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RIVERSIDE MEDICAL ASSOCIATES, PLLC PROFIT SHARING 401K PLAN 401k Plan overview

Plan NameRIVERSIDE MEDICAL ASSOCIATES, PLLC PROFIT SHARING 401K PLAN
Plan identification number 001

RIVERSIDE MEDICAL ASSOCIATES, PLLC PROFIT SHARING 401K PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • 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.
  • Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of 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.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Plan covering Self-Employed individuals.
  • 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.
  • Life insurance

401k Sponsoring company profile

RIVERSIDE MEDICAL ASSOCIATES, PLLC has sponsored the creation of one or more 401k plans.

Company Name:RIVERSIDE MEDICAL ASSOCIATES, PLLC
Employer identification number (EIN):561283166
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan RIVERSIDE MEDICAL ASSOCIATES, PLLC PROFIT SHARING 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01PAMELA MYERS2023-10-06 PAMELA MYERS2023-10-06
0012021-01-01GRETA TEMPLETON2022-10-13 GRETA TEMPLETON2022-10-13
0012020-01-01GRETA TEMPLETON2021-09-07 GRETA TEMPLETON2021-09-07
0012018-01-01GRETA TEMPLETON2019-09-04 GRETA TEMPLETON2019-09-04
0012017-01-01GRETA TEMPLETON2018-07-23 GRETA TEMPLETON2018-07-23
0012016-01-01GRETA TEMPLETON2017-10-06 GRETA TEMPLETON2017-10-06
0012015-01-01GRETA TEMPLETON
0012014-01-01GRETA TEMPLETON
0012013-01-01GRETA TEMPLETON
0012012-01-01GRETA TEMPLETON
0012012-01-01GRETA TEMPLETON
0012011-01-01GRETA TEMPLETON
0012010-01-01GRETA TEMPLETON
0012009-01-01GRETA TEMPLETON

Plan Statistics for RIVERSIDE MEDICAL ASSOCIATES, PLLC PROFIT SHARING 401K PLAN

401k plan membership statisitcs for RIVERSIDE MEDICAL ASSOCIATES, PLLC PROFIT SHARING 401K PLAN

Measure Date Value
2015: RIVERSIDE MEDICAL ASSOCIATES, PLLC PROFIT SHARING 401K PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0111
Total number of active participants reported on line 7a of the Form 55002015-01-0110
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-0110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0110
Number of participants with account balances2015-01-0110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: RIVERSIDE MEDICAL ASSOCIATES, PLLC PROFIT SHARING 401K PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0112
Total number of active participants reported on line 7a of the Form 55002014-01-0110
Number of other retired or separated participants entitled to future benefits2014-01-011
Total of all active and inactive participants2014-01-0111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0111
Number of participants with account balances2014-01-019
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: RIVERSIDE MEDICAL ASSOCIATES, PLLC PROFIT SHARING 401K PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0112
Total number of active participants reported on line 7a of the Form 55002013-01-0111
Number of retired or separated participants receiving benefits2013-01-011
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-0112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0112
Number of participants with account balances2013-01-0112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: RIVERSIDE MEDICAL ASSOCIATES, PLLC PROFIT SHARING 401K PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0112
Total number of active participants reported on line 7a of the Form 55002012-01-0112
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-0112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0112
Number of participants with account balances2012-01-0112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: RIVERSIDE MEDICAL ASSOCIATES, PLLC PROFIT SHARING 401K PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0111
Total number of active participants reported on line 7a of the Form 55002011-01-0112
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-0112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0112
Number of participants with account balances2011-01-0112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: RIVERSIDE MEDICAL ASSOCIATES, PLLC PROFIT SHARING 401K PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0113
Total number of active participants reported on line 7a of the Form 55002010-01-0111
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-0111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0111
Number of participants with account balances2010-01-0111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: RIVERSIDE MEDICAL ASSOCIATES, PLLC PROFIT SHARING 401K PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0111
Total number of active participants reported on line 7a of the Form 55002009-01-0110
Number of retired or separated participants receiving benefits2009-01-011
Number of other retired or separated participants entitled to future benefits2009-01-012
Total of all active and inactive participants2009-01-0113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0113
Number of participants with account balances2009-01-0113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on RIVERSIDE MEDICAL ASSOCIATES, PLLC PROFIT SHARING 401K PLAN

Measure Date Value
2015 : RIVERSIDE MEDICAL ASSOCIATES, PLLC PROFIT SHARING 401K PLAN 2015 401k financial data
Total income from all sources2015-12-31$52,682
Expenses. Total of all expenses incurred2015-12-31$16,363
Benefits paid (including direct rollovers)2015-12-31$519
Total plan assets at end of year2015-12-31$1,761,226
Total plan assets at beginning of year2015-12-31$1,724,907
Value of fidelity bond covering the plan2015-12-31$185,000
Total contributions received or receivable from participants2015-12-31$72,416
Other income received2015-12-31$-30,538
Net income (gross income less expenses)2015-12-31$36,319
Net plan assets at end of year (total assets less liabilities)2015-12-31$1,761,226
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$1,724,907
Total contributions received or receivable from employer(s)2015-12-31$10,804
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$15,844
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : RIVERSIDE MEDICAL ASSOCIATES, PLLC PROFIT SHARING 401K PLAN 2014 401k financial data
Total income from all sources2014-12-31$138,000
Expenses. Total of all expenses incurred2014-12-31$52,619
Benefits paid (including direct rollovers)2014-12-31$36,281
Total plan assets at end of year2014-12-31$1,724,907
Total plan assets at beginning of year2014-12-31$1,639,526
Value of fidelity bond covering the plan2014-12-31$165,000
Total contributions received or receivable from participants2014-12-31$63,653
Other income received2014-12-31$60,702
Net income (gross income less expenses)2014-12-31$85,381
Net plan assets at end of year (total assets less liabilities)2014-12-31$1,724,907
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$1,639,526
Total contributions received or receivable from employer(s)2014-12-31$13,645
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$16,338
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : RIVERSIDE MEDICAL ASSOCIATES, PLLC PROFIT SHARING 401K PLAN 2013 401k financial data
Total income from all sources2013-12-31$362,736
Expenses. Total of all expenses incurred2013-12-31$64,500
Benefits paid (including direct rollovers)2013-12-31$48,546
Total plan assets at end of year2013-12-31$1,639,526
Total plan assets at beginning of year2013-12-31$1,341,290
Value of fidelity bond covering the plan2013-12-31$165,000
Total contributions received or receivable from participants2013-12-31$70,305
Other income received2013-12-31$281,155
Net income (gross income less expenses)2013-12-31$298,236
Net plan assets at end of year (total assets less liabilities)2013-12-31$1,639,526
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$1,341,290
Total contributions received or receivable from employer(s)2013-12-31$11,276
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$15,954
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : RIVERSIDE MEDICAL ASSOCIATES, PLLC PROFIT SHARING 401K PLAN 2012 401k financial data
Total income from all sources2012-12-31$241,593
Expenses. Total of all expenses incurred2012-12-31$12,214
Benefits paid (including direct rollovers)2012-12-31$0
Total plan assets at end of year2012-12-31$1,344,605
Total plan assets at beginning of year2012-12-31$1,115,226
Value of fidelity bond covering the plan2012-12-31$150,000
Total contributions received or receivable from participants2012-12-31$64,086
Other income received2012-12-31$162,431
Net income (gross income less expenses)2012-12-31$229,379
Net plan assets at end of year (total assets less liabilities)2012-12-31$1,344,605
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$1,115,226
Total contributions received or receivable from employer(s)2012-12-31$15,076
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$12,214
2011 : RIVERSIDE MEDICAL ASSOCIATES, PLLC PROFIT SHARING 401K PLAN 2011 401k financial data
Total income from all sources2011-12-31$53,822
Expenses. Total of all expenses incurred2011-12-31$11,070
Benefits paid (including direct rollovers)2011-12-31$0
Total plan assets at end of year2011-12-31$1,115,226
Total plan assets at beginning of year2011-12-31$1,072,474
Value of fidelity bond covering the plan2011-12-31$150,000
Total contributions received or receivable from participants2011-12-31$69,366
Other income received2011-12-31$-30,544
Net income (gross income less expenses)2011-12-31$42,752
Net plan assets at end of year (total assets less liabilities)2011-12-31$1,115,226
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$1,072,474
Total contributions received or receivable from employer(s)2011-12-31$15,000
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$11,070
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : RIVERSIDE MEDICAL ASSOCIATES, PLLC PROFIT SHARING 401K PLAN 2010 401k financial data
Total income from all sources2010-12-31$248,812
Expenses. Total of all expenses incurred2010-12-31$264,846
Benefits paid (including direct rollovers)2010-12-31$253,314
Total plan assets at end of year2010-12-31$1,072,474
Total plan assets at beginning of year2010-12-31$1,088,508
Value of fidelity bond covering the plan2010-12-31$150,000
Total contributions received or receivable from participants2010-12-31$64,432
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$158,030
Net income (gross income less expenses)2010-12-31$-16,034
Net plan assets at end of year (total assets less liabilities)2010-12-31$1,072,474
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$1,088,508
Total contributions received or receivable from employer(s)2010-12-31$26,350
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$11,532
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0

Form 5500 Responses for RIVERSIDE MEDICAL ASSOCIATES, PLLC PROFIT SHARING 401K PLAN

2015: RIVERSIDE MEDICAL ASSOCIATES, PLLC PROFIT SHARING 401K 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: RIVERSIDE MEDICAL ASSOCIATES, PLLC PROFIT SHARING 401K PLAN 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 – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: RIVERSIDE MEDICAL ASSOCIATES, PLLC PROFIT SHARING 401K PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: RIVERSIDE MEDICAL ASSOCIATES, PLLC PROFIT SHARING 401K PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: RIVERSIDE MEDICAL ASSOCIATES, PLLC PROFIT SHARING 401K PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: RIVERSIDE MEDICAL ASSOCIATES, PLLC PROFIT SHARING 401K PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: RIVERSIDE MEDICAL ASSOCIATES, PLLC PROFIT SHARING 401K PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0309930
Policy instance 1
Insurance contract or identification number0309930
Number of Individuals Covered1
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $4
Total amount of fees paid to insurance companyUSD $1
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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
Insurance broker nameEDGAR P ROBERTS, JR
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0309930
Policy instance 1
Insurance contract or identification number0309930
Number of Individuals Covered1
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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
Insurance broker nameEDGAR P ROBERTS, JR CLU CH
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0309930
Policy instance 1
Insurance contract or identification number0309930
Number of Individuals Covered1
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2
Total amount of fees paid to insurance companyUSD $1
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $2
Amount paid for insurance broker fees1
Additional information about fees paid to insurance brokerSERVICING FEE
Insurance broker organization code?3
Insurance broker nameEDGAR P ROBERTS, JR CLU CH
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0309930
Policy instance 1
Insurance contract or identification number0309930
Number of Individuals Covered1
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0309930
Policy instance 1
Insurance contract or identification number0309930
Number of Individuals Covered1
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0309930
Policy instance 1
Insurance contract or identification number0309930
Number of Individuals Covered1
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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

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