-31$2,142,891
Employer contributions (assets) at beginning of year2020-12-31$1,088,796
Income. Dividends from common stock2020-12-31$57,658
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$2,585,071
Asset. Corporate debt instrument preferred debt at end of year2020-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2020-12-31$1,478,103
Asset. Corporate debt instrument debt (other) at end of year2020-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2020-12-31$2,727,955
Contract administrator fees2020-12-31$15,219
Assets. Corporate common stocks other than exployer securities at end of year2020-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2020-12-31$9,239,418
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Aggregate proceeds on sale of assets2020-12-31$10,277,990
Aggregate carrying amount (costs) on sale of assets2020-12-31$9,658,840
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31DIXON HUGHES GOODMAN
Accountancy firm EIN2020-12-31560747981
2019 : EAST CAROLINA ANESTHESIA ASSOCIATES, PLLC CASH BALANCE PENSION PLAN 2019 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2019-12-31$2,478,411
Unrealized appreciation/depreciation of other (non real estate) assets2019-12-31$2,478,411
Total unrealized appreciation/depreciation of assets2019-12-31$2,478,411
Total unrealized appreciation/depreciation of assets2019-12-31$2,478,411
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$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 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$8,104,834
Total income from all sources (including contributions)2019-12-31$8,104,834
Total loss/gain on sale of assets2019-12-31$-100,744
Total loss/gain on sale of assets2019-12-31$-100,744
Total of all expenses incurred2019-12-31$498,804
Total of all expenses incurred2019-12-31$498,804
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$350,101
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$350,101
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$4,837,042
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$4,837,042
Value of total assets at end of year2019-12-31$27,393,120
Value of total assets at end of year2019-12-31$27,393,120
Value of total assets at beginning of year2019-12-31$19,787,090
Value of total assets at beginning of year2019-12-31$19,787,090
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$148,703
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$148,703
Total interest from all sources2019-12-31$239,338
Total interest from all sources2019-12-31$239,338
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$251,946
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$251,946
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$8,348
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$8,348
Administrative expenses professional fees incurred2019-12-31$17,220
Administrative expenses professional fees incurred2019-12-31$17,220
Assets. Corporate prefeered stocks other than exployer securities at end of year2019-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2019-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2019-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2019-12-31$0
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$1,000,000
Value of fidelity bond cover2019-12-31$1,000,000
If this is an individual account plan, was there a blackout period2019-12-31No
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
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Assets. Other investments not covered elsewhere at end of year2019-12-31$1,289,039
Assets. Other investments not covered elsewhere at end of year2019-12-31$1,289,039
Assets. Other investments not covered elsewhere at beginning of year2019-12-31$993,657
Assets. Other investments not covered elsewhere at beginning of year2019-12-31$993,657
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$22,965
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$22,965
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$0
Other income not declared elsewhere2019-12-31$596,410
Other income not declared elsewhere2019-12-31$596,410
Administrative expenses (other) incurred2019-12-31$4,144
Administrative expenses (other) incurred2019-12-31$4,144
Total non interest bearing cash at end of year2019-12-31$36,961
Total non interest bearing cash at beginning of year2019-12-31$0
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
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$7,606,030
Value of net income/loss2019-12-31$7,606,030
Value of net assets at end of year (total assets less liabilities)2019-12-31$27,393,120
Value of net assets at end of year (total assets less liabilities)2019-12-31$27,393,120
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$19,787,090
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$19,787,090
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
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 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
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Assets. partnership/joint venture interests at end of year2019-12-31$15,980
Assets. partnership/joint venture interests at end of year2019-12-31$15,980
Assets. partnership/joint venture interests at beginning of year2019-12-31$91,080
Assets. partnership/joint venture interests at beginning of year2019-12-31$91,080
Investment advisory and management fees2019-12-31$127,339
Investment advisory and management fees2019-12-31$127,339
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 end of year2019-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$227,599
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$227,599
Income. Interest from US Government securities2019-12-31$23,486
Income. Interest from US Government securities2019-12-31$23,486
Income. Interest from corporate debt instruments2019-12-31$195,306
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$4,563,241
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$4,563,241
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$2,206,029
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$2,206,029
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$20,546
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$20,546
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$5,959,329
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$5,959,329
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$4,899,867
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$4,899,867
Asset value of US Government securities at end of year2019-12-31$1,008,294
Asset value of US Government securities at end of year2019-12-31$1,008,294
Asset value of US Government securities at beginning of year2019-12-31$1,965,990
Asset value of US Government securities at beginning of year2019-12-31$1,965,990
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$-197,569
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$-197,569
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
Was there a failure to transmit to the plan any participant contributions2019-12-31No
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
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$4,837,042
Contributions received in cash from employer2019-12-31$4,837,042
Employer contributions (assets) at end of year2019-12-31$1,088,796
Employer contributions (assets) at end of year2019-12-31$1,088,796
Employer contributions (assets) at beginning of year2019-12-31$0
Employer contributions (assets) at beginning of year2019-12-31$0
Income. Dividends from common stock2019-12-31$243,598
Income. Dividends from common stock2019-12-31$243,598
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$350,101
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$350,101
Asset. Corporate debt instrument preferred debt at end of year2019-12-31$1,478,103
Asset. Corporate debt instrument preferred debt at end of year2019-12-31$1,478,103
Asset. Corporate debt instrument preferred debt at beginning of year2019-12-31$721,945
Asset. Corporate debt instrument preferred debt at beginning of year2019-12-31$721,945
Asset. Corporate debt instrument debt (other) at end of year2019-12-31$2,727,955
Asset. Corporate debt instrument debt (other) at end of year2019-12-31$2,727,955
Asset. Corporate debt instrument debt (other) at beginning of year2019-12-31$2,943,934
Asset. Corporate debt instrument debt (other) at beginning of year2019-12-31$2,943,934
Contract administrator fees2019-12-31$0
Contract administrator fees2019-12-31$0
Assets. Corporate common stocks other than exployer securities at end of year2019-12-31$9,239,418
Assets. Corporate common stocks other than exployer securities at end of year2019-12-31$9,239,418
Assets. Corporate common stocks other than exployer securities at beginning of year2019-12-31$5,736,989
Assets. Corporate common stocks other than exployer securities at beginning of year2019-12-31$5,736,989
Did the plan have assets held for investment2019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
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 PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Aggregate proceeds on sale of assets2019-12-31$5,713,493
Aggregate proceeds on sale of assets2019-12-31$5,713,493
Aggregate carrying amount (costs) on sale of assets2019-12-31$5,814,237
Aggregate carrying amount (costs) on sale of assets2019-12-31$5,814,237
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
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
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31DIXON HUGHES GOODMAN
Accountancy firm name2019-12-31DIXON HUGHES GOODMAN
Accountancy firm EIN2019-12-31560747981
Accountancy firm EIN2019-12-31560747981

Form 5500 Responses for EAST CAROLINA ANESTHESIA ASSOCIATES, PLLC CASH BALANCE PENSION PLAN

2021: EAST CAROLINA ANESTHESIA ASSOCIATES, PLLC CASH BALANCE PENSION PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedYes
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: EAST CAROLINA ANESTHESIA ASSOCIATES, PLLC CASH BALANCE PENSION PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: EAST CAROLINA ANESTHESIA ASSOCIATES, PLLC CASH BALANCE PENSION PLAN 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 filingNo
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 funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

JACKSON NATIONAL (National Association of Insurance Commissioners NAIC id number: 70211 )
Policy contract number1020315535
Policy instance 1
Insurance contract or identification number1020315535
Number of Individuals Covered0
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?1
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
JACKSON NATIONAL (National Association of Insurance Commissioners NAIC id number: 70211 )
Policy contract number1020315535
Policy instance 1
Insurance contract or identification number1020315535
Number of Individuals Covered1
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?1
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number317019376
Policy instance 1
Insurance contract or identification number317019376
Number of Individuals Covered1
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?1
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number316069110
Policy instance 2
Insurance contract or identification number316069110
Number of Individuals Covered1
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?1
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number317091410
Policy instance 3
Insurance contract or identification number317091410
Number of Individuals Covered1
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $20,000
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?1
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,000
Insurance broker organization code?3
JACKSON NATIONAL (National Association of Insurance Commissioners NAIC id number: 70211 )
Policy contract number1007699367
Policy instance 4
Insurance contract or identification number1007699367
Number of Individuals Covered1
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?1
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
JACKSON NATIONAL (National Association of Insurance Commissioners NAIC id number: 70211 )
Policy contract number1013189281
Policy instance 5
Insurance contract or identification number1013189281
Number of Individuals Covered1
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?1
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
JACKSON NATIONAL (National Association of Insurance Commissioners NAIC id number: 70211 )
Policy contract number1019210240
Policy instance 6
Insurance contract or identification number1019210240
Number of Individuals Covered1
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?1
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
JACKSON NATIONAL (National Association of Insurance Commissioners NAIC id number: 70211 )
Policy contract number1020315535
Policy instance 7
Insurance contract or identification number1020315535
Number of Individuals Covered1
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?1
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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