NELDA, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan EMPLOYEE HEALTH PLAN OF NELDA, LLC
| Measure | Date | Value |
|---|
| 2016: EMPLOYEE HEALTH PLAN OF NELDA, LLC 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-05-01 | 23 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-05-01 | 19 |
| Number of retired or separated participants receiving benefits | 2016-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-05-01 | 0 |
| Total of all active and inactive participants | 2016-05-01 | 19 |
| 2015: EMPLOYEE HEALTH PLAN OF NELDA, LLC 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-05-01 | 30 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-05-01 | 22 |
| Number of retired or separated participants receiving benefits | 2015-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-05-01 | 0 |
| Total of all active and inactive participants | 2015-05-01 | 22 |
| 2014: EMPLOYEE HEALTH PLAN OF NELDA, LLC 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-05-01 | 32 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-05-01 | 24 |
| Number of retired or separated participants receiving benefits | 2014-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-05-01 | 0 |
| Total of all active and inactive participants | 2014-05-01 | 24 |
| 2013: EMPLOYEE HEALTH PLAN OF NELDA, LLC 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-05-01 | 27 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-05-01 | 26 |
| Number of retired or separated participants receiving benefits | 2013-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-05-01 | 0 |
| Total of all active and inactive participants | 2013-05-01 | 26 |
| 2012: EMPLOYEE HEALTH PLAN OF NELDA, LLC 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-05-01 | 21 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-05-01 | 27 |
| Number of retired or separated participants receiving benefits | 2012-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-05-01 | 0 |
| Total of all active and inactive participants | 2012-05-01 | 27 |
| 2011: EMPLOYEE HEALTH PLAN OF NELDA, LLC 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-05-01 | 22 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-05-01 | 21 |
| Number of retired or separated participants receiving benefits | 2011-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-05-01 | 0 |
| Total of all active and inactive participants | 2011-05-01 | 21 |
| 2010: EMPLOYEE HEALTH PLAN OF NELDA, LLC 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-05-01 | 23 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-05-01 | 22 |
| Number of retired or separated participants receiving benefits | 2010-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2010-05-01 | 0 |
| Total of all active and inactive participants | 2010-05-01 | 22 |
| Measure | Date | Value |
|---|
| 2017 : EMPLOYEE HEALTH PLAN OF NELDA, LLC 2017 401k financial data |
|---|
| Total plan liabilities at end of year | 2017-04-30 | $0 |
| Total plan liabilities at beginning of year | 2017-04-30 | $0 |
| Total income from all sources | 2017-04-30 | $13,107 |
| Expenses. Total of all expenses incurred | 2017-04-30 | $10,768 |
| Benefits paid (including direct rollovers) | 2017-04-30 | $4,340 |
| Total plan assets at end of year | 2017-04-30 | $9,757 |
| Total plan assets at beginning of year | 2017-04-30 | $7,418 |
| Value of fidelity bond covering the plan | 2017-04-30 | $10,000 |
| Expenses. Other expenses not covered elsewhere | 2017-04-30 | $6,428 |
| Net income (gross income less expenses) | 2017-04-30 | $2,339 |
| Net plan assets at end of year (total assets less liabilities) | 2017-04-30 | $9,757 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-04-30 | $7,418 |
| Total contributions received or receivable from employer(s) | 2017-04-30 | $13,107 |
| 2016 : EMPLOYEE HEALTH PLAN OF NELDA, LLC 2016 401k financial data |
|---|
| Total plan liabilities at end of year | 2016-04-30 | $0 |
| Total plan liabilities at beginning of year | 2016-04-30 | $482 |
| Total income from all sources | 2016-04-30 | $17,524 |
| Expenses. Total of all expenses incurred | 2016-04-30 | $15,747 |
| Benefits paid (including direct rollovers) | 2016-04-30 | $9,191 |
| Total plan assets at end of year | 2016-04-30 | $7,418 |
| Total plan assets at beginning of year | 2016-04-30 | $6,123 |
| Value of fidelity bond covering the plan | 2016-04-30 | $10,000 |
| Expenses. Other expenses not covered elsewhere | 2016-04-30 | $6,556 |
| Net income (gross income less expenses) | 2016-04-30 | $1,777 |
| Net plan assets at end of year (total assets less liabilities) | 2016-04-30 | $7,418 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-04-30 | $5,641 |
| Total contributions received or receivable from employer(s) | 2016-04-30 | $17,524 |
| 2015 : EMPLOYEE HEALTH PLAN OF NELDA, LLC 2015 401k financial data |
|---|
| Total plan liabilities at end of year | 2015-04-30 | $482 |
| Total plan liabilities at beginning of year | 2015-04-30 | $852 |
| Total income from all sources | 2015-04-30 | $35,628 |
| Expenses. Total of all expenses incurred | 2015-04-30 | $29,987 |
| Benefits paid (including direct rollovers) | 2015-04-30 | $13,092 |
| Total plan assets at end of year | 2015-04-30 | $6,123 |
| Total plan assets at beginning of year | 2015-04-30 | $852 |
| Value of fidelity bond covering the plan | 2015-04-30 | $10,000 |
| Expenses. Other expenses not covered elsewhere | 2015-04-30 | $16,895 |
| Net income (gross income less expenses) | 2015-04-30 | $5,641 |
| Net plan assets at end of year (total assets less liabilities) | 2015-04-30 | $5,641 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-04-30 | $0 |
| Total contributions received or receivable from employer(s) | 2015-04-30 | $35,628 |
| 2014 : EMPLOYEE HEALTH PLAN OF NELDA, LLC 2014 401k financial data |
|---|
| Total plan liabilities at end of year | 2014-04-30 | $852 |
| Total plan liabilities at beginning of year | 2014-04-30 | $1,092 |
| Total income from all sources | 2014-04-30 | $23,260 |
| Expenses. Total of all expenses incurred | 2014-04-30 | $23,260 |
| Benefits paid (including direct rollovers) | 2014-04-30 | $14,302 |
| Total plan assets at end of year | 2014-04-30 | $852 |
| Total plan assets at beginning of year | 2014-04-30 | $1,092 |
| Value of fidelity bond covering the plan | 2014-04-30 | $10,000 |
| Expenses. Other expenses not covered elsewhere | 2014-04-30 | $8,958 |
| Net income (gross income less expenses) | 2014-04-30 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2014-04-30 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-04-30 | $0 |
| Total contributions received or receivable from employer(s) | 2014-04-30 | $23,260 |
| 2013 : EMPLOYEE HEALTH PLAN OF NELDA, LLC 2013 401k financial data |
|---|
| Total plan liabilities at end of year | 2013-04-30 | $1,092 |
| Total plan liabilities at beginning of year | 2013-04-30 | $2,372 |
| Total income from all sources | 2013-04-30 | $18,110 |
| Expenses. Total of all expenses incurred | 2013-04-30 | $18,110 |
| Benefits paid (including direct rollovers) | 2013-04-30 | $12,169 |
| Total plan assets at end of year | 2013-04-30 | $1,092 |
| Total plan assets at beginning of year | 2013-04-30 | $2,372 |
| Expenses. Other expenses not covered elsewhere | 2013-04-30 | $5,941 |
| Net income (gross income less expenses) | 2013-04-30 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2013-04-30 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-04-30 | $0 |
| Total contributions received or receivable from employer(s) | 2013-04-30 | $18,110 |
| 2012 : EMPLOYEE HEALTH PLAN OF NELDA, LLC 2012 401k financial data |
|---|
| Total plan liabilities at end of year | 2012-04-30 | $2,372 |
| Total plan liabilities at beginning of year | 2012-04-30 | $1,731 |
| Total income from all sources | 2012-04-30 | $11,997 |
| Expenses. Total of all expenses incurred | 2012-04-30 | $11,997 |
| Benefits paid (including direct rollovers) | 2012-04-30 | $7,926 |
| Total plan assets at end of year | 2012-04-30 | $2,372 |
| Total plan assets at beginning of year | 2012-04-30 | $1,731 |
| Expenses. Other expenses not covered elsewhere | 2012-04-30 | $4,071 |
| Net income (gross income less expenses) | 2012-04-30 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2012-04-30 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-04-30 | $0 |
| Total contributions received or receivable from employer(s) | 2012-04-30 | $11,997 |
| 2011 : EMPLOYEE HEALTH PLAN OF NELDA, LLC 2011 401k financial data |
|---|
| Total plan liabilities at end of year | 2011-04-30 | $1,731 |
| Total plan liabilities at beginning of year | 2011-04-30 | $0 |
| Total income from all sources | 2011-04-30 | $52,528 |
| Expenses. Total of all expenses incurred | 2011-04-30 | $52,528 |
| Benefits paid (including direct rollovers) | 2011-04-30 | $27,777 |
| Total plan assets at end of year | 2011-04-30 | $1,731 |
| Total plan assets at beginning of year | 2011-04-30 | $0 |
| Expenses. Other expenses not covered elsewhere | 2011-04-30 | $24,751 |
| Net income (gross income less expenses) | 2011-04-30 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2011-04-30 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-04-30 | $0 |
| Total contributions received or receivable from employer(s) | 2011-04-30 | $52,528 |
| 2016: EMPLOYEE HEALTH PLAN OF NELDA, LLC 2016 form 5500 responses |
|---|
| 2016-05-01 | Type of plan entity | Single employer plan |
| 2016-05-01 | Submission has been amended | No |
| 2016-05-01 | This submission is the final filing | No |
| 2016-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-05-01 | Plan is a collectively bargained plan | No |
| 2016-05-01 | Plan funding arrangement – Insurance | Yes |
| 2016-05-01 | Plan funding arrangement – Trust | Yes |
| 2016-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-05-01 | Plan benefit arrangement - Trust | Yes |
| 2015: EMPLOYEE HEALTH PLAN OF NELDA, LLC 2015 form 5500 responses |
|---|
| 2015-05-01 | Type of plan entity | Single employer plan |
| 2015-05-01 | Submission has been amended | No |
| 2015-05-01 | This submission is the final filing | No |
| 2015-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-05-01 | Plan is a collectively bargained plan | No |
| 2015-05-01 | Plan funding arrangement – Insurance | Yes |
| 2015-05-01 | Plan funding arrangement – Trust | Yes |
| 2015-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-05-01 | Plan benefit arrangement - Trust | Yes |
| 2014: EMPLOYEE HEALTH PLAN OF NELDA, LLC 2014 form 5500 responses |
|---|
| 2014-05-01 | Type of plan entity | Single employer plan |
| 2014-05-01 | Submission has been amended | No |
| 2014-05-01 | This submission is the final filing | No |
| 2014-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-05-01 | Plan is a collectively bargained plan | No |
| 2014-05-01 | Plan funding arrangement – Insurance | Yes |
| 2014-05-01 | Plan funding arrangement – Trust | Yes |
| 2014-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-05-01 | Plan benefit arrangement - Trust | Yes |
| 2013: EMPLOYEE HEALTH PLAN OF NELDA, LLC 2013 form 5500 responses |
|---|
| 2013-05-01 | Type of plan entity | Single employer plan |
| 2013-05-01 | Submission has been amended | No |
| 2013-05-01 | This submission is the final filing | No |
| 2013-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-05-01 | Plan is a collectively bargained plan | No |
| 2013-05-01 | Plan funding arrangement – Insurance | Yes |
| 2013-05-01 | Plan funding arrangement – Trust | Yes |
| 2013-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-05-01 | Plan benefit arrangement - Trust | Yes |
| 2012: EMPLOYEE HEALTH PLAN OF NELDA, LLC 2012 form 5500 responses |
|---|
| 2012-05-01 | Type of plan entity | Single employer plan |
| 2012-05-01 | Submission has been amended | No |
| 2012-05-01 | This submission is the final filing | No |
| 2012-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-05-01 | Plan is a collectively bargained plan | No |
| 2012-05-01 | Plan funding arrangement – Insurance | Yes |
| 2012-05-01 | Plan funding arrangement – Trust | Yes |
| 2012-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-05-01 | Plan benefit arrangement - Trust | Yes |
| 2011: EMPLOYEE HEALTH PLAN OF NELDA, LLC 2011 form 5500 responses |
|---|
| 2011-05-01 | Type of plan entity | Single employer plan |
| 2011-05-01 | Submission has been amended | No |
| 2011-05-01 | This submission is the final filing | No |
| 2011-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-05-01 | Plan is a collectively bargained plan | No |
| 2011-05-01 | Plan funding arrangement – Insurance | Yes |
| 2011-05-01 | Plan funding arrangement – Trust | Yes |
| 2011-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-05-01 | Plan benefit arrangement - Trust | Yes |
| 2010: EMPLOYEE HEALTH PLAN OF NELDA, LLC 2010 form 5500 responses |
|---|
| 2010-05-01 | Type of plan entity | Single employer plan |
| 2010-05-01 | First time form 5500 has been submitted | Yes |
| 2010-05-01 | Submission has been amended | No |
| 2010-05-01 | This submission is the final filing | No |
| 2010-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-05-01 | Plan is a collectively bargained plan | No |
| 2010-05-01 | Plan funding arrangement – Insurance | Yes |
| 2010-05-01 | Plan funding arrangement – Trust | Yes |
| 2010-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-05-01 | Plan benefit arrangement - Trust | Yes |
| NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 ) |
| Policy contract number | 27027 NFA 0283 |
| Policy instance | 1 |
| Insurance contract or identification number | 27027 NFA 0283 | | Number of Individuals Covered | 44 | | Insurance policy start date | 2015-05-01 | | Insurance policy end date | 2016-04-30 | | 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 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 | | Welfare Benefit Premiums Paid to Carrier | USD $5,102 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 ) |
| Policy contract number | 27027 NFA 0283 |
| Policy instance | 1 |
| Insurance contract or identification number | 27027 NFA 0283 | | Number of Individuals Covered | 48 | | Insurance policy start date | 2014-05-01 | | Insurance policy end date | 2015-04-30 | | 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 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 | | Welfare Benefit Premiums Paid to Carrier | USD $12,583 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 ) |
| Policy contract number | 27027 NFA 0283 |
| Policy instance | 1 |
| Insurance contract or identification number | 27027 NFA 0283 | | Number of Individuals Covered | 59 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | 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 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 | | Welfare Benefit Premiums Paid to Carrier | USD $6,939 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 ) |
| Policy contract number | 27027 NFA 0283 |
| Policy instance | 1 |
| Insurance contract or identification number | 27027 NFA 0283 | | Number of Individuals Covered | 60 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-04-30 | | 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 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 | | Welfare Benefit Premiums Paid to Carrier | USD $4,325 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 ) |
| Policy contract number | 27027 NFA 0283 |
| Policy instance | 1 |
| Insurance contract or identification number | 27027 NFA 0283 | | Number of Individuals Covered | 33 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-04-30 | | 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 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 | | Welfare Benefit Premiums Paid to Carrier | USD $2,905 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 ) |
| Policy contract number | 27027 NFA 0283 |
| Policy instance | 1 |
| Insurance contract or identification number | 27027 NFA 0283 | | Number of Individuals Covered | 32 | | Insurance policy start date | 2010-05-01 | | Insurance policy end date | 2011-04-30 | | 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 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 | | Welfare Benefit Premiums Paid to Carrier | USD $19,578 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
