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SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN 401k Plan overview

Plan NameSCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN
Plan identification number 002

SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • 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.
  • 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.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • 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.
  • Life insurance

401k Sponsoring company profile

SCHENECTADY ANESTHESIA ASSOCIATES, P.C. has sponsored the creation of one or more 401k plans.

Company Name:SCHENECTADY ANESTHESIA ASSOCIATES, P.C.
Employer identification number (EIN):141540889
NAIC Classification:621399
NAIC Description:Offices of All Other Miscellaneous Health Practitioners

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022022-01-01MARGARET SEE2023-08-28
0022021-01-01MARGARET SEE2022-09-06
0022020-01-01MARGARET SEE2021-08-23
0022019-01-01MARGARET SEE2020-10-08
0022018-01-01MARGARET SEE2019-07-17
0022017-01-01MARGARET SEE
0022016-01-01MARGARET SEE
0022015-01-01FRANCINE KAISER
0022014-01-01FRANCINE KAISER
0022013-01-01FRANCINE KAISER
0022012-01-01FRANCINE KAISER
0022011-01-01FRANCINE KAISER
0022010-01-01FRANCINE KAISER KEVIN MURPHY2011-06-20
0022009-01-01FRAN KAISER KEVIN MURPHY, MD2010-10-05

Plan Statistics for SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN

401k plan membership statisitcs for SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN

Measure Date Value
2017: SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0136
Total number of active participants reported on line 7a of the Form 55002017-01-0134
Number of retired or separated participants receiving benefits2017-01-018
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-0142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0142
Number of participants with account balances2017-01-0141
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0138
Total number of active participants reported on line 7a of the Form 55002016-01-0133
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-013
Total of all active and inactive participants2016-01-0136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0136
Number of participants with account balances2016-01-0135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0141
Total number of active participants reported on line 7a of the Form 55002015-01-0132
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-017
Total of all active and inactive participants2015-01-0139
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0139
Number of participants with account balances2015-01-0138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0145
Total number of active participants reported on line 7a of the Form 55002014-01-0133
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-018
Total of all active and inactive participants2014-01-0141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0141
Number of participants with account balances2014-01-0141
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0142
Total number of active participants reported on line 7a of the Form 55002013-01-0132
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0113
Total of all active and inactive participants2013-01-0145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0145
Number of participants with account balances2013-01-0145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0147
Total number of active participants reported on line 7a of the Form 55002012-01-0130
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0112
Total of all active and inactive participants2012-01-0142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0142
Number of participants with account balances2012-01-0142
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0147
Total number of active participants reported on line 7a of the Form 55002011-01-0132
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-0115
Total of all active and inactive participants2011-01-0147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0147
Number of participants with account balances2011-01-0146
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0143
Total number of active participants reported on line 7a of the Form 55002010-01-0134
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-0113
Total of all active and inactive participants2010-01-0147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0147
Number of participants with account balances2010-01-0147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0146
Total number of active participants reported on line 7a of the Form 55002009-01-0138
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-015
Total of all active and inactive participants2009-01-0143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0143
Number of participants with account balances2009-01-0143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN

Measure Date Value
2017 : SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources2017-12-31$4,996,353
Expenses. Total of all expenses incurred2017-12-31$1,256,635
Benefits paid (including direct rollovers)2017-12-31$1,115,580
Total plan assets at end of year2017-12-31$32,307,292
Total plan assets at beginning of year2017-12-31$28,567,574
Value of fidelity bond covering the plan2017-12-31$500,000
Total contributions received or receivable from participants2017-12-31$137,502
Other income received2017-12-31$3,816,700
Net income (gross income less expenses)2017-12-31$3,739,718
Net plan assets at end of year (total assets less liabilities)2017-12-31$32,307,292
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$28,567,574
Total contributions received or receivable from employer(s)2017-12-31$1,042,151
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$141,055
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources2016-12-31$3,538,690
Expenses. Total of all expenses incurred2016-12-31$1,709,470
Benefits paid (including direct rollovers)2016-12-31$1,567,449
Total plan assets at end of year2016-12-31$28,567,574
Total plan assets at beginning of year2016-12-31$26,738,354
Value of fidelity bond covering the plan2016-12-31$500,000
Total contributions received or receivable from participants2016-12-31$144,723
Other income received2016-12-31$2,381,312
Net income (gross income less expenses)2016-12-31$1,829,220
Net plan assets at end of year (total assets less liabilities)2016-12-31$28,567,574
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$26,738,354
Total contributions received or receivable from employer(s)2016-12-31$1,012,655
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$142,021
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources2015-12-31$761,215
Expenses. Total of all expenses incurred2015-12-31$10,089,383
Benefits paid (including direct rollovers)2015-12-31$9,920,985
Total plan assets at end of year2015-12-31$26,738,354
Total plan assets at beginning of year2015-12-31$36,066,522
Value of fidelity bond covering the plan2015-12-31$500,000
Total contributions received or receivable from participants2015-12-31$122,732
Other income received2015-12-31$-370,779
Net income (gross income less expenses)2015-12-31$-9,328,168
Net plan assets at end of year (total assets less liabilities)2015-12-31$26,738,354
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$36,066,522
Total contributions received or receivable from employer(s)2015-12-31$1,009,262
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$168,398
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources2014-12-31$3,841,607
Expenses. Total of all expenses incurred2014-12-31$2,153,473
Benefits paid (including direct rollovers)2014-12-31$1,942,063
Total plan assets at end of year2014-12-31$36,066,522
Total plan assets at beginning of year2014-12-31$34,378,388
Value of fidelity bond covering the plan2014-12-31$500,000
Total contributions received or receivable from participants2014-12-31$132,594
Other income received2014-12-31$2,656,722
Net income (gross income less expenses)2014-12-31$1,688,134
Net plan assets at end of year (total assets less liabilities)2014-12-31$36,066,522
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$34,378,388
Total contributions received or receivable from employer(s)2014-12-31$1,052,291
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$211,410
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources2013-12-31$6,881,414
Expenses. Total of all expenses incurred2013-12-31$3,286,948
Benefits paid (including direct rollovers)2013-12-31$3,106,006
Total plan assets at end of year2013-12-31$34,378,388
Total plan assets at beginning of year2013-12-31$30,783,922
Value of fidelity bond covering the plan2013-12-31$500,000
Total contributions received or receivable from participants2013-12-31$71,515
Other income received2013-12-31$5,858,416
Net income (gross income less expenses)2013-12-31$3,594,466
Net plan assets at end of year (total assets less liabilities)2013-12-31$34,378,388
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$30,783,922
Assets. Value of participant loans2013-12-31$1,589
Total contributions received or receivable from employer(s)2013-12-31$951,483
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$180,942
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources2012-12-31$3,594,195
Expenses. Total of all expenses incurred2012-12-31$896,407
Benefits paid (including direct rollovers)2012-12-31$722,392
Total plan assets at end of year2012-12-31$30,783,922
Total plan assets at beginning of year2012-12-31$28,086,134
Value of fidelity bond covering the plan2012-12-31$500,000
Total contributions received or receivable from participants2012-12-31$70,865
Other income received2012-12-31$2,626,366
Net income (gross income less expenses)2012-12-31$2,697,788
Net plan assets at end of year (total assets less liabilities)2012-12-31$30,783,922
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$28,086,134
Assets. Value of participant loans2012-12-31$9,093
Total contributions received or receivable from employer(s)2012-12-31$896,964
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$174,015
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources2011-12-31$1,513,486
Expenses. Total of all expenses incurred2011-12-31$1,024,304
Benefits paid (including direct rollovers)2011-12-31$1,010,387
Total plan assets at end of year2011-12-31$28,086,134
Total plan assets at beginning of year2011-12-31$27,596,952
Value of fidelity bond covering the plan2011-12-31$500,000
Total contributions received or receivable from participants2011-12-31$52,892
Expenses. Other expenses not covered elsewhere2011-12-31$0
Other income received2011-12-31$569,171
Net income (gross income less expenses)2011-12-31$489,182
Net plan assets at end of year (total assets less liabilities)2011-12-31$28,086,134
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$27,596,952
Assets. Value of participant loans2011-12-31$14,567
Total contributions received or receivable from employer(s)2011-12-31$891,423
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$13,917
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN 2010 401k financial data
Total income from all sources2010-12-31$2,493,175
Expenses. Total of all expenses incurred2010-12-31$854,366
Benefits paid (including direct rollovers)2010-12-31$840,509
Total plan assets at end of year2010-12-31$27,596,952
Total plan assets at beginning of year2010-12-31$25,958,143
Value of fidelity bond covering the plan2010-12-31$500,000
Total contributions received or receivable from participants2010-12-31$20,625
Other income received2010-12-31$1,538,835
Net income (gross income less expenses)2010-12-31$1,638,809
Net plan assets at end of year (total assets less liabilities)2010-12-31$27,596,952
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$25,958,143
Assets. Value of participant loans2010-12-31$11,985
Total contributions received or receivable from employer(s)2010-12-31$933,715
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$13,857
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
2009 : SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN

2017: SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING 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 planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING 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 planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING 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
2010-01-01Plan benefit arrangement - TrustYes
2009: SCHENECTADY ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number3892934
Policy instance 1
Insurance contract or identification number3892934
Number of Individuals Covered1
Insurance policy start date2016-09-21
Insurance policy end date2017-09-20
Are there contracts with allocated funds for individual policies?1
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 BenefitYes
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 numberN101095140
Policy instance 2
Insurance contract or identification numberN101095140
Number of Individuals Covered1
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?1
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 BenefitYes
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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