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THE 401(K) PLAN OF PE GASTRO MANAGEMENT, LLC 401k Plan overview

Plan NameTHE 401(K) PLAN OF PE GASTRO MANAGEMENT, LLC
Plan identification number 001

THE 401(K) PLAN OF PE GASTRO MANAGEMENT, LLC Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Plan covering Self-Employed individuals.
  • 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.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

PE GASTRO MANAGEMENT, LLC has sponsored the creation of one or more 401k plans.

Company Name:PE GASTRO MANAGEMENT, LLC
Employer identification number (EIN):842396811
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE 401(K) PLAN OF PE GASTRO MANAGEMENT, LLC

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01J. DAVID GUNNING2023-10-15 J. DAVID GUNNING2023-10-15
0012021-01-01NAEEMAH FUENTES2022-10-17 NAEEMAH FUENTES2022-10-17
0012020-01-01NAEEMAH FUENTES2021-10-15 NAEEMAH FUENTES2021-10-15

Plan Statistics for THE 401(K) PLAN OF PE GASTRO MANAGEMENT, LLC

401k plan membership statisitcs for THE 401(K) PLAN OF PE GASTRO MANAGEMENT, LLC

Measure Date Value
2022: THE 401(K) PLAN OF PE GASTRO MANAGEMENT, LLC 2022 401k membership
Total participants, beginning-of-year2022-01-01399
Total number of active participants reported on line 7a of the Form 55002022-01-01366
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-01121
Total of all active and inactive participants2022-01-01487
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-011
Total participants2022-01-01488
Number of participants with account balances2022-01-01478
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-0142
2021: THE 401(K) PLAN OF PE GASTRO MANAGEMENT, LLC 2021 401k membership
Total participants, beginning-of-year2021-01-01342
Total number of active participants reported on line 7a of the Form 55002021-01-01305
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0181
Total of all active and inactive participants2021-01-01386
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01386
Number of participants with account balances2021-01-01360
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-0118
2020: THE 401(K) PLAN OF PE GASTRO MANAGEMENT, LLC 2020 401k membership
Total participants, beginning-of-year2020-01-01332
Total number of active participants reported on line 7a of the Form 55002020-01-01240
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0182
Total of all active and inactive participants2020-01-01322
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01322
Number of participants with account balances2020-01-01319
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-0124

Financial Data on THE 401(K) PLAN OF PE GASTRO MANAGEMENT, LLC

Measure Date Value
2022 : THE 401(K) PLAN OF PE GASTRO MANAGEMENT, LLC 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total transfer of assets to this plan2022-12-31$9,289,763
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$173,347
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$3,980,028
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$3,838,918
Value of total corrective distributions2022-12-31$2,804
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$8,555,206
Value of total assets at end of year2022-12-31$67,057,292
Value of total assets at beginning of year2022-12-31$61,574,210
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$138,306
Total interest from all sources2022-12-31$345
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$712,083
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$712,083
Administrative expenses professional fees incurred2022-12-31$22,936
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$600,000
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$3,369,119
Participant contributions at end of year2022-12-31$29,523
Participant contributions at beginning of year2022-12-31$0
Participant contributions at end of year2022-12-31$0
Participant contributions at beginning of year2022-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$366,971
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-3,806,681
Value of net assets at end of year (total assets less liabilities)2022-12-31$67,057,292
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$61,574,210
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
Investment advisory and management fees2022-12-31$22,936
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$45,100,072
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$42,430,866
Value of interest in pooled separate accounts at end of year2022-12-31$17,108,581
Value of interest in pooled separate accounts at beginning of year2022-12-31$16,229,950
Interest on participant loans2022-12-31$345
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-6,898,245
Net investment gain/loss from pooled separate accounts2022-12-31$-2,196,042
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$4,819,116
Employer contributions (assets) at end of year2022-12-31$4,819,116
Employer contributions (assets) at beginning of year2022-12-31$2,913,394
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$3,838,918
Contract administrator fees2022-12-31$92,434
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 name2022-12-31SNYDER COHN, P.C.
Accountancy firm EIN2022-12-31521022232
2021 : THE 401(K) PLAN OF PE GASTRO MANAGEMENT, LLC 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$12,465,095
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$14,092,603
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$13,939,104
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$5,044,588
Value of total assets at end of year2021-12-31$61,574,210
Value of total assets at beginning of year2021-12-31$63,201,718
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$153,499
Total interest from all sources2021-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$622,360
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$622,360
Administrative expenses professional fees incurred2021-12-31$23,927
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$600,000
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$1,998,412
Participant contributions at end of year2021-12-31$0
Participant contributions at beginning of year2021-12-31$45,753
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$132,782
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$-1,627,508
Value of net assets at end of year (total assets less liabilities)2021-12-31$61,574,210
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$63,201,718
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
Investment advisory and management fees2021-12-31$42,317
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$42,430,866
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$44,819,668
Value of interest in pooled separate accounts at end of year2021-12-31$16,229,950
Value of interest in pooled separate accounts at beginning of year2021-12-31$16,582,547
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$3,931,192
Net investment gain/loss from pooled separate accounts2021-12-31$2,866,955
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$2,913,394
Employer contributions (assets) at end of year2021-12-31$2,913,394
Employer contributions (assets) at beginning of year2021-12-31$1,753,750
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$13,939,104
Contract administrator fees2021-12-31$87,255
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 name2021-12-31SNYDER COHN, P.C.
Accountancy firm EIN2021-12-31521022232
2020 : THE 401(K) PLAN OF PE GASTRO MANAGEMENT, LLC 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$90
Total income from all sources (including contributions)2020-12-31$11,529,295
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$2,550,564
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$2,435,540
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$3,614,093
Value of total assets at end of year2020-12-31$63,201,718
Value of total assets at beginning of year2020-12-31$54,223,077
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$115,024
Total interest from all sources2020-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$729,149
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$729,149
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$600,000
If this is an individual account plan, was there a blackout period2020-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$1,808,548
Participant contributions at end of year2020-12-31$45,753
Participant contributions at beginning of year2020-12-31$6,165
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$29,454
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$90
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$8,978,731
Value of net assets at end of year (total assets less liabilities)2020-12-31$63,201,718
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$54,222,987
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$44,819,668
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$0
Value of interest in pooled separate accounts at end of year2020-12-31$16,582,547
Value of interest in pooled separate accounts at beginning of year2020-12-31$51,633,887
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$383,212
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$4,042,225
Net investment gain/loss from pooled separate accounts2020-12-31$3,143,828
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$1,776,091
Employer contributions (assets) at end of year2020-12-31$1,753,750
Employer contributions (assets) at beginning of year2020-12-31$2,199,813
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$2,435,540
Contract administrator fees2020-12-31$115,024
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-12-31Yes
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31SNYDER COHN, P.C.
Accountancy firm EIN2020-12-31521022232

Form 5500 Responses for THE 401(K) PLAN OF PE GASTRO MANAGEMENT, LLC

2022: THE 401(K) PLAN OF PE GASTRO MANAGEMENT, LLC 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: THE 401(K) PLAN OF PE GASTRO MANAGEMENT, LLC 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
2020: THE 401(K) PLAN OF PE GASTRO MANAGEMENT, LLC 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number629379
Policy instance 1
Insurance contract or identification number629379
Number of Individuals Covered478
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $6,845
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
Amount paid for insurance broker fees6845
Additional information about fees paid to insurance brokerREFERRAL/SERVICE FEE
Insurance broker organization code?5
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number629379
Policy instance 1
Insurance contract or identification number629379
Number of Individuals Covered382
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $6,671
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
Amount paid for insurance broker fees6671
Additional information about fees paid to insurance brokerREFERRAL/SERVICE FEE
Insurance broker organization code?5
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number810356
Policy instance 1
Insurance contract or identification number810356
Number of Individuals Covered0
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number629379
Policy instance 2
Insurance contract or identification number629379
Number of Individuals Covered319
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $12,071
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
Amount paid for insurance broker fees12071
Additional information about fees paid to insurance brokerREFERRAL/SERVICE FEE
Insurance broker organization code?5

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