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HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 401k Plan overview

Plan NameHOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B
Plan identification number 003

HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • 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 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

HOME CARE, HOSPICE PALLIATIVE CARE ALLIANCE OF NEW HAMPSHIRE has sponsored the creation of one or more 401k plans.

Company Name:HOME CARE, HOSPICE PALLIATIVE CARE ALLIANCE OF NEW HAMPSHIRE
Employer identification number (EIN):020315706
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0032022-01-01GINA BALKUS2023-09-15
0032021-01-01GINA BALKUS2022-10-17
0032020-01-01
0032020-01-01
0032019-01-01
0032019-01-01
0032018-01-01GINA BALKUS
0032017-01-01GINA BALKUS
0032016-01-01GINA BALKUS
0032015-01-01GINA BALKUS
0032014-01-01GINA BALKUS
0032013-01-01GINA BALKUS
0032012-01-01GINA BALKUS
0032011-01-01GINA BALKUS
0032010-01-01SUSAN M. YOUNG
0032009-01-01SUSAN M. YOUNG

Plan Statistics for HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B

401k plan membership statisitcs for HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B

Measure Date Value
2020: HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2020 401k membership
Total participants, beginning-of-year2020-01-014
Total number of active participants reported on line 7a of the Form 55002020-01-013
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-011
Total of all active and inactive participants2020-01-014
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-014
Number of participants with account balances2020-01-014
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2019 401k membership
Total participants, beginning-of-year2019-01-015
Total number of active participants reported on line 7a of the Form 55002019-01-014
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-014
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-014
Number of participants with account balances2019-01-014
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2018 401k membership
Total participants, beginning-of-year2018-01-014
Total number of active participants reported on line 7a of the Form 55002018-01-013
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-012
Total of all active and inactive participants2018-01-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-015
Number of participants with account balances2018-01-015
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2017 401k membership
Total participants, beginning-of-year2017-01-018
Total number of active participants reported on line 7a of the Form 55002017-01-012
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-012
Total of all active and inactive participants2017-01-014
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-014
Number of participants with account balances2017-01-014
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2016 401k membership
Total participants, beginning-of-year2016-01-014
Total number of active participants reported on line 7a of the Form 55002016-01-013
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-015
Total of all active and inactive participants2016-01-018
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-018
Number of participants with account balances2016-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2015 401k membership
Total participants, beginning-of-year2015-01-014
Total number of active participants reported on line 7a of the Form 55002015-01-011
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-013
Total of all active and inactive participants2015-01-014
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-014
Number of participants with account balances2015-01-014
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2014 401k membership
Total participants, beginning-of-year2014-01-014
Total number of active participants reported on line 7a of the Form 55002014-01-011
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-013
Total of all active and inactive participants2014-01-014
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-014
Number of participants with account balances2014-01-014
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2013 401k membership
Total participants, beginning-of-year2013-01-014
Total number of active participants reported on line 7a of the Form 55002013-01-012
Number of other retired or separated participants entitled to future benefits2013-01-012
Total of all active and inactive participants2013-01-014
Total participants2013-01-014
2012: HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2012 401k membership
Total participants, beginning-of-year2012-01-013
Total number of active participants reported on line 7a of the Form 55002012-01-012
Number of other retired or separated participants entitled to future benefits2012-01-012
Total of all active and inactive participants2012-01-014
Total participants2012-01-014
2011: HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2011 401k membership
Total participants, beginning-of-year2011-01-015
Total number of active participants reported on line 7a of the Form 55002011-01-013
Total of all active and inactive participants2011-01-013
Total participants2011-01-013
2010: HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2010 401k membership
Total participants, beginning-of-year2010-01-015
Total number of active participants reported on line 7a of the Form 55002010-01-014
Total of all active and inactive participants2010-01-014
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-011
Total participants2010-01-015
2009: HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2009 401k membership
Total participants, beginning-of-year2009-01-014
Total number of active participants reported on line 7a of the Form 55002009-01-014
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-014
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-011
Total participants2009-01-015
Number of participants with account balances2009-01-015

Financial Data on HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B

Measure Date Value
2020 : HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2020 401k financial data
Total plan liabilities at end of year2020-12-31$0
Total plan liabilities at beginning of year2020-12-31$0
Total income from all sources2020-12-31$46,767
Expenses. Total of all expenses incurred2020-12-31$192,681
Benefits paid (including direct rollovers)2020-12-31$192,681
Total plan assets at end of year2020-12-31$112,603
Total plan assets at beginning of year2020-12-31$258,517
Value of fidelity bond covering the plan2020-12-31$26,000
Total contributions received or receivable from participants2020-12-31$3,126
Expenses. Other expenses not covered elsewhere2020-12-31$0
Contributions received from other sources (not participants or employers)2020-12-31$12,416
Other income received2020-12-31$9,676
Net income (gross income less expenses)2020-12-31$-145,914
Net plan assets at end of year (total assets less liabilities)2020-12-31$112,603
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$258,517
Total contributions received or receivable from employer(s)2020-12-31$21,549
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
2019 : HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2019 401k financial data
Transfers to/from the plan2019-12-31$0
Total plan liabilities at end of year2019-12-31$0
Total plan liabilities at beginning of year2019-12-31$0
Total income from all sources2019-12-31$64,781
Expenses. Total of all expenses incurred2019-12-31$0
Benefits paid (including direct rollovers)2019-12-31$0
Total plan assets at end of year2019-12-31$258,517
Total plan assets at beginning of year2019-12-31$193,736
Value of fidelity bond covering the plan2019-12-31$26,000
Total contributions received or receivable from participants2019-12-31$960
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$42,402
Net income (gross income less expenses)2019-12-31$64,781
Net plan assets at end of year (total assets less liabilities)2019-12-31$258,517
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$193,736
Total contributions received or receivable from employer(s)2019-12-31$21,419
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
2018 : HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2018 401k financial data
Total income from all sources2018-12-31$4,390
Expenses. Total of all expenses incurred2018-12-31$506
Total plan assets at end of year2018-12-31$193,736
Total plan assets at beginning of year2018-12-31$189,852
Total contributions received or receivable from participants2018-12-31$960
Expenses. Other expenses not covered elsewhere2018-12-31$506
Other income received2018-12-31$-15,051
Net income (gross income less expenses)2018-12-31$3,884
Net plan assets at end of year (total assets less liabilities)2018-12-31$193,736
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$189,852
Total contributions received or receivable from employer(s)2018-12-31$18,481
2017 : HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2017 401k financial data
Total income from all sources2017-12-31$12,081
Expenses. Total of all expenses incurred2017-12-31$166
Total plan assets at end of year2017-12-31$189,852
Total plan assets at beginning of year2017-12-31$177,937
Total contributions received or receivable from participants2017-12-31$520
Expenses. Other expenses not covered elsewhere2017-12-31$166
Other income received2017-12-31$-5,216
Net income (gross income less expenses)2017-12-31$11,915
Net plan assets at end of year (total assets less liabilities)2017-12-31$189,852
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$177,937
Assets. Value of participant loans2017-12-31$122
Total contributions received or receivable from employer(s)2017-12-31$16,777
2016 : HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2016 401k financial data
Total income from all sources2016-12-31$41,019
Expenses. Total of all expenses incurred2016-12-31$913
Total plan assets at end of year2016-12-31$177,937
Total plan assets at beginning of year2016-12-31$137,831
Expenses. Other expenses not covered elsewhere2016-12-31$913
Other income received2016-12-31$9,445
Net income (gross income less expenses)2016-12-31$40,106
Net plan assets at end of year (total assets less liabilities)2016-12-31$177,937
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$137,831
Assets. Value of participant loans2016-12-31$122
Total contributions received or receivable from employer(s)2016-12-31$31,574
2015 : HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2015 401k financial data
Total income from all sources2015-12-31$26,857
Expenses. Total of all expenses incurred2015-12-31$103
Total plan assets at end of year2015-12-31$137,831
Total plan assets at beginning of year2015-12-31$111,077
Total contributions received or receivable from participants2015-12-31$11,525
Expenses. Other expenses not covered elsewhere2015-12-31$103
Other income received2015-12-31$2,973
Net income (gross income less expenses)2015-12-31$26,754
Net plan assets at end of year (total assets less liabilities)2015-12-31$137,831
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$111,077
Assets. Value of participant loans2015-12-31$835
Total contributions received or receivable from employer(s)2015-12-31$12,359
2014 : HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2014 401k financial data
Total income from all sources2014-12-31$41,959
Expenses. Total of all expenses incurred2014-12-31$1,217
Total plan assets at end of year2014-12-31$111,077
Total plan assets at beginning of year2014-12-31$70,335
Total contributions received or receivable from participants2014-12-31$14,573
Expenses. Other expenses not covered elsewhere2014-12-31$1,217
Other income received2014-12-31$11,957
Net income (gross income less expenses)2014-12-31$40,742
Net plan assets at end of year (total assets less liabilities)2014-12-31$111,077
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$70,335
Assets. Value of participant loans2014-12-31$2,070
Total contributions received or receivable from employer(s)2014-12-31$15,429
2013 : HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2013 401k financial data
Total income from all sources2013-12-31$46,859
Expenses. Total of all expenses incurred2013-12-31$1,308
Total plan assets at end of year2013-12-31$70,335
Total plan assets at beginning of year2013-12-31$24,784
Total contributions received or receivable from participants2013-12-31$17,189
Expenses. Other expenses not covered elsewhere2013-12-31$1,308
Other income received2013-12-31$14,582
Net income (gross income less expenses)2013-12-31$45,551
Net plan assets at end of year (total assets less liabilities)2013-12-31$70,335
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$24,784
Assets. Value of participant loans2013-12-31$3,388
Total contributions received or receivable from employer(s)2013-12-31$15,088
2012 : HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2012 401k financial data
Total income from all sources2012-12-31$10,356
Expenses. Total of all expenses incurred2012-12-31$389
Total plan assets at end of year2012-12-31$24,784
Total plan assets at beginning of year2012-12-31$14,817
Total contributions received or receivable from participants2012-12-31$3,950
Expenses. Other expenses not covered elsewhere2012-12-31$389
Other income received2012-12-31$930
Net income (gross income less expenses)2012-12-31$9,967
Net plan assets at end of year (total assets less liabilities)2012-12-31$24,784
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$14,817
Assets. Value of participant loans2012-12-31$4,629
Total contributions received or receivable from employer(s)2012-12-31$5,476
2011 : HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2011 401k financial data
Total income from all sources2011-12-31$-10,773
Expenses. Total of all expenses incurred2011-12-31$508,789
Benefits paid (including direct rollovers)2011-12-31$507,422
Total plan assets at end of year2011-12-31$14,817
Total plan assets at beginning of year2011-12-31$534,379
Expenses. Other expenses not covered elsewhere2011-12-31$1,367
Other income received2011-12-31$-44,624
Net income (gross income less expenses)2011-12-31$-519,562
Net plan assets at end of year (total assets less liabilities)2011-12-31$14,817
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$534,379
Total contributions received or receivable from employer(s)2011-12-31$33,851
2010 : HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2010 401k financial data
Total income from all sources2010-12-31$107,706
Expenses. Total of all expenses incurred2010-12-31$1,304
Total plan assets at end of year2010-12-31$534,379
Total plan assets at beginning of year2010-12-31$427,977
Expenses. Other expenses not covered elsewhere2010-12-31$1,304
Other income received2010-12-31$75,373
Net income (gross income less expenses)2010-12-31$106,402
Net plan assets at end of year (total assets less liabilities)2010-12-31$534,379
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$427,977
Total contributions received or receivable from employer(s)2010-12-31$32,333

Form 5500 Responses for HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B

2020: HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedYes
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 benefit arrangement – InsuranceYes
2019: HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedYes
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: HOME CARE ASSOCIATION OF NEW HAMPSHIRE 403B 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number051493G
Policy instance 1
Insurance contract or identification number051493G
Number of Individuals Covered4
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 $163
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees163
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number020H09757757
Policy instance 2
Insurance contract or identification number020H09757757
Number of Individuals Covered1
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $517
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?1
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 $517
Insurance broker organization code?7
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number051493G
Policy instance 1
Insurance contract or identification number051493G
Number of Individuals Covered4
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number020H09757757
Policy instance 1
Insurance contract or identification number020H09757757
Number of Individuals Covered5
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $506
Are there contracts with allocated funds for individual policies?1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $506
Insurance broker organization code?7
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number020H09757757
Policy instance 1
Insurance contract or identification number020H09757757
Number of Individuals Covered7
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $166
Are there contracts with allocated funds for individual policies?1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $166
Insurance broker organization code?7
Insurance broker nameCOMMONWEALTH FINANCIAL NETWORK
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number02OH09884884
Policy instance 1
Insurance contract or identification number02OH09884884
Number of Individuals Covered4
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $103
Are there contracts with allocated funds for individual policies?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $103
Insurance broker organization code?7
Insurance broker nameLINCOLN FINANCIAL SECURITIES CORP
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number02OH09884884
Policy instance 1
Insurance contract or identification number02OH09884884
Number of Individuals Covered4
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,217
Are there contracts with allocated funds for individual policies?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,217
Insurance broker organization code?7
Insurance broker nameLINCOLN FINANCIAL SECURITIES CORP
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number02OH09884884
Policy instance 1
Insurance contract or identification number02OH09884884
Number of Individuals Covered3
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,308
Are there contracts with allocated funds for individual policies?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,308
Insurance broker organization code?7
Insurance broker nameLINCOLN FINANCIAL SECURITIES CORP
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number02OH09884884
Policy instance 1
Insurance contract or identification number02OH09884884
Number of Individuals Covered3
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $389
Are there contracts with allocated funds for individual policies?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $389
Insurance broker organization code?7
Insurance broker nameLINCOLN FINANCIAL SECURITIES CORP
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number02OH09884884
Policy instance 1
Insurance contract or identification number02OH09884884
Number of Individuals Covered3
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $1,367
Are there contracts with allocated funds for individual policies?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number02OH09884884
Policy instance 1
Insurance contract or identification number02OH09884884
Number of Individuals Covered5
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $1,304
Are there contracts with allocated funds for individual policies?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,304
Insurance broker organization code?7
Insurance broker nameLINCOLN FINANCIAL SECURITIES CORP

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