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403(B) THRIFT PLAN OF CHILD DEVELOPMENT CENTER OF NATRONA COUNTY 401k Plan overview

Plan Name403(B) THRIFT PLAN OF CHILD DEVELOPMENT CENTER OF NATRONA COUNTY
Plan identification number 002

403(B) THRIFT PLAN OF CHILD DEVELOPMENT CENTER OF NATRONA COUNTY Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • 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.
  • 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.
  • Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
  • 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

CHILD DEVELOPMENT CENTER has sponsored the creation of one or more 401k plans.

Company Name:CHILD DEVELOPMENT CENTER
Employer identification number (EIN):830207123
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Additional information about CHILD DEVELOPMENT CENTER

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division
Incorporation Date: 1992-06-25
Company Identification Number: 601397581
Legal Registered Office Address: 14819 145TH AVE CT E

ORTING
United States of America (USA)
98360

More information about CHILD DEVELOPMENT CENTER

Form 5500 Filing Information

Submission information for form 5500 for 401k plan 403(B) THRIFT PLAN OF CHILD DEVELOPMENT CENTER OF NATRONA COUNTY

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022022-01-01
0022021-01-01
0022021-01-01
0022020-01-01GEOFFREY DEAN2021-08-04 ALISHA RONE2021-08-09
0022019-01-01GEOFFREY DEAN2020-08-04
0022019-01-01
0022019-01-01
0022019-01-01
0022018-01-01GEOFFREY DEAN2019-10-11
0022018-01-01GEOFFREY BEAN2019-10-11
0022017-01-01GEOFFREY DEAN2018-04-26 GEOFFREY DEAN2018-04-26
0022016-01-01JOHN STARNES2017-05-17
0022015-01-01JOHN STARNES2016-07-19 JOHN STARNES2016-07-19
0022014-01-01JOHN STARNES2015-05-15 JOHN STARNES2015-05-15
0022014-01-01JOHN STARNES2015-05-14 JOHN STARNES2015-05-14
0022013-01-01JOHN STARNES2015-05-15 JOHN STARNES2015-05-15
0022012-01-01JOHN STARNES2013-05-16 JOHN STARNES2013-05-16
0022011-01-01JOHN STARNES2012-07-17 JOHN STARNES2012-07-17
0022010-01-01JOHN STARNES2011-07-26 JOHN STARNES2011-07-26

Plan Statistics for 403(B) THRIFT PLAN OF CHILD DEVELOPMENT CENTER OF NATRONA COUNTY

401k plan membership statisitcs for 403(B) THRIFT PLAN OF CHILD DEVELOPMENT CENTER OF NATRONA COUNTY

Measure Date Value
2022: 403(B) THRIFT PLAN OF CHILD DEVELOPMENT CENTER OF NATRONA COUNTY 2022 401k membership
Total participants, beginning-of-year2022-01-01144
Total number of active participants reported on line 7a of the Form 55002022-01-01108
Number of retired or separated participants receiving benefits2022-01-011
Number of other retired or separated participants entitled to future benefits2022-01-0140
Total of all active and inactive participants2022-01-01149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01149
Number of participants with account balances2022-01-01109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: 403(B) THRIFT PLAN OF CHILD DEVELOPMENT CENTER OF NATRONA COUNTY 2021 401k membership
Total participants, beginning-of-year2021-01-01138
Total number of active participants reported on line 7a of the Form 55002021-01-01100
Number of retired or separated participants receiving benefits2021-01-011
Number of other retired or separated participants entitled to future benefits2021-01-0143
Total of all active and inactive participants2021-01-01144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01144
Number of participants with account balances2021-01-01113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2019: 403(B) THRIFT PLAN OF CHILD DEVELOPMENT CENTER OF NATRONA COUNTY 2019 401k membership
Total participants, beginning-of-year2019-01-01104
Total number of active participants reported on line 7a of the Form 55002019-01-0167
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0140
Total of all active and inactive participants2019-01-01107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01107
Number of participants with account balances2019-01-01103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010

Financial Data on 403(B) THRIFT PLAN OF CHILD DEVELOPMENT CENTER OF NATRONA COUNTY

Measure Date Value
2022 : 403(B) THRIFT PLAN OF CHILD DEVELOPMENT CENTER OF NATRONA COUNTY 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$-612,538
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$153,231
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$117,927
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$411,784
Value of total assets at end of year2022-12-31$5,754,574
Value of total assets at beginning of year2022-12-31$6,520,343
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$35,304
Total interest from all sources2022-12-31$8,328
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$6,905
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$6,905
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$428,367
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$248,814
Participant contributions at end of year2022-12-31$31,018
Participant contributions at beginning of year2022-12-31$31,767
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$5,371
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-765,769
Value of net assets at end of year (total assets less liabilities)2022-12-31$5,754,574
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$6,520,343
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$5,280,054
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$5,963,043
Interest on participant loans2022-12-31$1,177
Interest earned on other investments2022-12-31$7,151
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$443,502
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$525,533
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-1,039,555
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$157,599
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$117,927
Contract administrator fees2022-12-31$35,304
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31NEEDLES & ASSOCIATES, LLC
Accountancy firm EIN2022-12-31510435869
2021 : 403(B) THRIFT PLAN OF CHILD DEVELOPMENT CENTER OF NATRONA COUNTY 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$1,129,473
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$99,671
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$65,970
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$355,475
Value of total assets at end of year2021-12-31$6,520,343
Value of total assets at beginning of year2021-12-31$5,490,541
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$33,701
Total interest from all sources2021-12-31$101,566
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$4,056
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$4,056
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$211,512
Participant contributions at end of year2021-12-31$31,767
Participant contributions at beginning of year2021-12-31$18,266
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$6,515
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$1,029,802
Value of net assets at end of year (total assets less liabilities)2021-12-31$6,520,343
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$5,490,541
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$5,963,043
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$5,140,633
Interest on participant loans2021-12-31$1,176
Interest earned on other investments2021-12-31$100,390
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$525,533
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$331,642
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$668,376
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$137,448
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$65,970
Contract administrator fees2021-12-31$33,701
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31NEEDLES & ASSOCIATES, LLC
Accountancy firm EIN2021-12-31510435869
2019 : 403(B) THRIFT PLAN OF CHILD DEVELOPMENT CENTER OF NATRONA COUNTY 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$1,393,741
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$139,625
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$139,099
Expenses. Certain deemed distributions of participant loans2019-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$323,505
Value of total assets at end of year2019-12-31$5,864,802
Value of total assets at beginning of year2019-12-31$4,610,686
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$526
Total interest from all sources2019-12-31$5,376
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$184,845
Participant contributions at end of year2019-12-31$32,654
Participant contributions at beginning of year2019-12-31$39,192
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$10,737
Other income not declared elsewhere2019-12-31$0
Administrative expenses (other) incurred2019-12-31$526
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$1,254,116
Value of net assets at end of year (total assets less liabilities)2019-12-31$5,864,802
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$4,610,686
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$5,573,429
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$4,269,581
Interest on participant loans2019-12-31$0
Interest earned on other investments2019-12-31$5,376
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$258,719
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$301,913
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$0
Net investment gain/loss from pooled separate accounts2019-12-31$1,064,860
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$127,923
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$139,099
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer

Form 5500 Responses for 403(B) THRIFT PLAN OF CHILD DEVELOPMENT CENTER OF NATRONA COUNTY

2022: 403(B) THRIFT PLAN OF CHILD DEVELOPMENT CENTER OF NATRONA COUNTY 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: 403(B) THRIFT PLAN OF CHILD DEVELOPMENT CENTER OF NATRONA COUNTY 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
2019: 403(B) THRIFT PLAN OF CHILD DEVELOPMENT CENTER OF NATRONA COUNTY 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedYes
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number896338007
Policy instance 1
Insurance contract or identification number896338007
Number of Individuals Covered3
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $169
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?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
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 $169
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberCDC-001
Policy instance 2
Insurance contract or identification numberCDC-001
Number of Individuals Covered19
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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?Yes
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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number896338007
Policy instance 1
Insurance contract or identification number896338007
Number of Individuals Covered3
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $364
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?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
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 $364
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberCDC-001
Policy instance 2
Insurance contract or identification numberCDC-001
Number of Individuals Covered23
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number055246J
Policy instance 1
Insurance contract or identification number055246J
Number of Individuals Covered107
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $528
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 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 fees528
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3

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