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PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN 401k Plan overview

Plan NamePEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN
Plan identification number 003

PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • 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.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH has sponsored the creation of one or more 401k plans.

Company Name:PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH
Employer identification number (EIN):223591652
NAIC Classification:621210
NAIC Description:Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0032019-01-01
0032018-01-01
0032017-01-01
0032016-01-01
0032015-01-01
0032014-01-01AARON MANNELLA, DMD
0032013-01-01AARON MANNELLA, DMD
0032012-01-01AARON MANNELLA, DMD
0032011-01-01AARON MANNELLA, DMD
0032010-01-01AARON MANNELLA, DMD
0032009-01-01AARON MANNELLA, DMD

Plan Statistics for PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN

401k plan membership statisitcs for PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN

Measure Date Value
2017: PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0113
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 benefits2017-01-015
Total of all active and inactive participants2017-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-017
Number of participants with account balances2017-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0113
Total number of active participants reported on line 7a of the Form 55002016-01-012
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0111
Total of all active and inactive participants2016-01-0113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0113
Number of participants with account balances2016-01-0113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0114
Total number of active participants reported on line 7a of the Form 55002015-01-012
Number of retired or separated participants receiving benefits2015-01-014
Number of other retired or separated participants entitled to future benefits2015-01-017
Total of all active and inactive participants2015-01-0113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0113
Number of participants with account balances2015-01-0113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0115
Total number of active participants reported on line 7a of the Form 55002014-01-0111
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-013
Total of all active and inactive participants2014-01-0114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0114
Number of participants with account balances2014-01-0114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-012
2013: PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0121
Total number of active participants reported on line 7a of the Form 55002013-01-0112
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-013
Total of all active and inactive participants2013-01-0115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0115
Number of participants with account balances2013-01-0114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-011
2012: PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0119
Total number of active participants reported on line 7a of the Form 55002012-01-0112
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-017
Total of all active and inactive participants2012-01-0119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0119
Number of participants with account balances2012-01-0119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-013
2011: PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0118
Total number of active participants reported on line 7a of the Form 55002011-01-0115
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-013
Total of all active and inactive participants2011-01-0118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0118
Number of participants with account balances2011-01-0118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-012
2010: PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0115
Total number of active participants reported on line 7a of the Form 55002010-01-0114
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-011
Total of all active and inactive participants2010-01-0115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0115
Number of participants with account balances2010-01-0115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0116
Total number of active participants reported on line 7a of the Form 55002009-01-0114
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-011
Total of all active and inactive participants2009-01-0115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0115
Number of participants with account balances2009-01-0115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN

Measure Date Value
2017 : PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources2017-12-31$267,450
Expenses. Total of all expenses incurred2017-12-31$43,401
Benefits paid (including direct rollovers)2017-12-31$34,271
Total plan assets at end of year2017-12-31$1,900,789
Total plan assets at beginning of year2017-12-31$1,676,740
Value of fidelity bond covering the plan2017-12-31$500,000
Other income received2017-12-31$267,450
Net income (gross income less expenses)2017-12-31$224,049
Net plan assets at end of year (total assets less liabilities)2017-12-31$1,900,789
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$1,676,740
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$9,130
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources2016-12-31$51,247
Expenses. Total of all expenses incurred2016-12-31$7,900
Total plan assets at end of year2016-12-31$1,676,740
Total plan assets at beginning of year2016-12-31$1,633,393
Value of fidelity bond covering the plan2016-12-31$500,000
Other income received2016-12-31$51,247
Net income (gross income less expenses)2016-12-31$43,347
Net plan assets at end of year (total assets less liabilities)2016-12-31$1,676,740
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$1,633,393
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$7,900
2015 : PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources2015-12-31$2,279
Expenses. Total of all expenses incurred2015-12-31$261,693
Benefits paid (including direct rollovers)2015-12-31$253,676
Total plan assets at end of year2015-12-31$1,633,393
Total plan assets at beginning of year2015-12-31$1,892,807
Value of fidelity bond covering the plan2015-12-31$500,000
Total contributions received or receivable from participants2015-12-31$28,756
Other income received2015-12-31$-67,291
Net income (gross income less expenses)2015-12-31$-259,414
Net plan assets at end of year (total assets less liabilities)2015-12-31$1,633,393
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$1,892,807
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-1022015-12-31$3,134
Total contributions received or receivable from employer(s)2015-12-31$40,814
Value of certain deemed distributions of participant loans2015-12-31$8,017
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources2014-12-31$147,836
Expenses. Total of all expenses incurred2014-12-31$10,082
Benefits paid (including direct rollovers)2014-12-31$2,388
Total plan assets at end of year2014-12-31$1,892,807
Total plan assets at beginning of year2014-12-31$1,755,053
Value of fidelity bond covering the plan2014-12-31$500,000
Total contributions received or receivable from participants2014-12-31$77,391
Other income received2014-12-31$19,486
Net income (gross income less expenses)2014-12-31$137,754
Net plan assets at end of year (total assets less liabilities)2014-12-31$1,892,807
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$1,755,053
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-1022014-12-31$9
Total contributions received or receivable from employer(s)2014-12-31$50,959
Value of certain deemed distributions of participant loans2014-12-31$7,694
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources2013-12-31$309,189
Expenses. Total of all expenses incurred2013-12-31$50,646
Benefits paid (including direct rollovers)2013-12-31$43,605
Total plan assets at end of year2013-12-31$1,755,053
Total plan assets at beginning of year2013-12-31$1,496,510
Value of fidelity bond covering the plan2013-12-31$500,000
Total contributions received or receivable from participants2013-12-31$65,211
Other income received2013-12-31$198,340
Net income (gross income less expenses)2013-12-31$258,543
Net plan assets at end of year (total assets less liabilities)2013-12-31$1,755,053
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$1,496,510
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-1022013-12-31$926
Total contributions received or receivable from employer(s)2013-12-31$45,638
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$7,041
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources2012-12-31$189,622
Expenses. Total of all expenses incurred2012-12-31$17,177
Benefits paid (including direct rollovers)2012-12-31$13,844
Total plan assets at end of year2012-12-31$1,496,510
Total plan assets at beginning of year2012-12-31$1,324,065
Value of fidelity bond covering the plan2012-12-31$500,000
Total contributions received or receivable from participants2012-12-31$46,774
Other income received2012-12-31$57,078
Net income (gross income less expenses)2012-12-31$172,445
Net plan assets at end of year (total assets less liabilities)2012-12-31$1,496,510
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$1,324,065
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-1022012-12-31$926
Total contributions received or receivable from employer(s)2012-12-31$85,770
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$3,333
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources2011-12-31$80,619
Expenses. Total of all expenses incurred2011-12-31$9,496
Total plan assets at end of year2011-12-31$1,324,065
Total plan assets at beginning of year2011-12-31$1,252,942
Value of fidelity bond covering the plan2011-12-31$150,000
Total contributions received or receivable from participants2011-12-31$44,523
Other income received2011-12-31$-45,399
Net income (gross income less expenses)2011-12-31$71,123
Net plan assets at end of year (total assets less liabilities)2011-12-31$1,324,065
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$1,252,942
Total contributions received or receivable from employer(s)2011-12-31$81,495
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$9,496
2010 : PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN 2010 401k financial data
Total income from all sources2010-12-31$186,308
Expenses. Total of all expenses incurred2010-12-31$9,564
Total plan assets at end of year2010-12-31$1,252,942
Total plan assets at beginning of year2010-12-31$1,076,198
Value of fidelity bond covering the plan2010-12-31$120,000
Total contributions received or receivable from participants2010-12-31$33,589
Other income received2010-12-31$53,360
Net income (gross income less expenses)2010-12-31$176,744
Net plan assets at end of year (total assets less liabilities)2010-12-31$1,252,942
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$1,076,198
Total contributions received or receivable from employer(s)2010-12-31$99,359
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$9,564
2009 : PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN

2017: PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement - TrustYes
2010: PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement - TrustYes
2009: PEDIATRIC DENTAL ASSOCIATES OF RANDOLPH 401K PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )
Policy contract number300186
Policy instance 1
Insurance contract or identification number300186
Number of Individuals Covered7
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $7,652
Total amount of fees paid to insurance companyUSD $509
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,826
Insurance broker organization code?4
Amount paid for insurance broker fees509
Additional information about fees paid to insurance brokerADVISORY SERVICES TO PLAN SPONSORS
Insurance broker nameSWBC INVESTMENT ADVISORY SERVICES
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )
Policy contract number300186
Policy instance 1
Insurance contract or identification number300186
Number of Individuals Covered14
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $7,346
Total amount of fees paid to insurance companyUSD $1,224
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,673
Insurance broker organization code?4
Amount paid for insurance broker fees847
Additional information about fees paid to insurance brokerSERVICE FEES
Insurance broker nameSWBC INVESTMENT ADVISORY SERVICES
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )
Policy contract number300186
Policy instance 1
Insurance contract or identification number300186
Number of Individuals Covered14
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $7,294
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,647
Insurance broker organization code?3
Insurance broker nameLAX, ROBERT
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )
Policy contract number300186
Policy instance 1
Insurance contract or identification number300186
Number of Individuals Covered14
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $6,656
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,380
Insurance broker organization code?3
Insurance broker nameLAX, ROBERT
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )
Policy contract number300186
Policy instance 1
Insurance contract or identification number300186
Number of Individuals Covered18
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $4,338
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,169
Insurance broker organization code?3
Insurance broker nameBENOWITZ, JEFFREY

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