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CHARTER OAK HEALTH CENTER PROFIT SHARING PLAN 401k Plan overview

Plan NameCHARTER OAK HEALTH CENTER PROFIT SHARING PLAN
Plan identification number 002

CHARTER OAK HEALTH CENTER PROFIT SHARING 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.
  • 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

CHARTER OAK HEALTH CENTER has sponsored the creation of one or more 401k plans.

Company Name:CHARTER OAK HEALTH CENTER
Employer identification number (EIN):060986747
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CHARTER OAK HEALTH CENTER PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022015-01-01NAVIN SANGOI NAVIN SANGOI2016-10-17
0022014-01-01NAVIN SANGOI NAVIN SANGOI2015-10-15
0022014-01-01NAVIN SANGOI NAVIN SANGOI2015-10-22
0022013-01-01NAVIN SANGOI NAVIN SANGOI2014-10-13
0022012-01-01NAVIN SANGOI2013-10-07 NAVIN SANGOI2013-10-07
0022011-01-01NAVIN SANGOI2012-09-24 NAVIN SANGOI2012-09-24
0022010-01-01THOMAS MORRISON2011-05-16 THOMAS MORRISON2011-05-16

Plan Statistics for CHARTER OAK HEALTH CENTER PROFIT SHARING PLAN

401k plan membership statisitcs for CHARTER OAK HEALTH CENTER PROFIT SHARING PLAN

Measure Date Value
2015: CHARTER OAK HEALTH CENTER PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01155
Total number of active participants reported on line 7a of the Form 55002015-01-010
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-010
Number of participants with account balances2015-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: CHARTER OAK HEALTH CENTER PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01165
Total number of active participants reported on line 7a of the Form 55002014-01-01114
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0121
Total of all active and inactive participants2014-01-01135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01135
Number of participants with account balances2014-01-01115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-0112
2013: CHARTER OAK HEALTH CENTER PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01125
Total number of active participants reported on line 7a of the Form 55002013-01-01128
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0112
Total of all active and inactive participants2013-01-01140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01140
Number of participants with account balances2013-01-0178
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-013

Financial Data on CHARTER OAK HEALTH CENTER PROFIT SHARING PLAN

Measure Date Value
2015 : CHARTER OAK HEALTH CENTER PROFIT SHARING PLAN 2015 401k financial data
Unrealized appreciation/depreciation of real estate assets2015-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2015-12-31$0
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total transfer of assets to this plan2015-12-31$0
Total transfer of assets from this plan2015-12-31$729,215
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$9,289
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$98,221
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$96,949
Value of total corrective distributions2015-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$1,961
Value of total assets at end of year2015-12-31$0
Value of total assets at beginning of year2015-12-31$818,147
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$1,272
Total income from rents2015-12-31$0
Total interest from all sources2015-12-31$7,383
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$2,969
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$2,969
Administrative expenses professional fees incurred2015-12-31$0
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Amount of non-exempt transactions with any party-in-interest2015-12-31$0
Contributions received from participants2015-12-31$0
Participant contributions at end of year2015-12-31$0
Participant contributions at beginning of year2015-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2015-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$0
Other income not declared elsewhere2015-12-31$234
Administrative expenses (other) incurred2015-12-31$0
Liabilities. Value of operating payables at beginning of year2015-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-88,932
Value of net assets at end of year (total assets less liabilities)2015-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$818,147
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2015-12-31$0
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2015-12-31$0
Investment advisory and management fees2015-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$282,141
Income. Interest from loans (other than to participants)2015-12-31$0
Interest earned on other investments2015-12-31$7,383
Income. Interest from US Government securities2015-12-31$0
Income. Interest from corporate debt instruments2015-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$536,006
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-3,258
Net investment gain/loss from pooled separate accounts2015-12-31$0
Net investment gain or loss from common/collective trusts2015-12-31$0
Net gain/loss from 103.12 investment entities2015-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$1,961
Employer contributions (assets) at end of year2015-12-31$0
Employer contributions (assets) at beginning of year2015-12-31$0
Income. Dividends from preferred stock2015-12-31$0
Income. Dividends from common stock2015-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$96,949
Contract administrator fees2015-12-31$1,272
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$0
Did the plan have assets held for investment2015-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31Yes
Aggregate proceeds on sale of assets2015-12-31$0
Aggregate carrying amount (costs) on sale of assets2015-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2015-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31COHNREZNICK LLP
Accountancy firm EIN2015-12-31221478099
2014 : CHARTER OAK HEALTH CENTER PROFIT SHARING PLAN 2014 401k financial data
Unrealized appreciation/depreciation of real estate assets2014-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2014-12-31$0
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total transfer of assets to this plan2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$29,345
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$96,226
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$94,215
Value of total corrective distributions2014-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$0
Value of total assets at end of year2014-12-31$818,147
Value of total assets at beginning of year2014-12-31$885,028
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$2,011
Total income from rents2014-12-31$0
Total interest from all sources2014-12-31$11,991
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$1,472
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2014-12-31$1,472
Administrative expenses professional fees incurred2014-12-31$0
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$75,000
If this is an individual account plan, was there a blackout period2014-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Amount of non-exempt transactions with any party-in-interest2014-12-31$0
Contributions received from participants2014-12-31$0
Participant contributions at end of year2014-12-31$0
Participant contributions at beginning of year2014-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2014-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-12-31$0
Other income not declared elsewhere2014-12-31$0
Administrative expenses (other) incurred2014-12-31$0
Liabilities. Value of operating payables at beginning of year2014-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-66,881
Value of net assets at end of year (total assets less liabilities)2014-12-31$818,147
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$885,028
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2014-12-31$0
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2014-12-31$0
Investment advisory and management fees2014-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$282,141
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$238,426
Income. Interest from loans (other than to participants)2014-12-31$0
Interest earned on other investments2014-12-31$11,991
Income. Interest from US Government securities2014-12-31$0
Income. Interest from corporate debt instruments2014-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$536,006
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$646,602
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$15,882
Net investment gain/loss from pooled separate accounts2014-12-31$0
Net investment gain or loss from common/collective trusts2014-12-31$0
Net gain/loss from 103.12 investment entities2014-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$0
Employer contributions (assets) at end of year2014-12-31$0
Employer contributions (assets) at beginning of year2014-12-31$0
Income. Dividends from preferred stock2014-12-31$0
Income. Dividends from common stock2014-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$94,215
Contract administrator fees2014-12-31$2,011
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$0
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Aggregate proceeds on sale of assets2014-12-31$0
Aggregate carrying amount (costs) on sale of assets2014-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2014-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31COHNREZNICK LLP
Accountancy firm EIN2014-12-31221478099
2013 : CHARTER OAK HEALTH CENTER PROFIT SHARING PLAN 2013 401k financial data
Unrealized appreciation/depreciation of real estate assets2013-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2013-12-31$0
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total transfer of assets to this plan2013-12-31$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$68,634
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$56,212
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$55,188
Value of total corrective distributions2013-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$0
Value of total assets at end of year2013-12-31$885,028
Value of total assets at beginning of year2013-12-31$872,606
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$1,024
Total income from rents2013-12-31$0
Total interest from all sources2013-12-31$15,529
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$1,350
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$1,350
Administrative expenses professional fees incurred2013-12-31$0
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$50,000
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
Amount of non-exempt transactions with any party-in-interest2013-12-31$0
Contributions received from participants2013-12-31$0
Participant contributions at end of year2013-12-31$0
Participant contributions at beginning of year2013-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$0
Other income not declared elsewhere2013-12-31$0
Administrative expenses (other) incurred2013-12-31$0
Liabilities. Value of operating payables at beginning of year2013-12-31$0
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$12,422
Value of net assets at end of year (total assets less liabilities)2013-12-31$885,028
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$872,606
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
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2013-12-31$0
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2013-12-31$0
Investment advisory and management fees2013-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$238,426
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$170,936
Income. Interest from loans (other than to participants)2013-12-31$0
Interest earned on other investments2013-12-31$15,529
Income. Interest from US Government securities2013-12-31$0
Income. Interest from corporate debt instruments2013-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$646,602
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$701,670
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$51,755
Net investment gain/loss from pooled separate accounts2013-12-31$0
Net investment gain or loss from common/collective trusts2013-12-31$0
Net gain/loss from 103.12 investment entities2013-12-31$0
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 contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$0
Employer contributions (assets) at end of year2013-12-31$0
Employer contributions (assets) at beginning of year2013-12-31$0
Income. Dividends from preferred stock2013-12-31$0
Income. Dividends from common stock2013-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$55,188
Contract administrator fees2013-12-31$1,024
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$0
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
Aggregate proceeds on sale of assets2013-12-31$0
Aggregate carrying amount (costs) on sale of assets2013-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2013-12-31$0
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 name2013-12-31SASLOW LUFKIN & BUGGY, LLP
Accountancy firm EIN2013-12-31061533253

Form 5500 Responses for CHARTER OAK HEALTH CENTER PROFIT SHARING PLAN

2015: CHARTER OAK HEALTH CENTER PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01This submission is the final filingYes
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: CHARTER OAK HEALTH CENTER PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedYes
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: CHARTER OAK HEALTH CENTER PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedYes
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

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number441462
Policy instance 1
Insurance contract or identification number441462
Number of Individuals Covered0
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number441462
Policy instance 1
Insurance contract or identification number441462
Number of Individuals Covered135
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $70
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
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 fees70
Additional information about fees paid to insurance brokerPRORATED INCENTIVE, NOT DEDUCTED FROM PLAN
Insurance broker organization code?3
Insurance broker nameMORGAN STANLEY DW INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number441462
Policy instance 1
Insurance contract or identification number441462
Number of Individuals Covered140
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $101
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
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 fees101
Additional information about fees paid to insurance brokerPRORATED INCENTIVE, NOT DEDUCTED FROM PLAN
Insurance broker organization code?3
Insurance broker nameMORGAN STANLEY DW INC

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