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ORTHOPEDIC CENTER OF FLORIDA, INC. EMPLOYEES 401(K) PS PLAN 401k Plan overview

Plan NameORTHOPEDIC CENTER OF FLORIDA, INC. EMPLOYEES 401(K) PS PLAN
Plan identification number 001

ORTHOPEDIC CENTER OF FLORIDA, INC. EMPLOYEES 401(K) PS PLAN Benefits

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

401k Sponsoring company profile

ORTHOPEDIC CENTER OF FLORIDA, INC. has sponsored the creation of one or more 401k plans.

Company Name:ORTHOPEDIC CENTER OF FLORIDA, INC.
Employer identification number (EIN):592750728
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Additional information about ORTHOPEDIC CENTER OF FLORIDA, INC.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations
Incorporation Date: 1986-12-30
Company Identification Number: J49268
Legal Registered Office Address: 1617 RIDGEWOOD AVE

DAYTONA BEACH

32117

More information about ORTHOPEDIC CENTER OF FLORIDA, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ORTHOPEDIC CENTER OF FLORIDA, INC. EMPLOYEES 401(K) PS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01MARK FARMER, MD2024-01-09 MARK FARMER, MD2024-01-09
0012021-01-01MARK FARMER, MD2022-09-20 MARK FARMER, MD2022-09-20
0012020-01-01
0012018-01-01
0012017-01-01
0012016-01-01MARK FARMER, MD2017-08-24
0012015-01-01MARK FARMER, MD2016-07-18
0012014-01-01MARK FARMER, MD2015-08-26
0012013-01-01JOHN MEHALIK, MD2014-10-09 JOHN MEHALIK, MD2014-10-09
0012012-01-01MARK FARMER, MD MARK FARMER, MD2013-10-10
0012011-01-01MARK FARMER, MD MARK FARMER, MD2012-10-12
0012010-01-01MARK FARMER, MD MARK FARMER, MD2011-10-07
0012009-01-01MARK FARMER, MD MARK FARMER, MD2010-09-18

Plan Statistics for ORTHOPEDIC CENTER OF FLORIDA, INC. EMPLOYEES 401(K) PS PLAN

401k plan membership statisitcs for ORTHOPEDIC CENTER OF FLORIDA, INC. EMPLOYEES 401(K) PS PLAN

Measure Date Value
2022: ORTHOPEDIC CENTER OF FLORIDA, INC. EMPLOYEES 401(K) PS PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0198
Total number of active participants reported on line 7a of the Form 55002022-01-0158
Number of retired or separated participants receiving benefits2022-01-015
Number of other retired or separated participants entitled to future benefits2022-01-0136
Total of all active and inactive participants2022-01-0199
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-0199
Number of participants with account balances2022-01-0186
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-011
2021: ORTHOPEDIC CENTER OF FLORIDA, INC. EMPLOYEES 401(K) PS PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0185
Total number of active participants reported on line 7a of the Form 55002021-01-0147
Number of retired or separated participants receiving benefits2021-01-017
Number of other retired or separated participants entitled to future benefits2021-01-0130
Total of all active and inactive participants2021-01-0184
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-0184
Number of participants with account balances2021-01-0182
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-0112
2012: ORTHOPEDIC CENTER OF FLORIDA, INC. EMPLOYEES 401(K) PS PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0159
Total number of active participants reported on line 7a of the Form 55002012-01-0134
Number of retired or separated participants receiving benefits2012-01-013
Number of other retired or separated participants entitled to future benefits2012-01-0115
Total of all active and inactive participants2012-01-0152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0152
Number of participants with account balances2012-01-0151
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-011
2011: ORTHOPEDIC CENTER OF FLORIDA, INC. EMPLOYEES 401(K) PS PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0162
Total number of active participants reported on line 7a of the Form 55002011-01-0133
Number of retired or separated participants receiving benefits2011-01-012
Number of other retired or separated participants entitled to future benefits2011-01-0116
Total of all active and inactive participants2011-01-0151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0151
Number of participants with account balances2011-01-0149
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-013
2010: ORTHOPEDIC CENTER OF FLORIDA, INC. EMPLOYEES 401(K) PS PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0163
Total number of active participants reported on line 7a of the Form 55002010-01-0137
Number of retired or separated participants receiving benefits2010-01-014
Number of other retired or separated participants entitled to future benefits2010-01-0116
Total of all active and inactive participants2010-01-0157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0157
Number of participants with account balances2010-01-0154
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-012
2009: ORTHOPEDIC CENTER OF FLORIDA, INC. EMPLOYEES 401(K) PS PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0153
Total number of active participants reported on line 7a of the Form 55002009-01-0129
Number of retired or separated participants receiving benefits2009-01-012
Number of other retired or separated participants entitled to future benefits2009-01-0117
Total of all active and inactive participants2009-01-0148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0148
Number of participants with account balances2009-01-0148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-015

Financial Data on ORTHOPEDIC CENTER OF FLORIDA, INC. EMPLOYEES 401(K) PS PLAN

Measure Date Value
2022 : ORTHOPEDIC CENTER OF FLORIDA, INC. EMPLOYEES 401(K) PS PLAN 2022 401k financial data
Total income from all sources2022-12-31$-207,548
Expenses. Total of all expenses incurred2022-12-31$601,463
Benefits paid (including direct rollovers)2022-12-31$565,595
Total plan assets at end of year2022-12-31$4,269,083
Total plan assets at beginning of year2022-12-31$5,078,094
Value of fidelity bond covering the plan2022-12-31$500,000
Total contributions received or receivable from participants2022-12-31$280,060
Contributions received from other sources (not participants or employers)2022-12-31$33,917
Other income received2022-12-31$-569,001
Net income (gross income less expenses)2022-12-31$-809,011
Net plan assets at end of year (total assets less liabilities)2022-12-31$4,269,083
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$5,078,094
Assets. Value of participant loans2022-12-31$84,138
Assets. Value of real-estate (other than employer real property)2022-12-31$59,957
Total contributions received or receivable from employer(s)2022-12-31$47,476
Value of corrective distributions2022-12-31$35,868
2021 : ORTHOPEDIC CENTER OF FLORIDA, INC. EMPLOYEES 401(K) PS PLAN 2021 401k financial data
Total income from all sources2021-12-31$922,876
Expenses. Total of all expenses incurred2021-12-31$154,515
Benefits paid (including direct rollovers)2021-12-31$135,822
Total plan assets at end of year2021-12-31$5,078,094
Total plan assets at beginning of year2021-12-31$4,309,733
Value of fidelity bond covering the plan2021-12-31$500,000
Total contributions received or receivable from participants2021-12-31$270,740
Other income received2021-12-31$604,268
Net income (gross income less expenses)2021-12-31$768,361
Net plan assets at end of year (total assets less liabilities)2021-12-31$5,078,094
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$4,309,733
Assets. Value of participant loans2021-12-31$69,131
Assets. Value of real-estate (other than employer real property)2021-12-31$59,957
Total contributions received or receivable from employer(s)2021-12-31$47,868
Value of certain deemed distributions of participant loans2021-12-31$12,430
Value of corrective distributions2021-12-31$6,263
2012 : ORTHOPEDIC CENTER OF FLORIDA, INC. EMPLOYEES 401(K) PS PLAN 2012 401k financial data
Total income from all sources2012-12-31$479,971
Expenses. Total of all expenses incurred2012-12-31$76,866
Benefits paid (including direct rollovers)2012-12-31$72,245
Total plan assets at end of year2012-12-31$2,870,877
Total plan assets at beginning of year2012-12-31$2,467,772
Value of fidelity bond covering the plan2012-12-31$250,000
Total contributions received or receivable from participants2012-12-31$191,126
Other income received2012-12-31$252,641
Net income (gross income less expenses)2012-12-31$403,105
Net plan assets at end of year (total assets less liabilities)2012-12-31$2,870,877
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$2,467,772
Assets. Value of participant loans2012-12-31$55,119
Assets. Value of real-estate (other than employer real property)2012-12-31$138,221
Total contributions received or receivable from employer(s)2012-12-31$36,204
Value of certain deemed distributions of participant loans2012-12-31$4,621
2011 : ORTHOPEDIC CENTER OF FLORIDA, INC. EMPLOYEES 401(K) PS PLAN 2011 401k financial data
Total income from all sources2011-12-31$45,086
Expenses. Total of all expenses incurred2011-12-31$25,452
Benefits paid (including direct rollovers)2011-12-31$23,752
Total plan assets at end of year2011-12-31$2,467,772
Total plan assets at beginning of year2011-12-31$2,448,138
Value of fidelity bond covering the plan2011-12-31$250,000
Total contributions received or receivable from participants2011-12-31$146,707
Other income received2011-12-31$-114,039
Net income (gross income less expenses)2011-12-31$19,634
Net plan assets at end of year (total assets less liabilities)2011-12-31$2,467,772
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$2,448,138
Assets. Value of participant loans2011-12-31$36,479
Assets. Value of real-estate (other than employer real property)2011-12-31$0
Total contributions received or receivable from employer(s)2011-12-31$12,418
Value of corrective distributions2011-12-31$1,700
2010 : ORTHOPEDIC CENTER OF FLORIDA, INC. EMPLOYEES 401(K) PS PLAN 2010 401k financial data
Total income from all sources2010-12-31$355,784
Expenses. Total of all expenses incurred2010-12-31$362,378
Benefits paid (including direct rollovers)2010-12-31$362,378
Total plan assets at end of year2010-12-31$2,448,138
Total plan assets at beginning of year2010-12-31$2,454,732
Value of fidelity bond covering the plan2010-12-31$250,000
Total contributions received or receivable from participants2010-12-31$152,482
Contributions received from other sources (not participants or employers)2010-12-31$800
Other income received2010-12-31$173,056
Net income (gross income less expenses)2010-12-31$-6,594
Net plan assets at end of year (total assets less liabilities)2010-12-31$2,448,138
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$2,454,732
Assets. Value of participant loans2010-12-31$55,605
Assets. Value of real-estate (other than employer real property)2010-12-31$106
Total contributions received or receivable from employer(s)2010-12-31$29,446

Form 5500 Responses for ORTHOPEDIC CENTER OF FLORIDA, INC. EMPLOYEES 401(K) PS PLAN

2022: ORTHOPEDIC CENTER OF FLORIDA, INC. EMPLOYEES 401(K) PS PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: ORTHOPEDIC CENTER OF FLORIDA, INC. EMPLOYEES 401(K) PS PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2012: ORTHOPEDIC CENTER OF FLORIDA, INC. EMPLOYEES 401(K) PS PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: ORTHOPEDIC CENTER OF FLORIDA, INC. EMPLOYEES 401(K) PS PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: ORTHOPEDIC CENTER OF FLORIDA, INC. EMPLOYEES 401(K) PS PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: ORTHOPEDIC CENTER OF FLORIDA, INC. EMPLOYEES 401(K) PS PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number636981
Policy instance 1
Insurance contract or identification number636981
Number of Individuals Covered86
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $13,933
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $10,063
Insurance broker organization code?4
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number636981
Policy instance 1
Insurance contract or identification number636981
Number of Individuals Covered636981
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $14,084
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $10,172
Insurance broker organization code?4
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number15175
Policy instance 1
Insurance contract or identification number15175
Number of Individuals Covered51
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $10,289
Total amount of fees paid to insurance companyUSD $6,701
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Amount paid for insurance broker fees6701
Additional information about fees paid to insurance brokerPLAN SERVICE FEES
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $6,701
Insurance broker nameFLORIDA ACTUARIAL CORP
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number15175
Policy instance 1
Insurance contract or identification number15175
Number of Individuals Covered49
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $6,531
Total amount of fees paid to insurance companyUSD $8,621
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )
Policy contract number670153
Policy instance 1
Insurance contract or identification number670153
Number of Individuals Covered0
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $5,102
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $5,102
Insurance broker organization code?3
Insurance broker nameNEWBRIDGE SECURITIES CORP
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number15175
Policy instance 2
Insurance contract or identification number15175
Number of Individuals Covered54
Insurance policy start date2010-10-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $935
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Amount paid for insurance broker fees935
Additional information about fees paid to insurance brokerPLAN SERVICE FEES
Insurance broker organization code?3
Insurance broker nameFLORIDA ACTUARIAL CORP.

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