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JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 401k Plan overview

Plan NameJAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN
Plan identification number 002

JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • 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

JAMES E. ROBERTS, DMD, PC has sponsored the creation of one or more 401k plans.

Company Name:JAMES E. ROBERTS, DMD, PC
Employer identification number (EIN):630714211
NAIC Classification:621210
NAIC Description:Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022020-09-01
0022019-09-01
0022018-09-01
0022017-09-01JAMES ROBERTS
0022015-09-01JAMES ROBERTS
0022014-09-01JAMES ROBERTS
0022013-09-01JAMES ROBERTS
0022012-09-01JAMES ROBERTS
0022011-09-01JAMES ROBERTS
0022009-09-01JAMES ROBERTS

Plan Statistics for JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN

401k plan membership statisitcs for JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN

Measure Date Value
2020: JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year2020-09-014
Total number of active participants reported on line 7a of the Form 55002020-09-010
Total of all active and inactive participants2020-09-010
Total participants2020-09-010
Number of participants with account balances2020-09-010
2019: JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year2019-09-015
Total number of active participants reported on line 7a of the Form 55002019-09-010
Number of retired or separated participants receiving benefits2019-09-010
Number of other retired or separated participants entitled to future benefits2019-09-014
Total of all active and inactive participants2019-09-014
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-09-010
Total participants2019-09-014
Number of participants with account balances2019-09-014
2018: JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year2018-09-015
Total number of active participants reported on line 7a of the Form 55002018-09-014
Number of other retired or separated participants entitled to future benefits2018-09-011
Total of all active and inactive participants2018-09-015
Total participants2018-09-015
Number of participants with account balances2018-09-014
2017: JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-09-014
Total number of active participants reported on line 7a of the Form 55002017-09-014
Number of retired or separated participants receiving benefits2017-09-010
Number of other retired or separated participants entitled to future benefits2017-09-011
Total of all active and inactive participants2017-09-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-09-010
Total participants2017-09-015
Number of participants with account balances2017-09-014
2015: JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-09-013
Total number of active participants reported on line 7a of the Form 55002015-09-013
Number of other retired or separated participants entitled to future benefits2015-09-011
Total of all active and inactive participants2015-09-014
Total participants2015-09-014
Number of participants with account balances2015-09-014
2014: JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-09-015
Total number of active participants reported on line 7a of the Form 55002014-09-013
Total of all active and inactive participants2014-09-013
Total participants2014-09-013
Number of participants with account balances2014-09-014
2013: JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-09-015
Total number of active participants reported on line 7a of the Form 55002013-09-014
Number of other retired or separated participants entitled to future benefits2013-09-011
Total of all active and inactive participants2013-09-015
Total participants2013-09-015
Number of participants with account balances2013-09-015
2012: JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-09-015
Total number of active participants reported on line 7a of the Form 55002012-09-014
Number of other retired or separated participants entitled to future benefits2012-09-011
Total of all active and inactive participants2012-09-015
Total participants2012-09-015
Number of participants with account balances2012-09-015
2011: JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-09-016
Total number of active participants reported on line 7a of the Form 55002011-09-014
Number of other retired or separated participants entitled to future benefits2011-09-011
Total of all active and inactive participants2011-09-015
Total participants2011-09-015
Number of participants with account balances2011-09-015
2009: JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-09-017
Total number of active participants reported on line 7a of the Form 55002009-09-014
Number of other retired or separated participants entitled to future benefits2009-09-012
Total of all active and inactive participants2009-09-016
Total participants2009-09-016
Number of participants with account balances2009-09-016

Financial Data on JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN

Measure Date Value
2021 : JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2021 401k financial data
Total plan liabilities at beginning of year2021-08-31$21,000
Total income from all sources2021-08-31$142,119
Expenses. Total of all expenses incurred2021-08-31$1,672,661
Benefits paid (including direct rollovers)2021-08-31$1,672,661
Total plan assets at end of year2021-08-31$0
Total plan assets at beginning of year2021-08-31$1,551,542
Value of fidelity bond covering the plan2021-08-31$154,000
Other income received2021-08-31$142,119
Net income (gross income less expenses)2021-08-31$-1,530,542
Net plan assets at end of year (total assets less liabilities)2021-08-31$0
Net plan assets at beginning of year (total assets less liabilities)2021-08-31$1,530,542
2020 : JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2020 401k financial data
Total plan liabilities at end of year2020-08-31$21,000
Total income from all sources2020-08-31$128,365
Expenses. Total of all expenses incurred2020-08-31$84,100
Benefits paid (including direct rollovers)2020-08-31$64,847
Total plan assets at end of year2020-08-31$1,551,542
Total plan assets at beginning of year2020-08-31$1,486,277
Value of fidelity bond covering the plan2020-08-31$154,000
Other income received2020-08-31$128,365
Net income (gross income less expenses)2020-08-31$44,265
Net plan assets at end of year (total assets less liabilities)2020-08-31$1,530,542
Net plan assets at beginning of year (total assets less liabilities)2020-08-31$1,486,277
Expenses. Administrative service providers (salaries,fees and commissions)2020-08-31$19,253
2019 : JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2019 401k financial data
Total income from all sources2019-08-31$69,965
Expenses. Total of all expenses incurred2019-08-31$19,556
Total plan assets at end of year2019-08-31$1,486,277
Total plan assets at beginning of year2019-08-31$1,435,868
Value of fidelity bond covering the plan2019-08-31$145,000
Other income received2019-08-31$69,965
Net income (gross income less expenses)2019-08-31$50,409
Net plan assets at end of year (total assets less liabilities)2019-08-31$1,486,277
Net plan assets at beginning of year (total assets less liabilities)2019-08-31$1,435,868
Expenses. Administrative service providers (salaries,fees and commissions)2019-08-31$19,556
2018 : JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2018 401k financial data
Total income from all sources2018-08-31$86,421
Expenses. Total of all expenses incurred2018-08-31$131,619
Benefits paid (including direct rollovers)2018-08-31$111,400
Total plan assets at end of year2018-08-31$1,435,868
Total plan assets at beginning of year2018-08-31$1,481,066
Value of fidelity bond covering the plan2018-08-31$145,000
Other income received2018-08-31$86,421
Net income (gross income less expenses)2018-08-31$-45,198
Net plan assets at end of year (total assets less liabilities)2018-08-31$1,435,868
Net plan assets at beginning of year (total assets less liabilities)2018-08-31$1,481,066
Expenses. Administrative service providers (salaries,fees and commissions)2018-08-31$20,219
2016 : JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources2016-08-31$80,216
Expenses. Total of all expenses incurred2016-08-31$69,981
Benefits paid (including direct rollovers)2016-08-31$53,504
Total plan assets at end of year2016-08-31$1,448,340
Total plan assets at beginning of year2016-08-31$1,438,105
Value of fidelity bond covering the plan2016-08-31$145,000
Other income received2016-08-31$80,216
Net income (gross income less expenses)2016-08-31$10,235
Net plan assets at end of year (total assets less liabilities)2016-08-31$1,448,340
Net plan assets at beginning of year (total assets less liabilities)2016-08-31$1,438,105
Expenses. Administrative service providers (salaries,fees and commissions)2016-08-31$16,477
2015 : JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources2015-08-31$-20,810
Expenses. Total of all expenses incurred2015-08-31$70,204
Benefits paid (including direct rollovers)2015-08-31$47,809
Total plan assets at end of year2015-08-31$1,438,105
Total plan assets at beginning of year2015-08-31$1,529,119
Value of fidelity bond covering the plan2015-08-31$144,000
Other income received2015-08-31$-20,810
Net income (gross income less expenses)2015-08-31$-91,014
Net plan assets at end of year (total assets less liabilities)2015-08-31$1,438,105
Net plan assets at beginning of year (total assets less liabilities)2015-08-31$1,529,119
Expenses. Administrative service providers (salaries,fees and commissions)2015-08-31$22,395
2014 : JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources2014-08-31$170,334
Expenses. Total of all expenses incurred2014-08-31$24,318
Total plan assets at end of year2014-08-31$1,529,119
Total plan assets at beginning of year2014-08-31$1,383,103
Value of fidelity bond covering the plan2014-08-31$153,000
Other income received2014-08-31$170,334
Net income (gross income less expenses)2014-08-31$146,016
Net plan assets at end of year (total assets less liabilities)2014-08-31$1,529,119
Net plan assets at beginning of year (total assets less liabilities)2014-08-31$1,383,103
Expenses. Administrative service providers (salaries,fees and commissions)2014-08-31$24,318
2013 : JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources2013-08-31$67,015
Expenses. Total of all expenses incurred2013-08-31$66,136
Benefits paid (including direct rollovers)2013-08-31$45,330
Total plan assets at end of year2013-08-31$1,383,103
Total plan assets at beginning of year2013-08-31$1,382,224
Value of fidelity bond covering the plan2013-08-31$139,000
Other income received2013-08-31$67,015
Net income (gross income less expenses)2013-08-31$879
Net plan assets at end of year (total assets less liabilities)2013-08-31$1,383,103
Net plan assets at beginning of year (total assets less liabilities)2013-08-31$1,382,224
Expenses. Administrative service providers (salaries,fees and commissions)2013-08-31$20,806
2012 : JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources2012-08-31$117,059
Expenses. Total of all expenses incurred2012-08-31$10,870
Benefits paid (including direct rollovers)2012-08-31$1,361
Total plan assets at end of year2012-08-31$1,382,224
Total plan assets at beginning of year2012-08-31$1,276,035
Value of fidelity bond covering the plan2012-08-31$139,000
Other income received2012-08-31$117,059
Net income (gross income less expenses)2012-08-31$106,189
Net plan assets at end of year (total assets less liabilities)2012-08-31$1,382,224
Net plan assets at beginning of year (total assets less liabilities)2012-08-31$1,276,035
Expenses. Administrative service providers (salaries,fees and commissions)2012-08-31$9,509
2011 : JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources2011-08-31$133,551
Expenses. Total of all expenses incurred2011-08-31$25,454
Total plan assets at end of year2011-08-31$1,276,035
Total plan assets at beginning of year2011-08-31$1,167,938
Value of fidelity bond covering the plan2011-08-31$130,000
Other income received2011-08-31$133,551
Net income (gross income less expenses)2011-08-31$108,097
Net plan assets at end of year (total assets less liabilities)2011-08-31$1,276,035
Net plan assets at beginning of year (total assets less liabilities)2011-08-31$1,167,938
Expenses. Administrative service providers (salaries,fees and commissions)2011-08-31$25,454

Form 5500 Responses for JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN

2020: JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2020 form 5500 responses
2020-09-01Type of plan entitySingle employer plan
2020-09-01This submission is the final filingYes
2020-09-01Plan funding arrangement – InsuranceYes
2020-09-01Plan funding arrangement – TrustYes
2020-09-01Plan benefit arrangement – InsuranceYes
2020-09-01Plan benefit arrangement - TrustYes
2019: JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2019 form 5500 responses
2019-09-01Type of plan entitySingle employer plan
2019-09-01Plan funding arrangement – InsuranceYes
2019-09-01Plan funding arrangement – TrustYes
2019-09-01Plan benefit arrangement – InsuranceYes
2019-09-01Plan benefit arrangement - TrustYes
2018: JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2018 form 5500 responses
2018-09-01Type of plan entitySingle employer plan
2018-09-01Plan funding arrangement – InsuranceYes
2018-09-01Plan funding arrangement – TrustYes
2018-09-01Plan benefit arrangement – InsuranceYes
2018-09-01Plan benefit arrangement - TrustYes
2017: JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2017 form 5500 responses
2017-09-01Type of plan entitySingle employer plan
2017-09-01Plan funding arrangement – InsuranceYes
2017-09-01Plan funding arrangement – TrustYes
2017-09-01Plan benefit arrangement – InsuranceYes
2017-09-01Plan benefit arrangement - TrustYes
2015: JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2015 form 5500 responses
2015-09-01Type of plan entitySingle employer plan
2015-09-01Plan funding arrangement – InsuranceYes
2015-09-01Plan funding arrangement – TrustYes
2015-09-01Plan benefit arrangement – InsuranceYes
2015-09-01Plan benefit arrangement - TrustYes
2014: JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2014 form 5500 responses
2014-09-01Type of plan entitySingle employer plan
2014-09-01Plan funding arrangement – InsuranceYes
2014-09-01Plan funding arrangement – TrustYes
2014-09-01Plan benefit arrangement – InsuranceYes
2014-09-01Plan benefit arrangement - TrustYes
2013: JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2013 form 5500 responses
2013-09-01Type of plan entitySingle employer plan
2013-09-01Plan funding arrangement – InsuranceYes
2013-09-01Plan funding arrangement – TrustYes
2013-09-01Plan benefit arrangement – InsuranceYes
2013-09-01Plan benefit arrangement - TrustYes
2012: JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2012 form 5500 responses
2012-09-01Type of plan entitySingle employer plan
2012-09-01Plan funding arrangement – InsuranceYes
2012-09-01Plan funding arrangement – TrustYes
2012-09-01Plan benefit arrangement – InsuranceYes
2012-09-01Plan benefit arrangement - TrustYes
2011: JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2011 form 5500 responses
2011-09-01Type of plan entitySingle employer plan
2011-09-01Plan funding arrangement – InsuranceYes
2011-09-01Plan funding arrangement – TrustYes
2011-09-01Plan benefit arrangement - TrustYes
2009: JAMES E. ROBERTS, DMD, PC PROFIT SHARING PLAN 2009 form 5500 responses
2009-09-01Type of plan entitySingle employer plan
2009-09-01This submission is the final filingNo
2009-09-01Plan funding arrangement – InsuranceYes
2009-09-01Plan funding arrangement – TrustYes
2009-09-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0115200
Policy instance 2
Insurance contract or identification number0115200
Number of Individuals Covered1
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?3
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0115210
Policy instance 1
Insurance contract or identification number0115210
Number of Individuals Covered2
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?3
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0115210
Policy instance 1
Insurance contract or identification number0115210
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0115200
Policy instance 2
Insurance contract or identification number0115200
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0115200
Policy instance 2
Insurance contract or identification number0115200
Number of Individuals Covered2
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0115210
Policy instance 1
Insurance contract or identification number0115210
Number of Individuals Covered2
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0115210
Policy instance 2
Insurance contract or identification number0115210
Insurance policy start date2015-09-01
Insurance policy end date2016-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameHENRY W. STRONG
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0115210
Policy instance 1
Insurance contract or identification number0115210
Insurance policy start date2015-09-01
Insurance policy end date2016-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameHENRY W. STRONG
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0115210
Policy instance 2
Insurance contract or identification number0115210
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameHENRY W. STRONG
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0115210
Policy instance 1
Insurance contract or identification number0115210
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameHENRY W. STRONG
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0115210
Policy instance 2
Insurance contract or identification number0115210
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameHENRY W. STRONG
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0115210
Policy instance 1
Insurance contract or identification number0115210
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameHENRY W. STRONG
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0115210
Policy instance 1
Insurance contract or identification number0115210
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameHENRY W. STRONG
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0115210
Policy instance 2
Insurance contract or identification number0115210
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameHENRY W. STRONG
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0115210
Policy instance 2
Insurance contract or identification number0115210
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0115210
Policy instance 1
Insurance contract or identification number0115210
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0115210
Policy instance 1
Insurance contract or identification number0115210
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0115210
Policy instance 2
Insurance contract or identification number0115210
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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