BANK OF LAFAYETTE has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan BANK OF LAFAYETTE PROFIT-SHARING TRUST
| Measure | Date | Value |
|---|
| 2022: BANK OF LAFAYETTE PROFIT-SHARING TRUST 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-12-31 | 67 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-12-31 | 46 |
| Number of retired or separated participants receiving benefits | 2022-12-31 | 21 |
| Total of all active and inactive participants | 2022-12-31 | 67 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2022-12-31 | 0 |
| Total participants | 2022-12-31 | 67 |
| Number of participants with account balances | 2022-12-31 | 67 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2022-12-31 | 0 |
| 2021: BANK OF LAFAYETTE PROFIT-SHARING TRUST 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-12-31 | 71 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-12-31 | 45 |
| Number of retired or separated participants receiving benefits | 2021-12-31 | 22 |
| Total of all active and inactive participants | 2021-12-31 | 67 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2021-12-31 | 0 |
| Total participants | 2021-12-31 | 67 |
| Number of participants with account balances | 2021-12-31 | 67 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2021-12-31 | 0 |
| 2020: BANK OF LAFAYETTE PROFIT-SHARING TRUST 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-12-31 | 70 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-12-31 | 50 |
| Number of retired or separated participants receiving benefits | 2020-12-31 | 21 |
| Total of all active and inactive participants | 2020-12-31 | 71 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2020-12-31 | 0 |
| Total participants | 2020-12-31 | 71 |
| Number of participants with account balances | 2020-12-31 | 71 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2020-12-31 | 0 |
| 2019: BANK OF LAFAYETTE PROFIT-SHARING TRUST 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-12-31 | 69 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-12-31 | 52 |
| Number of retired or separated participants receiving benefits | 2019-12-31 | 18 |
| Total of all active and inactive participants | 2019-12-31 | 70 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2019-12-31 | 0 |
| Total participants | 2019-12-31 | 70 |
| Number of participants with account balances | 2019-12-31 | 70 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2019-12-31 | 0 |
| 2018: BANK OF LAFAYETTE PROFIT-SHARING TRUST 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-12-31 | 68 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-12-31 | 53 |
| Number of retired or separated participants receiving benefits | 2018-12-31 | 16 |
| Total of all active and inactive participants | 2018-12-31 | 69 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2018-12-31 | 0 |
| Total participants | 2018-12-31 | 69 |
| Number of participants with account balances | 2018-12-31 | 69 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2018-12-31 | 0 |
| 2017: BANK OF LAFAYETTE PROFIT-SHARING TRUST 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-12-31 | 68 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-12-31 | 52 |
| Number of retired or separated participants receiving benefits | 2017-12-31 | 16 |
| Total of all active and inactive participants | 2017-12-31 | 68 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2017-12-31 | 0 |
| Total participants | 2017-12-31 | 68 |
| Number of participants with account balances | 2017-12-31 | 68 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2017-12-31 | 0 |
| 2016: BANK OF LAFAYETTE PROFIT-SHARING TRUST 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-12-31 | 66 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-12-31 | 52 |
| Number of retired or separated participants receiving benefits | 2016-12-31 | 16 |
| Total of all active and inactive participants | 2016-12-31 | 68 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2016-12-31 | 0 |
| Total participants | 2016-12-31 | 68 |
| Number of participants with account balances | 2016-12-31 | 68 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2016-12-31 | 0 |
| 2015: BANK OF LAFAYETTE PROFIT-SHARING TRUST 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-12-31 | 63 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-12-31 | 52 |
| Number of retired or separated participants receiving benefits | 2015-12-31 | 14 |
| Total of all active and inactive participants | 2015-12-31 | 66 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2015-12-31 | 0 |
| Total participants | 2015-12-31 | 66 |
| Number of participants with account balances | 2015-12-31 | 66 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2015-12-31 | 0 |
| 2014: BANK OF LAFAYETTE PROFIT-SHARING TRUST 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-12-31 | 64 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-12-31 | 50 |
| Number of retired or separated participants receiving benefits | 2014-12-31 | 13 |
| Total of all active and inactive participants | 2014-12-31 | 63 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-12-31 | 0 |
| Total participants | 2014-12-31 | 63 |
| Number of participants with account balances | 2014-12-31 | 63 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2014-12-31 | 0 |
| 2013: BANK OF LAFAYETTE PROFIT-SHARING TRUST 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-12-31 | 69 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-12-31 | 51 |
| Number of retired or separated participants receiving benefits | 2013-12-31 | 13 |
| Total of all active and inactive participants | 2013-12-31 | 64 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-12-31 | 0 |
| Total participants | 2013-12-31 | 64 |
| Number of participants with account balances | 2013-12-31 | 64 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-12-31 | 0 |
| 2012: BANK OF LAFAYETTE PROFIT-SHARING TRUST 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-12-31 | 67 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-12-31 | 52 |
| Number of retired or separated participants receiving benefits | 2012-12-31 | 15 |
| Total of all active and inactive participants | 2012-12-31 | 67 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-12-31 | 2 |
| Total participants | 2012-12-31 | 69 |
| Number of participants with account balances | 2012-12-31 | 69 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-12-31 | 0 |
| 2011: BANK OF LAFAYETTE PROFIT-SHARING TRUST 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-12-31 | 70 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-12-31 | 52 |
| Number of retired or separated participants receiving benefits | 2011-12-31 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-12-31 | 14 |
| Total of all active and inactive participants | 2011-12-31 | 66 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-12-31 | 1 |
| Total participants | 2011-12-31 | 67 |
| Number of participants with account balances | 2011-12-31 | 67 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2011-12-31 | 0 |
| 2009: BANK OF LAFAYETTE PROFIT-SHARING TRUST 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-12-31 | 76 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-12-31 | 72 |
| Total of all active and inactive participants | 2009-12-31 | 72 |
| Total participants | 2009-12-31 | 72 |
| Number of participants with account balances | 2009-12-31 | 72 |
| Measure | Date | Value |
|---|
| 2023 : BANK OF LAFAYETTE PROFIT-SHARING TRUST 2023 401k financial data |
|---|
| Total income from all sources | 2023-12-30 | $297,756 |
| Expenses. Total of all expenses incurred | 2023-12-30 | $192,994 |
| Benefits paid (including direct rollovers) | 2023-12-30 | $168,889 |
| Total plan assets at end of year | 2023-12-30 | $4,939,704 |
| Total plan assets at beginning of year | 2023-12-30 | $4,834,942 |
| Value of fidelity bond covering the plan | 2023-12-30 | $500,000 |
| Expenses. Other expenses not covered elsewhere | 2023-12-30 | $24,105 |
| Other income received | 2023-12-30 | $115,756 |
| Net income (gross income less expenses) | 2023-12-30 | $104,762 |
| Net plan assets at end of year (total assets less liabilities) | 2023-12-30 | $4,939,704 |
| Net plan assets at beginning of year (total assets less liabilities) | 2023-12-30 | $4,834,942 |
| Total contributions received or receivable from employer(s) | 2023-12-30 | $182,000 |
| 2022 : BANK OF LAFAYETTE PROFIT-SHARING TRUST 2022 401k financial data |
|---|
| Total income from all sources | 2022-12-30 | $161,396 |
| Expenses. Total of all expenses incurred | 2022-12-30 | $984,469 |
| Benefits paid (including direct rollovers) | 2022-12-30 | $963,471 |
| Total plan assets at end of year | 2022-12-30 | $4,834,942 |
| Total plan assets at beginning of year | 2022-12-30 | $5,658,015 |
| Value of fidelity bond covering the plan | 2022-12-30 | $500,000 |
| Expenses. Other expenses not covered elsewhere | 2022-12-30 | $20,998 |
| Other income received | 2022-12-30 | $43,396 |
| Net income (gross income less expenses) | 2022-12-30 | $-823,073 |
| Net plan assets at end of year (total assets less liabilities) | 2022-12-30 | $4,834,942 |
| Net plan assets at beginning of year (total assets less liabilities) | 2022-12-30 | $5,658,015 |
| Total contributions received or receivable from employer(s) | 2022-12-30 | $118,000 |
| 2021 : BANK OF LAFAYETTE PROFIT-SHARING TRUST 2021 401k financial data |
|---|
| Total income from all sources | 2021-12-30 | $211,081 |
| Expenses. Total of all expenses incurred | 2021-12-30 | $231,948 |
| Benefits paid (including direct rollovers) | 2021-12-30 | $220,734 |
| Total plan assets at end of year | 2021-12-30 | $5,658,015 |
| Total plan assets at beginning of year | 2021-12-30 | $5,678,882 |
| Value of fidelity bond covering the plan | 2021-12-30 | $500,000 |
| Expenses. Other expenses not covered elsewhere | 2021-12-30 | $11,214 |
| Other income received | 2021-12-30 | $47,621 |
| Net income (gross income less expenses) | 2021-12-30 | $-20,867 |
| Net plan assets at end of year (total assets less liabilities) | 2021-12-30 | $5,658,015 |
| Net plan assets at beginning of year (total assets less liabilities) | 2021-12-30 | $5,678,882 |
| Total contributions received or receivable from employer(s) | 2021-12-30 | $163,460 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2021-12-30 | $0 |
| 2020 : BANK OF LAFAYETTE PROFIT-SHARING TRUST 2020 401k financial data |
|---|
| Total income from all sources | 2020-12-30 | $201,306 |
| Expenses. Total of all expenses incurred | 2020-12-30 | $69,145 |
| Benefits paid (including direct rollovers) | 2020-12-30 | $58,930 |
| Total plan assets at end of year | 2020-12-30 | $5,678,882 |
| Total plan assets at beginning of year | 2020-12-30 | $5,546,721 |
| Value of fidelity bond covering the plan | 2020-12-30 | $500,000 |
| Expenses. Other expenses not covered elsewhere | 2020-12-30 | $10,215 |
| Other income received | 2020-12-30 | $101,306 |
| Net income (gross income less expenses) | 2020-12-30 | $132,161 |
| Net plan assets at end of year (total assets less liabilities) | 2020-12-30 | $5,678,882 |
| Net plan assets at beginning of year (total assets less liabilities) | 2020-12-30 | $5,546,721 |
| Total contributions received or receivable from employer(s) | 2020-12-30 | $100,000 |
| 2019 : BANK OF LAFAYETTE PROFIT-SHARING TRUST 2019 401k financial data |
|---|
| Total income from all sources | 2019-12-30 | $267,239 |
| Expenses. Total of all expenses incurred | 2019-12-30 | $148,406 |
| Benefits paid (including direct rollovers) | 2019-12-30 | $143,151 |
| Total plan assets at end of year | 2019-12-30 | $5,546,721 |
| Total plan assets at beginning of year | 2019-12-30 | $5,427,888 |
| Value of fidelity bond covering the plan | 2019-12-30 | $500,000 |
| Expenses. Other expenses not covered elsewhere | 2019-12-30 | $5,255 |
| Other income received | 2019-12-30 | $121,239 |
| Net income (gross income less expenses) | 2019-12-30 | $118,833 |
| Net plan assets at end of year (total assets less liabilities) | 2019-12-30 | $5,546,721 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-12-30 | $5,427,888 |
| Total contributions received or receivable from employer(s) | 2019-12-30 | $146,000 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2019-12-30 | $0 |
| 2018 : BANK OF LAFAYETTE PROFIT-SHARING TRUST 2018 401k financial data |
|---|
| Total income from all sources | 2018-12-30 | $263,797 |
| Expenses. Total of all expenses incurred | 2018-12-30 | $103,041 |
| Benefits paid (including direct rollovers) | 2018-12-30 | $91,933 |
| Total plan assets at end of year | 2018-12-30 | $5,427,888 |
| Total plan assets at beginning of year | 2018-12-30 | $5,267,132 |
| Value of fidelity bond covering the plan | 2018-12-30 | $500,000 |
| Expenses. Other expenses not covered elsewhere | 2018-12-30 | $6,108 |
| Other income received | 2018-12-30 | $87,797 |
| Net income (gross income less expenses) | 2018-12-30 | $160,756 |
| Net plan assets at end of year (total assets less liabilities) | 2018-12-30 | $5,427,888 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-12-30 | $5,267,132 |
| Total contributions received or receivable from employer(s) | 2018-12-30 | $176,000 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2018-12-30 | $5,000 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2018-12-30 | $0 |
| 2017 : BANK OF LAFAYETTE PROFIT-SHARING TRUST 2017 401k financial data |
|---|
| Total income from all sources | 2017-12-30 | $190,176 |
| Expenses. Total of all expenses incurred | 2017-12-30 | $42,739 |
| Benefits paid (including direct rollovers) | 2017-12-30 | $34,587 |
| Total plan assets at end of year | 2017-12-30 | $5,267,132 |
| Total plan assets at beginning of year | 2017-12-30 | $5,119,695 |
| Value of fidelity bond covering the plan | 2017-12-30 | $500,000 |
| Expenses. Other expenses not covered elsewhere | 2017-12-30 | $3,132 |
| Other income received | 2017-12-30 | $71,176 |
| Net income (gross income less expenses) | 2017-12-30 | $147,437 |
| Net plan assets at end of year (total assets less liabilities) | 2017-12-30 | $5,267,132 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-12-30 | $5,119,695 |
| Total contributions received or receivable from employer(s) | 2017-12-30 | $119,000 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-12-30 | $5,020 |
| 2016 : BANK OF LAFAYETTE PROFIT-SHARING TRUST 2016 401k financial data |
|---|
| Total income from all sources | 2016-12-30 | $191,758 |
| Expenses. Total of all expenses incurred | 2016-12-30 | $96,671 |
| Benefits paid (including direct rollovers) | 2016-12-30 | $86,383 |
| Total plan assets at end of year | 2016-12-30 | $5,119,695 |
| Total plan assets at beginning of year | 2016-12-30 | $5,024,608 |
| Value of fidelity bond covering the plan | 2016-12-30 | $500,000 |
| Expenses. Other expenses not covered elsewhere | 2016-12-30 | $5,268 |
| Other income received | 2016-12-30 | $70,258 |
| Net income (gross income less expenses) | 2016-12-30 | $95,087 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-30 | $5,119,695 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-30 | $5,024,608 |
| Total contributions received or receivable from employer(s) | 2016-12-30 | $121,500 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-12-30 | $5,020 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2016-12-30 | $0 |
| 2015 : BANK OF LAFAYETTE PROFIT-SHARING TRUST 2015 401k financial data |
|---|
| Total income from all sources | 2015-12-30 | $209,075 |
| Expenses. Total of all expenses incurred | 2015-12-30 | $109,164 |
| Benefits paid (including direct rollovers) | 2015-12-30 | $98,906 |
| Total plan assets at end of year | 2015-12-30 | $5,024,608 |
| Total plan assets at beginning of year | 2015-12-30 | $4,924,697 |
| Value of fidelity bond covering the plan | 2015-12-30 | $500,000 |
| Expenses. Other expenses not covered elsewhere | 2015-12-30 | $5,268 |
| Other income received | 2015-12-30 | $77,075 |
| Net income (gross income less expenses) | 2015-12-30 | $99,911 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-30 | $5,024,608 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-30 | $4,924,697 |
| Total contributions received or receivable from employer(s) | 2015-12-30 | $132,000 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-12-30 | $4,990 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2015-12-30 | $0 |
| 2014 : BANK OF LAFAYETTE PROFIT-SHARING TRUST 2014 401k financial data |
|---|
| Total income from all sources | 2014-12-30 | $230,144 |
| Expenses. Total of all expenses incurred | 2014-12-30 | $503,629 |
| Benefits paid (including direct rollovers) | 2014-12-30 | $493,248 |
| Total plan assets at end of year | 2014-12-30 | $4,924,697 |
| Total plan assets at beginning of year | 2014-12-30 | $5,198,182 |
| Value of fidelity bond covering the plan | 2014-12-30 | $500,000 |
| Expenses. Other expenses not covered elsewhere | 2014-12-30 | $5,267 |
| Other income received | 2014-12-30 | $93,644 |
| Net income (gross income less expenses) | 2014-12-30 | $-273,485 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-30 | $4,924,697 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-30 | $5,198,182 |
| Total contributions received or receivable from employer(s) | 2014-12-30 | $136,500 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2014-12-30 | $5,114 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2014-12-30 | $0 |
| 2013 : BANK OF LAFAYETTE PROFIT-SHARING TRUST 2013 401k financial data |
|---|
| Total income from all sources | 2013-12-30 | $211,762 |
| Expenses. Total of all expenses incurred | 2013-12-30 | $43,972 |
| Benefits paid (including direct rollovers) | 2013-12-30 | $32,971 |
| Total plan assets at end of year | 2013-12-30 | $5,198,182 |
| Total plan assets at beginning of year | 2013-12-30 | $5,030,392 |
| Value of fidelity bond covering the plan | 2013-12-30 | $500,000 |
| Expenses. Other expenses not covered elsewhere | 2013-12-30 | $5,267 |
| Other income received | 2013-12-30 | $110,762 |
| Net income (gross income less expenses) | 2013-12-30 | $167,790 |
| Net plan assets at end of year (total assets less liabilities) | 2013-12-30 | $5,198,182 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-12-30 | $5,030,392 |
| Total contributions received or receivable from employer(s) | 2013-12-30 | $101,000 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2013-12-30 | $5,734 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2013-12-30 | $0 |
| 2012 : BANK OF LAFAYETTE PROFIT-SHARING TRUST 2012 401k financial data |
|---|
| Total income from all sources | 2012-12-30 | $511,697 |
| Expenses. Total of all expenses incurred | 2012-12-30 | $395,889 |
| Benefits paid (including direct rollovers) | 2012-12-30 | $382,927 |
| Total plan assets at end of year | 2012-12-30 | $5,030,392 |
| Total plan assets at beginning of year | 2012-12-30 | $4,914,584 |
| Value of fidelity bond covering the plan | 2012-12-30 | $500,000 |
| Expenses. Other expenses not covered elsewhere | 2012-12-30 | $5,267 |
| Other income received | 2012-12-30 | $108,679 |
| Noncash contributions received | 2012-12-30 | $281,018 |
| Net income (gross income less expenses) | 2012-12-30 | $115,808 |
| Net plan assets at end of year (total assets less liabilities) | 2012-12-30 | $5,030,392 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-12-30 | $4,914,584 |
| Total contributions received or receivable from employer(s) | 2012-12-30 | $122,000 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2012-12-30 | $7,695 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2012-12-30 | $0 |
| 2011 : BANK OF LAFAYETTE PROFIT-SHARING TRUST 2011 401k financial data |
|---|
| Total income from all sources | 2011-12-30 | $264,420 |
| Expenses. Total of all expenses incurred | 2011-12-30 | $47,598 |
| Benefits paid (including direct rollovers) | 2011-12-30 | $41,943 |
| Total plan assets at end of year | 2011-12-30 | $4,914,584 |
| Total plan assets at beginning of year | 2011-12-30 | $4,697,762 |
| Value of fidelity bond covering the plan | 2011-12-30 | $500,000 |
| Other income received | 2011-12-30 | $120,920 |
| Net income (gross income less expenses) | 2011-12-30 | $216,822 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-30 | $4,914,584 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-30 | $4,697,762 |
| Total contributions received or receivable from employer(s) | 2011-12-30 | $143,500 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2011-12-30 | $5,655 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2011-12-30 | $0 |
| 2022: BANK OF LAFAYETTE PROFIT-SHARING TRUST 2022 form 5500 responses |
|---|
| 2022-12-31 | Type of plan entity | Single employer plan |
| 2022-12-31 | Submission has been amended | No |
| 2022-12-31 | This submission is the final filing | No |
| 2022-12-31 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-12-31 | Plan is a collectively bargained plan | No |
| 2022-12-31 | Plan funding arrangement – Insurance | Yes |
| 2022-12-31 | Plan funding arrangement – Trust | Yes |
| 2022-12-31 | Plan benefit arrangement – Insurance | Yes |
| 2022-12-31 | Plan benefit arrangement - Trust | Yes |
| 2021: BANK OF LAFAYETTE PROFIT-SHARING TRUST 2021 form 5500 responses |
|---|
| 2021-12-31 | Type of plan entity | Single employer plan |
| 2021-12-31 | Submission has been amended | No |
| 2021-12-31 | This submission is the final filing | No |
| 2021-12-31 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-12-31 | Plan is a collectively bargained plan | No |
| 2021-12-31 | Plan funding arrangement – Insurance | Yes |
| 2021-12-31 | Plan funding arrangement – Trust | Yes |
| 2021-12-31 | Plan benefit arrangement – Insurance | Yes |
| 2021-12-31 | Plan benefit arrangement - Trust | Yes |
| 2020: BANK OF LAFAYETTE PROFIT-SHARING TRUST 2020 form 5500 responses |
|---|
| 2020-12-31 | Type of plan entity | Single employer plan |
| 2020-12-31 | Submission has been amended | No |
| 2020-12-31 | This submission is the final filing | No |
| 2020-12-31 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-12-31 | Plan is a collectively bargained plan | No |
| 2020-12-31 | Plan funding arrangement – Insurance | Yes |
| 2020-12-31 | Plan funding arrangement – Trust | Yes |
| 2020-12-31 | Plan benefit arrangement – Insurance | Yes |
| 2020-12-31 | Plan benefit arrangement - Trust | Yes |
| 2019: BANK OF LAFAYETTE PROFIT-SHARING TRUST 2019 form 5500 responses |
|---|
| 2019-12-31 | Type of plan entity | Single employer plan |
| 2019-12-31 | Submission has been amended | No |
| 2019-12-31 | This submission is the final filing | No |
| 2019-12-31 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-12-31 | Plan is a collectively bargained plan | No |
| 2019-12-31 | Plan funding arrangement – Insurance | Yes |
| 2019-12-31 | Plan funding arrangement – Trust | Yes |
| 2019-12-31 | Plan benefit arrangement – Insurance | Yes |
| 2019-12-31 | Plan benefit arrangement - Trust | Yes |
| 2018: BANK OF LAFAYETTE PROFIT-SHARING TRUST 2018 form 5500 responses |
|---|
| 2018-12-31 | Type of plan entity | Single employer plan |
| 2018-12-31 | Submission has been amended | No |
| 2018-12-31 | This submission is the final filing | No |
| 2018-12-31 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-12-31 | Plan is a collectively bargained plan | No |
| 2018-12-31 | Plan funding arrangement – Insurance | Yes |
| 2018-12-31 | Plan funding arrangement – Trust | Yes |
| 2018-12-31 | Plan benefit arrangement – Insurance | Yes |
| 2018-12-31 | Plan benefit arrangement - Trust | Yes |
| 2017: BANK OF LAFAYETTE PROFIT-SHARING TRUST 2017 form 5500 responses |
|---|
| 2017-12-31 | Type of plan entity | Single employer plan |
| 2017-12-31 | Submission has been amended | No |
| 2017-12-31 | This submission is the final filing | No |
| 2017-12-31 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-12-31 | Plan is a collectively bargained plan | No |
| 2017-12-31 | Plan funding arrangement – Insurance | Yes |
| 2017-12-31 | Plan funding arrangement – Trust | Yes |
| 2017-12-31 | Plan benefit arrangement – Insurance | Yes |
| 2017-12-31 | Plan benefit arrangement - Trust | Yes |
| 2016: BANK OF LAFAYETTE PROFIT-SHARING TRUST 2016 form 5500 responses |
|---|
| 2016-12-31 | Type of plan entity | Single employer plan |
| 2016-12-31 | Submission has been amended | No |
| 2016-12-31 | This submission is the final filing | No |
| 2016-12-31 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-12-31 | Plan is a collectively bargained plan | No |
| 2016-12-31 | Plan funding arrangement – Insurance | Yes |
| 2016-12-31 | Plan funding arrangement – Trust | Yes |
| 2016-12-31 | Plan benefit arrangement – Insurance | Yes |
| 2016-12-31 | Plan benefit arrangement - Trust | Yes |
| 2015: BANK OF LAFAYETTE PROFIT-SHARING TRUST 2015 form 5500 responses |
|---|
| 2015-12-31 | Type of plan entity | Single employer plan |
| 2015-12-31 | Submission has been amended | No |
| 2015-12-31 | This submission is the final filing | No |
| 2015-12-31 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-12-31 | Plan is a collectively bargained plan | No |
| 2015-12-31 | Plan funding arrangement – Insurance | Yes |
| 2015-12-31 | Plan funding arrangement – Trust | Yes |
| 2015-12-31 | Plan benefit arrangement – Insurance | Yes |
| 2015-12-31 | Plan benefit arrangement - Trust | Yes |
| 2014: BANK OF LAFAYETTE PROFIT-SHARING TRUST 2014 form 5500 responses |
|---|
| 2014-12-31 | Type of plan entity | Single employer plan |
| 2014-12-31 | Submission has been amended | No |
| 2014-12-31 | This submission is the final filing | No |
| 2014-12-31 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-12-31 | Plan is a collectively bargained plan | No |
| 2014-12-31 | Plan funding arrangement – Insurance | Yes |
| 2014-12-31 | Plan funding arrangement – Trust | Yes |
| 2014-12-31 | Plan benefit arrangement – Insurance | Yes |
| 2014-12-31 | Plan benefit arrangement - Trust | Yes |
| 2013: BANK OF LAFAYETTE PROFIT-SHARING TRUST 2013 form 5500 responses |
|---|
| 2013-12-31 | Type of plan entity | Single employer plan |
| 2013-12-31 | Submission has been amended | No |
| 2013-12-31 | This submission is the final filing | No |
| 2013-12-31 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-12-31 | Plan is a collectively bargained plan | No |
| 2013-12-31 | Plan funding arrangement – Insurance | Yes |
| 2013-12-31 | Plan funding arrangement – Trust | Yes |
| 2013-12-31 | Plan benefit arrangement – Insurance | Yes |
| 2013-12-31 | Plan benefit arrangement - Trust | Yes |
| 2012: BANK OF LAFAYETTE PROFIT-SHARING TRUST 2012 form 5500 responses |
|---|
| 2012-12-31 | Type of plan entity | Single employer plan |
| 2012-12-31 | Submission has been amended | No |
| 2012-12-31 | This submission is the final filing | No |
| 2012-12-31 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-12-31 | Plan is a collectively bargained plan | No |
| 2012-12-31 | Plan funding arrangement – Insurance | Yes |
| 2012-12-31 | Plan funding arrangement – Trust | Yes |
| 2012-12-31 | Plan benefit arrangement – Insurance | Yes |
| 2012-12-31 | Plan benefit arrangement - Trust | Yes |
| 2011: BANK OF LAFAYETTE PROFIT-SHARING TRUST 2011 form 5500 responses |
|---|
| 2011-12-31 | Type of plan entity | Single employer plan |
| 2011-12-31 | Submission has been amended | No |
| 2011-12-31 | This submission is the final filing | No |
| 2011-12-31 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-12-31 | Plan is a collectively bargained plan | No |
| 2011-12-31 | Plan funding arrangement – Insurance | Yes |
| 2011-12-31 | Plan funding arrangement – Trust | Yes |
| 2011-12-31 | Plan benefit arrangement – Insurance | Yes |
| 2011-12-31 | Plan benefit arrangement - Trust | Yes |
| 2009: BANK OF LAFAYETTE PROFIT-SHARING TRUST 2009 form 5500 responses |
|---|
| 2009-12-31 | Type of plan entity | Single employer plan |
| 2009-12-31 | Submission has been amended | Yes |
| 2009-12-31 | This submission is the final filing | No |
| 2009-12-31 | Plan funding arrangement – Trust | Yes |
| 2009-12-31 | Plan benefit arrangement - Trust | Yes |
| 2008: BANK OF LAFAYETTE PROFIT-SHARING TRUST 2008 form 5500 responses |
|---|
| 2008-12-31 | Type of plan entity | Single employer plan |
| 2008-12-31 | Submission has been amended | No |
| 2008-12-31 | This submission is the final filing | No |
| 2008-12-31 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2008-12-31 | Plan is a collectively bargained plan | No |
| CONTINTAL ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62413 ) |
| Policy contract number | 0070338340 |
| Policy instance | 4 |
| Insurance contract or identification number | 0070338340 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2022-04-01 | | Insurance policy end date | 2023-03-31 | | Are there contracts with allocated funds for individual policies? | 1 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STATE MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69132 ) |
| Policy contract number | 00107721 |
| Policy instance | 3 |
| Insurance contract or identification number | 00107721 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2022-12-31 | | Insurance policy end date | 2023-12-30 | | Are there contracts with allocated funds for individual policies? | 1 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88536 ) |
| Policy contract number | E00460476 |
| Policy instance | 2 |
| Insurance contract or identification number | E00460476 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2022-12-31 | | Insurance policy end date | 2023-12-30 | | Are there contracts with allocated funds for individual policies? | 1 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN EQUITY INVESTMENT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61689 ) |
| Policy contract number | AB00176250 |
| Policy instance | 1 |
| Insurance contract or identification number | AB00176250 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2022-08-01 | | Insurance policy end date | 2023-07-31 | | Are there contracts with allocated funds for individual policies? | 1 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN EQUITY INVESTMENT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61689 ) |
| Policy contract number | AB00176250 |
| Policy instance | 1 |
| Insurance contract or identification number | AB00176250 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2021-08-01 | | Insurance policy end date | 2022-07-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 1 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88536 ) |
| Policy contract number | E00460476 |
| Policy instance | 2 |
| Insurance contract or identification number | E00460476 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2021-12-31 | | Insurance policy end date | 2022-12-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 1 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STATE MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69132 ) |
| Policy contract number | 00107721 |
| Policy instance | 3 |
| Insurance contract or identification number | 00107721 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2021-12-31 | | Insurance policy end date | 2022-12-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 1 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CONTINTAL ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62413 ) |
| Policy contract number | 0070338340 |
| Policy instance | 4 |
| Insurance contract or identification number | 0070338340 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 1 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CONTINTAL ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62413 ) |
| Policy contract number | 0070338340 |
| Policy instance | 4 |
| Insurance contract or identification number | 0070338340 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 1 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STATE MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69132 ) |
| Policy contract number | 00107721 |
| Policy instance | 3 |
| Insurance contract or identification number | 00107721 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2020-12-31 | | Insurance policy end date | 2021-12-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 1 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88536 ) |
| Policy contract number | E00460476 |
| Policy instance | 2 |
| Insurance contract or identification number | E00460476 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2020-12-31 | | Insurance policy end date | 2021-12-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 1 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN EQUITY INVESTMENT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61689 ) |
| Policy contract number | AB00176250 |
| Policy instance | 1 |
| Insurance contract or identification number | AB00176250 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2020-08-01 | | Insurance policy end date | 2021-07-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 1 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN EQUITY INVESTMENT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61689 ) |
| Policy contract number | AB00176250 |
| Policy instance | 1 |
| Insurance contract or identification number | AB00176250 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2019-08-01 | | Insurance policy end date | 2020-07-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 1 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WAHINGTON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65900 ) |
| Policy contract number | 0070338340 |
| Policy instance | 2 |
| Insurance contract or identification number | 0070338340 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 1 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88536 ) |
| Policy contract number | E00460476 |
| Policy instance | 3 |
| Insurance contract or identification number | E00460476 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2019-12-31 | | Insurance policy end date | 2020-12-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 1 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STATE MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69132 ) |
| Policy contract number | 00107721 |
| Policy instance | 4 |
| Insurance contract or identification number | 00107721 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2019-12-31 | | Insurance policy end date | 2020-12-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 1 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WAHINGTON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65900 ) |
| Policy contract number | 0070338340 |
| Policy instance | 2 |
| Insurance contract or identification number | 0070338340 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 1 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88536 ) |
| Policy contract number | E00460476 |
| Policy instance | 3 |
| Insurance contract or identification number | E00460476 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2018-12-31 | | Insurance policy end date | 2019-12-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 1 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN EQUITY INVESTMENT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61689 ) |
| Policy contract number | AB00176250 |
| Policy instance | 1 |
| Insurance contract or identification number | AB00176250 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2018-08-01 | | Insurance policy end date | 2019-07-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 1 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STATE MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69132 ) |
| Policy contract number | 00107721 |
| Policy instance | 4 |
| Insurance contract or identification number | 00107721 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2018-12-31 | | Insurance policy end date | 2019-12-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 1 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STATE MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69132 ) |
| Policy contract number | 00107721 |
| Policy instance | 4 |
| Insurance contract or identification number | 00107721 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2017-12-31 | | Insurance policy end date | 2018-12-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 1 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88536 ) |
| Policy contract number | E00460476 |
| Policy instance | 3 |
| Insurance contract or identification number | E00460476 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2017-12-31 | | Insurance policy end date | 2018-12-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 1 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WAHINGTON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65900 ) |
| Policy contract number | 0070338340 |
| Policy instance | 2 |
| Insurance contract or identification number | 0070338340 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 1 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN EQUITY INVESTMENT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61689 ) |
| Policy contract number | AB00176250 |
| Policy instance | 1 |
| Insurance contract or identification number | AB00176250 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2017-08-01 | | Insurance policy end date | 2018-07-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 1 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN EQUITY INVESTMENT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61689 ) |
| Policy contract number | AB00176250 |
| Policy instance | 1 |
| Insurance contract or identification number | AB00176250 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2015-08-01 | | Insurance policy end date | 2016-07-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WAHINGTON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65900 ) |
| Policy contract number | 0070338340 |
| Policy instance | 2 |
| Insurance contract or identification number | 0070338340 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88536 ) |
| Policy contract number | E00460476 |
| Policy instance | 3 |
| Insurance contract or identification number | E00460476 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2015-12-31 | | Insurance policy end date | 2016-12-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STATE MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69132 ) |
| Policy contract number | 00107721 |
| Policy instance | 4 |
| Insurance contract or identification number | 00107721 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2015-12-31 | | Insurance policy end date | 2016-12-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN EQUITY INVESTMENT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61689 ) |
| Policy contract number | AB00176250 |
| Policy instance | 1 |
| Insurance contract or identification number | AB00176250 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2014-08-01 | | Insurance policy end date | 2015-07-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WAHINGTON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65900 ) |
| Policy contract number | 0070338340 |
| Policy instance | 2 |
| Insurance contract or identification number | 0070338340 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88536 ) |
| Policy contract number | E00460476 |
| Policy instance | 3 |
| Insurance contract or identification number | E00460476 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2014-12-31 | | Insurance policy end date | 2015-12-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STATE MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69132 ) |
| Policy contract number | 00107721 |
| Policy instance | 4 |
| Insurance contract or identification number | 00107721 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2014-12-31 | | Insurance policy end date | 2015-12-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WAHINGTON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65900 ) |
| Policy contract number | 0070338340 |
| Policy instance | 4 |
| Insurance contract or identification number | 0070338340 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88536 ) |
| Policy contract number | E00460476 |
| Policy instance | 1 |
| Insurance contract or identification number | E00460476 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2013-12-31 | | Insurance policy end date | 2014-12-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STATE MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69132 ) |
| Policy contract number | 00107721 |
| Policy instance | 2 |
| Insurance contract or identification number | 00107721 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2013-12-31 | | Insurance policy end date | 2014-12-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN EQUITY INVESTMENT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61689 ) |
| Policy contract number | AB00176250 |
| Policy instance | 3 |
| Insurance contract or identification number | AB00176250 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2013-08-01 | | Insurance policy end date | 2014-07-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88536 ) |
| Policy contract number | B00394230 |
| Policy instance | 1 |
| Insurance contract or identification number | B00394230 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2012-12-31 | | Insurance policy end date | 2013-12-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN EQUITY INVESTMENT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61689 ) |
| Policy contract number | AB00176250 |
| Policy instance | 3 |
| Insurance contract or identification number | AB00176250 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2012-08-01 | | Insurance policy end date | 2013-07-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STATE MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69132 ) |
| Policy contract number | 00107721 |
| Policy instance | 2 |
| Insurance contract or identification number | 00107721 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2012-12-31 | | Insurance policy end date | 2013-12-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WAHINGTON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65900 ) |
| Policy contract number | 0070338340 |
| Policy instance | 4 |
| Insurance contract or identification number | 0070338340 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STATE MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69132 ) |
| Policy contract number | 00086512 |
| Policy instance | 4 |
| Insurance contract or identification number | 00086512 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2011-12-31 | | Insurance policy end date | 2012-12-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88536 ) |
| Policy contract number | B00394230 |
| Policy instance | 3 |
| Insurance contract or identification number | B00394230 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2011-12-31 | | Insurance policy end date | 2012-12-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WAHINGTON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65900 ) |
| Policy contract number | 0070338340 |
| Policy instance | 2 |
| Insurance contract or identification number | 0070338340 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN EQUITY INVESTMENT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61689 ) |
| Policy contract number | AB00176250 |
| Policy instance | 1 |
| Insurance contract or identification number | AB00176250 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2011-08-01 | | Insurance policy end date | 2012-07-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STATE MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69132 ) |
| Policy contract number | 00086512 |
| Policy instance | 4 |
| Insurance contract or identification number | 00086512 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2010-12-31 | | Insurance policy end date | 2011-12-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WAHINGTON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65900 ) |
| Policy contract number | 0070338340 |
| Policy instance | 2 |
| Insurance contract or identification number | 0070338340 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88536 ) |
| Policy contract number | B00394230 |
| Policy instance | 3 |
| Insurance contract or identification number | B00394230 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2010-12-31 | | Insurance policy end date | 2011-12-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN EQUITY INVESTMENT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61689 ) |
| Policy contract number | AB00176250 |
| Policy instance | 1 |
| Insurance contract or identification number | AB00176250 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2010-08-01 | | Insurance policy end date | 2011-07-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
