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DAVID S. TEARSE, M.D. 401(K) PLAN 401k Plan overview

Plan NameDAVID S. TEARSE, M.D. 401(K) PLAN
Plan identification number 001

DAVID S. TEARSE, M.D. 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Plan covering Self-Employed individuals.
  • 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

DAVID S. TEARSE, M.D., L.L.C. has sponsored the creation of one or more 401k plans.

Company Name:DAVID S. TEARSE, M.D., L.L.C.
Employer identification number (EIN):203423807
NAIC Classification:812990
NAIC Description:All Other Personal Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DAVID S. TEARSE, M.D. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01MINDY TEARSE2023-08-14
0012021-01-01MINDY TEARSE2022-06-28
0012020-01-01MINDY TEARSE2021-09-20
0012019-01-01
0012018-01-01MINDY TEARSE
0012017-01-01MINDY TEARSE
0012016-01-01MINDY TEARSE
0012016-01-01MINDY TEARSE
0012015-01-01MINDY TEARSE
0012015-01-01MINDY TEARSE
0012014-01-01MINDY TEARSE
0012014-01-01MINDY TEARSE
0012013-01-01MINDY TEARSE
0012012-01-01MINDY TEARSE
0012012-01-01MINDY TEARSE
0012011-01-01MINDY TEARSE
0012009-01-01MINDY TEARSE
0012009-01-01

Plan Statistics for DAVID S. TEARSE, M.D. 401(K) PLAN

401k plan membership statisitcs for DAVID S. TEARSE, M.D. 401(K) PLAN

Measure Date Value
2019: DAVID S. TEARSE, M.D. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-012
Total number of active participants reported on line 7a of the Form 55002019-01-012
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-012
Number of participants with account balances2019-01-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: DAVID S. TEARSE, M.D. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-012
Total number of active participants reported on line 7a of the Form 55002018-01-012
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-012
Number of participants with account balances2018-01-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: DAVID S. TEARSE, M.D. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-013
Total number of active participants reported on line 7a of the Form 55002017-01-012
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-012
Number of participants with account balances2017-01-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: DAVID S. TEARSE, M.D. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-013
Total number of active participants reported on line 7a of the Form 55002016-01-012
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-011
Total of all active and inactive participants2016-01-013
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-013
Number of participants with account balances2016-01-013
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: DAVID S. TEARSE, M.D. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-013
Total number of active participants reported on line 7a of the Form 55002015-01-013
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-013
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-013
Number of participants with account balances2015-01-013
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: DAVID S. TEARSE, M.D. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-013
Total number of active participants reported on line 7a of the Form 55002014-01-013
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-013
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-013
Number of participants with account balances2014-01-013
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: DAVID S. TEARSE, M.D. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-013
Total number of active participants reported on line 7a of the Form 55002013-01-013
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-013
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-013
Number of participants with account balances2013-01-013
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: DAVID S. TEARSE, M.D. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-013
Total number of active participants reported on line 7a of the Form 55002012-01-013
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-013
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-013
Number of participants with account balances2012-01-013
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: DAVID S. TEARSE, M.D. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-013
Total number of active participants reported on line 7a of the Form 55002011-01-013
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-013
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-013
Number of participants with account balances2011-01-013
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: DAVID S. TEARSE, M.D. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-014
Total number of active participants reported on line 7a of the Form 55002009-01-013
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-013
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-013
Number of participants with account balances2009-01-013
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on DAVID S. TEARSE, M.D. 401(K) PLAN

Measure Date Value
2019 : DAVID S. TEARSE, M.D. 401(K) PLAN 2019 401k financial data
Total income from all sources2019-12-31$248,039
Expenses. Total of all expenses incurred2019-12-31$0
Total plan assets at end of year2019-12-31$1,005,348
Total plan assets at beginning of year2019-12-31$757,309
Value of fidelity bond covering the plan2019-12-31$75,000
Total contributions received or receivable from participants2019-12-31$40,600
Other income received2019-12-31$201,631
Net income (gross income less expenses)2019-12-31$248,039
Net plan assets at end of year (total assets less liabilities)2019-12-31$1,005,348
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$757,309
Total contributions received or receivable from employer(s)2019-12-31$5,808
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
2018 : DAVID S. TEARSE, M.D. 401(K) PLAN 2018 401k financial data
Total income from all sources2018-12-31$-13,593
Expenses. Total of all expenses incurred2018-12-31$243
Benefits paid (including direct rollovers)2018-12-31$133
Total plan assets at end of year2018-12-31$757,309
Total plan assets at beginning of year2018-12-31$771,145
Value of fidelity bond covering the plan2018-12-31$75,000
Total contributions received or receivable from participants2018-12-31$39,495
Other income received2018-12-31$-58,752
Net income (gross income less expenses)2018-12-31$-13,836
Net plan assets at end of year (total assets less liabilities)2018-12-31$757,309
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$771,145
Total contributions received or receivable from employer(s)2018-12-31$5,664
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$110
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
2017 : DAVID S. TEARSE, M.D. 401(K) PLAN 2017 401k financial data
Total income from all sources2017-12-31$155,168
Expenses. Total of all expenses incurred2017-12-31$0
Total plan assets at end of year2017-12-31$771,145
Total plan assets at beginning of year2017-12-31$615,977
Value of fidelity bond covering the plan2017-12-31$75,000
Total contributions received or receivable from participants2017-12-31$13,800
Other income received2017-12-31$131,033
Net income (gross income less expenses)2017-12-31$155,168
Net plan assets at end of year (total assets less liabilities)2017-12-31$771,145
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$615,977
Total contributions received or receivable from employer(s)2017-12-31$10,335
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : DAVID S. TEARSE, M.D. 401(K) PLAN 2016 401k financial data
Total plan liabilities at beginning of year2016-12-31$2,264
Total income from all sources2016-12-31$67,983
Expenses. Total of all expenses incurred2016-12-31$41,917
Benefits paid (including direct rollovers)2016-12-31$41,807
Total plan assets at end of year2016-12-31$619,999
Total plan assets at beginning of year2016-12-31$596,197
Value of fidelity bond covering the plan2016-12-31$75,000
Total contributions received or receivable from participants2016-12-31$15,471
Other income received2016-12-31$43,304
Net income (gross income less expenses)2016-12-31$26,066
Net plan assets at end of year (total assets less liabilities)2016-12-31$619,999
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$593,933
Total contributions received or receivable from employer(s)2016-12-31$9,208
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$110
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : DAVID S. TEARSE, M.D. 401(K) PLAN 2015 401k financial data
Total plan liabilities at end of year2015-12-31$2,264
Total income from all sources2015-12-31$30,225
Expenses. Total of all expenses incurred2015-12-31$150,110
Benefits paid (including direct rollovers)2015-12-31$150,000
Total plan assets at end of year2015-12-31$596,197
Total plan assets at beginning of year2015-12-31$713,818
Value of fidelity bond covering the plan2015-12-31$75,000
Total contributions received or receivable from participants2015-12-31$16,320
Other income received2015-12-31$4,093
Net income (gross income less expenses)2015-12-31$-119,885
Net plan assets at end of year (total assets less liabilities)2015-12-31$593,933
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$713,818
Total contributions received or receivable from employer(s)2015-12-31$9,812
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$110
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : DAVID S. TEARSE, M.D. 401(K) PLAN 2014 401k financial data
Total income from all sources2014-12-31$82,237
Expenses. Total of all expenses incurred2014-12-31$36,600
Benefits paid (including direct rollovers)2014-12-31$25,000
Total plan assets at end of year2014-12-31$713,818
Total plan assets at beginning of year2014-12-31$668,181
Total contributions received or receivable from participants2014-12-31$15,650
Other income received2014-12-31$53,858
Net income (gross income less expenses)2014-12-31$45,637
Net plan assets at end of year (total assets less liabilities)2014-12-31$713,818
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$668,181
Total contributions received or receivable from employer(s)2014-12-31$12,729
Value of certain deemed distributions of participant loans2014-12-31$11,490
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$110
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : DAVID S. TEARSE, M.D. 401(K) PLAN 2013 401k financial data
Total income from all sources2013-12-31$154,734
Expenses. Total of all expenses incurred2013-12-31$0
Total plan assets at end of year2013-12-31$656,905
Total plan assets at beginning of year2013-12-31$502,171
Total contributions received or receivable from participants2013-12-31$14,987
Other income received2013-12-31$132,310
Net income (gross income less expenses)2013-12-31$154,734
Net plan assets at end of year (total assets less liabilities)2013-12-31$656,905
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$502,171
Assets. Value of participant loans2013-12-31$13,550
Total contributions received or receivable from employer(s)2013-12-31$7,437
2012 : DAVID S. TEARSE, M.D. 401(K) PLAN 2012 401k financial data
Total income from all sources2012-12-31$87,907
Expenses. Total of all expenses incurred2012-12-31$168
Total plan assets at end of year2012-12-31$502,171
Total plan assets at beginning of year2012-12-31$414,432
Total contributions received or receivable from participants2012-12-31$15,740
Other income received2012-12-31$63,684
Net income (gross income less expenses)2012-12-31$87,739
Net plan assets at end of year (total assets less liabilities)2012-12-31$502,171
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$414,432
Assets. Value of participant loans2012-12-31$24,321
Total contributions received or receivable from employer(s)2012-12-31$8,483
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$168
2011 : DAVID S. TEARSE, M.D. 401(K) PLAN 2011 401k financial data
Total income from all sources2011-12-31$-2,700
Expenses. Total of all expenses incurred2011-12-31$300,050
Benefits paid (including direct rollovers)2011-12-31$300,000
Total plan assets at end of year2011-12-31$414,432
Total plan assets at beginning of year2011-12-31$717,182
Total contributions received or receivable from participants2011-12-31$14,973
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-29,847
Net income (gross income less expenses)2011-12-31$-302,750
Net plan assets at end of year (total assets less liabilities)2011-12-31$414,432
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$717,182
Assets. Value of participant loans2011-12-31$34,154
Total contributions received or receivable from employer(s)2011-12-31$12,174
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$50
2010 : DAVID S. TEARSE, M.D. 401(K) PLAN 2010 401k financial data
Total income from all sources2010-12-31$91,894
Expenses. Total of all expenses incurred2010-12-31$200,050
Benefits paid (including direct rollovers)2010-12-31$200,000
Total plan assets at end of year2010-12-31$717,182
Total plan assets at beginning of year2010-12-31$825,338
Total contributions received or receivable from participants2010-12-31$14,917
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$64,861
Net income (gross income less expenses)2010-12-31$-108,156
Net plan assets at end of year (total assets less liabilities)2010-12-31$717,182
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$825,338
Assets. Value of participant loans2010-12-31$42,784
Total contributions received or receivable from employer(s)2010-12-31$12,116
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$50
2009 : DAVID S. TEARSE, M.D. 401(K) PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for DAVID S. TEARSE, M.D. 401(K) PLAN

2019: DAVID S. TEARSE, M.D. 401(K) 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
2018: DAVID S. TEARSE, M.D. 401(K) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: DAVID S. TEARSE, M.D. 401(K) PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: DAVID S. TEARSE, M.D. 401(K) PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: DAVID S. TEARSE, M.D. 401(K) PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: DAVID S. TEARSE, M.D. 401(K) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedYes
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: DAVID S. TEARSE, M.D. 401(K) PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedYes
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: DAVID S. TEARSE, M.D. 401(K) PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: DAVID S. TEARSE, M.D. 401(K) PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement - TrustYes
2009: DAVID S. TEARSE, M.D. 401(K) PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01First time form 5500 has been submittedYes
2009-01-01Submission has been amendedYes
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number873760
Policy instance 1
Insurance contract or identification number873760
Number of Individuals Covered2
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $2,176
Total amount of fees paid to insurance companyUSD $424
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit 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 $2,176
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSIONS
Insurance broker organization code?7
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number873760
Policy instance 1
Insurance contract or identification number873760
Number of Individuals Covered2
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $1,999
Total amount of fees paid to insurance companyUSD $396
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit 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 $1,999
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSIONS
Insurance broker organization code?7
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number873760
Policy instance 1
Insurance contract or identification number873760
Number of Individuals Covered2
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,720
Total amount of fees paid to insurance companyUSD $335
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit 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 $1,720
Insurance broker organization code?7
Amount paid for insurance broker fees335
Additional information about fees paid to insurance brokerTPA SERVICE PROGRAM FEES
Insurance broker namePPG RETIREMENT PLAN SERVICES, LTD.
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number873760
Policy instance 1
Insurance contract or identification number873760
Number of Individuals Covered3
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,694
Total amount of fees paid to insurance companyUSD $348
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 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 $1,694
Insurance broker organization code?7
Amount paid for insurance broker fees348
Additional information about fees paid to insurance brokerTPA SERVICE PROGRAM FEES
Insurance broker namePPG RETIREMENT PLAN SERVICES, LTD.
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number873760
Policy instance 1
Insurance contract or identification number873760
Number of Individuals Covered3
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,676
Total amount of fees paid to insurance companyUSD $329
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 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 $1,676
Insurance broker organization code?7
Amount paid for insurance broker fees329
Additional information about fees paid to insurance brokerTPA SERVICE PROGRAM FEES
Insurance broker namePPG RETIREMENT PLAN SERVICES, LTD.
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number873760
Policy instance 1
Insurance contract or identification number873760
Insurance policy start date2013-11-16
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,571
Total amount of fees paid to insurance companyUSD $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 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
Number of Individuals Covered3
Amount paid for insurance broker fees1562
Additional information about fees paid to insurance brokerTPA SERVICE PROGRAM FEES
Insurance broker organization code?5
Commission paid to Insurance BrokerUSD $334
Insurance broker nameANDREW BURT
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number873760
Policy instance 1
Insurance contract or identification number873760
Number of Individuals Covered3
Insurance policy start date2012-11-16
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $4,571
Total amount of fees paid to insurance companyUSD $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 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 $4,571
Insurance broker organization code?7
Insurance broker nameANDREW BURT

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