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KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 401(K) RETIREMENT PLAN 401k Plan overview

Plan NameKETTLE MORAINE HEATING & AIR CONDITIONING, LLC 401(K) RETIREMENT PLAN
Plan identification number 001

KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 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.
  • 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.
  • 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

KETTLE MORAINE HEATING & AIR CONDITIONING, LLC has sponsored the creation of one or more 401k plans.

Company Name:KETTLE MORAINE HEATING & AIR CONDITIONING, LLC
Employer identification number (EIN):010858492
NAIC Classification:238220
NAIC Description:Plumbing, Heating, and Air-Conditioning Contractors

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 401(K) RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01WILLIAM BRINK2023-07-11
0012021-01-01WILLIAM BRINK2022-10-03
0012020-01-01WILLIAM D. BRINK2021-06-22
0012019-01-01
0012018-01-01SARA KAHL
0012017-01-01SARA KAHL
0012016-01-01SARAH BRINK
0012015-01-01SARAH BRINK
0012014-01-01SARAH BRINK
0012013-01-01SARAH BRINK
0012012-01-01SARAH BRINK

Plan Statistics for KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 401(K) RETIREMENT PLAN

401k plan membership statisitcs for KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 401(K) RETIREMENT PLAN

Measure Date Value
2019: KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 401(K) RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0138
Total number of active participants reported on line 7a of the Form 55002019-01-0159
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-013
Total of all active and inactive participants2019-01-0162
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0162
Number of participants with account balances2019-01-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 401(K) RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0138
Total number of active participants reported on line 7a of the Form 55002018-01-0135
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-013
Total of all active and inactive participants2018-01-0138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0138
Number of participants with account balances2018-01-0113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 401(K) RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0136
Total number of active participants reported on line 7a of the Form 55002017-01-0135
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-013
Total of all active and inactive participants2017-01-0138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0138
Number of participants with account balances2017-01-0110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 401(K) RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0131
Total number of active participants reported on line 7a of the Form 55002016-01-0132
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-014
Total of all active and inactive participants2016-01-0136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0136
Number of participants with account balances2016-01-0113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 401(K) RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0127
Total number of active participants reported on line 7a of the Form 55002015-01-0125
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-016
Total of all active and inactive participants2015-01-0131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0131
Number of participants with account balances2015-01-0114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-011
2014: KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 401(K) RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0124
Total number of active participants reported on line 7a of the Form 55002014-01-0122
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-015
Total of all active and inactive participants2014-01-0127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0127
Number of participants with account balances2014-01-0110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-011
2013: KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 401(K) RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0111
Total number of active participants reported on line 7a of the Form 55002013-01-0120
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-014
Total of all active and inactive participants2013-01-0124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0124
Number of participants with account balances2013-01-019
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-013
2012: KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 401(K) RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-010
Total number of active participants reported on line 7a of the Form 55002012-01-0111
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-0111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0111
Number of participants with account balances2012-01-0111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010

Financial Data on KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 401(K) RETIREMENT PLAN

Measure Date Value
2019 : KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 401(K) RETIREMENT PLAN 2019 401k financial data
Total income from all sources2019-12-31$98,696
Expenses. Total of all expenses incurred2019-12-31$2,835
Benefits paid (including direct rollovers)2019-12-31$0
Total plan assets at end of year2019-12-31$204,587
Total plan assets at beginning of year2019-12-31$108,726
Value of fidelity bond covering the plan2019-12-31$100,000
Total contributions received or receivable from participants2019-12-31$57,684
Expenses. Other expenses not covered elsewhere2019-12-31$0
Contributions received from other sources (not participants or employers)2019-12-31$0
Other income received2019-12-31$33,204
Noncash contributions received2019-12-31$0
Net income (gross income less expenses)2019-12-31$95,861
Net plan assets at end of year (total assets less liabilities)2019-12-31$204,587
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$108,726
Total contributions received or receivable from employer(s)2019-12-31$7,808
Value of certain deemed distributions of participant loans2019-12-31$0
Value of corrective distributions2019-12-31$255
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$2,580
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
2018 : KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 401(K) RETIREMENT PLAN 2018 401k financial data
Total income from all sources2018-12-31$23,019
Expenses. Total of all expenses incurred2018-12-31$9,677
Benefits paid (including direct rollovers)2018-12-31$6,712
Total plan assets at end of year2018-12-31$108,726
Total plan assets at beginning of year2018-12-31$95,384
Value of fidelity bond covering the plan2018-12-31$100,000
Total contributions received or receivable from participants2018-12-31$27,540
Expenses. Other expenses not covered elsewhere2018-12-31$0
Contributions received from other sources (not participants or employers)2018-12-31$0
Other income received2018-12-31$-8,717
Noncash contributions received2018-12-31$0
Net income (gross income less expenses)2018-12-31$13,342
Net plan assets at end of year (total assets less liabilities)2018-12-31$108,726
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$95,384
Total contributions received or receivable from employer(s)2018-12-31$4,196
Value of certain deemed distributions of participant loans2018-12-31$0
Value of corrective distributions2018-12-31$843
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$2,122
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
2017 : KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 401(K) RETIREMENT PLAN 2017 401k financial data
Total income from all sources2017-12-31$32,698
Expenses. Total of all expenses incurred2017-12-31$14,073
Benefits paid (including direct rollovers)2017-12-31$10,760
Total plan assets at end of year2017-12-31$95,384
Total plan assets at beginning of year2017-12-31$76,759
Value of fidelity bond covering the plan2017-12-31$100,000
Total contributions received or receivable from participants2017-12-31$15,337
Expenses. Other expenses not covered elsewhere2017-12-31$0
Contributions received from other sources (not participants or employers)2017-12-31$0
Other income received2017-12-31$14,197
Noncash contributions received2017-12-31$0
Net income (gross income less expenses)2017-12-31$18,625
Net plan assets at end of year (total assets less liabilities)2017-12-31$95,384
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$76,759
Total contributions received or receivable from employer(s)2017-12-31$3,164
Value of certain deemed distributions of participant loans2017-12-31$0
Value of corrective distributions2017-12-31$1,352
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$1,961
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 401(K) RETIREMENT PLAN 2016 401k financial data
Total income from all sources2016-12-31$25,296
Expenses. Total of all expenses incurred2016-12-31$17,914
Benefits paid (including direct rollovers)2016-12-31$14,971
Total plan assets at end of year2016-12-31$76,759
Total plan assets at beginning of year2016-12-31$69,377
Value of fidelity bond covering the plan2016-12-31$100,000
Total contributions received or receivable from participants2016-12-31$15,665
Expenses. Other expenses not covered elsewhere2016-12-31$0
Contributions received from other sources (not participants or employers)2016-12-31$0
Other income received2016-12-31$6,557
Noncash contributions received2016-12-31$0
Net income (gross income less expenses)2016-12-31$7,382
Net plan assets at end of year (total assets less liabilities)2016-12-31$76,759
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$69,377
Total contributions received or receivable from employer(s)2016-12-31$3,074
Value of certain deemed distributions of participant loans2016-12-31$0
Value of corrective distributions2016-12-31$1,092
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$1,851
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 401(K) RETIREMENT PLAN 2015 401k financial data
Total income from all sources2015-12-31$13,578
Expenses. Total of all expenses incurred2015-12-31$6,247
Benefits paid (including direct rollovers)2015-12-31$3,651
Total plan assets at end of year2015-12-31$69,377
Total plan assets at beginning of year2015-12-31$62,046
Value of fidelity bond covering the plan2015-12-31$100,000
Total contributions received or receivable from participants2015-12-31$13,017
Expenses. Other expenses not covered elsewhere2015-12-31$0
Contributions received from other sources (not participants or employers)2015-12-31$0
Other income received2015-12-31$-1,817
Noncash contributions received2015-12-31$0
Net income (gross income less expenses)2015-12-31$7,331
Net plan assets at end of year (total assets less liabilities)2015-12-31$69,377
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$62,046
Total contributions received or receivable from employer(s)2015-12-31$2,378
Value of certain deemed distributions of participant loans2015-12-31$0
Value of corrective distributions2015-12-31$708
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$1,888
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 401(K) RETIREMENT PLAN 2014 401k financial data
Total income from all sources2014-12-31$18,703
Expenses. Total of all expenses incurred2014-12-31$1,547
Benefits paid (including direct rollovers)2014-12-31$0
Total plan assets at end of year2014-12-31$62,046
Total plan assets at beginning of year2014-12-31$44,890
Value of fidelity bond covering the plan2014-12-31$100,000
Total contributions received or receivable from participants2014-12-31$12,603
Expenses. Other expenses not covered elsewhere2014-12-31$0
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$2,968
Noncash contributions received2014-12-31$0
Net income (gross income less expenses)2014-12-31$17,156
Net plan assets at end of year (total assets less liabilities)2014-12-31$62,046
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$44,890
Total contributions received or receivable from employer(s)2014-12-31$3,132
Value of certain deemed distributions of participant loans2014-12-31$0
Value of corrective distributions2014-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$1,547
2013 : KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 401(K) RETIREMENT PLAN 2013 401k financial data
Total income from all sources2013-12-31$30,831
Expenses. Total of all expenses incurred2013-12-31$9,502
Benefits paid (including direct rollovers)2013-12-31$2,759
Total plan assets at end of year2013-12-31$44,890
Total plan assets at beginning of year2013-12-31$23,561
Value of fidelity bond covering the plan2013-12-31$100,000
Total contributions received or receivable from participants2013-12-31$20,163
Expenses. Other expenses not covered elsewhere2013-12-31$0
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$6,882
Noncash contributions received2013-12-31$0
Net income (gross income less expenses)2013-12-31$21,329
Net plan assets at end of year (total assets less liabilities)2013-12-31$44,890
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$23,561
Total contributions received or receivable from employer(s)2013-12-31$3,786
Value of certain deemed distributions of participant loans2013-12-31$0
Value of corrective distributions2013-12-31$5,452
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$1,291
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 401(K) RETIREMENT PLAN 2012 401k financial data
Total income from all sources2012-12-31$23,768
Expenses. Total of all expenses incurred2012-12-31$207
Benefits paid (including direct rollovers)2012-12-31$0
Total plan assets at end of year2012-12-31$23,561
Total plan assets at beginning of year2012-12-31$0
Value of fidelity bond covering the plan2012-12-31$100,000
Total contributions received or receivable from participants2012-12-31$21,074
Expenses. Other expenses not covered elsewhere2012-12-31$0
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$566
Noncash contributions received2012-12-31$0
Net income (gross income less expenses)2012-12-31$23,561
Net plan assets at end of year (total assets less liabilities)2012-12-31$23,561
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$0
Total contributions received or receivable from employer(s)2012-12-31$2,128
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$207

Form 5500 Responses for KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 401(K) RETIREMENT PLAN

2019: KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 401(K) RETIREMENT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
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 funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 401(K) RETIREMENT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 401(K) RETIREMENT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
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 funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 401(K) RETIREMENT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
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 funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 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
2015-01-01Plan benefit arrangement - TrustYes
2014: KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 401(K) RETIREMENT PLAN 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 funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 401(K) RETIREMENT PLAN 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 funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: KETTLE MORAINE HEATING & AIR CONDITIONING, LLC 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
2012-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number803290-000
Policy instance 1
Insurance contract or identification number803290-000
Number of Individuals Covered16
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $605
Total amount of fees paid to insurance companyUSD $77
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 $363
Amount paid for insurance broker fees0
Insurance broker organization code?7
Additional information about fees paid to insurance brokerTPA FEES
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number803290-000
Policy instance 1
Insurance contract or identification number803290-000
Number of Individuals Covered13
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $430
Total amount of fees paid to insurance companyUSD $54
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 $258
Amount paid for insurance broker fees0
Insurance broker organization code?7
Additional information about fees paid to insurance brokerTPA FEES
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number803290-000
Policy instance 1
Insurance contract or identification number803290-000
Number of Individuals Covered10
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $339
Total amount of fees paid to insurance companyUSD $43
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 $188
Amount paid for insurance broker fees0
Insurance broker organization code?7
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker namePPG RETIREMENT PLAN SERVICES
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number803290-000
Policy instance 1
Insurance contract or identification number803290-000
Number of Individuals Covered13
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
Total amount of commissions paid to insurance brokerUSD $266
Total amount of fees paid to insurance companyUSD $41
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 $266
Insurance broker organization code?7
Amount paid for insurance broker fees41
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker name
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number803290-000
Policy instance 1
Insurance contract or identification number803290-000
Number of Individuals Covered14
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $265
Total amount of fees paid to insurance companyUSD $32
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 $265
Insurance broker organization code?7
Amount paid for insurance broker fees32
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker name
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number803290-000
Policy instance 1
Insurance contract or identification number803290-000
Number of Individuals Covered10
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $210
Total amount of fees paid to insurance companyUSD $26
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 $119
Insurance broker organization code?3
Amount paid for insurance broker fees26
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker namePPG RETIREMENT PLAN SERVICES
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number803290-000
Policy instance 1
Insurance contract or identification number803290-000
Number of Individuals Covered9
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $273
Total amount of fees paid to insurance companyUSD $15
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 $191
Insurance broker organization code?3
Amount paid for insurance broker fees15
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker namePPG RETIREMENT PLAN SERVICES
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number803290-000
Policy instance 1
Insurance contract or identification number803290-000
Number of Individuals Covered11
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $186
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 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 $159
Insurance broker organization code?3
Insurance broker namePPG RETIREMNT PLAN SERVICES

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