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EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES 401k Plan overview

Plan NameEMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES
Plan identification number 001

EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Money purchase (other than target benefit)
  • 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.
  • 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

FAMILY SUPPORT SERVICES OF AMARILLO has sponsored the creation of one or more 401k plans.

Company Name:FAMILY SUPPORT SERVICES OF AMARILLO
Employer identification number (EIN):750800642
NAIC Classification:621112
NAIC Description:Offices of Physicians, Mental Health Specialists

Additional information about FAMILY SUPPORT SERVICES OF AMARILLO

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 1950-02-10
Company Identification Number: 0010179901
Legal Registered Office Address: PO BOX 31150

AMARILLO
United States of America (USA)
79120

More information about FAMILY SUPPORT SERVICES OF AMARILLO

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012018-01-01JIM WOMACK2019-07-15 JIM WOMACK2019-07-15
0012017-01-01JIM WOMACK
0012016-01-01JIM WOMACK JIM WOMACK2017-07-28
0012015-01-01JIM WOMACK
0012014-01-01JIM WOMACK
0012013-01-01JIM WOMACK
0012012-01-01JANET BYARS
0012011-01-01JANET BYARS
0012010-01-01JANET BYARS
0012009-01-01JANET BYARS

Plan Statistics for EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES

401k plan membership statisitcs for EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES

Measure Date Value
2017: EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES 2017 401k membership
Total participants, beginning-of-year2017-01-0145
Total number of active participants reported on line 7a of the Form 55002017-01-0137
Total of all active and inactive participants2017-01-0137
Total participants2017-01-0137
Number of participants with account balances2017-01-0142
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-015
2016: EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES 2016 401k membership
Total participants, beginning-of-year2016-01-0143
Total number of active participants reported on line 7a of the Form 55002016-01-0133
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0112
Total of all active and inactive participants2016-01-0145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0145
Number of participants with account balances2016-01-0135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-013
2015: EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES 2015 401k membership
Total participants, beginning-of-year2015-01-0140
Total number of active participants reported on line 7a of the Form 55002015-01-0133
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0110
Total of all active and inactive participants2015-01-0143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0143
Number of participants with account balances2015-01-0143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-011
2014: EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES 2014 401k membership
Total participants, beginning-of-year2014-01-0136
Total number of active participants reported on line 7a of the Form 55002014-01-0129
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0111
Total of all active and inactive participants2014-01-0140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0140
Number of participants with account balances2014-01-0140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-011
2013: EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES 2013 401k membership
Total participants, beginning-of-year2013-01-0134
Total number of active participants reported on line 7a of the Form 55002013-01-0125
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0111
Total of all active and inactive participants2013-01-0136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0136
Number of participants with account balances2013-01-0136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES 2012 401k membership
Total participants, beginning-of-year2012-01-0138
Total number of active participants reported on line 7a of the Form 55002012-01-0120
Number of other retired or separated participants entitled to future benefits2012-01-0114
Total of all active and inactive participants2012-01-0134
Total participants2012-01-0134
Number of participants with account balances2012-01-0134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-013
2011: EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES 2011 401k membership
Total participants, beginning-of-year2011-01-0140
Total number of active participants reported on line 7a of the Form 55002011-01-0129
Number of other retired or separated participants entitled to future benefits2011-01-019
Total of all active and inactive participants2011-01-0138
Total participants2011-01-0138
Number of participants with account balances2011-01-0138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-011
2010: EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES 2010 401k membership
Total participants, beginning-of-year2010-01-0139
Total number of active participants reported on line 7a of the Form 55002010-01-0130
Number of other retired or separated participants entitled to future benefits2010-01-0110
Total of all active and inactive participants2010-01-0140
Total participants2010-01-0140
Number of participants with account balances2010-01-0140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-012
2009: EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES 2009 401k membership
Total participants, beginning-of-year2009-01-0138
Total number of active participants reported on line 7a of the Form 55002009-01-0130
Number of other retired or separated participants entitled to future benefits2009-01-019
Total of all active and inactive participants2009-01-0139
Total participants2009-01-0139
Number of participants with account balances2009-01-0139
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-013

Financial Data on EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES

Measure Date Value
2017 : EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES 2017 401k financial data
Total income from all sources2017-12-31$47,723
Expenses. Total of all expenses incurred2017-12-31$52,715
Benefits paid (including direct rollovers)2017-12-31$49,348
Total plan assets at end of year2017-12-31$241,831
Total plan assets at beginning of year2017-12-31$246,823
Expenses. Other expenses not covered elsewhere2017-12-31$2,557
Contributions received from other sources (not participants or employers)2017-12-31$1,278
Other income received2017-12-31$21,042
Net income (gross income less expenses)2017-12-31$-4,992
Net plan assets at end of year (total assets less liabilities)2017-12-31$241,831
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$246,823
Total contributions received or receivable from employer(s)2017-12-31$25,403
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$810
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Funding deficiency by the employer to the plan for this plan year2017-12-31$0
Minimum employer required contribution for this plan year2017-12-31$26,681
Amount contributed by the employer to the plan for this plan year2017-12-31$26,681
2016 : EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES 2016 401k financial data
Total income from all sources2016-12-31$30,478
Expenses. Total of all expenses incurred2016-12-31$32,563
Benefits paid (including direct rollovers)2016-12-31$29,941
Total plan assets at end of year2016-12-31$246,823
Total plan assets at beginning of year2016-12-31$248,908
Expenses. Other expenses not covered elsewhere2016-12-31$1,750
Contributions received from other sources (not participants or employers)2016-12-31$981
Other income received2016-12-31$7,172
Net income (gross income less expenses)2016-12-31$-2,085
Net plan assets at end of year (total assets less liabilities)2016-12-31$246,823
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$248,908
Total contributions received or receivable from employer(s)2016-12-31$22,325
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$872
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Funding deficiency by the employer to the plan for this plan year2016-12-31$0
Minimum employer required contribution for this plan year2016-12-31$22,325
Amount contributed by the employer to the plan for this plan year2016-12-31$22,325
2015 : EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES 2015 401k financial data
Total income from all sources2015-12-31$19,144
Expenses. Total of all expenses incurred2015-12-31$9,319
Benefits paid (including direct rollovers)2015-12-31$7,638
Total plan assets at end of year2015-12-31$248,908
Total plan assets at beginning of year2015-12-31$239,083
Expenses. Other expenses not covered elsewhere2015-12-31$948
Other income received2015-12-31$-663
Net income (gross income less expenses)2015-12-31$9,825
Net plan assets at end of year (total assets less liabilities)2015-12-31$248,908
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$239,083
Total contributions received or receivable from employer(s)2015-12-31$19,807
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$733
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Funding deficiency by the employer to the plan for this plan year2015-12-31$0
Minimum employer required contribution for this plan year2015-12-31$19,807
Amount contributed by the employer to the plan for this plan year2015-12-31$19,807
2014 : EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES 2014 401k financial data
Total income from all sources2014-12-31$23,261
Expenses. Total of all expenses incurred2014-12-31$3,287
Benefits paid (including direct rollovers)2014-12-31$1,638
Total plan assets at end of year2014-12-31$239,083
Total plan assets at beginning of year2014-12-31$219,109
Expenses. Other expenses not covered elsewhere2014-12-31$940
Other income received2014-12-31$7,132
Net income (gross income less expenses)2014-12-31$19,974
Net plan assets at end of year (total assets less liabilities)2014-12-31$239,083
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$219,109
Total contributions received or receivable from employer(s)2014-12-31$16,129
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$709
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Funding deficiency by the employer to the plan for this plan year2014-12-31$0
Minimum employer required contribution for this plan year2014-12-31$16,129
Amount contributed by the employer to the plan for this plan year2014-12-31$16,129
2013 : EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES 2013 401k financial data
Total income from all sources2013-12-31$38,744
Expenses. Total of all expenses incurred2013-12-31$5,627
Benefits paid (including direct rollovers)2013-12-31$4,635
Total plan assets at end of year2013-12-31$219,109
Total plan assets at beginning of year2013-12-31$185,992
Value of fidelity bond covering the plan2013-12-31$180,000
Expenses. Other expenses not covered elsewhere2013-12-31$328
Contributions received from other sources (not participants or employers)2013-12-31$163
Other income received2013-12-31$24,288
Net income (gross income less expenses)2013-12-31$33,117
Net plan assets at end of year (total assets less liabilities)2013-12-31$219,109
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$185,992
Total contributions received or receivable from employer(s)2013-12-31$14,293
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$664
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Funding deficiency by the employer to the plan for this plan year2013-12-31$0
Minimum employer required contribution for this plan year2013-12-31$14,293
Amount contributed by the employer to the plan for this plan year2013-12-31$14,293
2012 : EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES 2012 401k financial data
Total plan liabilities at beginning of year2012-12-31$0
Total income from all sources2012-12-31$26,640
Expenses. Total of all expenses incurred2012-12-31$16,253
Benefits paid (including direct rollovers)2012-12-31$15,033
Total plan assets at end of year2012-12-31$185,992
Total plan assets at beginning of year2012-12-31$175,604
Value of fidelity bond covering the plan2012-12-31$180,000
Expenses. Other expenses not covered elsewhere2012-12-31$1,220
Other income received2012-12-31$11,723
Net income (gross income less expenses)2012-12-31$10,387
Net plan assets at end of year (total assets less liabilities)2012-12-31$185,992
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$175,604
Total contributions received or receivable from employer(s)2012-12-31$14,917
Minimum employer required contribution for this plan year2012-12-31$14,917
Amount contributed by the employer to the plan for this plan year2012-12-31$14,917
2011 : EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES 2011 401k financial data
Total plan liabilities at beginning of year2011-12-31$0
Total income from all sources2011-12-31$15,282
Expenses. Total of all expenses incurred2011-12-31$9,759
Benefits paid (including direct rollovers)2011-12-31$6,646
Total plan assets at end of year2011-12-31$175,604
Total plan assets at beginning of year2011-12-31$170,081
Value of fidelity bond covering the plan2011-12-31$180,000
Expenses. Other expenses not covered elsewhere2011-12-31$3,113
Other income received2011-12-31$-1,110
Net income (gross income less expenses)2011-12-31$5,523
Net plan assets at end of year (total assets less liabilities)2011-12-31$175,604
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$170,081
Total contributions received or receivable from employer(s)2011-12-31$16,392
Minimum employer required contribution for this plan year2011-12-31$16,392
Amount contributed by the employer to the plan for this plan year2011-12-31$16,392
2010 : EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES 2010 401k financial data
Total plan liabilities at beginning of year2010-12-31$0
Total income from all sources2010-12-31$41,225
Expenses. Total of all expenses incurred2010-12-31$6,506
Benefits paid (including direct rollovers)2010-12-31$2,691
Total plan assets at end of year2010-12-31$170,081
Total plan assets at beginning of year2010-12-31$135,362
Value of fidelity bond covering the plan2010-12-31$180,000
Total contributions received or receivable from participants2010-12-31$100
Expenses. Other expenses not covered elsewhere2010-12-31$3,815
Other income received2010-12-31$14,448
Net income (gross income less expenses)2010-12-31$34,719
Net plan assets at end of year (total assets less liabilities)2010-12-31$170,081
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$135,362
Total contributions received or receivable from employer(s)2010-12-31$26,677
Minimum employer required contribution for this plan year2010-12-31$26,677
Amount contributed by the employer to the plan for this plan year2010-12-31$26,677
2009 : EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES 2009 401k financial data
Minimum employer required contribution for this plan year2009-12-31$35,898
Amount contributed by the employer to the plan for this plan year2009-12-31$35,898

Form 5500 Responses for EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES

2017: EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01First time form 5500 has been submittedYes
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01First time form 5500 has been submittedYes
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01First time form 5500 has been submittedYes
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: EMPLOYEE BENEFITS PLAN OF FAMILY SUPPORT SERVICES 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number052467-K
Policy instance 1
Insurance contract or identification number052467-K
Number of Individuals Covered43
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $37
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?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees37
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP PROGRAM
Insurance broker organization code?3
Insurance broker nameHOUSTON REGIONAL OFFICE
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number052467-K
Policy instance 1
Insurance contract or identification number052467-K
Number of Individuals Covered43
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $25
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 Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees25
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP PROGRAM
Insurance broker organization code?3
Insurance broker nameHOUSTON REGIONAL OFFICE
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number052467K-01
Policy instance 1
Insurance contract or identification number052467K-01
Number of Individuals Covered40
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $23
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 Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees23
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP PROGRAM
Insurance broker organization code?3
Insurance broker nameHOUSTON REGIONAL OFFICE
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number052-467-K-01
Policy instance 1
Insurance contract or identification number052-467-K-01
Number of Individuals Covered36
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,030
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 Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees2972
Additional information about fees paid to insurance brokerDIRECT COMPENSATION
Insurance broker organization code?3
Insurance broker nameHOUSTON REGIONAL OFFICE
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number052467-K
Policy instance 1
Insurance contract or identification number052467-K
Number of Individuals Covered34
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of fees paid to insurance companyUSD $19
Contracts With Unallocated Funds Deposit Administration1
Amount paid for insurance broker fees8
Additional information about fees paid to insurance brokerCOMPENSATION
Insurance broker organization code?3
Insurance broker nameFANNY HUNG
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number052467-K
Policy instance 1
Insurance contract or identification number052467-K
Number of Individuals Covered38
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of fees paid to insurance companyUSD $60
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number052467-K
Policy instance 1
Insurance contract or identification number052467-K
Number of Individuals Covered40
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of fees paid to insurance companyUSD $121
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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