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COUNCIL FOR OLDER ADULTS MATCHED SAVINGS PLAN 401k Plan overview

Plan NameCOUNCIL FOR OLDER ADULTS MATCHED SAVINGS PLAN
Plan identification number 001

COUNCIL FOR OLDER ADULTS MATCHED SAVINGS PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.

401k Sponsoring company profile

SOURCEPOINT has sponsored the creation of one or more 401k plans.

Company Name:SOURCEPOINT
Employer identification number (EIN):311354284
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Additional information about SOURCEPOINT

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division
Incorporation Date: 1992-06-01
Company Identification Number: 820496
Legal Registered Office Address: 800 CHESHIRE RD
SUITE A
DELAWARE
United States of America (USA)
43015

More information about SOURCEPOINT

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COUNCIL FOR OLDER ADULTS MATCHED SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01KIM CLEWELL2020-07-29
0012018-01-01KIM CLEWELL2019-10-07
0012017-01-01KIM CLEWELL2018-10-12
0012016-01-01KIM CLEWELL2017-08-25
0012015-01-01KIM CLEWELL2016-09-26
0012014-01-01KIM CLEWELL2015-10-14
0012013-01-01KIM CLEWELL2014-07-30
0012012-01-01KIM CLEWELL2013-04-23
0012011-01-01KIM CLEWELL2012-07-05
0012009-01-01KIM CLEWELL

Plan Statistics for COUNCIL FOR OLDER ADULTS MATCHED SAVINGS PLAN

401k plan membership statisitcs for COUNCIL FOR OLDER ADULTS MATCHED SAVINGS PLAN

Measure Date Value
2022: COUNCIL FOR OLDER ADULTS MATCHED SAVINGS PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01142
Total number of active participants reported on line 7a of the Form 55002022-01-01103
Number of retired or separated participants receiving benefits2022-01-017
Number of other retired or separated participants entitled to future benefits2022-01-0137
Total of all active and inactive participants2022-01-01147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01147
Number of participants with account balances2022-01-01118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-0110
2021: COUNCIL FOR OLDER ADULTS MATCHED SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01130
Total number of active participants reported on line 7a of the Form 55002021-01-01103
Number of retired or separated participants receiving benefits2021-01-015
Number of other retired or separated participants entitled to future benefits2021-01-0133
Total of all active and inactive participants2021-01-01141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01141
Number of participants with account balances2021-01-01114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-018
2020: COUNCIL FOR OLDER ADULTS MATCHED SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01127
Total number of active participants reported on line 7a of the Form 55002020-01-0199
Number of retired or separated participants receiving benefits2020-01-015
Number of other retired or separated participants entitled to future benefits2020-01-0127
Total of all active and inactive participants2020-01-01131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01131
Number of participants with account balances2020-01-01110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-014
2009: COUNCIL FOR OLDER ADULTS MATCHED SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-010
Total number of active participants reported on line 7a of the Form 55002009-01-010
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 participants2009-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-010

Financial Data on COUNCIL FOR OLDER ADULTS MATCHED SAVINGS PLAN

Measure Date Value
2022 : COUNCIL FOR OLDER ADULTS MATCHED SAVINGS PLAN 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2022-12-31$-18,028
Total unrealized appreciation/depreciation of assets2022-12-31$-18,028
Total transfer of assets from this plan2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$-87,658
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$477,201
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$401,175
Value of total corrective distributions2022-12-31$63
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$753,734
Value of total assets at end of year2022-12-31$4,904,325
Value of total assets at beginning of year2022-12-31$5,469,184
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$75,963
Total interest from all sources2022-12-31$594
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$91,029
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$91,029
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$345,707
Participant contributions at end of year2022-12-31$19,679
Participant contributions at beginning of year2022-12-31$51,080
Participant contributions at end of year2022-12-31$13,228
Participant contributions at beginning of year2022-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$157,597
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$153
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$0
Administrative expenses (other) incurred2022-12-31$75,864
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-564,859
Value of net assets at end of year (total assets less liabilities)2022-12-31$4,904,325
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$5,469,184
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$4,510,130
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$4,943,306
Interest on participant loans2022-12-31$594
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$351,931
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$471,485
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-914,987
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$250,430
Employer contributions (assets) at end of year2022-12-31$9,204
Employer contributions (assets) at beginning of year2022-12-31$3,313
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$401,175
Contract administrator fees2022-12-31$99
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31PLANCHECK
Accountancy firm EIN2022-12-31842614035
2021 : COUNCIL FOR OLDER ADULTS MATCHED SAVINGS PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
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$1,122,036
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$568,005
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$556,457
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$575,415
Value of total assets at end of year2021-12-31$5,469,184
Value of total assets at beginning of year2021-12-31$4,915,153
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$11,548
Total interest from all sources2021-12-31$1,215
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$13,892
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$13,892
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$317,338
Participant contributions at end of year2021-12-31$51,080
Participant contributions at beginning of year2021-12-31$61,706
Participant contributions at end of year2021-12-31$0
Participant contributions at beginning of year2021-12-31$12,344
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$1,439
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2021-12-31$364
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$554,031
Value of net assets at end of year (total assets less liabilities)2021-12-31$5,469,184
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$4,915,153
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$11,548
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$4,943,306
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$4,074,310
Interest on participant loans2021-12-31$1,215
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$471,485
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$758,164
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$531,514
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
Contributions received in cash from employer2021-12-31$256,638
Employer contributions (assets) at end of year2021-12-31$3,313
Employer contributions (assets) at beginning of year2021-12-31$8,629
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$556,093
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 plan2021-12-31Unqualified
Accountancy firm name2021-12-31PLANCHECK
Accountancy firm EIN2021-12-31842614035
2020 : COUNCIL FOR OLDER ADULTS MATCHED SAVINGS 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$1,260,794
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$177,706
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$151,792
Expenses. Certain deemed distributions of participant loans2020-12-31$7,668
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$596,686
Value of total assets at end of year2020-12-31$4,915,153
Value of total assets at beginning of year2020-12-31$3,832,065
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$18,246
Total interest from all sources2020-12-31$18,591
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
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
Contributions received from participants2020-12-31$305,392
Participant contributions at end of year2020-12-31$61,706
Participant contributions at beginning of year2020-12-31$41,178
Participant contributions at end of year2020-12-31$12,344
Participant contributions at beginning of year2020-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$21,280
Administrative expenses (other) incurred2020-12-31$18,246
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$1,083,088
Value of net assets at end of year (total assets less liabilities)2020-12-31$4,915,153
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$3,832,065
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
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$4,074,310
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$3,227,331
Interest on participant loans2020-12-31$1,883
Interest earned on other investments2020-12-31$16,708
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$758,164
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$563,556
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$645,517
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
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$270,014
Employer contributions (assets) at end of year2020-12-31$8,629
Employer contributions (assets) at beginning of year2020-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$151,792
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
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31PLANCHEC(K) CPA'S, LLC
Accountancy firm EIN2020-12-31842614035

Form 5500 Responses for COUNCIL FOR OLDER ADULTS MATCHED SAVINGS PLAN

2022: COUNCIL FOR OLDER ADULTS MATCHED SAVINGS PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: COUNCIL FOR OLDER ADULTS MATCHED SAVINGS PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
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: COUNCIL FOR OLDER ADULTS MATCHED SAVINGS 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
2009: COUNCIL FOR OLDER ADULTS MATCHED SAVINGS PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
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 – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number57443
Policy instance 1
Insurance contract or identification number57443
Number of Individuals Covered48
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 2
Insurance contract or identification number613953
Number of Individuals Covered113
Insurance policy start date2022-12-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $101
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees101
Additional information about fees paid to insurance brokerREFERRAL/SERVICE FEE
Insurance broker organization code?3
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number57443
Policy instance 1
Insurance contract or identification number57443
Number of Individuals Covered103
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $5,363
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit 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 $4,355
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSION
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 2
Insurance contract or identification number613953
Number of Individuals Covered104
Insurance policy start date2021-12-01
Insurance policy end date2021-12-31
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?Yes
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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number57443
Policy instance 1
Insurance contract or identification number57443
Number of Individuals Covered110
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $9,123
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit 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 $5,574
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSION
Insurance broker organization code?3

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