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GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS PLAN 401k Plan overview

Plan NameGROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS PLAN
Plan identification number 002

GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • Plan not intended to be qualified - A plan not intended to be qualified under Code sections 401, 403, or 408.
  • 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.

401k Sponsoring company profile

GROCERY PRODUCTS DISTRIBUTION SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name:GROCERY PRODUCTS DISTRIBUTION SERVICES, INC.
Employer identification number (EIN):222463567
NAIC Classification:541990
NAIC Description:All Other Professional, Scientific, and Technical Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022017-01-01BARBARA BROWN BARBARA BROWN2018-10-04
0022016-01-01WILBERT E. RICHARDS WILBERT E. RICHARDS2017-10-03
0022015-01-01WILBERT E. RICHARDS WILBERT E. RICHARDS2016-09-08
0022014-01-01WILBERT E. RICHARDS WILBERT E. RICHARDS2015-10-02
0022013-01-01WILBERT E. RICHARDS
0022011-01-01WILBERT E. RICHARDS WILBERT E. RICHARDS2012-05-10
0022010-01-01WILBERT E. RICHARDS WILBERT E. RICHARDS2011-09-22
0022009-01-01WILBERT E. RICHARDS WILBERT E. RICHARDS2010-07-30

Plan Statistics for GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS PLAN

401k plan membership statisitcs for GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS PLAN

Measure Date Value
2017: GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-014
Total number of active participants reported on line 7a of the Form 55002017-01-012
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-012
Total participants2017-01-014
Number of participants with account balances2017-01-014
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-014
Total number of active participants reported on line 7a of the Form 55002016-01-014
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-014
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-014
Number of participants with account balances2016-01-014
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-014
Total number of active participants reported on line 7a of the Form 55002015-01-014
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-014
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-014
Number of participants with account balances2015-01-014
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-014
Total number of active participants reported on line 7a of the Form 55002014-01-014
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-014
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-014
Number of participants with account balances2014-01-014
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-014
Total number of active participants reported on line 7a of the Form 55002013-01-014
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-014
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-014
Number of participants with account balances2013-01-014
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2011: GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-014
Total number of active participants reported on line 7a of the Form 55002011-01-014
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 participants2011-01-014
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-014
Number of participants with account balances2011-01-014
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-014
Total number of active participants reported on line 7a of the Form 55002010-01-014
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-014
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-014
Number of participants with account balances2010-01-014
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-014
Total number of active participants reported on line 7a of the Form 55002009-01-014
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-014
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-014
Number of participants with account balances2009-01-014
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS PLAN

Measure Date Value
2017 : GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS PLAN 2017 401k financial data
Total plan liabilities at end of year2017-12-31$0
Total plan liabilities at beginning of year2017-12-31$0
Total income from all sources2017-12-31$156,600
Expenses. Total of all expenses incurred2017-12-31$42,694
Benefits paid (including direct rollovers)2017-12-31$35,416
Total plan assets at end of year2017-12-31$1,446,218
Total plan assets at beginning of year2017-12-31$1,332,312
Value of fidelity bond covering the plan2017-12-31$25,000
Total contributions received or receivable from participants2017-12-31$0
Contributions received from other sources (not participants or employers)2017-12-31$0
Other income received2017-12-31$156,600
Noncash contributions received2017-12-31$0
Net income (gross income less expenses)2017-12-31$113,906
Net plan assets at end of year (total assets less liabilities)2017-12-31$1,446,218
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$1,332,312
Total contributions received or receivable from employer(s)2017-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$7,278
2016 : GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS PLAN 2016 401k financial data
Total plan liabilities at end of year2016-12-31$0
Total plan liabilities at beginning of year2016-12-31$0
Total income from all sources2016-12-31$122,444
Expenses. Total of all expenses incurred2016-12-31$41,528
Benefits paid (including direct rollovers)2016-12-31$33,319
Total plan assets at end of year2016-12-31$1,332,312
Total plan assets at beginning of year2016-12-31$1,251,396
Value of fidelity bond covering the plan2016-12-31$25,000
Total contributions received or receivable from participants2016-12-31$0
Expenses. Other expenses not covered elsewhere2016-12-31$8,209
Contributions received from other sources (not participants or employers)2016-12-31$0
Other income received2016-12-31$122,444
Noncash contributions received2016-12-31$0
Net income (gross income less expenses)2016-12-31$80,916
Net plan assets at end of year (total assets less liabilities)2016-12-31$1,332,312
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$1,251,396
Total contributions received or receivable from employer(s)2016-12-31$0
2015 : GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS PLAN 2015 401k financial data
Total plan liabilities at end of year2015-12-31$0
Total plan liabilities at beginning of year2015-12-31$0
Total income from all sources2015-12-31$57,304
Expenses. Total of all expenses incurred2015-12-31$40,919
Benefits paid (including direct rollovers)2015-12-31$34,614
Total plan assets at end of year2015-12-31$1,251,396
Total plan assets at beginning of year2015-12-31$1,235,011
Value of fidelity bond covering the plan2015-12-31$25,000
Total contributions received or receivable from participants2015-12-31$0
Expenses. Other expenses not covered elsewhere2015-12-31$6,305
Contributions received from other sources (not participants or employers)2015-12-31$0
Other income received2015-12-31$57,304
Noncash contributions received2015-12-31$0
Net income (gross income less expenses)2015-12-31$16,385
Net plan assets at end of year (total assets less liabilities)2015-12-31$1,251,396
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$1,235,011
Total contributions received or receivable from employer(s)2015-12-31$0
Value of certain deemed distributions of participant loans2015-12-31$0
Value of corrective distributions2015-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$0
2014 : GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS PLAN 2014 401k financial data
Total plan liabilities at end of year2014-12-31$0
Total plan liabilities at beginning of year2014-12-31$0
Total income from all sources2014-12-31$94,010
Expenses. Total of all expenses incurred2014-12-31$39,949
Benefits paid (including direct rollovers)2014-12-31$32,593
Total plan assets at end of year2014-12-31$1,235,011
Total plan assets at beginning of year2014-12-31$1,180,950
Value of fidelity bond covering the plan2014-12-31$25,000
Total contributions received or receivable from participants2014-12-31$0
Expenses. Other expenses not covered elsewhere2014-12-31$7,356
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$94,010
Noncash contributions received2014-12-31$0
Net income (gross income less expenses)2014-12-31$54,061
Net plan assets at end of year (total assets less liabilities)2014-12-31$1,235,011
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$1,180,950
Total contributions received or receivable from employer(s)2014-12-31$0
2013 : GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS PLAN 2013 401k financial data
Total plan liabilities at end of year2013-12-31$0
Total plan liabilities at beginning of year2013-12-31$0
Total income from all sources2013-12-31$219,114
Expenses. Total of all expenses incurred2013-12-31$36,189
Benefits paid (including direct rollovers)2013-12-31$26,076
Total plan assets at end of year2013-12-31$1,180,950
Total plan assets at beginning of year2013-12-31$998,025
Value of fidelity bond covering the plan2013-12-31$25,000
Expenses. Other expenses not covered elsewhere2013-12-31$10,113
Other income received2013-12-31$219,114
Net income (gross income less expenses)2013-12-31$182,925
Net plan assets at end of year (total assets less liabilities)2013-12-31$1,180,950
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$998,025
2011 : GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS PLAN 2011 401k financial data
Total plan liabilities at end of year2011-12-31$0
Total plan liabilities at beginning of year2011-12-31$0
Total income from all sources2011-12-31$24,700
Expenses. Total of all expenses incurred2011-12-31$45,771
Benefits paid (including direct rollovers)2011-12-31$24,282
Total plan assets at end of year2011-12-31$928,105
Total plan assets at beginning of year2011-12-31$949,176
Value of fidelity bond covering the plan2011-12-31$25,000
Total contributions received or receivable from participants2011-12-31$0
Expenses. Other expenses not covered elsewhere2011-12-31$21,489
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$24,700
Noncash contributions received2011-12-31$0
Net income (gross income less expenses)2011-12-31$-21,071
Net plan assets at end of year (total assets less liabilities)2011-12-31$928,105
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$949,176
Total contributions received or receivable from employer(s)2011-12-31$0
2010 : GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS PLAN 2010 401k financial data
Total plan liabilities at end of year2010-12-31$0
Total plan liabilities at beginning of year2010-12-31$0
Total income from all sources2010-12-31$84,177
Expenses. Total of all expenses incurred2010-12-31$32,328
Benefits paid (including direct rollovers)2010-12-31$22,215
Total plan assets at end of year2010-12-31$949,176
Total plan assets at beginning of year2010-12-31$897,327
Value of fidelity bond covering the plan2010-12-31$25,000
Total contributions received or receivable from participants2010-12-31$0
Expenses. Other expenses not covered elsewhere2010-12-31$10,113
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$84,177
Noncash contributions received2010-12-31$0
Net income (gross income less expenses)2010-12-31$51,849
Net plan assets at end of year (total assets less liabilities)2010-12-31$949,176
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$897,327
Total contributions received or receivable from employer(s)2010-12-31$0
2009 : GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS 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 GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS PLAN

2017: GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS 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: GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS 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: GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS 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: GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS 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: GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS 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
2011: GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS 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: GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS 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: GROCERY PRODUCTS DISTRIBUTION SERVICES,INC. 401(K) PS 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

PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract numberINDIVIDUAL
Policy instance 3
Insurance contract or identification numberINDIVIDUAL
Number of Individuals Covered2
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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 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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number080321
Policy instance 2
Insurance contract or identification number080321
Number of Individuals Covered1
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
GENWORTH LIFE AND ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65536 )
Policy contract numberINDIVIDUAL
Policy instance 1
Insurance contract or identification numberINDIVIDUAL
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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 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
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract numberINDIVIDUAL
Policy instance 3
Insurance contract or identification numberINDIVIDUAL
Number of Individuals Covered2
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number080321
Policy instance 2
Insurance contract or identification number080321
Number of Individuals Covered2
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
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?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
GENWORTH LIFE AND ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65536 )
Policy contract numberINDIVIDUAL
Policy instance 1
Insurance contract or identification numberINDIVIDUAL
Number of Individuals Covered2
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number080321
Policy instance 3
Insurance contract or identification number080321
Number of Individuals Covered2
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
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?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
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract numberINDIVIDUAL
Policy instance 1
Insurance contract or identification numberINDIVIDUAL
Number of Individuals Covered2
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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
GENWORTH LIFE AND ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65536 )
Policy contract numberINDIVIDUAL
Policy instance 2
Insurance contract or identification numberINDIVIDUAL
Number of Individuals Covered2
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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
GENWORTH LIFE AND ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65536 )
Policy contract numberINDIVIDUAL
Policy instance 2
Insurance contract or identification numberINDIVIDUAL
Number of Individuals Covered2
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number080321
Policy instance 3
Insurance contract or identification number080321
Number of Individuals Covered2
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
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?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
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract numberINDIVIDUAL
Policy instance 1
Insurance contract or identification numberINDIVIDUAL
Number of Individuals Covered2
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number080321
Policy instance 2
Insurance contract or identification number080321
Number of Individuals Covered2
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
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?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
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract numberINDIVIDUAL
Policy instance 3
Insurance contract or identification numberINDIVIDUAL
Number of Individuals Covered2
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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
GENWORTH LIFE AND ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65536 )
Policy contract numberINDIVIDUAL
Policy instance 1
Insurance contract or identification numberINDIVIDUAL
Number of Individuals Covered2
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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
GENWORTH LIFE AND ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65536 )
Policy contract numberINDIVIDUAL
Policy instance 2
Insurance contract or identification numberINDIVIDUAL
Number of Individuals Covered2
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract numberINDIVIDUAL
Policy instance 1
Insurance contract or identification numberINDIVIDUAL
Number of Individuals Covered2
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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

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