LEGACY COOPERATIVE has sponsored the creation of one or more 401k plans.
Measure | Date | Value |
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2022 : CO-OP 401(K) PLAN 2022 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2022-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $1,133 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $1,399 |
Total income from all sources (including contributions) | 2022-12-31 | $-837,635 |
Total loss/gain on sale of assets | 2022-12-31 | $0 |
Total of all expenses incurred | 2022-12-31 | $1,545,557 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-12-31 | $1,504,824 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-12-31 | $747,384 |
Value of total assets at end of year | 2022-12-31 | $8,969,697 |
Value of total assets at beginning of year | 2022-12-31 | $11,353,155 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-12-31 | $40,733 |
Total interest from all sources | 2022-12-31 | $4,750 |
Total dividends received (eg from common stock, registered investment company shares) | 2022-12-31 | $248,636 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2022-12-31 | $248,636 |
Administrative expenses professional fees incurred | 2022-12-31 | $38,322 |
Was this plan covered by a fidelity bond | 2022-12-31 | Yes |
Value of fidelity bond cover | 2022-12-31 | $1,000,000 |
If this is an individual account plan, was there a blackout period | 2022-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2022-12-31 | No |
Contributions received from participants | 2022-12-31 | $495,736 |
Participant contributions at end of year | 2022-12-31 | $63,442 |
Participant contributions at beginning of year | 2022-12-31 | $107,805 |
Participant contributions at end of year | 2022-12-31 | $13,627 |
Participant contributions at beginning of year | 2022-12-31 | $16,811 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2022-12-31 | $1,133 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2022-12-31 | $1,399 |
Other income not declared elsewhere | 2022-12-31 | $-130,664 |
Administrative expenses (other) incurred | 2022-12-31 | $2,411 |
Total non interest bearing cash at end of year | 2022-12-31 | $9,739 |
Total non interest bearing cash at beginning of year | 2022-12-31 | $46,030 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
Value of net income/loss | 2022-12-31 | $-2,383,192 |
Value of net assets at end of year (total assets less liabilities) | 2022-12-31 | $8,968,564 |
Value of net assets at beginning of year (total assets less liabilities) | 2022-12-31 | $11,351,756 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2022-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2022-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2022-12-31 | $7,668,015 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2022-12-31 | $9,424,318 |
Interest on participant loans | 2022-12-31 | $4,750 |
Value of interest in common/collective trusts at end of year | 2022-12-31 | $25,909 |
Value of interest in common/collective trusts at beginning of year | 2022-12-31 | $75,151 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2022-12-31 | $224 |
Asset value of US Government securities at end of year | 2022-12-31 | $372,174 |
Asset value of US Government securities at beginning of year | 2022-12-31 | $726,494 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2022-12-31 | $-1,708,246 |
Net investment gain or loss from common/collective trusts | 2022-12-31 | $505 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2022-12-31 | Yes |
Has the plan failed to provide any benefit when due under the plan | 2022-12-31 | No |
Contributions received in cash from employer | 2022-12-31 | $251,648 |
Employer contributions (assets) at beginning of year | 2022-12-31 | $9,731 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-12-31 | $1,504,824 |
Asset. Corporate debt instrument preferred debt at end of year | 2022-12-31 | $286,559 |
Asset. Corporate debt instrument preferred debt at beginning of year | 2022-12-31 | $319,758 |
Asset. Corporate debt instrument debt (other) at end of year | 2022-12-31 | $530,008 |
Asset. Corporate debt instrument debt (other) at beginning of year | 2022-12-31 | $627,057 |
Did the plan have assets held for investment | 2022-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2022-12-31 | Unqualified |
Accountancy firm name | 2022-12-31 | EIDE BAILLY |
Accountancy firm EIN | 2022-12-31 | 450250958 |
2021 : CO-OP 401(K) PLAN 2021 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2021-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $1,399 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $1,526 |
Total income from all sources (including contributions) | 2021-12-31 | $1,757,928 |
Total loss/gain on sale of assets | 2021-12-31 | $0 |
Total of all expenses incurred | 2021-12-31 | $1,594,004 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-12-31 | $1,552,100 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-12-31 | $750,269 |
Value of total assets at end of year | 2021-12-31 | $11,353,155 |
Value of total assets at beginning of year | 2021-12-31 | $11,189,358 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-12-31 | $41,904 |
Total interest from all sources | 2021-12-31 | $6,028 |
Total dividends received (eg from common stock, registered investment company shares) | 2021-12-31 | $427,787 |
Total dividends received from registered investment company shares (eg mutual funds) | 2021-12-31 | $427,787 |
Administrative expenses professional fees incurred | 2021-12-31 | $39,105 |
Was this plan covered by a fidelity bond | 2021-12-31 | Yes |
Value of fidelity bond cover | 2021-12-31 | $1,000,000 |
If this is an individual account plan, was there a blackout period | 2021-12-31 | No |
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2021-12-31 | $0 |
Were there any nonexempt tranactions with any party-in-interest | 2021-12-31 | No |
Contributions received from participants | 2021-12-31 | $450,664 |
Participant contributions at end of year | 2021-12-31 | $107,805 |
Participant contributions at beginning of year | 2021-12-31 | $116,898 |
Participant contributions at end of year | 2021-12-31 | $16,811 |
Participant contributions at beginning of year | 2021-12-31 | $14,844 |
Income. Received or receivable in cash from other sources (including rollovers) | 2021-12-31 | $59,350 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2021-12-31 | $1,399 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2021-12-31 | $1,526 |
Other income not declared elsewhere | 2021-12-31 | $-70,295 |
Administrative expenses (other) incurred | 2021-12-31 | $2,799 |
Total non interest bearing cash at end of year | 2021-12-31 | $46,030 |
Total non interest bearing cash at beginning of year | 2021-12-31 | $114 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
Value of net income/loss | 2021-12-31 | $163,924 |
Value of net assets at end of year (total assets less liabilities) | 2021-12-31 | $11,351,756 |
Value of net assets at beginning of year (total assets less liabilities) | 2021-12-31 | $11,187,832 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2021-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2021-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2021-12-31 | $9,424,318 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2021-12-31 | $9,077,716 |
Interest on participant loans | 2021-12-31 | $6,028 |
Value of interest in common/collective trusts at end of year | 2021-12-31 | $75,151 |
Value of interest in common/collective trusts at beginning of year | 2021-12-31 | $164,801 |
Asset value of US Government securities at end of year | 2021-12-31 | $726,494 |
Asset value of US Government securities at beginning of year | 2021-12-31 | $828,729 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2021-12-31 | $644,094 |
Net investment gain or loss from common/collective trusts | 2021-12-31 | $45 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2021-12-31 | Yes |
Has the plan failed to provide any benefit when due under the plan | 2021-12-31 | No |
Contributions received in cash from employer | 2021-12-31 | $240,255 |
Employer contributions (assets) at end of year | 2021-12-31 | $9,731 |
Employer contributions (assets) at beginning of year | 2021-12-31 | $8,185 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2021-12-31 | $1,552,100 |
Asset. Corporate debt instrument preferred debt at end of year | 2021-12-31 | $319,758 |
Asset. Corporate debt instrument preferred debt at beginning of year | 2021-12-31 | $366,350 |
Asset. Corporate debt instrument debt (other) at end of year | 2021-12-31 | $627,057 |
Asset. Corporate debt instrument debt (other) at beginning of year | 2021-12-31 | $611,721 |
Did the plan have assets held for investment | 2021-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2021-12-31 | Unqualified |
Accountancy firm name | 2021-12-31 | EIDE BAILLY |
Accountancy firm EIN | 2021-12-31 | 450250958 |
2020 : CO-OP 401(K) PLAN 2020 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2020-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $1,526 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $1,562 |
Total income from all sources (including contributions) | 2020-12-31 | $2,959,211 |
Total loss/gain on sale of assets | 2020-12-31 | $0 |
Total of all expenses incurred | 2020-12-31 | $746,789 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-12-31 | $708,361 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-12-31 | $1,259,837 |
Value of total assets at end of year | 2020-12-31 | $11,189,358 |
Value of total assets at beginning of year | 2020-12-31 | $8,976,972 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-12-31 | $38,428 |
Total interest from all sources | 2020-12-31 | $6,547 |
Total dividends received (eg from common stock, registered investment company shares) | 2020-12-31 | $288,213 |
Total dividends received from registered investment company shares (eg mutual funds) | 2020-12-31 | $288,213 |
Administrative expenses professional fees incurred | 2020-12-31 | $35,586 |
Was this plan covered by a fidelity bond | 2020-12-31 | Yes |
Value of fidelity bond cover | 2020-12-31 | $1,000,000 |
If this is an individual account plan, was there a blackout period | 2020-12-31 | No |
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2020-12-31 | $0 |
Were there any nonexempt tranactions with any party-in-interest | 2020-12-31 | No |
Contributions received from participants | 2020-12-31 | $459,353 |
Participant contributions at end of year | 2020-12-31 | $116,898 |
Participant contributions at beginning of year | 2020-12-31 | $129,317 |
Participant contributions at end of year | 2020-12-31 | $14,844 |
Income. Received or receivable in cash from other sources (including rollovers) | 2020-12-31 | $564,494 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2020-12-31 | $1,526 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2020-12-31 | $1,562 |
Other income not declared elsewhere | 2020-12-31 | $154,226 |
Administrative expenses (other) incurred | 2020-12-31 | $2,842 |
Total non interest bearing cash at end of year | 2020-12-31 | $114 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
Value of net income/loss | 2020-12-31 | $2,212,422 |
Value of net assets at end of year (total assets less liabilities) | 2020-12-31 | $11,187,832 |
Value of net assets at beginning of year (total assets less liabilities) | 2020-12-31 | $8,975,410 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2020-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2020-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2020-12-31 | $9,077,716 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2020-12-31 | $7,057,111 |
Interest on participant loans | 2020-12-31 | $6,547 |
Value of interest in common/collective trusts at end of year | 2020-12-31 | $164,801 |
Value of interest in common/collective trusts at beginning of year | 2020-12-31 | $84,358 |
Asset value of US Government securities at end of year | 2020-12-31 | $828,729 |
Asset value of US Government securities at beginning of year | 2020-12-31 | $649,386 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2020-12-31 | $1,249,977 |
Net investment gain or loss from common/collective trusts | 2020-12-31 | $411 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2020-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2020-12-31 | No |
Contributions received in cash from employer | 2020-12-31 | $235,990 |
Employer contributions (assets) at end of year | 2020-12-31 | $8,185 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-12-31 | $708,361 |
Asset. Corporate debt instrument preferred debt at end of year | 2020-12-31 | $366,350 |
Asset. Corporate debt instrument preferred debt at beginning of year | 2020-12-31 | $377,945 |
Asset. Corporate debt instrument debt (other) at end of year | 2020-12-31 | $611,721 |
Asset. Corporate debt instrument debt (other) at beginning of year | 2020-12-31 | $678,855 |
Did the plan have assets held for investment | 2020-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2020-12-31 | Unqualified |
Accountancy firm name | 2020-12-31 | EIDE BAILLY |
Accountancy firm EIN | 2020-12-31 | 450250958 |
2010 : CO-OP 401(K) PLAN 2010 401k financial data |
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Total plan liabilities at end of year | 2010-12-31 | $0 |
Total plan liabilities at beginning of year | 2010-12-31 | $0 |
Total income from all sources | 2010-12-31 | $465,898 |
Expenses. Total of all expenses incurred | 2010-12-31 | $37,835 |
Benefits paid (including direct rollovers) | 2010-12-31 | $23,420 |
Total plan assets at end of year | 2010-12-31 | $2,159,902 |
Total plan assets at beginning of year | 2010-12-31 | $1,731,839 |
Value of fidelity bond covering the plan | 2010-12-31 | $300,000 |
Total contributions received or receivable from participants | 2010-12-31 | $125,691 |
Expenses. Other expenses not covered elsewhere | 2010-12-31 | $14,415 |
Contributions received from other sources (not participants or employers) | 2010-12-31 | $959 |
Other income received | 2010-12-31 | $293,403 |
Net income (gross income less expenses) | 2010-12-31 | $428,063 |
Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $2,159,902 |
Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $1,731,839 |
Assets. Value of participant loans | 2010-12-31 | $69,083 |
Total contributions received or receivable from employer(s) | 2010-12-31 | $45,845 |
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2010-12-31 | $0 |
2009 : CO-OP 401(K) PLAN 2009 401k financial data |
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Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2009-12-31 | $0 |
MONUMENTAL LIFE (National Association of Insurance Commissioners NAIC id number: 66281 ) |
Policy contract number | MDA01360TR |
Policy instance | 4 |
Insurance contract or identification number | MDA01360TR | Number of Individuals Covered | 133 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating 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? | Yes | 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 |
|
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 062491 |
Policy instance | 3 |
Insurance contract or identification number | 062491 | Number of Individuals Covered | 133 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating 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? | Yes | 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 |
|
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 ) |
Policy contract number | G-027795 |
Policy instance | 2 |
Insurance contract or identification number | G-027795 | Number of Individuals Covered | 133 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating 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? | Yes | 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 |
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AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | 1666920 |
Policy instance | 1 |
Insurance contract or identification number | 1666920 | Number of Individuals Covered | 133 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating 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? | Yes | 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 |
|
MONUMENTAL LIFE (National Association of Insurance Commissioners NAIC id number: 66281 ) |
Policy contract number | MDA01360TR |
Policy instance | 4 |
Insurance contract or identification number | MDA01360TR | Number of Individuals Covered | 135 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | 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? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating 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? | Yes | 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 |
|
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 062491 |
Policy instance | 3 |
Insurance contract or identification number | 062491 | Number of Individuals Covered | 135 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating 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? | Yes | 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 |
|
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 ) |
Policy contract number | G-027795 |
Policy instance | 2 |
Insurance contract or identification number | G-027795 | Number of Individuals Covered | 135 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating 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? | Yes | 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 |
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AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | 1666920 |
Policy instance | 1 |
Insurance contract or identification number | 1666920 | Number of Individuals Covered | 135 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | 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? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating 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? | Yes | 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 |
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MONUMENTAL LIFE (National Association of Insurance Commissioners NAIC id number: 66281 ) |
Policy contract number | MDA01360TR |
Policy instance | 4 |
Insurance contract or identification number | MDA01360TR | Number of Individuals Covered | 148 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | 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? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating 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? | Yes | 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 |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 062491 |
Policy instance | 3 |
Insurance contract or identification number | 062491 | Number of Individuals Covered | 148 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | 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? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating 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? | Yes | 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 |
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PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 ) |
Policy contract number | G-027795 |
Policy instance | 2 |
Insurance contract or identification number | G-027795 | Number of Individuals Covered | 148 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | 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? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating 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? | Yes | 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 |
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AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | 1666920 |
Policy instance | 1 |
Insurance contract or identification number | 1666920 | Number of Individuals Covered | 148 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | 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? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating 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? | Yes | 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 |
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