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AMERICAN INDUSTRIES, INC. 401(K) PLAN 401k Plan overview

Plan NameAMERICAN INDUSTRIES, INC. 401(K) PLAN
Plan identification number 001

AMERICAN INDUSTRIES, INC. 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.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

AMERICAN INDUSTRIES, INC. has sponsored the creation of one or more 401k plans.

Company Name:AMERICAN INDUSTRIES, INC.
Employer identification number (EIN):061476849
NAIC Classification:237310
NAIC Description:Highway, Street, and Bridge Construction

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AMERICAN INDUSTRIES, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01JON VERCELLONE2023-08-16
0012021-01-01JON VERCELLONE2022-11-03
0012020-01-01
0012020-01-01JON VERCELLONE2022-11-03
0012019-01-01
0012019-01-01
0012018-01-01
0012018-01-01
0012017-01-01JON VERCELLONE2018-10-01
0012016-01-01JON VERCELLONE2017-10-12
0012015-01-01JON VERCELLONE2016-10-11
0012014-01-01JVERCELLONE2015-10-12
0012013-01-01JON VERCELLONE2014-10-15
0012011-01-01JON VERCELLONE2012-10-08
0012010-01-01LISA SWIFT2011-09-13

Plan Statistics for AMERICAN INDUSTRIES, INC. 401(K) PLAN

401k plan membership statisitcs for AMERICAN INDUSTRIES, INC. 401(K) PLAN

Measure Date Value
2020: AMERICAN INDUSTRIES, INC. 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01105
Total number of active participants reported on line 7a of the Form 55002020-01-0132
Number of retired or separated participants receiving benefits2020-01-0167
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-0199
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-0199
Number of participants with account balances2020-01-0178
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-0164
2019: AMERICAN INDUSTRIES, INC. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01192
Total number of active participants reported on line 7a of the Form 55002019-01-0161
Number of retired or separated participants receiving benefits2019-01-0111
Number of other retired or separated participants entitled to future benefits2019-01-0133
Total of all active and inactive participants2019-01-01105
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01105
Number of participants with account balances2019-01-0160
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-0143
2018: AMERICAN INDUSTRIES, INC. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01144
Total number of active participants reported on line 7a of the Form 55002018-01-01180
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0112
Total of all active and inactive participants2018-01-01192
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01192
Number of participants with account balances2018-01-0174
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010

Financial Data on AMERICAN INDUSTRIES, INC. 401(K) PLAN

Measure Date Value
2021 : AMERICAN INDUSTRIES, INC. 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$1,706,769
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$592,785
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$574,388
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$1,161,061
Value of total assets at end of year2021-12-31$4,087,667
Value of total assets at beginning of year2021-12-31$2,973,683
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$18,397
Total interest from all sources2021-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$297,368
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$154,675
Other income not declared elsewhere2021-12-31$71
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$1,113,984
Value of net assets at end of year (total assets less liabilities)2021-12-31$4,087,667
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$2,973,683
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in pooled separate accounts at end of year2021-12-31$41,815
Value of interest in pooled separate accounts at beginning of year2021-12-31$16,477
Value of interest in common/collective trusts at end of year2021-12-31$4,037,779
Value of interest in common/collective trusts at beginning of year2021-12-31$2,957,206
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$8,073
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$0
Net investment gain/loss from pooled separate accounts2021-12-31$25,044
Net investment gain or loss from common/collective trusts2021-12-31$520,593
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31Yes
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$1,006,386
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$574,388
Contract administrator fees2021-12-31$18,397
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Disclaimer
Accountancy firm name2021-12-31TEMPLETON & COMPANY, LLP
Accountancy firm EIN2021-12-31141918990
2020 : AMERICAN INDUSTRIES, INC. 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$1,279,396
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$1,292,078
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$1,277,281
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$885,213
Value of total assets at end of year2020-12-31$2,973,683
Value of total assets at beginning of year2020-12-31$2,986,365
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$14,797
Total interest from all sources2020-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$298,637
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$77,483
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$-12,682
Value of net assets at end of year (total assets less liabilities)2020-12-31$2,973,683
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$2,986,365
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in pooled separate accounts at end of year2020-12-31$16,477
Value of interest in pooled separate accounts at beginning of year2020-12-31$0
Value of interest in common/collective trusts at end of year2020-12-31$2,957,206
Value of interest in common/collective trusts at beginning of year2020-12-31$2,745,421
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$394,183
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31Yes
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$807,730
Employer contributions (assets) at end of year2020-12-31$0
Employer contributions (assets) at beginning of year2020-12-31$240,944
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$1,277,281
Contract administrator fees2020-12-31$14,797
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31TEMPLETON & COMPANY, LLP
Accountancy firm EIN2020-12-31141918990
2019 : AMERICAN INDUSTRIES, INC. 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$2,999
Total income from all sources (including contributions)2019-12-31$1,307,063
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$654,741
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$641,074
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$799,750
Value of total assets at end of year2019-12-31$2,986,365
Value of total assets at beginning of year2019-12-31$2,337,042
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$13,667
Total interest from all sources2019-12-31$7,256
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$7,736
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$7,736
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$200,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$104,510
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$2,999
Total non interest bearing cash at end of year2019-12-31$0
Total non interest bearing cash at beginning of year2019-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$652,322
Value of net assets at end of year (total assets less liabilities)2019-12-31$2,986,365
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$2,334,043
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$428,122
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$220,940
Interest earned on other investments2019-12-31$7,256
Value of interest in common/collective trusts at end of year2019-12-31$2,260,516
Value of interest in common/collective trusts at beginning of year2019-12-31$2,116,102
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$56,783
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$492,321
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31Yes
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$695,240
Employer contributions (assets) at end of year2019-12-31$240,944
Employer contributions (assets) at beginning of year2019-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$641,074
Contract administrator fees2019-12-31$13,667
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31MARCUM, LLP
Accountancy firm EIN2019-12-31111986323
2018 : AMERICAN INDUSTRIES, INC. 401(K) PLAN 2018 401k financial data
Unrealized appreciation/depreciation of real estate assets2018-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2018-12-31$0
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total transfer of assets to this plan2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$1,033,431
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$721,200
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$709,164
Value of total corrective distributions2018-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$1,221,788
Value of total assets at end of year2018-12-31$2,337,042
Value of total assets at beginning of year2018-12-31$2,024,811
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$12,036
Total income from rents2018-12-31$0
Total interest from all sources2018-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$0
Administrative expenses professional fees incurred2018-12-31$0
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$250,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$86,409
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$2,999
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$0
Other income not declared elsewhere2018-12-31$0
Administrative expenses (other) incurred2018-12-31$0
Total non interest bearing cash at end of year2018-12-31$0
Total non interest bearing cash at beginning of year2018-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$312,231
Value of net assets at end of year (total assets less liabilities)2018-12-31$2,337,042
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$2,024,811
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Investment advisory and management fees2018-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$2,337,042
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$2,024,811
Income. Interest from loans (other than to participants)2018-12-31$0
Interest earned on other investments2018-12-31$0
Income. Interest from US Government securities2018-12-31$0
Income. Interest from corporate debt instruments2018-12-31$0
Value of interest in common/collective trusts at end of year2018-12-31$2,116,102
Value of interest in common/collective trusts at beginning of year2018-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-188,357
Net investment gain/loss from pooled separate accounts2018-12-31$0
Net investment gain or loss from common/collective trusts2018-12-31$0
Net gain/loss from 103.12 investment entities2018-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$1,135,379
Income. Dividends from preferred stock2018-12-31$0
Income. Dividends from common stock2018-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$709,164
Contract administrator fees2018-12-31$12,036
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31No
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Aggregate proceeds on sale of assets2018-12-31$0
Aggregate carrying amount (costs) on sale of assets2018-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31MARCUM, LLP
Accountancy firm EIN2018-12-31111986323

Form 5500 Responses for AMERICAN INDUSTRIES, INC. 401(K) PLAN

2020: AMERICAN INDUSTRIES, INC. 401(K) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
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 funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: AMERICAN INDUSTRIES, INC. 401(K) PLAN 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 funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: AMERICAN INDUSTRIES, INC. 401(K) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 1
Insurance contract or identification number613953
Number of Individuals Covered78
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $5
Total amount of fees paid to insurance companyUSD $1
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSIONS
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number625338
Policy instance 2
Insurance contract or identification number625338
Number of Individuals Covered78
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $54
Total amount of fees paid to insurance companyUSD $11
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?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 $54
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSIONS
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 1
Insurance contract or identification number613953
Number of Individuals Covered60
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $107
Total amount of fees paid to insurance companyUSD $21
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $107
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number625338
Policy instance 2
Insurance contract or identification number625338
Number of Individuals Covered60
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $17
Total amount of fees paid to insurance companyUSD $3
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?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 $17
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 1
Insurance contract or identification number613953
Number of Individuals Covered65
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $30
Total amount of fees paid to insurance companyUSD $6
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number625338
Policy instance 2
Insurance contract or identification number625338
Number of Individuals Covered65
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?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
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 1
Insurance contract or identification number613953
Number of Individuals Covered76
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number625338
Policy instance 2
Insurance contract or identification number625338
Number of Individuals Covered76
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?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

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