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KILGORE 401(K) PLAN 401k Plan overview

Plan NameKILGORE 401(K) PLAN
Plan identification number 001

KILGORE 401(K) 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.
  • Plan covering Self-Employed individuals.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

KILGORE INDUSTRIES, L.P. has sponsored the creation of one or more 401k plans.

Company Name:KILGORE INDUSTRIES, L.P.
Employer identification number (EIN):020650722
NAIC Classification:332510
NAIC Description:Hardware Manufacturing

Additional information about KILGORE INDUSTRIES, L.P.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2002-10-03
Company Identification Number: 0800128950
Legal Registered Office Address: 10050 HOUSTON OAKS DR

HOUSTON
United States of America (USA)
77064

More information about KILGORE INDUSTRIES, L.P.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KILGORE 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012014-01-01
0012013-01-01KENNETH F. KILGORE JR.
0012012-01-01KENNETH F. KILGORE, JR.
0012010-01-01KENNETH F. KILGORE, JR.

Plan Statistics for KILGORE 401(K) PLAN

401k plan membership statisitcs for KILGORE 401(K) PLAN

Measure Date Value
2014: KILGORE 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01330
Total number of active participants reported on line 7a of the Form 55002014-01-010
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-010
Number of participants with account balances2014-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: KILGORE 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01234
Total number of active participants reported on line 7a of the Form 55002013-01-01277
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0153
Total of all active and inactive participants2013-01-01330
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01330
Number of participants with account balances2013-01-0173
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: KILGORE 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01207
Total number of active participants reported on line 7a of the Form 55002012-01-01178
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0156
Total of all active and inactive participants2012-01-01234
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01234
Number of participants with account balances2012-01-0173
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2010: KILGORE 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01262
Total number of active participants reported on line 7a of the Form 55002010-01-01199
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-0164
Total of all active and inactive participants2010-01-01263
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-01263
Number of participants with account balances2010-01-0184
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010

Financial Data on KILGORE 401(K) PLAN

Measure Date Value
2014 : KILGORE 401(K) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-09-30$0
Total transfer of assets from this plan2014-09-30$722,742
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-09-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-09-30$0
Total income from all sources (including contributions)2014-09-30$67,334
Total loss/gain on sale of assets2014-09-30$0
Total of all expenses incurred2014-09-30$40
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-09-30$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-09-30$40,282
Value of total assets at end of year2014-09-30$0
Value of total assets at beginning of year2014-09-30$655,448
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-09-30$40
Total interest from all sources2014-09-30$936
Total dividends received (eg from common stock, registered investment company shares)2014-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-09-30No
Was this plan covered by a fidelity bond2014-09-30No
If this is an individual account plan, was there a blackout period2014-09-30Yes
Were there any nonexempt tranactions with any party-in-interest2014-09-30No
Contributions received from participants2014-09-30$40,282
Participant contributions at end of year2014-09-30$0
Participant contributions at beginning of year2014-09-30$25,549
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-09-30No
Value of net income/loss2014-09-30$67,294
Value of net assets at end of year (total assets less liabilities)2014-09-30$0
Value of net assets at beginning of year (total assets less liabilities)2014-09-30$655,448
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2014-09-30No
Were any leases to which the plan was party in default or uncollectible2014-09-30No
Value of interest in pooled separate accounts at end of year2014-09-30$0
Value of interest in pooled separate accounts at beginning of year2014-09-30$600,609
Interest on participant loans2014-09-30$936
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-09-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-09-30$29,290
Net investment gain/loss from pooled separate accounts2014-09-30$26,116
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-09-30No
Was there a failure to transmit to the plan any participant contributions2014-09-30Yes
Has the plan failed to provide any benefit when due under the plan2014-09-30No
Contract administrator fees2014-09-30$40
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-09-30Yes
Did the plan have assets held for investment2014-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-09-30Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-09-30Yes
Opinion of an independent qualified public accountant for this plan2014-09-30Disclaimer
Accountancy firm name2014-09-30MIDDLETONRAINESZAPATA,LLP
Accountancy firm EIN2014-09-30460597172
2013 : KILGORE 401(K) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total income from all sources (including contributions)2013-12-31$112,073
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$35,453
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$18,905
Value of total corrective distributions2013-12-31$16,472
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$54,224
Value of total assets at end of year2013-12-31$655,448
Value of total assets at beginning of year2013-12-31$578,828
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$76
Total interest from all sources2013-12-31$700
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31No
If this is an individual account plan, was there a blackout period2013-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$54,224
Participant contributions at end of year2013-12-31$25,549
Participant contributions at beginning of year2013-12-31$20,321
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$76,620
Value of net assets at end of year (total assets less liabilities)2013-12-31$655,448
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$578,828
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in pooled separate accounts at end of year2013-12-31$600,609
Value of interest in pooled separate accounts at beginning of year2013-12-31$537,816
Interest on participant loans2013-12-31$700
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$29,290
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$20,691
Net investment gain/loss from pooled separate accounts2013-12-31$57,149
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31Yes
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$18,905
Contract administrator fees2013-12-31$76
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31MIDDLETONRAINESZAPATA,LLP
Accountancy firm EIN2013-12-31460597172
2012 : KILGORE 401(K) 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$0
Total income from all sources (including contributions)2012-12-31$117,213
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$72,297
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$72,201
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$64,285
Value of total assets at end of year2012-12-31$578,828
Value of total assets at beginning of year2012-12-31$533,912
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$96
Total interest from all sources2012-12-31$1,655
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 bond2012-12-31No
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
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$64,285
Participant contributions at end of year2012-12-31$20,321
Participant contributions at beginning of year2012-12-31$32,572
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$44,916
Value of net assets at end of year (total assets less liabilities)2012-12-31$578,828
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$533,912
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
Investment advisory and management fees2012-12-31$96
Value of interest in pooled separate accounts at end of year2012-12-31$537,816
Value of interest in pooled separate accounts at beginning of year2012-12-31$492,843
Interest on participant loans2012-12-31$1,655
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$20,691
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$8,497
Net investment gain/loss from pooled separate accounts2012-12-31$51,273
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 contributions2012-12-31Yes
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$72,201
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 name2012-12-31MIDDLETONRAINESZAPATA LLP
Accountancy firm EIN2012-12-31460597172
2010 : KILGORE 401(K) PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total income from all sources (including contributions)2010-12-31$184,035
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$81,586
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$81,522
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$107,150
Value of total assets at end of year2010-12-31$515,581
Value of total assets at beginning of year2010-12-31$413,132
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$64
Total interest from all sources2010-12-31$807
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$57,973
Participant contributions at end of year2010-12-31$31,695
Participant contributions at beginning of year2010-12-31$24,096
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$49,177
Other income not declared elsewhere2010-12-31$378
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$102,449
Value of net assets at end of year (total assets less liabilities)2010-12-31$515,581
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$413,132
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Investment advisory and management fees2010-12-31$64
Value of interest in pooled separate accounts at end of year2010-12-31$475,636
Value of interest in pooled separate accounts at beginning of year2010-12-31$367,299
Interest on participant loans2010-12-31$807
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$8,250
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$21,737
Net investment gain/loss from pooled separate accounts2010-12-31$75,700
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$81,522
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31TREVANTHAN, CPA, PLLC
Accountancy firm EIN2010-12-31204454747

Form 5500 Responses for KILGORE 401(K) PLAN

2014: KILGORE 401(K) 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 filingYes
2014-01-01This return/report is a short plan year return/report (less than 12 months)Yes
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: KILGORE 401(K) 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: KILGORE 401(K) 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
2010: KILGORE 401(K) PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedYes
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-802964
Policy instance 1
Insurance contract or identification numberGA-802964
Number of Individuals Covered0
Insurance policy start date2014-01-01
Insurance policy end date2014-09-30
Total amount of commissions paid to insurance brokerUSD $2,365
Total amount of fees paid to insurance companyUSD $236
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?Yes
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 $2,365
Insurance broker organization code?3
Amount paid for insurance broker fees236
Additional information about fees paid to insurance brokerADMINISTRATION
Insurance broker nameLOREN D STARK COMPANY
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-802964
Policy instance 1
Insurance contract or identification numberGA-802964
Number of Individuals Covered74
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2,845
Total amount of fees paid to insurance companyUSD $285
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?Yes
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 $2,845
Insurance broker organization code?3
Amount paid for insurance broker fees285
Additional information about fees paid to insurance brokerADMINISTRATION
Insurance broker nameLOREN D STARK COMPANY
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-802964
Policy instance 1
Insurance contract or identification numberGA-802964
Number of Individuals Covered74
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $2,589
Total amount of fees paid to insurance companyUSD $259
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?Yes
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 $2,589
Insurance broker organization code?3
Amount paid for insurance broker fees259
Additional information about fees paid to insurance brokerADMINITRATION
Insurance broker nameLOREN D STARK COMPANY
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-802964
Policy instance 1
Insurance contract or identification numberGA-802964
Number of Individuals Covered84
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $2,010
Total amount of fees paid to insurance companyUSD $201
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

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