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JORMAC AEROSPACE, INC 401(K) 401k Plan overview

Plan NameJORMAC AEROSPACE, INC 401(K)
Plan identification number 001

JORMAC AEROSPACE, INC 401(K) 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

JORMAC AEROSPACE, INC has sponsored the creation of one or more 401k plans.

Company Name:JORMAC AEROSPACE, INC
Employer identification number (EIN):205113639
NAIC Classification:336410

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JORMAC AEROSPACE, INC 401(K)

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01PATRICIA HOLLINGSWORTH2023-06-09 PAOLA SUAREZ2023-06-12
0012021-01-01PATRICIA HOLLINGSWORTH2022-05-24 PAOLA SUAREZ2022-05-27
0012020-01-01PATRICIA HOLLINGSWORTH2021-06-17 PAOLA SUAREZ2021-06-21
0012019-01-01PATRICIA HOLLINGSWORTH2020-05-05 PAOLA SUAREZ2020-05-26
0012018-01-01PATRICIA HOLLINGSWORTH2019-05-23 PAOLA SUAREZ2019-06-07
0012017-01-01PATRICIA HOLLINGSWORTH2018-07-13 PAOLA SUAREZ2018-07-16
0012016-01-01PATTY HOLLINGSWORTH2017-08-10 PAOLA SUAREZ2017-08-16
0012015-01-01PETER HOKANSON2016-06-14 KENNARD E GOLDSMITH JR2016-06-21
0012014-01-01PETER HOKANSON2015-06-23 KENNARD E GOLDSMITH JR2015-06-24
0012013-01-01PETER HOKANSON2014-06-16 KENNARD E GOLDSMITH JR2014-07-14
0012012-01-01KENNARD GOLDSMITH JR
0012011-01-01KENNARD GOLDSMITH JR
0012009-01-01KENNARD GOLDSMITH JR. KENNARD GOLDSMITH JR.2010-10-14
0012009-01-01KENNARD GOLDSMITH JR. KENNARD GOLDSMITH JR.2010-10-14
0012009-01-01KENNARD GOLDSMITH JR. KENNARD GOLDSMITH JR.2010-10-14

Plan Statistics for JORMAC AEROSPACE, INC 401(K)

401k plan membership statisitcs for JORMAC AEROSPACE, INC 401(K)

Measure Date Value
2012: JORMAC AEROSPACE, INC 401(K) 2012 401k membership
Total participants, beginning-of-year2012-01-0160
Total number of active participants reported on line 7a of the Form 55002012-01-0148
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0115
Total of all active and inactive participants2012-01-0163
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0163
Number of participants with account balances2012-01-0148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-0119
2011: JORMAC AEROSPACE, INC 401(K) 2011 401k membership
Total participants, beginning-of-year2011-01-01128
Total number of active participants reported on line 7a of the Form 55002011-01-0147
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
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 balances2011-01-0137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: JORMAC AEROSPACE, INC 401(K) 2009 401k membership
Total participants, beginning-of-year2009-01-01130
Total number of active participants reported on line 7a of the Form 55002009-01-0179
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0117
Total of all active and inactive participants2009-01-0196
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0196
Number of participants with account balances2009-01-0164
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-019

Financial Data on JORMAC AEROSPACE, INC 401(K)

Measure Date Value
2012 : JORMAC AEROSPACE, INC 401(K) 2012 401k financial data
Transfers to/from the plan2012-12-31$0
Total income from all sources2012-12-31$179,739
Expenses. Total of all expenses incurred2012-12-31$314,927
Benefits paid (including direct rollovers)2012-12-31$303,105
Total plan assets at end of year2012-12-31$683,096
Total plan assets at beginning of year2012-12-31$818,284
Value of fidelity bond covering the plan2012-12-31$90,000
Total contributions received or receivable from participants2012-12-31$98,857
Expenses. Other expenses not covered elsewhere2012-12-31$880
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$80,670
Net income (gross income less expenses)2012-12-31$-135,188
Net plan assets at end of year (total assets less liabilities)2012-12-31$683,096
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$818,284
Assets. Value of participant loans2012-12-31$12,978
Total contributions received or receivable from employer(s)2012-12-31$212
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$10,942
Funding deficiency by the employer to the plan for this plan year2012-12-31$0
Minimum employer required contribution for this plan year2012-12-31$0
Amount contributed by the employer to the plan for this plan year2012-12-31$0
2011 : JORMAC AEROSPACE, INC 401(K) 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total transfer of assets from this plan2011-12-31$1,336,646
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total income from all sources (including contributions)2011-12-31$313,735
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$83,053
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$74,324
Value of total corrective distributions2011-12-31$7,544
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$360,062
Value of total assets at end of year2011-12-31$818,284
Value of total assets at beginning of year2011-12-31$1,924,248
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$1,185
Total interest from all sources2011-12-31$1,345
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
Transfers to/from the plan2011-12-31$-1,336,646
Total income from all sources2011-12-31$313,733
Expenses. Total of all expenses incurred2011-12-31$83,053
Benefits paid (including direct rollovers)2011-12-31$74,324
Total plan assets at end of year2011-12-31$818,284
Total plan assets at beginning of year2011-12-31$1,924,250
Value of fidelity bond covering the plan2011-12-31$90,000
Total contributions received or receivable from participants2011-12-31$293,752
Expenses. Other expenses not covered elsewhere2011-12-31$1,185
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-46,329
Net income (gross income less expenses)2011-12-31$230,680
Net plan assets at end of year (total assets less liabilities)2011-12-31$818,284
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$1,924,250
Assets. Value of participant loans2011-12-31$35,675
Total contributions received or receivable from employer(s)2011-12-31$66,310
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$7,544
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$90,000
If this is an individual account plan, was there a blackout period2011-12-31No
Funding deficiency by the employer to the plan for this plan year2011-12-31$0
Minimum employer required contribution for this plan year2011-12-31$0
Amount contributed by the employer to the plan for this plan year2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$293,752
Participant contributions at end of year2011-12-31$35,675
Participant contributions at beginning of year2011-12-31$16,110
Administrative expenses (other) incurred2011-12-31$1,185
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$230,682
Value of net assets at end of year (total assets less liabilities)2011-12-31$818,284
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$1,924,248
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$695,656
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$1,822,347
Interest on participant loans2011-12-31$1,345
Value of interest in common/collective trusts at end of year2011-12-31$86,953
Value of interest in common/collective trusts at beginning of year2011-12-31$85,791
Net investment gain/loss from pooled separate accounts2011-12-31$-47,672
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31Yes
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$66,310
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$74,324
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31BAKER NEWMAN NOYES
Accountancy firm EIN2011-12-31010494526
2010 : JORMAC AEROSPACE, INC 401(K) 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 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$590,169
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$55,559
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$53,098
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$377,204
Value of total assets at end of year2010-12-31$1,924,248
Value of total assets at beginning of year2010-12-31$1,389,638
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$2,461
Total interest from all sources2010-12-31$233
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$90,000
If this is an individual account plan, was there a blackout period2010-12-31Yes
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$236,502
Participant contributions at end of year2010-12-31$16,110
Participant contributions at beginning of year2010-12-31$2,433
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
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$51,214
Other income not declared elsewhere2010-12-31$0
Administrative expenses (other) incurred2010-12-31$2,461
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$534,610
Value of net assets at end of year (total assets less liabilities)2010-12-31$1,924,248
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$1,389,638
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$1,822,347
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$0
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$1,350,860
Interest on participant loans2010-12-31$233
Interest earned on other investments2010-12-31$0
Value of interest in common/collective trusts at end of year2010-12-31$85,791
Value of interest in common/collective trusts at beginning of year2010-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) 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$36,345
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$212,732
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 contributions2010-12-31Yes
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$89,488
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$53,098
Asset. Corporate debt instrument debt (other) at end of year2010-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2010-12-31$0
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31Yes
Assets. Corporate common stocks other than exployer securities at end of year2010-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2010-12-31$0
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31BAKER, NEWMAN & NOYES, LLC
Accountancy firm EIN2010-12-31010494526
2008 : JORMAC AEROSPACE, INC 401(K) 2008 401k financial data
Total income from all sources2008-12-31$-14,276
Expenses. Total of all expenses incurred2008-12-31$156,657
Benefits paid (including direct rollovers)2008-12-31$156,107
Total plan assets at end of year2008-12-31$728,194
Total plan assets at beginning of year2008-12-31$899,127
Value of fidelity bond covering the plan2008-12-31$90,000
Total contributions received or receivable from participants2008-12-31$232,558
Expenses. Other expenses not covered elsewhere2008-12-31$550
Other income received2008-12-31$-329,030
Net income (gross income less expenses)2008-12-31$-170,933
Net plan assets at end of year (total assets less liabilities)2008-12-31$728,194
Net plan assets at beginning of year (total assets less liabilities)2008-12-31$899,127
Total contributions received or receivable from employer(s)2008-12-31$82,196
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2008-12-31$0

Form 5500 Responses for JORMAC AEROSPACE, INC 401(K)

2012: JORMAC AEROSPACE, INC 401(K) 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
2011: JORMAC AEROSPACE, INC 401(K) 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
2009: JORMAC AEROSPACE, INC 401(K) 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedYes
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

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-815128
Policy instance 1
Insurance contract or identification numberGA-815128
Number of Individuals Covered48
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $4,516
Total amount of fees paid to insurance companyUSD $420
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
Commission paid to Insurance BrokerUSD $4,516
Insurance broker organization code?3
Amount paid for insurance broker fees420
Additional information about fees paid to insurance brokerSALES/MARKETING
Insurance broker nameMERRILL LYNCH PIERCE FENNER SMITH I
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-815128
Policy instance 1
Insurance contract or identification numberGA-815128
Number of Individuals Covered37
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $6,155
Total amount of fees paid to insurance companyUSD $1,096
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
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-815128
Policy instance 1
Insurance contract or identification numberGA-815128
Number of Individuals Covered65
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $13,411
Total amount of fees paid to insurance companyUSD $695
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
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: )
Policy contract numberGAP-50-SJ34
Policy instance 2
Insurance contract or identification numberGAP-50-SJ34
Number of Individuals Covered0
Insurance policy start date2010-01-01
Insurance policy end date2010-01-31
Total amount of commissions paid to insurance brokerUSD $143
Total amount of fees paid to insurance companyUSD $43
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?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
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP50SJ34
Policy instance 1
Insurance contract or identification numberGAP50SJ34
Number of Individuals Covered126
Insurance policy start date2008-01-01
Insurance policy end date2008-12-31
Total amount of commissions paid to insurance brokerUSD $54
Total amount of fees paid to insurance companyUSD $720
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Commission paid to Insurance BrokerUSD $720
Additional information about fees paid to insurance brokerADMIN OVERRIDE
Insurance broker organization code?5
Insurance broker nameLIBERTY LIFE SECURITIES LLC
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP54SJ33
Policy instance 2
Insurance contract or identification numberGAP54SJ33
Number of Individuals Covered126
Insurance policy start date2008-01-01
Insurance policy end date2008-12-31
Total amount of commissions paid to insurance brokerUSD $3,989
Total amount of fees paid to insurance companyUSD $0
Commission paid to Insurance BrokerUSD $3,989
Insurance broker organization code?3
Insurance broker nameLIBERTY LIFE SECURITIES LLC

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