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SIEMENS ENERGY, INC. SAVINGS PLAN 401k Plan overview

Plan NameSIEMENS ENERGY, INC. SAVINGS PLAN
Plan identification number 021

SIEMENS ENERGY, INC. SAVINGS PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • 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.
  • Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of 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.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • Plan sponsor(s) received services of leased employees, as defined in Code section 414(n), during the plan year.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

SIEMENS ENERGY, INC. has sponsored the creation of one or more 401k plans.

Company Name:SIEMENS ENERGY, INC.
Employer identification number (EIN):133987280
NAIC Classification:221100

Additional information about SIEMENS ENERGY, INC.

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 2819892

More information about SIEMENS ENERGY, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SIEMENS ENERGY, INC. SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0212022-01-01
0212021-01-01
0212021-01-01
0212020-09-28
0212020-09-28

Plan Statistics for SIEMENS ENERGY, INC. SAVINGS PLAN

401k plan membership statisitcs for SIEMENS ENERGY, INC. SAVINGS PLAN

Measure Date Value
2022: SIEMENS ENERGY, INC. SAVINGS PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0113,643
Total number of active participants reported on line 7a of the Form 55002022-01-019,777
Number of retired or separated participants receiving benefits2022-01-01122
Number of other retired or separated participants entitled to future benefits2022-01-013,845
Total of all active and inactive participants2022-01-0113,744
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-01224
Total participants2022-01-0113,968
Number of participants with account balances2022-01-0113,426
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-01318
2021: SIEMENS ENERGY, INC. SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0113,874
Total number of active participants reported on line 7a of the Form 55002021-01-019,342
Number of retired or separated participants receiving benefits2021-01-0171
Number of other retired or separated participants entitled to future benefits2021-01-013,711
Total of all active and inactive participants2021-01-0113,124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-01229
Total participants2021-01-0113,353
Number of participants with account balances2021-01-0113,311
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-01301
2020: SIEMENS ENERGY, INC. SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year2020-09-2810,425
Total number of active participants reported on line 7a of the Form 55002020-09-2810,063
Number of retired or separated participants receiving benefits2020-09-2855
Number of other retired or separated participants entitled to future benefits2020-09-283,560
Total of all active and inactive participants2020-09-2813,678
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-09-28196
Total participants2020-09-2813,874
Number of participants with account balances2020-09-2813,844
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-09-2840

Financial Data on SIEMENS ENERGY, INC. SAVINGS PLAN

Measure Date Value
2022 : SIEMENS ENERGY, INC. SAVINGS PLAN 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2022-12-31$-98,806,369
Total unrealized appreciation/depreciation of assets2022-12-31$-98,806,369
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$5,251,629
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$7,387,569
Total income from all sources (including contributions)2022-12-31$-341,176,830
Total loss/gain on sale of assets2022-12-31$-7,409,818
Total of all expenses incurred2022-12-31$264,855,748
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$256,875,082
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$204,714,520
Value of total assets at end of year2022-12-31$3,109,363,137
Value of total assets at beginning of year2022-12-31$3,717,531,655
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$7,980,666
Total interest from all sources2022-12-31$12,356,574
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$7,029,269
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$2,611,696
Administrative expenses professional fees incurred2022-12-31$2,087,967
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$10,000,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$118,697,638
Participant contributions at end of year2022-12-31$31,251,317
Participant contributions at beginning of year2022-12-31$31,232,196
Assets. Other investments not covered elsewhere at end of year2022-12-31$1,099,139,924
Assets. Other investments not covered elsewhere at beginning of year2022-12-31$1,356,837,125
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$6,839,455
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$1,550,084
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$1,057,913
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$5,041,422
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$4,743,011
Total non interest bearing cash at end of year2022-12-31$1,395,791
Total non interest bearing cash at beginning of year2022-12-31$1,005,529
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-606,032,578
Value of net assets at end of year (total assets less liabilities)2022-12-31$3,104,111,508
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$3,710,144,086
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Investment advisory and management fees2022-12-31$5,892,699
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$72,615,971
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$121,783,176
Interest on participant loans2022-12-31$1,113,243
Interest earned on other investments2022-12-31$9,747,909
Income. Interest from US Government securities2022-12-31$2,947
Income. Interest from corporate debt instruments2022-12-31$1,491,824
Value of interest in common/collective trusts at end of year2022-12-31$1,148,013,860
Value of interest in common/collective trusts at beginning of year2022-12-31$1,451,596,543
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$651
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$478,224,910
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$431,356,726
Asset value of US Government securities at end of year2022-12-31$1,477,218
Asset value of US Government securities at beginning of year2022-12-31$146,724
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-12,367,620
Net investment gain or loss from common/collective trusts2022-12-31$-446,693,386
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$79,177,427
Employer contributions (assets) at end of year2022-12-31$16,390,846
Employer contributions (assets) at beginning of year2022-12-31$16,809,456
Income. Dividends from common stock2022-12-31$4,417,573
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$256,875,082
Asset. Corporate debt instrument preferred debt at end of year2022-12-31$24,325,075
Asset. Corporate debt instrument preferred debt at beginning of year2022-12-31$27,408,722
Assets. Corporate common stocks other than exployer securities at end of year2022-12-31$234,978,141
Assets. Corporate common stocks other than exployer securities at beginning of year2022-12-31$278,297,545
Liabilities. Value of benefit claims payable at end of year2022-12-31$210,207
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$2,644,558
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Aggregate proceeds on sale of assets2022-12-31$72,993,500
Aggregate carrying amount (costs) on sale of assets2022-12-31$80,403,318
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31DOPKINS AND COMPANY LLP
Accountancy firm EIN2022-12-31160929175
2021 : SIEMENS ENERGY, INC. SAVINGS PLAN 2021 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2021-12-31$129,355,811
Total unrealized appreciation/depreciation of assets2021-12-31$129,355,811
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$7,387,569
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$3,329,819
Total income from all sources (including contributions)2021-12-31$666,509,646
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$304,580,659
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$294,502,241
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$207,833,260
Value of total assets at end of year2021-12-31$3,717,531,655
Value of total assets at beginning of year2021-12-31$3,351,544,918
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$10,078,418
Total interest from all sources2021-12-31$11,104,573
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$8,056,558
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$3,528,110
Administrative expenses professional fees incurred2021-12-31$1,255,980
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$10,000,000
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$118,088,458
Participant contributions at end of year2021-12-31$31,232,196
Participant contributions at beginning of year2021-12-31$35,275,442
Participant contributions at end of year2021-12-31$0
Participant contributions at beginning of year2021-12-31$2,931,243
Assets. Other investments not covered elsewhere at end of year2021-12-31$1,356,837,125
Assets. Other investments not covered elsewhere at beginning of year2021-12-31$1,244,887,985
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$1,057,913
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$2,738,258
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$4,743,011
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$1,524,269
Total non interest bearing cash at end of year2021-12-31$1,005,529
Total non interest bearing cash at beginning of year2021-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Income. Non cash contributions2021-12-31$11,113,928
Value of net income/loss2021-12-31$361,928,987
Value of net assets at end of year (total assets less liabilities)2021-12-31$3,710,144,086
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$3,348,215,099
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
Investment advisory and management fees2021-12-31$8,822,438
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$121,783,176
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$121,939,128
Interest on participant loans2021-12-31$1,371,704
Interest earned on other investments2021-12-31$8,270,203
Income. Interest from US Government securities2021-12-31$900
Income. Interest from corporate debt instruments2021-12-31$1,461,766
Value of interest in common/collective trusts at end of year2021-12-31$1,451,596,543
Value of interest in common/collective trusts at beginning of year2021-12-31$1,196,647,144
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$431,356,726
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$467,112,262
Asset value of US Government securities at end of year2021-12-31$146,724
Asset value of US Government securities at beginning of year2021-12-31$114,104
Net investment gain or loss from common/collective trusts2021-12-31$310,159,444
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 contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$78,630,874
Employer contributions (assets) at end of year2021-12-31$16,809,456
Employer contributions (assets) at beginning of year2021-12-31$18,942,910
Income. Dividends from common stock2021-12-31$4,528,448
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$294,502,241
Asset. Corporate debt instrument preferred debt at end of year2021-12-31$27,408,722
Asset. Corporate debt instrument preferred debt at beginning of year2021-12-31$27,532,670
Assets. Corporate common stocks other than exployer securities at end of year2021-12-31$278,297,545
Assets. Corporate common stocks other than exployer securities at beginning of year2021-12-31$233,423,772
Liabilities. Value of benefit claims payable at end of year2021-12-31$2,644,558
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$1,805,550
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 plan2021-12-31Unqualified
Accountancy firm name2021-12-31DOPKINS AND COMPANY LLP
Accountancy firm EIN2021-12-31160929175
2020 : SIEMENS ENERGY, INC. SAVINGS PLAN 2020 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2020-12-31$72,784,344
Total unrealized appreciation/depreciation of assets2020-12-31$72,784,344
Total transfer of assets to this plan2020-12-31$3,017,553,009
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$3,329,819
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$385,837,065
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$55,174,975
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$53,673,874
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$74,936,134
Value of total assets at end of year2020-12-31$3,351,544,918
Value of total assets at beginning of year2020-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$1,501,101
Total interest from all sources2020-12-31$3,387,567
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$1,635,918
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$1,635,918
Administrative expenses professional fees incurred2020-12-31$124,489
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$10,000,000
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$34,995,645
Participant contributions at end of year2020-12-31$35,275,442
Participant contributions at beginning of year2020-12-31$0
Participant contributions at end of year2020-12-31$2,931,243
Participant contributions at beginning of year2020-12-31$0
Assets. Other investments not covered elsewhere at end of year2020-12-31$1,244,887,985
Assets. Other investments not covered elsewhere at beginning of year2020-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$3,031,117
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$2,738,258
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$1,524,269
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$330,662,090
Value of net assets at end of year (total assets less liabilities)2020-12-31$3,348,215,099
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$0
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
Investment advisory and management fees2020-12-31$1,376,612
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$121,939,128
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$0
Interest on participant loans2020-12-31$387,494
Interest earned on other investments2020-12-31$2,630,169
Income. Interest from US Government securities2020-12-31$2,253
Income. Interest from corporate debt instruments2020-12-31$367,651
Value of interest in common/collective trusts at end of year2020-12-31$1,196,647,144
Value of interest in common/collective trusts at beginning of year2020-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$467,112,262
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$0
Asset value of US Government securities at end of year2020-12-31$114,104
Asset value of US Government securities at beginning of year2020-12-31$0
Net investment gain or loss from common/collective trusts2020-12-31$233,093,102
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 contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$36,909,372
Employer contributions (assets) at end of year2020-12-31$18,942,910
Employer contributions (assets) at beginning of year2020-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$53,673,874
Asset. Corporate debt instrument preferred debt at end of year2020-12-31$27,532,670
Asset. Corporate debt instrument preferred debt at beginning of year2020-12-31$0
Assets. Corporate common stocks other than exployer securities at end of year2020-12-31$233,423,772
Assets. Corporate common stocks other than exployer securities at beginning of year2020-12-31$0
Liabilities. Value of benefit claims payable at end of year2020-12-31$1,805,550
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$0
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 name2020-12-31ERNST & YOUNG LLP
Accountancy firm EIN2020-12-31346565596

Form 5500 Responses for SIEMENS ENERGY, INC. SAVINGS PLAN

2022: SIEMENS ENERGY, INC. SAVINGS PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: SIEMENS ENERGY, INC. SAVINGS PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: SIEMENS ENERGY, INC. SAVINGS PLAN 2020 form 5500 responses
2020-09-28Type of plan entitySingle employer plan
2020-09-28First time form 5500 has been submittedYes
2020-09-28Submission has been amendedNo
2020-09-28This submission is the final filingNo
2020-09-28This return/report is a short plan year return/report (less than 12 months)Yes
2020-09-28Plan is a collectively bargained planNo
2020-09-28Plan funding arrangement – InsuranceYes
2020-09-28Plan funding arrangement – TrustYes
2020-09-28Plan benefit arrangement – InsuranceYes
2020-09-28Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number60516
Policy instance 6
Insurance contract or identification number60516
Number of Individuals Covered0
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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?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
STATE STREET BANK & TRUST COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number200005
Policy instance 5
Insurance contract or identification number200005
Number of Individuals Covered0
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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?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
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract numberFDA00052TR
Policy instance 4
Insurance contract or identification numberFDA00052TR
Number of Individuals Covered0
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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?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
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberGA-64289
Policy instance 3
Insurance contract or identification numberGA-64289
Number of Individuals Covered0
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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?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
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract numberG-27844.01.0001
Policy instance 2
Insurance contract or identification numberG-27844.01.0001
Number of Individuals Covered0
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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?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
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberINV_SME_IP_1020
Policy instance 1
Insurance contract or identification numberINV_SME_IP_1020
Number of Individuals Covered0
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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?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
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number60516
Policy instance 6
Insurance contract or identification number60516
Number of Individuals Covered0
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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?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
STATE STREET BANK & TRUST COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number200005
Policy instance 5
Insurance contract or identification number200005
Number of Individuals Covered0
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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?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
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract numberFDA00052TR
Policy instance 4
Insurance contract or identification numberFDA00052TR
Number of Individuals Covered0
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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?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
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberGA-64289
Policy instance 3
Insurance contract or identification numberGA-64289
Number of Individuals Covered0
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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?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
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract numberG-27844.01.0001
Policy instance 2
Insurance contract or identification numberG-27844.01.0001
Number of Individuals Covered0
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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?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
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberINV_SME_IP_1020
Policy instance 1
Insurance contract or identification numberINV_SME_IP_1020
Number of Individuals Covered0
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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?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
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number60516
Policy instance 6
Insurance contract or identification number60516
Number of Individuals Covered0
Insurance policy start date2020-09-28
Insurance policy end date2020-12-31
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?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
STATE STREET BANK & TRUST COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number200005
Policy instance 5
Insurance contract or identification number200005
Number of Individuals Covered0
Insurance policy start date2020-09-28
Insurance policy end date2020-12-31
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?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
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract numberFDA00052TR
Policy instance 4
Insurance contract or identification numberFDA00052TR
Number of Individuals Covered0
Insurance policy start date2020-09-28
Insurance policy end date2020-12-31
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?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
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberGA-64289
Policy instance 3
Insurance contract or identification numberGA-64289
Number of Individuals Covered0
Insurance policy start date2020-09-28
Insurance policy end date2020-12-31
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?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
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract numberG-27844.01.0001
Policy instance 2
Insurance contract or identification numberG-27844.01.0001
Number of Individuals Covered0
Insurance policy start date2020-09-28
Insurance policy end date2020-12-31
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?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
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberINV_SME_IP_1020
Policy instance 1
Insurance contract or identification numberINV_SME_IP_1020
Number of Individuals Covered0
Insurance policy start date2020-09-28
Insurance policy end date2020-12-31
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?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

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