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PLANNED PARENTHOOD OF THE PACIFIC SOUTHWEST 401(K) RETIREMENT PLAN 401k Plan overview

Plan NamePLANNED PARENTHOOD OF THE PACIFIC SOUTHWEST 401(K) RETIREMENT PLAN
Plan identification number 001

PLANNED PARENTHOOD OF THE PACIFIC SOUTHWEST 401(K) RETIREMENT PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • 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.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • 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

PLANNED PARENTHOOD OF THE PACIFIC SOUTHWEST has sponsored the creation of one or more 401k plans.

Company Name:PLANNED PARENTHOOD OF THE PACIFIC SOUTHWEST
Employer identification number (EIN):956111785
NAIC Classification:621410
NAIC Description:Family Planning Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PLANNED PARENTHOOD OF THE PACIFIC SOUTHWEST 401(K) RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012015-01-01FRANCIS PICKFORD CPA
0012012-01-01LEN DODSON LEN DODSON2013-10-02
0012011-01-01LEONARD DODSON

Plan Statistics for PLANNED PARENTHOOD OF THE PACIFIC SOUTHWEST 401(K) RETIREMENT PLAN

401k plan membership statisitcs for PLANNED PARENTHOOD OF THE PACIFIC SOUTHWEST 401(K) RETIREMENT PLAN

Measure Date Value
2015: PLANNED PARENTHOOD OF THE PACIFIC SOUTHWEST 401(K) RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01494
Total number of active participants reported on line 7a of the Form 55002015-01-01361
Number of retired or separated participants receiving benefits2015-01-012
Number of other retired or separated participants entitled to future benefits2015-01-01131
Total of all active and inactive participants2015-01-01494
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-011
Total participants2015-01-01495
Number of participants with account balances2015-01-01395
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-015
2012: PLANNED PARENTHOOD OF THE PACIFIC SOUTHWEST 401(K) RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01544
Total number of active participants reported on line 7a of the Form 55002012-01-01425
Number of retired or separated participants receiving benefits2012-01-011
Number of other retired or separated participants entitled to future benefits2012-01-01126
Total of all active and inactive participants2012-01-01552
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01552
Number of participants with account balances2012-01-01426
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-0134
2011: PLANNED PARENTHOOD OF THE PACIFIC SOUTHWEST 401(K) RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01611
Total number of active participants reported on line 7a of the Form 55002011-01-01466
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-01134
Total of all active and inactive participants2011-01-01600
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01600
Number of participants with account balances2011-01-01395
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-017

Financial Data on PLANNED PARENTHOOD OF THE PACIFIC SOUTHWEST 401(K) RETIREMENT PLAN

Measure Date Value
2015 : PLANNED PARENTHOOD OF THE PACIFIC SOUTHWEST 401(K) RETIREMENT PLAN 2015 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2015-12-31$0
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total transfer of assets to this plan2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$1,589,418
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$1,790,548
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$1,646,411
Expenses. Certain deemed distributions of participant loans2015-12-31$22,789
Value of total corrective distributions2015-12-31$119,428
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$1,825,203
Value of total assets at end of year2015-12-31$15,555,630
Value of total assets at beginning of year2015-12-31$15,756,760
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$1,920
Total interest from all sources2015-12-31$27,779
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$1,421,666
Participant contributions at end of year2015-12-31$248,776
Participant contributions at beginning of year2015-12-31$297,715
Assets. Other investments not covered elsewhere at end of year2015-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2015-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$3,360
Other income not declared elsewhere2015-12-31$0
Administrative expenses (other) incurred2015-12-31$1,920
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-201,130
Value of net assets at end of year (total assets less liabilities)2015-12-31$15,555,630
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$15,756,760
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$14,895,303
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$15,057,031
Value of interest in pooled separate accounts at end of year2015-12-31$0
Value of interest in pooled separate accounts at beginning of year2015-12-31$0
Interest on participant loans2015-12-31$15,745
Interest earned on other investments2015-12-31$12,034
Value of interest in common/collective trusts at end of year2015-12-31$0
Value of interest in common/collective trusts at beginning of year2015-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$411,551
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$402,014
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$0
Net investment gain/loss from pooled separate accounts2015-12-31$-263,564
Net investment gain or loss from common/collective trusts2015-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Assets. Invements in employer securities at end of year2015-12-31$0
Assets. Invements in employer securities at beginning of year2015-12-31$0
Contributions received in cash from employer2015-12-31$400,177
Income. Dividends from common stock2015-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$1,646,411
Asset. Corporate debt instrument debt (other) at end of year2015-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2015-12-31$0
Assets. Corporate common stocks other than exployer securities at end of year2015-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2015-12-31$0
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31MAYER HOFFMAN MCCANN P.C.
Accountancy firm EIN2015-12-31431947695
2012 : PLANNED PARENTHOOD OF THE PACIFIC SOUTHWEST 401(K) RETIREMENT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$51,840
Total income from all sources (including contributions)2012-12-31$3,147,699
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$1,844,978
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$1,793,428
Expenses. Certain deemed distributions of participant loans2012-12-31$0
Value of total corrective distributions2012-12-31$50,218
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$1,699,436
Value of total assets at end of year2012-12-31$11,989,690
Value of total assets at beginning of year2012-12-31$10,738,809
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$1,332
Total interest from all sources2012-12-31$26,392
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$500,000
If this is an individual account plan, was there a blackout period2012-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Funding deficiency by the employer to the plan for this plan year2012-12-31$0
Minimum employer required contribution for this plan year2012-12-31$0
Amount contributed by the employer to the plan for this plan year2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$1,267,691
Participant contributions at end of year2012-12-31$239,445
Participant contributions at beginning of year2012-12-31$271,203
Assets. Other investments not covered elsewhere at end of year2012-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2012-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$46,732
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$51,840
Administrative expenses (other) incurred2012-12-31$1,332
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$1,302,721
Value of net assets at end of year (total assets less liabilities)2012-12-31$11,989,690
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$10,686,969
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in pooled separate accounts at end of year2012-12-31$11,165,959
Value of interest in pooled separate accounts at beginning of year2012-12-31$9,696,193
Interest on participant loans2012-12-31$9,628
Interest earned on other investments2012-12-31$16,764
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$584,286
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$771,413
Net investment gain/loss from pooled separate accounts2012-12-31$1,421,871
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Assets. Invements in employer securities at end of year2012-12-31$0
Assets. Invements in employer securities at beginning of year2012-12-31$0
Contributions received in cash from employer2012-12-31$385,013
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$1,793,428
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31MAYER HOFFMAN MCCANN P.C.
Accountancy firm EIN2012-12-31431947695
2011 : PLANNED PARENTHOOD OF THE PACIFIC SOUTHWEST 401(K) RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$51,840
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$9,339
Total income from all sources (including contributions)2011-12-31$1,743,007
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$499,195
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$428,529
Value of total corrective distributions2011-12-31$61,519
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$2,013,441
Value of total assets at end of year2011-12-31$10,738,747
Value of total assets at beginning of year2011-12-31$9,452,434
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$9,147
Total interest from all sources2011-12-31$29,381
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$372,538
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$372,538
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$500,000
If this is an individual account plan, was there a blackout period2011-12-31No
Funding deficiency by the employer to the plan for this plan year2011-12-31$0
Minimum employer required contribution for this plan year2011-12-31$0
Amount contributed by the employer to the plan for this plan year2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$1,427,811
Participant contributions at end of year2011-12-31$271,203
Participant contributions at beginning of year2011-12-31$170,954
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$167,591
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-12-31$51,840
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-12-31$9,339
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$1,243,812
Value of net assets at end of year (total assets less liabilities)2011-12-31$10,686,907
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$9,443,095
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in pooled separate accounts at end of year2011-12-31$9,696,131
Value of interest in pooled separate accounts at beginning of year2011-12-31$8,082,696
Interest on participant loans2011-12-31$9,876
Interest earned on other investments2011-12-31$19,505
Value of interest in common/collective trusts at beginning of year2011-12-31$987,564
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$771,413
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$211,220
Net investment gain/loss from pooled separate accounts2011-12-31$-672,353
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$418,039
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$428,529
Contract administrator fees2011-12-31$9,147
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31MAYER HOFFMAN MCCANN P.C.
Accountancy firm EIN2011-12-31431947695

Form 5500 Responses for PLANNED PARENTHOOD OF THE PACIFIC SOUTHWEST 401(K) RETIREMENT PLAN

2015: PLANNED PARENTHOOD OF THE PACIFIC SOUTHWEST 401(K) RETIREMENT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
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 funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2012: PLANNED PARENTHOOD OF THE PACIFIC SOUTHWEST 401(K) RETIREMENT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: PLANNED PARENTHOOD OF THE PACIFIC SOUTHWEST 401(K) RETIREMENT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-822481
Policy instance 1
Insurance contract or identification numberGA-822481
Number of Individuals Covered394
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $43,113
Total amount of fees paid to insurance companyUSD $0
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?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 $43,113
Insurance broker organization code?3
Insurance broker nameSAGEPOINT FINANCIAL, INC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-822481
Policy instance 1
Insurance contract or identification numberGA-822481
Number of Individuals Covered426
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $30,902
Total amount of fees paid to insurance companyUSD $4,287
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 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 $30,902
Insurance broker organization code?3
Amount paid for insurance broker fees4287
Additional information about fees paid to insurance brokerSALES/MARKETING
Insurance broker nameMERRILL LYNCH PIERCE FENNER SMITH I
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-822481
Policy instance 1
Insurance contract or identification numberGA-822481
Number of Individuals Covered395
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $13,748
Total amount of fees paid to insurance companyUSD $8,798
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 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

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