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BOYS & GIRLS CLUBS OF CENTRAL VIRGINIA 403(B) RETIREMENT PLAN 401k Plan overview

Plan NameBOYS & GIRLS CLUBS OF CENTRAL VIRGINIA 403(B) RETIREMENT PLAN
Plan identification number 001

BOYS & GIRLS CLUBS OF CENTRAL VIRGINIA 403(B) RETIREMENT PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
  • 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

BOYS & GIRLS CLUBS OF CENTRAL VIRGI NIA has sponsored the creation of one or more 401k plans.

Company Name:BOYS & GIRLS CLUBS OF CENTRAL VIRGI NIA
Employer identification number (EIN):541602004
NAIC Classification:624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BOYS & GIRLS CLUBS OF CENTRAL VIRGINIA 403(B) RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01ALEXA BEAL2023-10-16 ALEXA BEAL2023-10-16
0012020-07-01ADAM ROSE2022-02-28
0012019-07-01
0012018-07-01
0012017-07-01EMILY HUNSAKER2018-10-24
0012017-07-01EMILY HUNSAKER2020-07-15
0012017-07-01
0012016-07-01ABBY POOL2017-10-19 ABBY POOL2017-10-19
0012016-07-01
0012015-07-01ABBY POOL2016-12-15 ABBY POOL2016-12-15
0012014-07-01SUSAN DICKERSON2015-09-24 SUSAN DICKERSON2015-09-24

Plan Statistics for BOYS & GIRLS CLUBS OF CENTRAL VIRGINIA 403(B) RETIREMENT PLAN

401k plan membership statisitcs for BOYS & GIRLS CLUBS OF CENTRAL VIRGINIA 403(B) RETIREMENT PLAN

Measure Date Value
2019: BOYS & GIRLS CLUBS OF CENTRAL VIRGINIA 403(B) RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-01139
Total number of active participants reported on line 7a of the Form 55002019-07-0187
Number of retired or separated participants receiving benefits2019-07-010
Number of other retired or separated participants entitled to future benefits2019-07-019
Total of all active and inactive participants2019-07-0196
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-07-010
Total participants2019-07-0196
Number of participants with account balances2019-07-0145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-07-011
2018: BOYS & GIRLS CLUBS OF CENTRAL VIRGINIA 403(B) RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year2018-07-01137
Total number of active participants reported on line 7a of the Form 55002018-07-01159
Number of retired or separated participants receiving benefits2018-07-010
Number of other retired or separated participants entitled to future benefits2018-07-019
Total of all active and inactive participants2018-07-01168
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-07-010
Total participants2018-07-01168
Number of participants with account balances2018-07-0141
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-07-016
2017: BOYS & GIRLS CLUBS OF CENTRAL VIRGINIA 403(B) RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-01119
Total number of active participants reported on line 7a of the Form 55002017-07-01138
Number of retired or separated participants receiving benefits2017-07-010
Number of other retired or separated participants entitled to future benefits2017-07-016
Total of all active and inactive participants2017-07-01144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-07-010
Total participants2017-07-01144
Number of participants with account balances2017-07-0129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-07-014
2016: BOYS & GIRLS CLUBS OF CENTRAL VIRGINIA 403(B) RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-01112
Total number of active participants reported on line 7a of the Form 55002016-07-01119
Number of retired or separated participants receiving benefits2016-07-010
Number of other retired or separated participants entitled to future benefits2016-07-013
Total of all active and inactive participants2016-07-01122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-07-010
Total participants2016-07-01122
Number of participants with account balances2016-07-0128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-07-013

Financial Data on BOYS & GIRLS CLUBS OF CENTRAL VIRGINIA 403(B) RETIREMENT PLAN

Measure Date Value
2020 : BOYS & GIRLS CLUBS OF CENTRAL VIRGINIA 403(B) RETIREMENT PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-06-30$0
Total income from all sources (including contributions)2020-06-30$128,498
Total loss/gain on sale of assets2020-06-30$0
Total of all expenses incurred2020-06-30$92,057
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-06-30$91,389
Expenses. Certain deemed distributions of participant loans2020-06-30$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-06-30$109,282
Value of total assets at end of year2020-06-30$570,771
Value of total assets at beginning of year2020-06-30$534,330
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-06-30$668
Total interest from all sources2020-06-30$346
Total dividends received (eg from common stock, registered investment company shares)2020-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-06-30No
Was this plan covered by a fidelity bond2020-06-30No
If this is an individual account plan, was there a blackout period2020-06-30No
Were there any nonexempt tranactions with any party-in-interest2020-06-30No
Contributions received from participants2020-06-30$64,566
Income. Received or receivable in cash from other sources (including rollovers)2020-06-30$0
Other income not declared elsewhere2020-06-30$910
Administrative expenses (other) incurred2020-06-30$668
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-06-30No
Value of net income/loss2020-06-30$36,441
Value of net assets at end of year (total assets less liabilities)2020-06-30$570,771
Value of net assets at beginning of year (total assets less liabilities)2020-06-30$534,330
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2020-06-30No
Were any leases to which the plan was party in default or uncollectible2020-06-30No
Value of interest in pooled separate accounts at end of year2020-06-30$549,534
Value of interest in pooled separate accounts at beginning of year2020-06-30$505,415
Interest on participant loans2020-06-30$0
Interest earned on other investments2020-06-30$346
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-06-30$21,237
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-06-30$28,915
Expenses. Payments to insurance carriers foe the provision of benefits2020-06-30$0
Net investment gain/loss from pooled separate accounts2020-06-30$17,960
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-06-30No
Was there a failure to transmit to the plan any participant contributions2020-06-30No
Has the plan failed to provide any benefit when due under the plan2020-06-30No
Contributions received in cash from employer2020-06-30$44,716
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-06-30$91,389
Did the plan have assets held for investment2020-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-06-30Yes
Opinion of an independent qualified public accountant for this plan2020-06-30Disclaimer
Accountancy firm name2020-06-30HANTZMON WIEBEL LLP
Accountancy firm EIN2020-06-30540618213
2019 : BOYS & GIRLS CLUBS OF CENTRAL VIRGINIA 403(B) RETIREMENT PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-06-30$0
Total income from all sources (including contributions)2019-06-30$141,653
Total loss/gain on sale of assets2019-06-30$0
Total of all expenses incurred2019-06-30$115,539
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-06-30$114,836
Expenses. Certain deemed distributions of participant loans2019-06-30$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-06-30$117,773
Value of total assets at end of year2019-06-30$534,330
Value of total assets at beginning of year2019-06-30$508,216
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-06-30$703
Total interest from all sources2019-06-30$1,730
Total dividends received (eg from common stock, registered investment company shares)2019-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-06-30No
Was this plan covered by a fidelity bond2019-06-30Yes
Value of fidelity bond cover2019-06-30$100,000
If this is an individual account plan, was there a blackout period2019-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-06-30$0
Were there any nonexempt tranactions with any party-in-interest2019-06-30No
Contributions received from participants2019-06-30$59,662
Income. Received or receivable in cash from other sources (including rollovers)2019-06-30$16,807
Other income not declared elsewhere2019-06-30$0
Administrative expenses (other) incurred2019-06-30$703
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-06-30No
Value of net income/loss2019-06-30$26,114
Value of net assets at end of year (total assets less liabilities)2019-06-30$534,330
Value of net assets at beginning of year (total assets less liabilities)2019-06-30$508,216
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2019-06-30No
Were any leases to which the plan was party in default or uncollectible2019-06-30No
Value of interest in pooled separate accounts at end of year2019-06-30$505,415
Value of interest in pooled separate accounts at beginning of year2019-06-30$489,301
Interest on participant loans2019-06-30$0
Interest earned on other investments2019-06-30$1,730
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-06-30$28,915
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-06-30$18,915
Expenses. Payments to insurance carriers foe the provision of benefits2019-06-30$0
Net investment gain/loss from pooled separate accounts2019-06-30$22,150
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-06-30No
Was there a failure to transmit to the plan any participant contributions2019-06-30No
Has the plan failed to provide any benefit when due under the plan2019-06-30No
Contributions received in cash from employer2019-06-30$41,304
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-06-30$114,836
Did the plan have assets held for investment2019-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-06-30Yes
Opinion of an independent qualified public accountant for this plan2019-06-30Disclaimer
Accountancy firm name2019-06-30HANTZMON WIEBEL LLP
Accountancy firm EIN2019-06-30540618213
2018 : BOYS & GIRLS CLUBS OF CENTRAL VIRGINIA 403(B) RETIREMENT PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-06-30$0
Total income from all sources (including contributions)2018-06-30$113,472
Total loss/gain on sale of assets2018-06-30$0
Total of all expenses incurred2018-06-30$8,796
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-06-30$8,327
Expenses. Certain deemed distributions of participant loans2018-06-30$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-06-30$78,258
Value of total assets at end of year2018-06-30$508,216
Value of total assets at beginning of year2018-06-30$403,540
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-06-30$469
Total interest from all sources2018-06-30$150
Total dividends received (eg from common stock, registered investment company shares)2018-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-06-30No
Was this plan covered by a fidelity bond2018-06-30Yes
Value of fidelity bond cover2018-06-30$500,000
If this is an individual account plan, was there a blackout period2018-06-30No
Were there any nonexempt tranactions with any party-in-interest2018-06-30No
Contributions received from participants2018-06-30$48,510
Income. Received or receivable in cash from other sources (including rollovers)2018-06-30$0
Other income not declared elsewhere2018-06-30$142
Administrative expenses (other) incurred2018-06-30$469
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-06-30No
Value of net income/loss2018-06-30$104,676
Value of net assets at end of year (total assets less liabilities)2018-06-30$508,216
Value of net assets at beginning of year (total assets less liabilities)2018-06-30$403,540
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2018-06-30No
Were any leases to which the plan was party in default or uncollectible2018-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-06-30$489,301
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-06-30$391,908
Interest on participant loans2018-06-30$0
Interest earned on other investments2018-06-30$150
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-06-30$18,915
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-06-30$11,632
Expenses. Payments to insurance carriers foe the provision of benefits2018-06-30$0
Net investment gain/loss from pooled separate accounts2018-06-30$34,922
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-06-30No
Was there a failure to transmit to the plan any participant contributions2018-06-30No
Has the plan failed to provide any benefit when due under the plan2018-06-30No
Contributions received in cash from employer2018-06-30$29,748
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-06-30$8,327
Did the plan have assets held for investment2018-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-06-30No
Opinion of an independent qualified public accountant for this plan2018-06-30Disclaimer
Accountancy firm name2018-06-30HANTZMON WIEBEL LLP
Accountancy firm EIN2018-06-30540618213
2017 : BOYS & GIRLS CLUBS OF CENTRAL VIRGINIA 403(B) RETIREMENT PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-06-30$0
Total income from all sources (including contributions)2017-06-30$212,913
Total loss/gain on sale of assets2017-06-30$0
Total of all expenses incurred2017-06-30$14,574
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-06-30$14,268
Expenses. Certain deemed distributions of participant loans2017-06-30$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-06-30$173,617
Value of total assets at end of year2017-06-30$403,540
Value of total assets at beginning of year2017-06-30$205,201
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-06-30$306
Total interest from all sources2017-06-30$85
Total dividends received (eg from common stock, registered investment company shares)2017-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-06-30No
Was this plan covered by a fidelity bond2017-06-30Yes
Value of fidelity bond cover2017-06-30$500,000
If this is an individual account plan, was there a blackout period2017-06-30No
Were there any nonexempt tranactions with any party-in-interest2017-06-30No
Contributions received from participants2017-06-30$38,323
Income. Received or receivable in cash from other sources (including rollovers)2017-06-30$108,025
Other income not declared elsewhere2017-06-30$0
Administrative expenses (other) incurred2017-06-30$306
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-06-30No
Value of net income/loss2017-06-30$198,339
Value of net assets at end of year (total assets less liabilities)2017-06-30$403,540
Value of net assets at beginning of year (total assets less liabilities)2017-06-30$205,201
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2017-06-30No
Were any leases to which the plan was party in default or uncollectible2017-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-06-30$391,908
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-06-30$199,683
Interest on participant loans2017-06-30$0
Interest earned on other investments2017-06-30$85
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-06-30$11,632
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-06-30$5,518
Expenses. Payments to insurance carriers foe the provision of benefits2017-06-30$0
Net investment gain/loss from pooled separate accounts2017-06-30$39,211
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-06-30No
Was there a failure to transmit to the plan any participant contributions2017-06-30No
Has the plan failed to provide any benefit when due under the plan2017-06-30No
Contributions received in cash from employer2017-06-30$27,269
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-06-30$14,268
Did the plan have assets held for investment2017-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-06-30No
Opinion of an independent qualified public accountant for this plan2017-06-30Disclaimer
Accountancy firm name2017-06-30HANTZMON WIEBEL LLP
Accountancy firm EIN2017-06-30540618213

Form 5500 Responses for BOYS & GIRLS CLUBS OF CENTRAL VIRGINIA 403(B) RETIREMENT PLAN

2019: BOYS & GIRLS CLUBS OF CENTRAL VIRGINIA 403(B) RETIREMENT PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Submission has been amendedNo
2019-07-01This submission is the final filingNo
2019-07-01This return/report is a short plan year return/report (less than 12 months)No
2019-07-01Plan is a collectively bargained planNo
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – InsuranceYes
2018: BOYS & GIRLS CLUBS OF CENTRAL VIRGINIA 403(B) RETIREMENT PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Submission has been amendedNo
2018-07-01This submission is the final filingNo
2018-07-01This return/report is a short plan year return/report (less than 12 months)No
2018-07-01Plan is a collectively bargained planNo
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – InsuranceYes
2017: BOYS & GIRLS CLUBS OF CENTRAL VIRGINIA 403(B) RETIREMENT PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Submission has been amendedYes
2017-07-01This submission is the final filingNo
2017-07-01This return/report is a short plan year return/report (less than 12 months)No
2017-07-01Plan is a collectively bargained planNo
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – InsuranceYes
2016: BOYS & GIRLS CLUBS OF CENTRAL VIRGINIA 403(B) RETIREMENT PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Submission has been amendedYes
2016-07-01This submission is the final filingNo
2016-07-01This return/report is a short plan year return/report (less than 12 months)No
2016-07-01Plan is a collectively bargained planNo
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number059078B
Policy instance 1
Insurance contract or identification number059078B
Number of Individuals Covered46
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $210
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 Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees210
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number059078B
Policy instance 1
Insurance contract or identification number059078B
Number of Individuals Covered42
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $157
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 Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees157
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number059078B
Policy instance 1
Insurance contract or identification number059078B
Number of Individuals Covered31
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $437
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 Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees437
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number059078B
Policy instance 1
Insurance contract or identification number059078B
Number of Individuals Covered29
Insurance policy start date2016-07-01
Insurance policy end date2017-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $309
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 Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees309
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3

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