A & B MACHINE WORKS, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan A & B MACHINE WORKS, INC. PENSION TRUST
401k plan membership statisitcs for A & B MACHINE WORKS, INC. PENSION TRUST
| Measure | Date | Value |
|---|
| 2016: A & B MACHINE WORKS, INC. PENSION TRUST 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-07-01 | 7 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 0 |
| Number of retired or separated participants receiving benefits | 2016-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-07-01 | 0 |
| Total of all active and inactive participants | 2016-07-01 | 0 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2016-07-01 | 0 |
| Total participants | 2016-07-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2016-07-01 | 0 |
| 2015: A & B MACHINE WORKS, INC. PENSION TRUST 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-07-01 | 7 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-07-01 | 5 |
| Number of retired or separated participants receiving benefits | 2015-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-07-01 | 2 |
| Total of all active and inactive participants | 2015-07-01 | 7 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2015-07-01 | 0 |
| Total participants | 2015-07-01 | 7 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2015-07-01 | 0 |
| 2014: A & B MACHINE WORKS, INC. PENSION TRUST 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-07-01 | 7 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 5 |
| Number of retired or separated participants receiving benefits | 2014-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-07-01 | 2 |
| Total of all active and inactive participants | 2014-07-01 | 7 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-07-01 | 0 |
| Total participants | 2014-07-01 | 7 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2014-07-01 | 0 |
| 2013: A & B MACHINE WORKS, INC. PENSION TRUST 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-07-01 | 8 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 5 |
| Number of retired or separated participants receiving benefits | 2013-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-07-01 | 2 |
| Total of all active and inactive participants | 2013-07-01 | 7 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-07-01 | 0 |
| Total participants | 2013-07-01 | 7 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-07-01 | 0 |
| 2012: A & B MACHINE WORKS, INC. PENSION TRUST 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-07-01 | 8 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 5 |
| Number of retired or separated participants receiving benefits | 2012-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-07-01 | 3 |
| Total of all active and inactive participants | 2012-07-01 | 8 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-07-01 | 0 |
| Total participants | 2012-07-01 | 8 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-07-01 | 0 |
| 2011: A & B MACHINE WORKS, INC. PENSION TRUST 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-07-01 | 9 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 5 |
| Number of retired or separated participants receiving benefits | 2011-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-07-01 | 3 |
| Total of all active and inactive participants | 2011-07-01 | 8 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-07-01 | 0 |
| Total participants | 2011-07-01 | 8 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2011-07-01 | 0 |
| 2009: A & B MACHINE WORKS, INC. PENSION TRUST 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-07-01 | 9 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-07-01 | 6 |
| Number of retired or separated participants receiving benefits | 2009-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-07-01 | 3 |
| Total of all active and inactive participants | 2009-07-01 | 9 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-07-01 | 0 |
| Total participants | 2009-07-01 | 9 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-07-01 | 0 |
| Measure | Date | Value |
|---|
| 2017 : A & B MACHINE WORKS, INC. PENSION TRUST 2017 401k financial data |
|---|
| Total plan liabilities at end of year | 2017-02-16 | $0 |
| Total plan liabilities at beginning of year | 2017-02-16 | $0 |
| Total income from all sources | 2017-02-16 | $106,331 |
| Expenses. Total of all expenses incurred | 2017-02-16 | $837,266 |
| Benefits paid (including direct rollovers) | 2017-02-16 | $837,266 |
| Total plan assets at end of year | 2017-02-16 | $0 |
| Total plan assets at beginning of year | 2017-02-16 | $730,935 |
| Value of fidelity bond covering the plan | 2017-02-16 | $100,000 |
| Other income received | 2017-02-16 | $85,858 |
| Net income (gross income less expenses) | 2017-02-16 | $-730,935 |
| Net plan assets at end of year (total assets less liabilities) | 2017-02-16 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-02-16 | $730,935 |
| Total contributions received or receivable from employer(s) | 2017-02-16 | $20,473 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2017-02-16 | $0 |
| 2016 : A & B MACHINE WORKS, INC. PENSION TRUST 2016 401k financial data |
|---|
| Total plan liabilities at end of year | 2016-06-30 | $0 |
| Total plan liabilities at beginning of year | 2016-06-30 | $0 |
| Total income from all sources | 2016-06-30 | $-40,097 |
| Expenses. Total of all expenses incurred | 2016-06-30 | $5,056 |
| Total plan assets at end of year | 2016-06-30 | $730,935 |
| Total plan assets at beginning of year | 2016-06-30 | $776,088 |
| Value of fidelity bond covering the plan | 2016-06-30 | $100,000 |
| Other income received | 2016-06-30 | $-40,281 |
| Net income (gross income less expenses) | 2016-06-30 | $-45,153 |
| Net plan assets at end of year (total assets less liabilities) | 2016-06-30 | $730,935 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-06-30 | $776,088 |
| Total contributions received or receivable from employer(s) | 2016-06-30 | $184 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-06-30 | $5,056 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2016-06-30 | $0 |
| 2015 : A & B MACHINE WORKS, INC. PENSION TRUST 2015 401k financial data |
|---|
| Transfers to/from the plan | 2015-06-30 | $0 |
| Total plan liabilities at end of year | 2015-06-30 | $0 |
| Total income from all sources | 2015-06-30 | $31,101 |
| Expenses. Total of all expenses incurred | 2015-06-30 | $5,039 |
| Total plan assets at end of year | 2015-06-30 | $776,088 |
| Total plan assets at beginning of year | 2015-06-30 | $750,026 |
| Value of fidelity bond covering the plan | 2015-06-30 | $100,000 |
| Other income received | 2015-06-30 | $30,051 |
| Net income (gross income less expenses) | 2015-06-30 | $26,062 |
| Net plan assets at end of year (total assets less liabilities) | 2015-06-30 | $776,088 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-06-30 | $750,026 |
| Total contributions received or receivable from employer(s) | 2015-06-30 | $1,050 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-06-30 | $5,039 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2015-06-30 | $0 |
| 2014 : A & B MACHINE WORKS, INC. PENSION TRUST 2014 401k financial data |
|---|
| Total income from all sources | 2014-06-30 | $186,787 |
| Expenses. Total of all expenses incurred | 2014-06-30 | $67,470 |
| Benefits paid (including direct rollovers) | 2014-06-30 | $67,470 |
| Total plan assets at end of year | 2014-06-30 | $750,026 |
| Total plan assets at beginning of year | 2014-06-30 | $630,709 |
| Value of fidelity bond covering the plan | 2014-06-30 | $100,000 |
| Other income received | 2014-06-30 | $185,737 |
| Net income (gross income less expenses) | 2014-06-30 | $119,317 |
| Net plan assets at end of year (total assets less liabilities) | 2014-06-30 | $750,026 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-06-30 | $630,709 |
| Total contributions received or receivable from employer(s) | 2014-06-30 | $1,050 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2014-06-30 | $0 |
| 2013 : A & B MACHINE WORKS, INC. PENSION TRUST 2013 401k financial data |
|---|
| Total income from all sources | 2013-06-30 | $121,468 |
| Expenses. Total of all expenses incurred | 2013-06-30 | $0 |
| Total plan assets at end of year | 2013-06-30 | $630,709 |
| Total plan assets at beginning of year | 2013-06-30 | $509,241 |
| Value of fidelity bond covering the plan | 2013-06-30 | $100,000 |
| Other income received | 2013-06-30 | $120,418 |
| Net income (gross income less expenses) | 2013-06-30 | $121,468 |
| Net plan assets at end of year (total assets less liabilities) | 2013-06-30 | $630,709 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-06-30 | $509,241 |
| Total contributions received or receivable from employer(s) | 2013-06-30 | $1,050 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2013-06-30 | $0 |
| 2012 : A & B MACHINE WORKS, INC. PENSION TRUST 2012 401k financial data |
|---|
| Total income from all sources | 2012-06-30 | $6,604 |
| Expenses. Total of all expenses incurred | 2012-06-30 | $17,980 |
| Benefits paid (including direct rollovers) | 2012-06-30 | $17,973 |
| Total plan assets at end of year | 2012-06-30 | $509,241 |
| Total plan assets at beginning of year | 2012-06-30 | $520,617 |
| Value of fidelity bond covering the plan | 2012-06-30 | $100,000 |
| Expenses. Other expenses not covered elsewhere | 2012-06-30 | $7 |
| Other income received | 2012-06-30 | $5,554 |
| Net income (gross income less expenses) | 2012-06-30 | $-11,376 |
| Net plan assets at end of year (total assets less liabilities) | 2012-06-30 | $509,241 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-06-30 | $520,617 |
| Total contributions received or receivable from employer(s) | 2012-06-30 | $1,050 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2012-06-30 | $0 |
| 2011 : A & B MACHINE WORKS, INC. PENSION TRUST 2011 401k financial data |
|---|
| Total income from all sources | 2011-06-30 | $169,295 |
| Expenses. Total of all expenses incurred | 2011-06-30 | $71,911 |
| Benefits paid (including direct rollovers) | 2011-06-30 | $71,891 |
| Total plan assets at end of year | 2011-06-30 | $520,617 |
| Total plan assets at beginning of year | 2011-06-30 | $423,233 |
| Value of fidelity bond covering the plan | 2011-06-30 | $100,000 |
| Expenses. Other expenses not covered elsewhere | 2011-06-30 | $20 |
| Other income received | 2011-06-30 | $112,852 |
| Net income (gross income less expenses) | 2011-06-30 | $97,384 |
| Net plan assets at end of year (total assets less liabilities) | 2011-06-30 | $520,617 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-06-30 | $423,233 |
| Total contributions received or receivable from employer(s) | 2011-06-30 | $56,443 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2011-06-30 | $0 |
| 2010 : A & B MACHINE WORKS, INC. PENSION TRUST 2010 401k financial data |
|---|
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2010-06-30 | $0 |
| 2016: A & B MACHINE WORKS, INC. PENSION TRUST 2016 form 5500 responses |
|---|
| 2016-07-01 | Type of plan entity | Single employer plan |
| 2016-07-01 | Submission has been amended | No |
| 2016-07-01 | This submission is the final filing | Yes |
| 2016-07-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2016-07-01 | Plan is a collectively bargained plan | No |
| 2016-07-01 | Plan funding arrangement – Insurance | Yes |
| 2016-07-01 | Plan funding arrangement – Trust | Yes |
| 2016-07-01 | Plan benefit arrangement - Trust | Yes |
| 2015: A & B MACHINE WORKS, INC. PENSION TRUST 2015 form 5500 responses |
|---|
| 2015-07-01 | Type of plan entity | Single employer plan |
| 2015-07-01 | Submission has been amended | No |
| 2015-07-01 | This submission is the final filing | No |
| 2015-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-07-01 | Plan is a collectively bargained plan | No |
| 2015-07-01 | Plan funding arrangement – Insurance | Yes |
| 2015-07-01 | Plan funding arrangement – Trust | Yes |
| 2015-07-01 | Plan benefit arrangement - Trust | Yes |
| 2014: A & B MACHINE WORKS, INC. PENSION TRUST 2014 form 5500 responses |
|---|
| 2014-07-01 | Type of plan entity | Single employer plan |
| 2014-07-01 | Submission has been amended | No |
| 2014-07-01 | This submission is the final filing | No |
| 2014-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-07-01 | Plan is a collectively bargained plan | No |
| 2014-07-01 | Plan funding arrangement – Insurance | Yes |
| 2014-07-01 | Plan funding arrangement – Trust | Yes |
| 2014-07-01 | Plan benefit arrangement - Trust | Yes |
| 2013: A & B MACHINE WORKS, INC. PENSION TRUST 2013 form 5500 responses |
|---|
| 2013-07-01 | Type of plan entity | Single employer plan |
| 2013-07-01 | Submission has been amended | No |
| 2013-07-01 | This submission is the final filing | No |
| 2013-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-07-01 | Plan is a collectively bargained plan | No |
| 2013-07-01 | Plan funding arrangement – Insurance | Yes |
| 2013-07-01 | Plan funding arrangement – Trust | Yes |
| 2013-07-01 | Plan benefit arrangement - Trust | Yes |
| 2012: A & B MACHINE WORKS, INC. PENSION TRUST 2012 form 5500 responses |
|---|
| 2012-07-01 | Type of plan entity | Single employer plan |
| 2012-07-01 | Submission has been amended | No |
| 2012-07-01 | This submission is the final filing | No |
| 2012-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-07-01 | Plan is a collectively bargained plan | No |
| 2012-07-01 | Plan funding arrangement – Insurance | Yes |
| 2012-07-01 | Plan funding arrangement – Trust | Yes |
| 2012-07-01 | Plan benefit arrangement - Trust | Yes |
| 2011: A & B MACHINE WORKS, INC. PENSION TRUST 2011 form 5500 responses |
|---|
| 2011-07-01 | Type of plan entity | Single employer plan |
| 2011-07-01 | Submission has been amended | No |
| 2011-07-01 | This submission is the final filing | No |
| 2011-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-07-01 | Plan is a collectively bargained plan | No |
| 2011-07-01 | Plan funding arrangement – Insurance | Yes |
| 2011-07-01 | Plan funding arrangement – Trust | Yes |
| 2011-07-01 | Plan benefit arrangement - Trust | Yes |
| 2009: A & B MACHINE WORKS, INC. PENSION TRUST 2009 form 5500 responses |
|---|
| 2009-07-01 | Type of plan entity | Single employer plan |
| 2009-07-01 | Submission has been amended | No |
| 2009-07-01 | This submission is the final filing | No |
| 2009-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-07-01 | Plan is a collectively bargained plan | No |
| 2009-07-01 | Plan funding arrangement – Insurance | Yes |
| 2009-07-01 | Plan funding arrangement – Trust | Yes |
| 2009-07-01 | Plan benefit arrangement - Trust | Yes |
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 700302 |
| Policy instance | 1 |
| Insurance contract or identification number | 700302 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $2,151 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | Yes | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,151 | | Insurance broker organization code? | 3 | | Insurance broker name | RUSSELL F. CAFORIO & ASSOC., INC. |
|
| TRANSAMERICA OCCIDENTAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67121 ) |
| Policy contract number | 92525188 |
| Policy instance | 4 |
| Insurance contract or identification number | 92525188 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2014-12-31 | | Insurance policy end date | 2015-12-30 | | Are there contracts with allocated funds for individual policies? | Yes | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LINCOLN (National Association of Insurance Commissioners NAIC id number: 101 ) |
| Policy contract number | W4205447 |
| Policy instance | 3 |
| Insurance contract or identification number | W4205447 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2014-12-31 | | Insurance policy end date | 2015-12-30 | | Are there contracts with allocated funds for individual policies? | Yes | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | U01423713 |
| Policy instance | 2 |
| Insurance contract or identification number | U01423713 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Are there contracts with allocated funds for individual policies? | Yes | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LINCOLN (National Association of Insurance Commissioners NAIC id number: 101 ) |
| Policy contract number | W4205447 |
| Policy instance | 3 |
| Insurance contract or identification number | W4205447 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2013-12-31 | | Insurance policy end date | 2014-12-30 | | Are there contracts with allocated funds for individual policies? | Yes | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 700302 |
| Policy instance | 1 |
| Insurance contract or identification number | 700302 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $2,115 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | Yes | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,115 | | Insurance broker organization code? | 3 | | Insurance broker name | RUSSELL F. CAFORIO & ASSOC., INC. |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | U01423713 |
| Policy instance | 2 |
| Insurance contract or identification number | U01423713 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Are there contracts with allocated funds for individual policies? | Yes | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| TRANSAMERICA OCCIDENTAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67121 ) |
| Policy contract number | 92525188 |
| Policy instance | 4 |
| Insurance contract or identification number | 92525188 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2013-12-31 | | Insurance policy end date | 2014-12-30 | | Are there contracts with allocated funds for individual policies? | Yes | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| TRANSAMERICA OCCIDENTAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67121 ) |
| Policy contract number | 92525188 |
| Policy instance | 4 |
| Insurance contract or identification number | 92525188 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2012-12-31 | | Insurance policy end date | 2013-12-30 | | Are there contracts with allocated funds for individual policies? | Yes | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LINCOLN (National Association of Insurance Commissioners NAIC id number: 101 ) |
| Policy contract number | W4205447 |
| Policy instance | 3 |
| Insurance contract or identification number | W4205447 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2012-12-31 | | Insurance policy end date | 2013-12-30 | | Are there contracts with allocated funds for individual policies? | Yes | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | GD 31858-00-4 |
| Policy instance | 1 |
| Insurance contract or identification number | GD 31858-00-4 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-02-24 | | Total amount of commissions paid to insurance broker | USD $1,661 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | Yes | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,661 | | Insurance broker organization code? | 3 | | Insurance broker name | RUSSELL F. CAFORIO & ASSOC., INC. |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | U01423713 |
| Policy instance | 2 |
| Insurance contract or identification number | U01423713 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Are there contracts with allocated funds for individual policies? | Yes | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | GD 31858-00-4 |
| Policy instance | 1 |
| Insurance contract or identification number | GD 31858-00-4 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $1,608 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | Yes | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,608 | | Insurance broker organization code? | 3 | | Insurance broker name | RUSSELL F. CAFORIO & ASSOC., INC. |
|
| TRANSAMERICA OCCIDENTAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67121 ) |
| Policy contract number | 92525188 |
| Policy instance | 4 |
| Insurance contract or identification number | 92525188 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2011-12-31 | | Insurance policy end date | 2012-12-30 | | Are there contracts with allocated funds for individual policies? | Yes | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LINCOLN (National Association of Insurance Commissioners NAIC id number: 101 ) |
| Policy contract number | W4205447 |
| Policy instance | 3 |
| Insurance contract or identification number | W4205447 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2011-12-31 | | Insurance policy end date | 2012-12-30 | | Are there contracts with allocated funds for individual policies? | Yes | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | U01423713 |
| Policy instance | 2 |
| Insurance contract or identification number | U01423713 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Are there contracts with allocated funds for individual policies? | Yes | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LINCOLN (National Association of Insurance Commissioners NAIC id number: 101 ) |
| Policy contract number | W4205447 |
| Policy instance | 3 |
| Insurance contract or identification number | W4205447 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2010-12-31 | | Insurance policy end date | 2011-12-30 | | Are there contracts with allocated funds for individual policies? | Yes | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | U01423713 |
| Policy instance | 2 |
| Insurance contract or identification number | U01423713 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Are there contracts with allocated funds for individual policies? | Yes | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | GD 31858-00-4 |
| Policy instance | 1 |
| Insurance contract or identification number | GD 31858-00-4 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $1,318 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | Yes | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| TRANSAMERICA OCCIDENTAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67121 ) |
| Policy contract number | 92525188 |
| Policy instance | 4 |
| Insurance contract or identification number | 92525188 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2010-12-31 | | Insurance policy end date | 2011-12-30 | | Are there contracts with allocated funds for individual policies? | Yes | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| TRANSAMERICA OCCIDENTAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67121 ) |
| Policy contract number | 92525188 |
| Policy instance | 4 |
| Insurance contract or identification number | 92525188 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2009-12-31 | | Insurance policy end date | 2010-12-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | Yes | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | U01423713 |
| Policy instance | 2 |
| Insurance contract or identification number | U01423713 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | Yes | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | GD 31858-00-4 |
| Policy instance | 1 |
| Insurance contract or identification number | GD 31858-00-4 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $1,149 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | Yes | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LINCOLN (National Association of Insurance Commissioners NAIC id number: 101 ) |
| Policy contract number | W4205447 |
| Policy instance | 3 |
| Insurance contract or identification number | W4205447 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2009-12-31 | | Insurance policy end date | 2010-12-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | Yes | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
