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ADVANTAGECARE PHYSICIANS, P. C. UNION 401(K) PLAN 401k Plan overview

Plan NameADVANTAGECARE PHYSICIANS, P. C. UNION 401(K) PLAN
Plan identification number 002

ADVANTAGECARE PHYSICIANS, P. C. UNION 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

LHHN MEDICAL, P.C. has sponsored the creation of one or more 401k plans.

Company Name:LHHN MEDICAL, P.C.
Employer identification number (EIN):134121055

Additional information about LHHN MEDICAL, P.C.

Jurisdiction of Incorporation: New York Department of State
Incorporation Date: 2000-01-07
Company Identification Number: 2458609
Legal Registered Office Address: 55 WATER ST
NEW YORK
NEW YORK
United States of America (USA)
10041

More information about LHHN MEDICAL, P.C.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ADVANTAGECARE PHYSICIANS, P. C. UNION 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022015-01-01MYRON SPEKTOR
0022014-01-01MARK MOYNIHAN
0022013-06-03MARK MOYNIHAN
0022010-01-01EMILE ONDRUS EMILE ONDRUS2011-10-05

Plan Statistics for ADVANTAGECARE PHYSICIANS, P. C. UNION 401(K) PLAN

401k plan membership statisitcs for ADVANTAGECARE PHYSICIANS, P. C. UNION 401(K) PLAN

Measure Date Value
2015: ADVANTAGECARE PHYSICIANS, P. C. UNION 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01994
Total number of active participants reported on line 7a of the Form 55002015-01-01868
Number of retired or separated participants receiving benefits2015-01-0119
Number of other retired or separated participants entitled to future benefits2015-01-01163
Total of all active and inactive participants2015-01-011,050
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-012
Total participants2015-01-011,052
Number of participants with account balances2015-01-01594
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: ADVANTAGECARE PHYSICIANS, P. C. UNION 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01964
Total number of active participants reported on line 7a of the Form 55002014-01-01808
Number of retired or separated participants receiving benefits2014-01-0113
Number of other retired or separated participants entitled to future benefits2014-01-01163
Total of all active and inactive participants2014-01-01984
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-012
Total participants2014-01-01986
Number of participants with account balances2014-01-01601
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: ADVANTAGECARE PHYSICIANS, P. C. UNION 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-06-0315
Total number of active participants reported on line 7a of the Form 55002013-06-03780
Number of retired or separated participants receiving benefits2013-06-0310
Number of other retired or separated participants entitled to future benefits2013-06-03171
Total of all active and inactive participants2013-06-03961
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-06-033
Total participants2013-06-03964
Number of participants with account balances2013-06-03584
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-06-030
2010: ADVANTAGECARE PHYSICIANS, P. C. UNION 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01162
Total number of active participants reported on line 7a of the Form 55002010-01-01115
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-0111
Total of all active and inactive participants2010-01-01126
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-01126
Number of participants with account balances2010-01-01126
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010

Financial Data on ADVANTAGECARE PHYSICIANS, P. C. UNION 401(K) PLAN

Measure Date Value
2015 : ADVANTAGECARE PHYSICIANS, P. C. UNION 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total transfer of assets to this plan2015-12-31$456,273
Total transfer of assets from this plan2015-12-31$65,867
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$992,207
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$518,001
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$500,001
Expenses. Certain deemed distributions of participant loans2015-12-31$6,344
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$974,464
Value of total assets at end of year2015-12-31$11,105,830
Value of total assets at beginning of year2015-12-31$10,241,218
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$11,656
Total interest from all sources2015-12-31$28,679
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$657,048
Participant contributions at end of year2015-12-31$700,732
Participant contributions at beginning of year2015-12-31$563,252
Participant contributions at end of year2015-12-31$14,844
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$41,857
Other income not declared elsewhere2015-12-31$-6,024
Administrative expenses (other) incurred2015-12-31$11,656
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$474,206
Value of net assets at end of year (total assets less liabilities)2015-12-31$11,105,830
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$10,241,218
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Interest on participant loans2015-12-31$28,679
Value of interest in master investment trust accounts at end of year2015-12-31$10,114,695
Value of interest in master investment trust accounts at beginning of year2015-12-31$9,441,153
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31Yes
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$275,559
Employer contributions (assets) at end of year2015-12-31$275,559
Employer contributions (assets) at beginning of year2015-12-31$236,813
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$500,001
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31BDO USA, LLP
Accountancy firm EIN2015-12-31135381590
2014 : ADVANTAGECARE PHYSICIANS, P. C. UNION 401(K) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total transfer of assets to this plan2014-12-31$58,582
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$1,493,408
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$530,978
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$517,129
Expenses. Certain deemed distributions of participant loans2014-12-31$3,321
Value of total corrective distributions2014-12-31$922
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$825,346
Value of total assets at end of year2014-12-31$10,241,218
Value of total assets at beginning of year2014-12-31$9,220,206
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$9,606
Total interest from all sources2014-12-31$25,223
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
If this is an individual account plan, was there a blackout period2014-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$588,533
Participant contributions at end of year2014-12-31$563,252
Participant contributions at beginning of year2014-12-31$485,660
Other income not declared elsewhere2014-12-31$1,949
Administrative expenses (other) incurred2014-12-31$9,606
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$962,430
Value of net assets at end of year (total assets less liabilities)2014-12-31$10,241,218
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$9,220,206
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Interest on participant loans2014-12-31$25,223
Value of interest in master investment trust accounts at end of year2014-12-31$9,441,153
Value of interest in master investment trust accounts at beginning of year2014-12-31$8,543,686
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31Yes
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$236,813
Employer contributions (assets) at end of year2014-12-31$236,813
Employer contributions (assets) at beginning of year2014-12-31$190,860
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$517,129
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31BDO USA, LLP
Accountancy firm EIN2014-12-31135381590
2013 : ADVANTAGECARE PHYSICIANS, P. C. UNION 401(K) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total transfer of assets to this plan2013-12-31$8,374,390
Total transfer of assets from this plan2013-12-31$2,212
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total income from all sources (including contributions)2013-12-31$1,074,799
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$226,771
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$222,924
Expenses. Certain deemed distributions of participant loans2013-12-31$-103
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$383,133
Value of total assets at end of year2013-12-31$9,220,206
Value of total assets at beginning of year2013-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$3,950
Total interest from all sources2013-12-31$6,905
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$500,000
If this is an individual account plan, was there a blackout period2013-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$180,345
Participant contributions at end of year2013-12-31$485,660
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$5,477
Administrative expenses (other) incurred2013-12-31$3,950
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$848,028
Value of net assets at end of year (total assets less liabilities)2013-12-31$9,220,206
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Interest on participant loans2013-12-31$6,905
Value of interest in master investment trust accounts at end of year2013-12-31$8,543,686
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$197,311
Employer contributions (assets) at end of year2013-12-31$190,860
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$222,924
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-12-31Yes
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31BDO USA, LLP
Accountancy firm EIN2013-12-31135381590
2010 : ADVANTAGECARE PHYSICIANS, P. C. UNION 401(K) PLAN 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$0
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total transfer of assets to this plan2010-12-31$0
Total transfer of assets from this plan2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total income from all sources (including contributions)2010-12-31$1,747,767
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$474,315
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$471,875
Expenses. Certain deemed distributions of participant loans2010-12-31$0
Value of total corrective distributions2010-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$1,156,920
Value of total assets at end of year2010-12-31$5,615,583
Value of total assets at beginning of year2010-12-31$4,342,131
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$2,440
Total interest from all sources2010-12-31$3,369
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$300,000
If this is an individual account plan, was there a blackout period2010-12-31No
Funding deficiency by the employer to the plan for this plan year2010-12-31$0
Minimum employer required contribution for this plan year2010-12-31$0
Amount contributed by the employer to the plan for this plan year2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$747,792
Participant contributions at end of year2010-12-31$137,723
Participant contributions at beginning of year2010-12-31$78,748
Assets. Other investments not covered elsewhere at end of year2010-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2010-12-31$0
Other income not declared elsewhere2010-12-31$0
Administrative expenses (other) incurred2010-12-31$2,440
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$1,273,452
Value of net assets at end of year (total assets less liabilities)2010-12-31$5,615,583
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$4,342,131
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$5,477,860
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$4,263,383
Value of interest in pooled separate accounts at end of year2010-12-31$0
Value of interest in pooled separate accounts at beginning of year2010-12-31$0
Interest on participant loans2010-12-31$3,369
Interest earned on other investments2010-12-31$0
Value of interest in common/collective trusts at end of year2010-12-31$0
Value of interest in common/collective trusts at beginning of year2010-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$0
Net investment gain/loss from pooled separate accounts2010-12-31$587,478
Net investment gain or loss from common/collective trusts2010-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Assets. Invements in employer securities at end of year2010-12-31$0
Assets. Invements in employer securities at beginning of year2010-12-31$0
Contributions received in cash from employer2010-12-31$409,128
Income. Dividends from common stock2010-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$471,875
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31O'CONNOR DAVIES MUNNS & DOBBINS LLP
Accountancy firm EIN2010-12-31133385019

Form 5500 Responses for ADVANTAGECARE PHYSICIANS, P. C. UNION 401(K) PLAN

2015: ADVANTAGECARE PHYSICIANS, P. C. UNION 401(K) PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2014: ADVANTAGECARE PHYSICIANS, P. C. UNION 401(K) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement - TrustYes
2013: ADVANTAGECARE PHYSICIANS, P. C. UNION 401(K) PLAN 2013 form 5500 responses
2013-06-03Type of plan entitySingle employer plan
2013-06-03First time form 5500 has been submittedYes
2013-06-03Submission has been amendedNo
2013-06-03This submission is the final filingNo
2013-06-03This return/report is a short plan year return/report (less than 12 months)Yes
2013-06-03Plan is a collectively bargained planYes
2013-06-03Plan funding arrangement – TrustYes
2013-06-03Plan benefit arrangement - TrustYes
2010: ADVANTAGECARE PHYSICIANS, P. C. UNION 401(K) PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-802904
Policy instance 1
Insurance contract or identification numberGA-802904
Number of Individuals Covered126
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $20,909
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?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

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