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EMPOWERING PEOPLE WORKSHOP, INC. 401(K) PLAN 401k Plan overview

Plan NameEMPOWERING PEOPLE WORKSHOP, INC. 401(K) PLAN
Plan identification number 001

EMPOWERING PEOPLE WORKSHOP, INC. 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
  • Plan sponsor(s) received services of leased employees, as defined in Code section 414(n), during the plan year.

401k Sponsoring company profile

EMPOWERING PEOPLE WORKSHOP, INC. has sponsored the creation of one or more 401k plans.

Company Name:EMPOWERING PEOPLE WORKSHOP, INC.
Employer identification number (EIN):455379336
NAIC Classification:812990
NAIC Description:All Other Personal Services

Additional information about EMPOWERING PEOPLE WORKSHOP, INC.

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division
Incorporation Date: 2012-05-29
Company Identification Number: 2110144
Legal Registered Office Address: 25000 COUNTRY CLUB BLVD #255
-
N OLMSTED
United States of America (USA)
44011

More information about EMPOWERING PEOPLE WORKSHOP, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPOWERING PEOPLE WORKSHOP, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012018-01-01KURT MILLER2018-10-01
0012017-01-01KURT MILLER
0012016-01-01MATTHEW PARKER
0012015-01-01
0012014-02-01MATTHEW PARKER

Plan Statistics for EMPOWERING PEOPLE WORKSHOP, INC. 401(K) PLAN

401k plan membership statisitcs for EMPOWERING PEOPLE WORKSHOP, INC. 401(K) PLAN

Measure Date Value
2017: EMPOWERING PEOPLE WORKSHOP, INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01176
Total number of active participants reported on line 7a of the Form 55002017-01-010
Number of retired or separated participants receiving benefits2017-01-011
Number of other retired or separated participants entitled to future benefits2017-01-0121
Total of all active and inactive participants2017-01-0122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0122
Number of participants with account balances2017-01-0122
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: EMPOWERING PEOPLE WORKSHOP, INC. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01164
Total number of active participants reported on line 7a of the Form 55002016-01-01138
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0134
Total of all active and inactive participants2016-01-01172
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01172
Number of participants with account balances2016-01-0155
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: EMPOWERING PEOPLE WORKSHOP, INC. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01180
Total number of active participants reported on line 7a of the Form 55002015-01-01153
Number of retired or separated participants receiving benefits2015-01-011
Number of other retired or separated participants entitled to future benefits2015-01-0123
Total of all active and inactive participants2015-01-01177
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01177
Number of participants with account balances2015-01-0152
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: EMPOWERING PEOPLE WORKSHOP, INC. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-02-01162
Total number of active participants reported on line 7a of the Form 55002014-02-01165
Number of retired or separated participants receiving benefits2014-02-010
Number of other retired or separated participants entitled to future benefits2014-02-0110
Total of all active and inactive participants2014-02-01175
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-02-010
Total participants2014-02-01175
Number of participants with account balances2014-02-0149
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-02-010

Financial Data on EMPOWERING PEOPLE WORKSHOP, INC. 401(K) PLAN

Measure Date Value
2017 : EMPOWERING PEOPLE WORKSHOP, INC. 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$25,726
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$88,959
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$87,043
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$8,726
Value of total assets at end of year2017-12-31$78,972
Value of total assets at beginning of year2017-12-31$142,205
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$1,916
Total interest from all sources2017-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Administrative expenses professional fees incurred2017-12-31$1,916
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$20,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$8,726
Participant contributions at end of year2017-12-31$0
Participant contributions at beginning of year2017-12-31$2,926
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$-63,233
Value of net assets at end of year (total assets less liabilities)2017-12-31$78,972
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$142,205
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$75,672
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$0
Value of interest in pooled separate accounts at end of year2017-12-31$0
Value of interest in pooled separate accounts at beginning of year2017-12-31$134,933
Value of interest in common/collective trusts at end of year2017-12-31$0
Value of interest in common/collective trusts at beginning of year2017-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$3,300
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$4,346
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$17,000
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31Yes
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$87,043
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31CORRIGAN KRAUSE
Accountancy firm EIN2017-12-31371574855
2016 : EMPOWERING PEOPLE WORKSHOP, INC. 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total income from all sources (including contributions)2016-12-31$28,641
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$10,182
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$9,942
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$20,098
Value of total assets at end of year2016-12-31$142,205
Value of total assets at beginning of year2016-12-31$123,746
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$240
Total interest from all sources2016-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Administrative expenses professional fees incurred2016-12-31$240
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$20,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$20,098
Participant contributions at end of year2016-12-31$2,926
Participant contributions at beginning of year2016-12-31$805
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$18,459
Value of net assets at end of year (total assets less liabilities)2016-12-31$142,205
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$123,746
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$0
Value of interest in pooled separate accounts at end of year2016-12-31$134,933
Value of interest in pooled separate accounts at beginning of year2016-12-31$119,315
Value of interest in common/collective trusts at end of year2016-12-31$0
Value of interest in common/collective trusts at beginning of year2016-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$4,346
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$3,626
Net investment gain/loss from pooled separate accounts2016-12-31$8,543
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31Yes
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$9,942
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31CORRIGAN KRAUSE
Accountancy firm EIN2016-12-31371574855
2015 : EMPOWERING PEOPLE WORKSHOP, INC. 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total transfer of assets to this plan2015-12-31$47,589
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$41,011
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$2,692
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$2,440
Value of total corrective distributions2015-12-31$132
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$44,807
Value of total assets at end of year2015-12-31$123,746
Value of total assets at beginning of year2015-12-31$37,838
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$120
Total interest from all sources2015-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Administrative expenses professional fees incurred2015-12-31$120
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$10,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$27,335
Participant contributions at end of year2015-12-31$805
Participant contributions at beginning of year2015-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$17,472
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$38,319
Value of net assets at end of year (total assets less liabilities)2015-12-31$123,746
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$37,838
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$0
Value of interest in pooled separate accounts at end of year2015-12-31$119,315
Value of interest in pooled separate accounts at beginning of year2015-12-31$35,695
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$3,626
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$2,143
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-3,796
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$2,440
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31CORRIGAN KRAUSE
Accountancy firm EIN2015-12-31371574855
2014 : EMPOWERING PEOPLE WORKSHOP, INC. 401(K) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$37,838
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$0
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$37,778
Value of total assets at end of year2014-12-31$37,838
Value of total assets at beginning of year2014-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$0
Total interest from all sources2014-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$10,000
If this is an individual account plan, was there a blackout period2014-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$20,797
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$16,981
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$37,838
Value of net assets at end of year (total assets less liabilities)2014-12-31$37,838
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$35,695
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$2,143
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$60
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31Yes
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No

Form 5500 Responses for EMPOWERING PEOPLE WORKSHOP, INC. 401(K) PLAN

2017: EMPOWERING PEOPLE WORKSHOP, INC. 401(K) PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: EMPOWERING PEOPLE WORKSHOP, INC. 401(K) PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: EMPOWERING PEOPLE WORKSHOP, INC. 401(K) PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: EMPOWERING PEOPLE WORKSHOP, INC. 401(K) PLAN 2014 form 5500 responses
2014-02-01Type of plan entitySingle employer plan
2014-02-01First time form 5500 has been submittedYes
2014-02-01Submission has been amendedNo
2014-02-01This submission is the final filingNo
2014-02-01This return/report is a short plan year return/report (less than 12 months)Yes
2014-02-01Plan is a collectively bargained planNo
2014-02-01Plan funding arrangement – InsuranceYes
2014-02-01Plan funding arrangement – TrustYes
2014-02-01Plan benefit arrangement – InsuranceYes
2014-02-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-834170
Policy instance 1
Insurance contract or identification numberGA-834170
Number of Individuals Covered22
Insurance policy start date2017-02-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $77
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees77
Additional information about fees paid to insurance brokerADMINISTRATIVE
Insurance broker organization code?5
Insurance broker nameDYATECH, LLC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-834170
Policy instance 1
Insurance contract or identification numberGA-834170
Number of Individuals Covered177
Insurance policy start date2015-02-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $40
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees40
Additional information about fees paid to insurance brokerADMINISTRATIVE
Insurance broker organization code?5
Insurance broker nameDYATECH, LLC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-834170
Policy instance 1
Insurance contract or identification numberGA-834170
Number of Individuals Covered46
Insurance policy start date2014-02-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $2,500
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees2500
Additional information about fees paid to insurance brokerADMINISTRATIVE
Insurance broker organization code?5
Insurance broker nameDYATECH, LLC

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