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GETTYSBURG FAMILY PRACTICE PROFIT SHARING PLAN 401k Plan overview

Plan NameGETTYSBURG FAMILY PRACTICE PROFIT SHARING PLAN
Plan identification number 002

GETTYSBURG FAMILY PRACTICE 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
  • 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.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • 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

GETTYSBURG FAMILY PRACTICE, INC. has sponsored the creation of one or more 401k plans.

Company Name:GETTYSBURG FAMILY PRACTICE, INC.
Employer identification number (EIN):232707038
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GETTYSBURG FAMILY PRACTICE PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022022-01-01
0022021-01-01
0022020-01-01
0022019-01-01WILLIAM ADAIR, MD2020-03-30
0022018-01-01
0022017-01-01
0022016-01-01
0022015-01-01
0022014-01-01DWIGHT MICHAEL MD

Plan Statistics for GETTYSBURG FAMILY PRACTICE PROFIT SHARING PLAN

401k plan membership statisitcs for GETTYSBURG FAMILY PRACTICE PROFIT SHARING PLAN

Measure Date Value
2022: GETTYSBURG FAMILY PRACTICE PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0138
Total number of active participants reported on line 7a of the Form 55002022-01-0123
Number of retired or separated participants receiving benefits2022-01-016
Number of other retired or separated participants entitled to future benefits2022-01-015
Total of all active and inactive participants2022-01-0134
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-0134
Number of participants with account balances2022-01-0134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: GETTYSBURG FAMILY PRACTICE PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0134
Total number of active participants reported on line 7a of the Form 55002021-01-0128
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0110
Total of all active and inactive participants2021-01-0138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-0138
Number of participants with account balances2021-01-0138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: GETTYSBURG FAMILY PRACTICE PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0132
Total number of active participants reported on line 7a of the Form 55002020-01-0128
Number of retired or separated participants receiving benefits2020-01-011
Number of other retired or separated participants entitled to future benefits2020-01-013
Total of all active and inactive participants2020-01-0132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-0132
Number of participants with account balances2020-01-0132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2018: GETTYSBURG FAMILY PRACTICE PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0130
Total number of active participants reported on line 7a of the Form 55002018-01-0126
Number of retired or separated participants receiving benefits2018-01-012
Number of other retired or separated participants entitled to future benefits2018-01-012
Total of all active and inactive participants2018-01-0130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0130
Number of participants with account balances2018-01-0130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: GETTYSBURG FAMILY PRACTICE PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0132
Total number of active participants reported on line 7a of the Form 55002017-01-0133
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-011
Total of all active and inactive participants2017-01-0134
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0134
Number of participants with account balances2017-01-0129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: GETTYSBURG FAMILY PRACTICE PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0133
Total number of active participants reported on line 7a of the Form 55002016-01-0128
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-011
Total of all active and inactive participants2016-01-0129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0129
Number of participants with account balances2016-01-0129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: GETTYSBURG FAMILY PRACTICE PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0132
Total number of active participants reported on line 7a of the Form 55002015-01-0130
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-011
Total of all active and inactive participants2015-01-0131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0131
Number of participants with account balances2015-01-0131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: GETTYSBURG FAMILY PRACTICE PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0130
Total number of active participants reported on line 7a of the Form 55002014-01-0128
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 participants2014-01-0131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0131
Number of participants with account balances2014-01-0131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010

Financial Data on GETTYSBURG FAMILY PRACTICE PROFIT SHARING PLAN

Measure Date Value
2022 : GETTYSBURG FAMILY PRACTICE PROFIT SHARING PLAN 2022 401k financial data
Total income from all sources2022-12-31$-294,724
Expenses. Total of all expenses incurred2022-12-31$400,505
Benefits paid (including direct rollovers)2022-12-31$383,304
Total plan assets at end of year2022-12-31$3,154,912
Total plan assets at beginning of year2022-12-31$3,850,141
Value of fidelity bond covering the plan2022-12-31$500,000
Total contributions received or receivable from participants2022-12-31$103,476
Other income received2022-12-31$-444,958
Net income (gross income less expenses)2022-12-31$-695,229
Net plan assets at end of year (total assets less liabilities)2022-12-31$3,154,912
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$3,850,141
Assets. Value of participant loans2022-12-31$2,859
Assets. Value of assets in partnership/joint-venture interests2022-12-31$536,718
Total contributions received or receivable from employer(s)2022-12-31$46,758
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$17,201
2021 : GETTYSBURG FAMILY PRACTICE PROFIT SHARING PLAN 2021 401k financial data
Total income from all sources2021-12-31$669,428
Expenses. Total of all expenses incurred2021-12-31$18,249
Total plan assets at end of year2021-12-31$3,850,141
Total plan assets at beginning of year2021-12-31$3,198,962
Value of fidelity bond covering the plan2021-12-31$500,000
Total contributions received or receivable from participants2021-12-31$92,178
Contributions received from other sources (not participants or employers)2021-12-31$0
Other income received2021-12-31$532,364
Net income (gross income less expenses)2021-12-31$651,179
Net plan assets at end of year (total assets less liabilities)2021-12-31$3,850,141
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$3,198,962
Assets. Value of participant loans2021-12-31$4,084
Assets. Value of assets in partnership/joint-venture interests2021-12-31$530,113
Total contributions received or receivable from employer(s)2021-12-31$44,886
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$18,249
2020 : GETTYSBURG FAMILY PRACTICE PROFIT SHARING PLAN 2020 401k financial data
Total plan liabilities at beginning of year2020-12-31$0
Total income from all sources2020-12-31$418,047
Expenses. Total of all expenses incurred2020-12-31$1,959,101
Benefits paid (including direct rollovers)2020-12-31$1,934,646
Total plan assets at end of year2020-12-31$3,198,962
Total plan assets at beginning of year2020-12-31$4,740,016
Value of fidelity bond covering the plan2020-12-31$500,000
Total contributions received or receivable from participants2020-12-31$84,218
Assets. Value of loans (other than to participants)2020-12-31$5,515
Other income received2020-12-31$292,982
Net income (gross income less expenses)2020-12-31$-1,541,054
Net plan assets at end of year (total assets less liabilities)2020-12-31$3,198,962
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$4,740,016
Assets. Value of assets in partnership/joint-venture interests2020-12-31$504,930
Total contributions received or receivable from employer(s)2020-12-31$40,847
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$24,455
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
2018 : GETTYSBURG FAMILY PRACTICE PROFIT SHARING PLAN 2018 401k financial data
Total plan liabilities at beginning of year2018-12-31$0
Total income from all sources2018-12-31$-154,538
Expenses. Total of all expenses incurred2018-12-31$1,544,333
Benefits paid (including direct rollovers)2018-12-31$1,510,354
Total plan assets at end of year2018-12-31$4,185,210
Total plan assets at beginning of year2018-12-31$5,884,081
Value of fidelity bond covering the plan2018-12-31$500,000
Total contributions received or receivable from participants2018-12-31$62,801
Contributions received from other sources (not participants or employers)2018-12-31$6,675
Other income received2018-12-31$-265,380
Net income (gross income less expenses)2018-12-31$-1,698,871
Net plan assets at end of year (total assets less liabilities)2018-12-31$4,185,210
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$5,884,081
Total contributions received or receivable from employer(s)2018-12-31$41,366
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$33,979
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
2017 : GETTYSBURG FAMILY PRACTICE PROFIT SHARING PLAN 2017 401k financial data
Total plan liabilities at end of year2017-12-31$0
Total plan liabilities at beginning of year2017-12-31$0
Total income from all sources2017-12-31$902,161
Expenses. Total of all expenses incurred2017-12-31$946,519
Benefits paid (including direct rollovers)2017-12-31$903,954
Total plan assets at end of year2017-12-31$5,884,081
Total plan assets at beginning of year2017-12-31$5,928,439
Value of fidelity bond covering the plan2017-12-31$500,000
Total contributions received or receivable from participants2017-12-31$78,369
Other income received2017-12-31$780,555
Net income (gross income less expenses)2017-12-31$-44,358
Net plan assets at end of year (total assets less liabilities)2017-12-31$5,884,081
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$5,928,439
Total contributions received or receivable from employer(s)2017-12-31$43,237
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$42,565
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : GETTYSBURG FAMILY PRACTICE PROFIT SHARING PLAN 2016 401k financial data
Total plan liabilities at end of year2016-12-31$0
Total income from all sources2016-12-31$517,478
Expenses. Total of all expenses incurred2016-12-31$155,545
Benefits paid (including direct rollovers)2016-12-31$111,997
Total plan assets at end of year2016-12-31$5,928,439
Total plan assets at beginning of year2016-12-31$5,566,506
Value of fidelity bond covering the plan2016-12-31$500,000
Total contributions received or receivable from participants2016-12-31$65,943
Other income received2016-12-31$410,319
Net income (gross income less expenses)2016-12-31$361,933
Net plan assets at end of year (total assets less liabilities)2016-12-31$5,928,439
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$5,566,506
Assets. Value of participant loans2016-12-31$422
Total contributions received or receivable from employer(s)2016-12-31$41,216
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$43,548
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : GETTYSBURG FAMILY PRACTICE PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources2015-12-31$96,608
Expenses. Total of all expenses incurred2015-12-31$70,072
Benefits paid (including direct rollovers)2015-12-31$24,998
Total plan assets at end of year2015-12-31$5,566,506
Total plan assets at beginning of year2015-12-31$5,539,970
Value of fidelity bond covering the plan2015-12-31$500,000
Total contributions received or receivable from participants2015-12-31$102,383
Other income received2015-12-31$-69,213
Net income (gross income less expenses)2015-12-31$26,536
Net plan assets at end of year (total assets less liabilities)2015-12-31$5,566,506
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$5,539,970
Assets. Value of participant loans2015-12-31$5,326
Total contributions received or receivable from employer(s)2015-12-31$63,438
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$45,074
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : GETTYSBURG FAMILY PRACTICE PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources2014-12-31$335,087
Expenses. Total of all expenses incurred2014-12-31$43,423
Benefits paid (including direct rollovers)2014-12-31$327
Total plan assets at end of year2014-12-31$5,539,970
Total plan assets at beginning of year2014-12-31$5,248,306
Value of fidelity bond covering the plan2014-12-31$500,000
Total contributions received or receivable from participants2014-12-31$97,242
Contributions received from other sources (not participants or employers)2014-12-31$16,020
Other income received2014-12-31$168,109
Net income (gross income less expenses)2014-12-31$291,664
Net plan assets at end of year (total assets less liabilities)2014-12-31$5,539,970
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$5,248,306
Assets. Value of participant loans2014-12-31$12,712
Total contributions received or receivable from employer(s)2014-12-31$53,716
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$43,096
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0

Form 5500 Responses for GETTYSBURG FAMILY PRACTICE PROFIT SHARING PLAN

2022: GETTYSBURG FAMILY PRACTICE PROFIT SHARING PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: GETTYSBURG FAMILY PRACTICE PROFIT SHARING PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: GETTYSBURG FAMILY PRACTICE PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2018: GETTYSBURG FAMILY PRACTICE PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: GETTYSBURG FAMILY PRACTICE 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: GETTYSBURG FAMILY PRACTICE 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: GETTYSBURG FAMILY PRACTICE 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: GETTYSBURG FAMILY PRACTICE 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

Insurance Providers Used on plan

VENERABLE INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 80942 )
Policy contract number1092571-OW
Policy instance 1
Insurance contract or identification number1092571-OW
Number of Individuals Covered1
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?1
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare 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
VENERABLE INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 80942 )
Policy contract number1092571-OW
Policy instance 1
Insurance contract or identification number1092571-OW
Number of Individuals Covered1
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?1
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
VENERABLE INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 80942 )
Policy contract number1092571-OW
Policy instance 1
Insurance contract or identification number1092571-OW
Number of Individuals Covered1
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?1
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
ING USA ANNUITY AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number1092571-OW
Policy instance 1
Insurance contract or identification number1092571-OW
Number of Individuals Covered1
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?1
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
ING USA ANNUITY AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number1092571-OW
Policy instance 1
Insurance contract or identification number1092571-OW
Number of Individuals Covered1
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $2,027
Are there contracts with allocated funds for individual policies?1
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees2027
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameDIRECTED SERVICES LL HOUSE ACCOUNT
ING USA ANNUITY AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number1092571-OW
Policy instance 1
Insurance contract or identification number1092571-OW
Number of Individuals Covered1
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $2,357
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,357
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameFRANK C PIZZUTO
ING USA ANNUITY AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number1092571-OW
Policy instance 1
Insurance contract or identification number1092571-OW
Number of Individuals Covered1
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker nameFRANK C PIZZUTO

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