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THE EYE DOCTORS PROFIT SHARING/401(K) PLAN AND TRUST 401k Plan overview

Plan NameTHE EYE DOCTORS PROFIT SHARING/401(K) PLAN AND TRUST
Plan identification number 001

THE EYE DOCTORS PROFIT SHARING/401(K) PLAN AND TRUST 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.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • 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.

401k Sponsoring company profile

DRS. PRICE, YOUNG, ODLE & HORSCH, P.A. has sponsored the creation of one or more 401k plans.

Company Name:DRS. PRICE, YOUNG, ODLE & HORSCH, P.A.
Employer identification number (EIN):480775376
NAIC Classification:621320
NAIC Description:Offices of Optometrists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE EYE DOCTORS PROFIT SHARING/401(K) PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012018-01-01
0012017-01-01
0012016-01-01
0012015-01-01BRIAN J HORSCH
0012014-01-01BRIAN J HORSCH
0012013-01-01BRIAN J HORSCH2014-08-06
0012012-01-01BRIAN J HORSCH2013-09-27
0012011-01-01BRIAN J HORSCH2012-07-24
0012010-01-01BRIAN J. HORSCH2011-10-13

Plan Statistics for THE EYE DOCTORS PROFIT SHARING/401(K) PLAN AND TRUST

401k plan membership statisitcs for THE EYE DOCTORS PROFIT SHARING/401(K) PLAN AND TRUST

Measure Date Value
2017: THE EYE DOCTORS PROFIT SHARING/401(K) PLAN AND TRUST 2017 401k membership
Total participants, beginning-of-year2017-01-01119
Total number of active participants reported on line 7a of the Form 55002017-01-011
Number of retired or separated participants receiving benefits2017-01-018
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-019
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-019
Number of participants with account balances2017-01-019
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: THE EYE DOCTORS PROFIT SHARING/401(K) PLAN AND TRUST 2016 401k membership
Total participants, beginning-of-year2016-01-01155
Total number of active participants reported on line 7a of the Form 55002016-01-016
Number of retired or separated participants receiving benefits2016-01-018
Number of other retired or separated participants entitled to future benefits2016-01-01106
Total of all active and inactive participants2016-01-01120
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01120
Number of participants with account balances2016-01-01118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-0121
2015: THE EYE DOCTORS PROFIT SHARING/401(K) PLAN AND TRUST 2015 401k membership
Total participants, beginning-of-year2015-01-01135
Total number of active participants reported on line 7a of the Form 55002015-01-01125
Number of retired or separated participants receiving benefits2015-01-013
Number of other retired or separated participants entitled to future benefits2015-01-0111
Total of all active and inactive participants2015-01-01139
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01139
Number of participants with account balances2015-01-01111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-015
2014: THE EYE DOCTORS PROFIT SHARING/401(K) PLAN AND TRUST 2014 401k membership
Total participants, beginning-of-year2014-01-01127
Total number of active participants reported on line 7a of the Form 55002014-01-01105
Number of retired or separated participants receiving benefits2014-01-012
Number of other retired or separated participants entitled to future benefits2014-01-019
Total of all active and inactive participants2014-01-01116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01116
Number of participants with account balances2014-01-0191
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-013

Financial Data on THE EYE DOCTORS PROFIT SHARING/401(K) PLAN AND TRUST

Measure Date Value
2017 : THE EYE DOCTORS PROFIT SHARING/401(K) PLAN AND TRUST 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total transfer of assets to this plan2017-12-31$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$491,896
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$4,655,937
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$4,610,218
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$3,537
Value of total assets at end of year2017-12-31$7,158
Value of total assets at beginning of year2017-12-31$4,171,199
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$45,719
Total interest from all sources2017-12-31$488,359
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 year2017-12-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2017-12-31$0
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
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$925
Participant contributions at end of year2017-12-31$0
Participant contributions at beginning of year2017-12-31$7,074
Participant contributions at end of year2017-12-31$0
Participant contributions at beginning of year2017-12-31$50
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$0
Total non interest bearing cash at beginning of year2017-12-31$236
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
Income. Non cash contributions2017-12-31$0
Value of net income/loss2017-12-31$-4,164,041
Value of net assets at end of year (total assets less liabilities)2017-12-31$7,158
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$4,171,199
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$7,158
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$4,162,638
Interest on participant loans2017-12-31$274
Interest earned on other investments2017-12-31$488,085
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 contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$2,612
Employer contributions (assets) at end of year2017-12-31$0
Employer contributions (assets) at beginning of year2017-12-31$1,201
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$4,610,218
Contract administrator fees2017-12-31$45,719
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 name2017-12-31BROWN SMITH WALLACE, LLP
Accountancy firm EIN2017-12-31431001367
2016 : THE EYE DOCTORS PROFIT SHARING/401(K) PLAN AND TRUST 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$551,574
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$292,980
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$290,454
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$299,740
Value of total assets at end of year2016-12-31$4,171,199
Value of total assets at beginning of year2016-12-31$3,912,605
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$2,526
Total interest from all sources2016-12-31$251,834
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 year2016-12-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2016-12-31$0
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$250,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$205,034
Participant contributions at end of year2016-12-31$7,074
Participant contributions at beginning of year2016-12-31$14,402
Participant contributions at end of year2016-12-31$50
Total non interest bearing cash at end of year2016-12-31$236
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$258,594
Value of net assets at end of year (total assets less liabilities)2016-12-31$4,171,199
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$3,912,605
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$4,162,638
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$3,895,564
Interest on participant loans2016-12-31$423
Interest earned on other investments2016-12-31$251,411
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$102
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$94,706
Employer contributions (assets) at end of year2016-12-31$1,201
Employer contributions (assets) at beginning of year2016-12-31$2,537
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$290,454
Contract administrator fees2016-12-31$2,526
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 name2016-12-31BROWN SMITH WALLACE, LLP
Accountancy firm EIN2016-12-31431001367
2015 : THE EYE DOCTORS PROFIT SHARING/401(K) PLAN AND TRUST 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$537,579
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$186,923
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$183,029
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$540,779
Value of total assets at end of year2015-12-31$3,912,605
Value of total assets at beginning of year2015-12-31$3,561,949
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$3,894
Total interest from all sources2015-12-31$-3,200
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$360,000
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$315,962
Participant contributions at end of year2015-12-31$14,402
Participant contributions at beginning of year2015-12-31$25,874
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$76,168
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$350,656
Value of net assets at end of year (total assets less liabilities)2015-12-31$3,912,605
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$3,561,949
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$3,895,564
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$3,531,846
Interest on participant loans2015-12-31$923
Interest earned on other investments2015-12-31$-4,123
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$102
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 contributions2015-12-31Yes
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$148,649
Employer contributions (assets) at end of year2015-12-31$2,537
Employer contributions (assets) at beginning of year2015-12-31$4,229
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$183,029
Contract administrator fees2015-12-31$3,894
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 name2015-12-31VARNEY'S & ASSOCIATES CPA LLC
Accountancy firm EIN2015-12-31300038643
2014 : THE EYE DOCTORS PROFIT SHARING/401(K) PLAN AND TRUST 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$494,247
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$148,076
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$141,902
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$360,684
Value of total assets at end of year2014-12-31$3,561,949
Value of total assets at beginning of year2014-12-31$3,215,778
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$6,174
Total interest from all sources2014-12-31$133,563
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$321,578
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$240,147
Participant contributions at end of year2014-12-31$25,874
Participant contributions at beginning of year2014-12-31$17,033
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$692
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$346,171
Value of net assets at end of year (total assets less liabilities)2014-12-31$3,561,949
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$3,215,778
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$3,531,846
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$3,198,745
Interest on participant loans2014-12-31$1,153
Interest earned on other investments2014-12-31$132,410
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 contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$119,845
Employer contributions (assets) at end of year2014-12-31$4,229
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$141,902
Contract administrator fees2014-12-31$6,174
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31VARNEY'S & ASSOCIATES CPA LLC
Accountancy firm EIN2014-12-31300038643

Form 5500 Responses for THE EYE DOCTORS PROFIT SHARING/401(K) PLAN AND TRUST

2017: THE EYE DOCTORS PROFIT SHARING/401(K) PLAN AND TRUST 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: THE EYE DOCTORS PROFIT SHARING/401(K) PLAN AND TRUST 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: THE EYE DOCTORS PROFIT SHARING/401(K) PLAN AND TRUST 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: THE EYE DOCTORS PROFIT SHARING/401(K) PLAN AND TRUST 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-CP-FWOF
Policy instance 1
Insurance contract or identification numberGAP-CP-FWOF
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1
Total amount of fees paid to insurance companyUSD $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 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?Yes
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 $1
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameRAYMOND JAMES FINANCIAL SERVICES
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-CP-GZ4C
Policy instance 2
Insurance contract or identification numberGAP-CP-GZ4C
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $141
Total amount of fees paid to insurance companyUSD $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 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?Yes
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
Commission paid to Insurance BrokerUSD $141
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameRAYMOND JAMES FINANCIAL SERVICES
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-CP-FWOF
Policy instance 1
Insurance contract or identification numberGAP-CP-FWOF
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $45
Total amount of fees paid to insurance companyUSD $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 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
Commission paid to Insurance BrokerUSD $45
Amount paid for insurance broker fees0
Insurance broker organization code?4
Insurance broker nameRAYMOND JAMES FINANCIAL SERVICES

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