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403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC. 401k Plan overview

Plan Name403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC.
Plan identification number 002

403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC. Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • 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 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.

401k Sponsoring company profile

GOODWILL OF SOUTHERN INDIANA, INC. has sponsored the creation of one or more 401k plans.

Company Name:GOODWILL OF SOUTHERN INDIANA, INC.
Employer identification number (EIN):351019658
NAIC Classification:453310
NAIC Description:Used Merchandise Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022017-01-01
0022016-01-01
0022015-01-01COURTNEY BRUTSCHER COURTNEY BRUTSCHER2016-07-26
0022014-01-01COURTNEY BRUTSCHER COURTNEY BRUTSCHER2015-07-22
0022013-01-01COURTNEY BRUTSCHER COURTNEY BRUTSCHER2014-07-25
0022012-01-01COURTNEY BRUTSCHER COURTNEY BRUTSCHER2013-07-26
0022011-01-01COURTNEY BRUTSCHER COURTNEY BRUTSCHER2012-07-27
0022009-01-01CANDICE BARKSDALE

Plan Statistics for 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC.

401k plan membership statisitcs for 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC.

Measure Date Value
2017: 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC. 2017 401k membership
Total participants, beginning-of-year2017-01-01174
Total number of active participants reported on line 7a of the Form 55002017-01-010
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 participants2017-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-010
Number of participants with account balances2017-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC. 2016 401k membership
Total participants, beginning-of-year2016-01-01202
Total number of active participants reported on line 7a of the Form 55002016-01-0190
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0182
Total of all active and inactive participants2016-01-01172
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-012
Total participants2016-01-01174
Number of participants with account balances2016-01-01174
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-0137
2015: 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC. 2015 401k membership
Total participants, beginning-of-year2015-01-01183
Total number of active participants reported on line 7a of the Form 55002015-01-01280
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0173
Total of all active and inactive participants2015-01-01353
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-011
Total participants2015-01-01354
Number of participants with account balances2015-01-01202
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-0121
2014: 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC. 2014 401k membership
Total participants, beginning-of-year2014-01-01177
Total number of active participants reported on line 7a of the Form 55002014-01-01112
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0171
Total of all active and inactive participants2014-01-01183
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01183
Number of participants with account balances2014-01-01183
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC. 2013 401k membership
Total participants, beginning-of-year2013-01-01335
Total number of active participants reported on line 7a of the Form 55002013-01-01280
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0165
Total of all active and inactive participants2013-01-01345
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-011
Total participants2013-01-01346
Number of participants with account balances2013-01-01177
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC. 2012 401k membership
Total participants, beginning-of-year2012-01-01363
Total number of active participants reported on line 7a of the Form 55002012-01-01267
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0168
Total of all active and inactive participants2012-01-01335
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01335
Number of participants with account balances2012-01-01180
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC. 2011 401k membership
Total participants, beginning-of-year2011-01-01229
Total number of active participants reported on line 7a of the Form 55002011-01-01264
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-0198
Total of all active and inactive participants2011-01-01362
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-011
Total participants2011-01-01363
Number of participants with account balances2011-01-01209
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC. 2009 401k membership
Total participants, beginning-of-year2009-01-01149
Total number of active participants reported on line 7a of the Form 55002009-01-0199
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0123
Total of all active and inactive participants2009-01-01122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-011
Total participants2009-01-01123
Number of participants with account balances2009-01-01123
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC.

Measure Date Value
2017 : 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC. 2017 401k financial data
Total income from all sources (including contributions)2017-01-31$12,819
Total of all expenses incurred2017-01-31$987,043
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-01-31$986,914
Value of total assets at beginning of year2017-01-31$974,224
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-01-31$129
Total interest from all sources2017-01-31$118
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-01-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2017-01-31$0
Was this plan covered by a fidelity bond2017-01-31No
If this is an individual account plan, was there a blackout period2017-01-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-01-31$0
Were there any nonexempt tranactions with any party-in-interest2017-01-31No
Administrative expenses (other) incurred2017-01-31$129
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-01-31No
Value of net income/loss2017-01-31$-974,224
Value of net assets at beginning of year (total assets less liabilities)2017-01-31$974,224
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-01-31No
Were any leases to which the plan was party in default or uncollectible2017-01-31No
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-01-31$828,694
Interest earned on other investments2017-01-31$118
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-01-31$145,530
Net investment gain/loss from pooled separate accounts2017-01-31$12,701
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-01-31No
Was there a failure to transmit to the plan any participant contributions2017-01-31No
Has the plan failed to provide any benefit when due under the plan2017-01-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-01-31$986,914
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-01-31No
Did the plan have assets held for investment2017-01-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-01-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-01-31Yes
Opinion of an independent qualified public accountant for this plan2017-01-31Disclaimer
Accountancy firm name2017-01-31MONROE SHINE & CO., INC.
Accountancy firm EIN2017-01-31351515068
2016 : 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC. 2016 401k financial data
Total income from all sources (including contributions)2016-12-31$206,426
Total of all expenses incurred2016-12-31$178,471
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$176,818
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$137,342
Value of total assets at end of year2016-12-31$974,224
Value of total assets at beginning of year2016-12-31$946,269
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$1,653
Total interest from all sources2016-12-31$1,439
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2016-12-31$0
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$250,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$103,411
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$2,461
Administrative expenses (other) incurred2016-12-31$1,653
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$27,955
Value of net assets at end of year (total assets less liabilities)2016-12-31$974,224
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$946,269
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$828,694
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$765,541
Interest earned on other investments2016-12-31$1,439
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$145,530
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$180,728
Net investment gain/loss from pooled separate accounts2016-12-31$67,645
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$31,470
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$176,818
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31MONROE SHINE & CO., INC.
Accountancy firm EIN2016-12-31351515068
2015 : 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC. 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$206
Total income from all sources (including contributions)2015-12-31$125,714
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$61,785
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$60,029
Expenses. Certain deemed distributions of participant loans2015-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$137,640
Value of total assets at end of year2015-12-31$946,269
Value of total assets at beginning of year2015-12-31$882,546
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$1,756
Total interest from all sources2015-12-31$1,821
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$250,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$104,999
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$206
Other income not declared elsewhere2015-12-31$0
Administrative expenses (other) incurred2015-12-31$1,756
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$63,929
Value of net assets at end of year (total assets less liabilities)2015-12-31$946,269
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$882,340
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$765,541
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$699,050
Interest on participant loans2015-12-31$0
Interest earned on other investments2015-12-31$1,821
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$180,728
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$183,496
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$0
Net investment gain/loss from pooled separate accounts2015-12-31$-13,747
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$32,641
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$60,029
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31MONROE SHINE & CO., INC.
Accountancy firm EIN2015-12-31351515068
2014 : 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC. 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$206
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$667
Total income from all sources (including contributions)2014-12-31$159,798
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$69,312
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$67,554
Expenses. Certain deemed distributions of participant loans2014-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$120,162
Value of total assets at end of year2014-12-31$882,546
Value of total assets at beginning of year2014-12-31$792,521
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$1,758
Total interest from all sources2014-12-31$1,682
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$250,000
If this is an individual account plan, was there a blackout period2014-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$88,073
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$1,969
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$206
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-12-31$667
Other income not declared elsewhere2014-12-31$7
Administrative expenses (other) incurred2014-12-31$1,758
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$90,486
Value of net assets at end of year (total assets less liabilities)2014-12-31$882,340
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$791,854
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$699,050
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$632,212
Interest on participant loans2014-12-31$0
Interest earned on other investments2014-12-31$1,682
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$183,496
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$160,309
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$0
Net investment gain/loss from pooled separate accounts2014-12-31$37,947
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31Yes
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$30,120
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$67,554
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31MONROE SHINE & CO. INC.
Accountancy firm EIN2014-12-31351515068
2013 : 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC. 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$667
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$946
Total income from all sources (including contributions)2013-12-31$219,251
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$132,972
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$131,239
Expenses. Certain deemed distributions of participant loans2013-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$104,286
Value of total assets at end of year2013-12-31$792,521
Value of total assets at beginning of year2013-12-31$706,521
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$1,733
Total interest from all sources2013-12-31$1,861
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$250,000
If this is an individual account plan, was there a blackout period2013-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$76,170
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-12-31$667
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$946
Other income not declared elsewhere2013-12-31$140
Administrative expenses (other) incurred2013-12-31$1,733
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$86,279
Value of net assets at end of year (total assets less liabilities)2013-12-31$791,854
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$705,575
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$632,212
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$538,505
Interest on participant loans2013-12-31$0
Interest earned on other investments2013-12-31$1,861
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$160,309
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$168,016
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$0
Net investment gain/loss from pooled separate accounts2013-12-31$112,964
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$28,116
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$131,239
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31MONROE SHINE & CO., INC.
Accountancy firm EIN2013-12-31351515068
2012 : 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC. 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$946
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total income from all sources (including contributions)2012-12-31$160,513
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$50,443
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$48,871
Expenses. Certain deemed distributions of participant loans2012-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$105,349
Value of total assets at end of year2012-12-31$706,521
Value of total assets at beginning of year2012-12-31$595,505
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$1,572
Total interest from all sources2012-12-31$2,685
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$250,000
If this is an individual account plan, was there a blackout period2012-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$76,136
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$1,345
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-12-31$946
Other income not declared elsewhere2012-12-31$0
Administrative expenses (other) incurred2012-12-31$1,572
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$110,070
Value of net assets at end of year (total assets less liabilities)2012-12-31$705,575
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$595,505
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$538,505
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$436,475
Interest on participant loans2012-12-31$0
Interest earned on other investments2012-12-31$2,685
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$168,016
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$159,030
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$0
Net investment gain/loss from pooled separate accounts2012-12-31$52,479
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31Yes
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$27,868
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$48,871
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31MONROE SHINE & CO., INC.
Accountancy firm EIN2012-12-31351515068
2011 : 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC. 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total income from all sources (including contributions)2011-12-31$113,757
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$143,980
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$142,500
Expenses. Certain deemed distributions of participant loans2011-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$112,641
Value of total assets at end of year2011-12-31$595,505
Value of total assets at beginning of year2011-12-31$625,728
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$1,480
Total interest from all sources2011-12-31$3,532
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$250,000
If this is an individual account plan, was there a blackout period2011-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$72,104
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$11,544
Other income not declared elsewhere2011-12-31$0
Administrative expenses (other) incurred2011-12-31$1,480
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-30,223
Value of net assets at end of year (total assets less liabilities)2011-12-31$595,505
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$625,728
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$436,475
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$435,614
Interest on participant loans2011-12-31$0
Interest earned on other investments2011-12-31$3,532
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$159,030
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$189,216
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$0
Net investment gain/loss from pooled separate accounts2011-12-31$-2,416
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31Yes
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$28,993
Employer contributions (assets) at end of year2011-12-31$0
Employer contributions (assets) at beginning of year2011-12-31$898
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$142,500
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31MONROE SHINE & CO., INC.
Accountancy firm EIN2011-12-31351515068
2010 : 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC. 2010 401k financial data
Total transfer of assets to this plan2010-12-31$2,404
Total income from all sources (including contributions)2010-12-31$178,677
Total of all expenses incurred2010-12-31$79,433
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$77,961
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$126,305
Value of total assets at end of year2010-12-31$625,728
Value of total assets at beginning of year2010-12-31$524,080
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$1,472
Total interest from all sources2010-12-31$4,530
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$250,000
If this is an individual account plan, was there a blackout period2010-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$67,476
Participant contributions at end of year2010-12-31$0
Participant contributions at beginning of year2010-12-31$2,584
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$99,244
Value of net assets at end of year (total assets less liabilities)2010-12-31$625,728
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$524,080
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in pooled separate accounts at end of year2010-12-31$435,614
Value of interest in pooled separate accounts at beginning of year2010-12-31$361,034
Interest earned on other investments2010-12-31$4,530
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$189,216
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$159,424
Net investment gain/loss from pooled separate accounts2010-12-31$47,842
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$58,829
Employer contributions (assets) at end of year2010-12-31$898
Employer contributions (assets) at beginning of year2010-12-31$1,038
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$77,961
Contract administrator fees2010-12-31$1,472
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31No
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31MONROE SHINE & CO., INC.
Accountancy firm EIN2010-12-31351515068
2009 : 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC. 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 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC.

2017: 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC. 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01This submission is the final filingYes
2017-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC. 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC. 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 benefit arrangement – InsuranceYes
2014: 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC. 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
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 benefit arrangement – InsuranceYes
2013: 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC. 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
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 benefit arrangement – InsuranceYes
2012: 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC. 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 benefit arrangement – InsuranceYes
2011: 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC. 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 – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: 403(B) THRIFT PLAN OF GOODWILL OF SOUTHERN INDIANA, INC. 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 – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number056835A
Policy instance 1
Insurance contract or identification number056835A
Number of Individuals Covered202
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $91
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 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
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees91
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
Insurance broker nameINDIANAPOLIS REGIONAL OFFICE
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number056835A
Policy instance 1
Insurance contract or identification number056835A
Number of Individuals Covered183
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $123
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 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
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees123
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
Insurance broker nameINDIANAPOLIS REGIONAL OFFICE
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number056835A
Policy instance 1
Insurance contract or identification number056835A
Number of Individuals Covered177
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $121
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 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
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees121
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
Insurance broker nameINDIANAPOLIS REGIONAL OFFICE
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number056835A
Policy instance 1
Insurance contract or identification number056835A
Number of Individuals Covered180
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $189
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 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
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees90
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
Insurance broker nameSARAH WIENCKEN
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number056835A
Policy instance 1
Insurance contract or identification number056835A
Number of Individuals Covered210
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $563
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 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
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number056835-A
Policy instance 1
Insurance contract or identification number056835-A
Number of Individuals Covered229
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $545
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 contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
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 fees183
Additional information about fees paid to insurance brokerCOMPENSATION
Insurance broker organization code?3
Insurance broker nameERIC J. OUSLEY

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