401k Plan data: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN plan

COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 401k Plan overview

Plan Name	COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN
Plan identification number	001

COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN Benefits

401k Plan Type

Defined 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.

401k Sponsoring company profile

COUCH BRAUNSDORF INSURANCE GROUP has sponsored the creation of one or more 401k plans.

Company Name: COUCH BRAUNSDORF INSURANCE GROUP

Employer identification number (EIN): 222567763

NAIC Classification: 524210
NAIC Description: Insurance Agencies and Brokerages

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2018-01-01
001 2017-01-01 LAWRENCE EVANS
001 2016-01-01 LAWRENCE EVANS
001 2015-01-01 LAWRENCE EVANS
001 2014-01-01 LAWRENCE EVANS
001 2013-01-01 LAWRENCE EVANS

Plan Statistics for COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN

401k plan membership statisitcs for COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN

Measure Date Value
2022: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 100
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 72
Number of retired or separated participants receiving benefits 2022-01-01 2
Number of other retired or separated participants entitled to future benefits 2022-01-01 12
Total of all active and inactive participants 2022-01-01 86
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 86
Number of participants with account balances 2022-01-01 65
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 1
2021: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 112
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 79
Number of retired or separated participants receiving benefits 2021-01-01 1
Number of other retired or separated participants entitled to future benefits 2021-01-01 18
Total of all active and inactive participants 2021-01-01 98
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 98
Number of participants with account balances 2021-01-01 72
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 6
2020: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 122
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 100
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 15
Total of all active and inactive participants 2020-01-01 115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 115
Number of participants with account balances 2020-01-01 79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 2
2019: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 129
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 107
Number of retired or separated participants receiving benefits 2019-01-01 2
Number of other retired or separated participants entitled to future benefits 2019-01-01 12
Total of all active and inactive participants 2019-01-01 121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 121
Number of participants with account balances 2019-01-01 78
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 5
2018: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 125
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 121
Number of retired or separated participants receiving benefits 2018-01-01 5
Number of other retired or separated participants entitled to future benefits 2018-01-01 8
Total of all active and inactive participants 2018-01-01 134
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 134
Number of participants with account balances 2018-01-01 79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 4
2017: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 123
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 114
Number of retired or separated participants receiving benefits 2017-01-01 2
Number of other retired or separated participants entitled to future benefits 2017-01-01 8
Total of all active and inactive participants 2017-01-01 124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 124
Number of participants with account balances 2017-01-01 77
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 2
2016: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 115
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 113
Number of retired or separated participants receiving benefits 2016-01-01 1
Number of other retired or separated participants entitled to future benefits 2016-01-01 9
Total of all active and inactive participants 2016-01-01 123
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 123
Number of participants with account balances 2016-01-01 76
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 3
2015: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 112
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 108
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 8
Total of all active and inactive participants 2015-01-01 116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 116
Number of participants with account balances 2015-01-01 68
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 120
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 106
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 5
Total of all active and inactive participants 2014-01-01 111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 111
Number of participants with account balances 2014-01-01 58
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 109
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 109
Number of retired or separated participants receiving benefits 2013-01-01 1
Number of other retired or separated participants entitled to future benefits 2013-01-01 8
Total of all active and inactive participants 2013-01-01 118
Total participants 2013-01-01 118
Number of participants with account balances 2013-01-01 59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 1

Measure	Date	Value
2022: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	100
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	72
Number of retired or separated participants receiving benefits	2022-01-01	2
Number of other retired or separated participants entitled to future benefits	2022-01-01	12
Total of all active and inactive participants	2022-01-01	86
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	86
Number of participants with account balances	2022-01-01	65
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	1
2021: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	112
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	79
Number of retired or separated participants receiving benefits	2021-01-01	1
Number of other retired or separated participants entitled to future benefits	2021-01-01	18
Total of all active and inactive participants	2021-01-01	98
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	98
Number of participants with account balances	2021-01-01	72
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	6
2020: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	122
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	100
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	15
Total of all active and inactive participants	2020-01-01	115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	115
Number of participants with account balances	2020-01-01	79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	2
2019: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	129
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	107
Number of retired or separated participants receiving benefits	2019-01-01	2
Number of other retired or separated participants entitled to future benefits	2019-01-01	12
Total of all active and inactive participants	2019-01-01	121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	121
Number of participants with account balances	2019-01-01	78
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	5
2018: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	125
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	121
Number of retired or separated participants receiving benefits	2018-01-01	5
Number of other retired or separated participants entitled to future benefits	2018-01-01	8
Total of all active and inactive participants	2018-01-01	134
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	134
Number of participants with account balances	2018-01-01	79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	4
2017: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	123
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	114
Number of retired or separated participants receiving benefits	2017-01-01	2
Number of other retired or separated participants entitled to future benefits	2017-01-01	8
Total of all active and inactive participants	2017-01-01	124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	124
Number of participants with account balances	2017-01-01	77
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	2
2016: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	115
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	113
Number of retired or separated participants receiving benefits	2016-01-01	1
Number of other retired or separated participants entitled to future benefits	2016-01-01	9
Total of all active and inactive participants	2016-01-01	123
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	123
Number of participants with account balances	2016-01-01	76
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	3
2015: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	112
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	108
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	8
Total of all active and inactive participants	2015-01-01	116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	116
Number of participants with account balances	2015-01-01	68
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	120
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	106
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	5
Total of all active and inactive participants	2014-01-01	111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	111
Number of participants with account balances	2014-01-01	58
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	109
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	109
Number of retired or separated participants receiving benefits	2013-01-01	1
Number of other retired or separated participants entitled to future benefits	2013-01-01	8
Total of all active and inactive participants	2013-01-01	118
Total participants	2013-01-01	118
Number of participants with account balances	2013-01-01	59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	1

Financial Data on COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN

Measure	Date	Value
2022 : COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2022 401k financial data
Unrealized appreciation/depreciation of real estate assets	2022-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2022-12-31	$0
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total transfer of assets to this plan	2022-12-31	$0
Total transfer of assets from this plan	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Expenses. Interest paid	2022-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-526,970
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$412,452
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$367,513
Expenses. Certain deemed distributions of participant loans	2022-12-31	$11,418
Value of total corrective distributions	2022-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$496,354
Value of total assets at end of year	2022-12-31	$7,148,731
Value of total assets at beginning of year	2022-12-31	$8,088,153
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$33,521
Total income from rents	2022-12-31	$0
Total interest from all sources	2022-12-31	$8,680
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$156,683
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$156,683
Assets. Real estate other than employer real property at end of year	2022-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2022-12-31	$0
Administrative expenses professional fees incurred	2022-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2022-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2022-12-31	$0
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$414,025
Participant contributions at end of year	2022-12-31	$154,922
Participant contributions at beginning of year	2022-12-31	$178,415
Participant contributions at end of year	2022-12-31	$14,907
Participant contributions at beginning of year	2022-12-31	$15,494
Assets. Other investments not covered elsewhere at end of year	2022-12-31	$667,652
Assets. Other investments not covered elsewhere at beginning of year	2022-12-31	$774,410
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$26,930
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2022-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-12-31	$0
Assets. Loans (other than to participants) at end of year	2022-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-12-31	$0
Other income not declared elsewhere	2022-12-31	$0
Administrative expenses (other) incurred	2022-12-31	$0
Liabilities. Value of operating payables at end of year	2022-12-31	$0
Liabilities. Value of operating payables at beginning of year	2022-12-31	$0
Total non interest bearing cash at end of year	2022-12-31	$0
Total non interest bearing cash at beginning of year	2022-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Income. Non cash contributions	2022-12-31	$0
Value of net income/loss	2022-12-31	$-939,422
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$7,148,731
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$8,088,153
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Assets. partnership/joint venture interests at end of year	2022-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2022-12-31	$0
Investment advisory and management fees	2022-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$4,828,908
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$5,678,500
Value of interest in pooled separate accounts at end of year	2022-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$0
Interest on participant loans	2022-12-31	$8,659
Income. Interest from loans (other than to participants)	2022-12-31	$0
Interest earned on other investments	2022-12-31	$0
Income. Interest from US Government securities	2022-12-31	$0
Income. Interest from corporate debt instruments	2022-12-31	$0
Value of interest in master investment trust accounts at end of year	2022-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2022-12-31	$0
Value of interest in common/collective trusts at end of year	2022-12-31	$0
Value of interest in common/collective trusts at beginning of year	2022-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$21
Assets. Value of investments in 103.12 investment entities at end of year	2022-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2022-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$1,424,519
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$1,386,875
Expenses. Payments to insurance carriers foe the provision of benefits	2022-12-31	$0
Asset value of US Government securities at end of year	2022-12-31	$0
Asset value of US Government securities at beginning of year	2022-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-1,188,687
Net investment gain/loss from pooled separate accounts	2022-12-31	$0
Net investment gain or loss from common/collective trusts	2022-12-31	$0
Net gain/loss from 103.12 investment entities	2022-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Assets. Invements in employer securities at end of year	2022-12-31	$0
Assets. Invements in employer securities at beginning of year	2022-12-31	$0
Assets. Value of employer real property at end of year	2022-12-31	$0
Assets. Value of employer real property at beginning of year	2022-12-31	$0
Contributions received in cash from employer	2022-12-31	$55,399
Employer contributions (assets) at end of year	2022-12-31	$57,823
Employer contributions (assets) at beginning of year	2022-12-31	$54,459
Income. Dividends from preferred stock	2022-12-31	$0
Income. Dividends from common stock	2022-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$367,513
Asset. Corporate debt instrument preferred debt at end of year	2022-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2022-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2022-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2022-12-31	$0
Contract administrator fees	2022-12-31	$33,521
Assets. Corporate common stocks other than exployer securities at end of year	2022-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2022-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2022-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2022-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2022-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2022-12-31	$0
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Aggregate proceeds on sale of assets	2022-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2022-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2022-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2022-12-31	$0
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	BAS PARTNERS LLC
Accountancy firm EIN	2022-12-31	208779390
2021 : COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2021 401k financial data
Total income from all sources (including contributions)	2021-12-31	$1,316,075
Total of all expenses incurred	2021-12-31	$373,103
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$338,701
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$467,615
Value of total assets at end of year	2021-12-31	$8,088,153
Value of total assets at beginning of year	2021-12-31	$7,145,181
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$34,402
Total interest from all sources	2021-12-31	$9,417
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$404,614
Participant contributions at end of year	2021-12-31	$178,415
Participant contributions at beginning of year	2021-12-31	$196,380
Participant contributions at end of year	2021-12-31	$15,494
Participant contributions at beginning of year	2021-12-31	$16,804
Assets. Other investments not covered elsewhere at end of year	2021-12-31	$774,410
Assets. Other investments not covered elsewhere at beginning of year	2021-12-31	$680,723
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$8,542
Administrative expenses (other) incurred	2021-12-31	$34,402
Total non interest bearing cash at end of year	2021-12-31	$2,448
Total non interest bearing cash at beginning of year	2021-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$942,972
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$8,088,153
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$7,145,181
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$5,678,500
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$4,699,302
Value of interest in pooled separate accounts at end of year	2021-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$0
Interest on participant loans	2021-12-31	$9,417
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$1,384,427
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$1,505,348
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$839,043
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$54,459
Employer contributions (assets) at end of year	2021-12-31	$54,459
Employer contributions (assets) at beginning of year	2021-12-31	$46,624
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$338,701
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2021-12-31	No
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Disclaimer
Accountancy firm name	2021-12-31	BAS PARTNERS LLC
Accountancy firm EIN	2021-12-31	208779390
2020 : COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2020 401k financial data
Total income from all sources (including contributions)	2020-12-31	$1,179,334
Total of all expenses incurred	2020-12-31	$438,283
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$407,856
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$438,002
Value of total assets at end of year	2020-12-31	$7,145,181
Value of total assets at beginning of year	2020-12-31	$6,404,130
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$30,427
Total interest from all sources	2020-12-31	$11,175
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$382,375
Participant contributions at end of year	2020-12-31	$196,380
Participant contributions at beginning of year	2020-12-31	$201,826
Participant contributions at end of year	2020-12-31	$16,804
Participant contributions at beginning of year	2020-12-31	$14,879
Assets. Other investments not covered elsewhere at end of year	2020-12-31	$680,723
Assets. Other investments not covered elsewhere at beginning of year	2020-12-31	$693,561
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$15,140
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Income. Non cash contributions	2020-12-31	$0
Value of net income/loss	2020-12-31	$741,051
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$7,145,181
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$6,404,130
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$4,699,302
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$5,041,618
Value of interest in pooled separate accounts at end of year	2020-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$0
Interest on participant loans	2020-12-31	$11,175
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$1,505,348
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$401,308
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$730,157
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$40,487
Employer contributions (assets) at end of year	2020-12-31	$46,624
Employer contributions (assets) at beginning of year	2020-12-31	$50,938
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$407,856
Contract administrator fees	2020-12-31	$30,427
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2020-12-31	No
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	BAS PARTNERS LLC
Accountancy firm EIN	2020-12-31	208779390
2019 : COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2019 401k financial data
Total income from all sources (including contributions)	2019-12-31	$1,568,718
Total of all expenses incurred	2019-12-31	$112,603
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$82,681
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$450,642
Value of total assets at end of year	2019-12-31	$6,404,130
Value of total assets at beginning of year	2019-12-31	$4,948,015
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$29,922
Total interest from all sources	2019-12-31	$14,996
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$399,704
Participant contributions at end of year	2019-12-31	$201,826
Participant contributions at beginning of year	2019-12-31	$155,605
Participant contributions at end of year	2019-12-31	$14,879
Participant contributions at beginning of year	2019-12-31	$15,915
Assets. Other investments not covered elsewhere at end of year	2019-12-31	$693,561
Assets. Other investments not covered elsewhere at beginning of year	2019-12-31	$514,839
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$1,456,115
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$6,404,130
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$4,948,015
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$5,041,618
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$3,839,037
Value of interest in pooled separate accounts at end of year	2019-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$0
Interest on participant loans	2019-12-31	$9,430
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$5,566
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$401,308
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$372,685
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$1,103,080
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$50,938
Employer contributions (assets) at end of year	2019-12-31	$50,938
Employer contributions (assets) at beginning of year	2019-12-31	$49,934
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$82,681
Contract administrator fees	2019-12-31	$29,922
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	BAS PARTNERS LLC
Accountancy firm EIN	2019-12-31	208779390
2018 : COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2018 401k financial data
Total income from all sources (including contributions)	2018-12-31	$106,206
Total of all expenses incurred	2018-12-31	$597,834
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$568,077
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$462,930
Value of total assets at end of year	2018-12-31	$4,948,015
Value of total assets at beginning of year	2018-12-31	$5,439,643
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$29,757
Total interest from all sources	2018-12-31	$12,264
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$412,996
Participant contributions at end of year	2018-12-31	$155,605
Participant contributions at beginning of year	2018-12-31	$173,391
Participant contributions at end of year	2018-12-31	$15,915
Participant contributions at beginning of year	2018-12-31	$16,334
Assets. Other investments not covered elsewhere at end of year	2018-12-31	$514,839
Assets. Other investments not covered elsewhere at beginning of year	2018-12-31	$643,917
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-491,628
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$4,948,015
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$5,439,643
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$3,839,037
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$4,194,943
Value of interest in pooled separate accounts at end of year	2018-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$0
Interest on participant loans	2018-12-31	$7,270
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$4,994
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$372,685
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$358,212
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-368,988
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$49,934
Employer contributions (assets) at end of year	2018-12-31	$49,934
Employer contributions (assets) at beginning of year	2018-12-31	$52,846
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$568,077
Contract administrator fees	2018-12-31	$29,757
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	BAS PARTNERS LLC
Accountancy firm EIN	2018-12-31	208779390
2017 : COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2017 401k financial data
Total income from all sources (including contributions)	2017-12-31	$1,179,365
Total of all expenses incurred	2017-12-31	$209,127
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$208,242
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$509,564
Value of total assets at end of year	2017-12-31	$5,439,643
Value of total assets at beginning of year	2017-12-31	$4,469,405
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$885
Total interest from all sources	2017-12-31	$11,134
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$449,710
Participant contributions at end of year	2017-12-31	$173,391
Participant contributions at beginning of year	2017-12-31	$139,863
Participant contributions at end of year	2017-12-31	$16,334
Participant contributions at beginning of year	2017-12-31	$20,547
Assets. Other investments not covered elsewhere at end of year	2017-12-31	$643,917
Assets. Other investments not covered elsewhere at beginning of year	2017-12-31	$553,718
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$7,008
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$970,238
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$5,439,643
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$4,469,405
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$4,194,943
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$3,373,416
Value of interest in pooled separate accounts at end of year	2017-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$0
Interest on participant loans	2017-12-31	$6,511
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-12-31	$4,623
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$358,212
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$334,275
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$658,667
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$52,846
Employer contributions (assets) at end of year	2017-12-31	$52,846
Employer contributions (assets) at beginning of year	2017-12-31	$47,586
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$208,242
Contract administrator fees	2017-12-31	$885
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	BAS PARTNERS LLC
Accountancy firm EIN	2017-12-31	208779390
2016 : COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2016 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2016-12-31	$3,463
Total unrealized appreciation/depreciation of assets	2016-12-31	$3,463
Total income from all sources (including contributions)	2016-12-31	$864,259
Total of all expenses incurred	2016-12-31	$163,490
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$136,805
Expenses. Certain deemed distributions of participant loans	2016-12-31	$7,418
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$539,027
Value of total assets at end of year	2016-12-31	$4,469,405
Value of total assets at beginning of year	2016-12-31	$3,768,636
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$19,267
Total interest from all sources	2016-12-31	$10,063
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$92,716
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$92,716
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$408,825
Participant contributions at end of year	2016-12-31	$139,863
Participant contributions at beginning of year	2016-12-31	$119,028
Participant contributions at end of year	2016-12-31	$20,547
Participant contributions at beginning of year	2016-12-31	$16,219
Assets. Other investments not covered elsewhere at end of year	2016-12-31	$553,718
Assets. Other investments not covered elsewhere at beginning of year	2016-12-31	$456,307
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$83,410
Other income not declared elsewhere	2016-12-31	$1,053
Administrative expenses (other) incurred	2016-12-31	$-642
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$700,769
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$4,469,405
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$3,768,636
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Investment advisory and management fees	2016-12-31	$19,909
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$3,373,416
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$2,824,583
Value of interest in pooled separate accounts at end of year	2016-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$0
Interest on participant loans	2016-12-31	$5,641
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$83
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$83
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-12-31	$4,422
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$334,275
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$307,213
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$217,937
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$46,792
Employer contributions (assets) at end of year	2016-12-31	$47,586
Employer contributions (assets) at beginning of year	2016-12-31	$45,203
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$136,805
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	BAS PARTNERS LLC
Accountancy firm EIN	2016-12-31	208779390
2015 : COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2015 401k financial data
Total income from all sources (including contributions)	2015-12-31	$679,693
Total of all expenses incurred	2015-12-31	$97,021
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$84,713
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$644,276
Value of total assets at end of year	2015-12-31	$3,768,636
Value of total assets at beginning of year	2015-12-31	$3,185,964
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$12,308
Total interest from all sources	2015-12-31	$2,498
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$77,627
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$77,627
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$375,621
Participant contributions at end of year	2015-12-31	$119,028
Participant contributions at beginning of year	2015-12-31	$39,652
Participant contributions at end of year	2015-12-31	$16,219
Participant contributions at beginning of year	2015-12-31	$21,910
Assets. Other investments not covered elsewhere at end of year	2015-12-31	$456,307
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$223,452
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$582,672
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$3,768,636
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$3,185,964
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$2,824,583
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$304,665
Value of interest in pooled separate accounts at end of year	2015-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$2,819,655
Interest on participant loans	2015-12-31	$2,498
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-12-31	$83
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$82
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$82
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$307,213
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-157,353
Net investment gain/loss from pooled separate accounts	2015-12-31	$112,645
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$45,203
Employer contributions (assets) at end of year	2015-12-31	$45,203
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$84,713
Contract administrator fees	2015-12-31	$12,308
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2015-12-31	Yes
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	BAS PARTNERS LLC
Accountancy firm EIN	2015-12-31	208779390
2014 : COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2014 401k financial data
Total income from all sources (including contributions)	2014-12-31	$459,512
Total of all expenses incurred	2014-12-31	$514,065
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$493,173
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$327,147
Value of total assets at end of year	2014-12-31	$3,185,964
Value of total assets at beginning of year	2014-12-31	$3,240,517
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$20,892
Total interest from all sources	2014-12-31	$1,546
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Administrative expenses professional fees incurred	2014-12-31	$2,526
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$297,692
Participant contributions at end of year	2014-12-31	$39,652
Participant contributions at beginning of year	2014-12-31	$34,999
Participant contributions at end of year	2014-12-31	$21,910
Participant contributions at beginning of year	2014-12-31	$9,732
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$29,455
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$-54,553
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$3,185,964
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$3,240,517
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$304,665
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$276,314
Value of interest in pooled separate accounts at end of year	2014-12-31	$2,819,655
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$2,919,390
Interest on participant loans	2014-12-31	$1,546
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-12-31	$82
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-12-31	$82
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-12-31	$82
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$130,819
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$493,173
Contract administrator fees	2014-12-31	$18,366
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	BAS PARTNERS LLC
Accountancy firm EIN	2014-12-31	208779390
2013 : COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2013 401k financial data
Total income from all sources (including contributions)	2013-12-31	$699,183
Total of all expenses incurred	2013-12-31	$212,024
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$212,024
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$223,241
Value of total assets at end of year	2013-12-31	$3,240,517
Value of total assets at beginning of year	2013-12-31	$2,753,358
Total interest from all sources	2013-12-31	$2,298
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$223,241
Participant contributions at end of year	2013-12-31	$34,999
Participant contributions at beginning of year	2013-12-31	$98,763
Participant contributions at end of year	2013-12-31	$9,732
Participant contributions at beginning of year	2013-12-31	$18,317
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$487,159
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$3,240,517
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$2,753,358
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$276,314
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$201,308
Value of interest in pooled separate accounts at end of year	2013-12-31	$2,919,390
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$2,434,888
Interest on participant loans	2013-12-31	$2,298
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$82
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$82
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$82
Net investment gain/loss from pooled separate accounts	2013-12-31	$473,644
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$212,024
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	BAS PARTNERS LLC
Accountancy firm EIN	2013-12-31	208779390

Form 5500 Responses for COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN

2022: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	Yes
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: COUCH BRAUNSDORF INSURANCE GROUP, INC. 401K PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

001

Policy instance

Insurance contract or identification number	001
Number of Individuals Covered	8
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

001

Policy instance

Insurance contract or identification number	001
Number of Individuals Covered	7
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

001

Policy instance

Insurance contract or identification number	001
Number of Individuals Covered	8
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

373225-01

Policy instance

Insurance contract or identification number	373225-01
Number of Individuals Covered	7
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

373225-01

Policy instance

Insurance contract or identification number	373225-01
Number of Individuals Covered	79
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $800
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $601
Insurance broker organization code?	3

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

373225-01

Policy instance

Insurance contract or identification number	373225-01
Number of Individuals Covered	9
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $935
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $935
Insurance broker organization code?	3
Insurance broker name	INVEST FINANCIAL CORPORATION

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

373225-01

Policy instance

Insurance contract or identification number	373225-01
Number of Individuals Covered	8
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $2,119
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,119
Insurance broker organization code?	3
Insurance broker name	INVEST FINANCIAL CORPORATION

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

78650

Policy instance

Insurance contract or identification number	78650
Number of Individuals Covered	0
Total amount of commissions paid to insurance broker	USD $9,128
Total amount of fees paid to insurance company	USD $1,061
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,128
Insurance broker organization code?	3
Amount paid for insurance broker fees	1061
Insurance broker name	INTAC ACTUARIAL SERVICES

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

78650

Policy instance

Insurance contract or identification number	78650
Number of Individuals Covered	65
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $18,366
Total amount of fees paid to insurance company	USD $2,526
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $18,366
Insurance broker organization code?	3
Amount paid for insurance broker fees	2526
Insurance broker name	INTAC ACTUARIAL SERVICES

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

78650

Policy instance

Insurance contract or identification number	78650
Number of Individuals Covered	118
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $17,257
Total amount of fees paid to insurance company	USD $750
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,535
Insurance broker organization code?	3
Amount paid for insurance broker fees	750
Insurance broker name	INVEST FINANCIAL CORP.

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Company Name:	COUCH BRAUNSDORF INSURANCE GROUP
Employer identification number (EIN):	222567763
NAIC Classification:	524210
NAIC Description:	Insurance Agencies and Brokerages