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WESBURY HILLSIDE HOME 403(B) PLAN 401k Plan overview

Plan NameWESBURY HILLSIDE HOME 403(B) PLAN
Plan identification number 001

WESBURY HILLSIDE HOME 403(B) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.

401k Sponsoring company profile

WESBURY HILLSIDE HOME has sponsored the creation of one or more 401k plans.

Company Name:WESBURY HILLSIDE HOME
Employer identification number (EIN):250986047
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WESBURY HILLSIDE HOME 403(B) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01
0012017-01-01DEAN YORK
0012016-01-01DEAN YORK
0012015-01-01CATHERINE HANSON
0012014-01-01CATHERINE HANSON
0012013-01-01CATHERINE HANSON
0012012-01-01CATHERINE HANSON CATHERINE HANSON2013-10-07
0012011-01-01CATHERINE HANSON CATHERINE HANSON2012-10-08
0012010-01-01CATHERINE HANSON CATHERINE HANSON2011-07-28
0012009-01-01CATHERINE HANSON CATHERINE HANSON2010-10-11

Plan Statistics for WESBURY HILLSIDE HOME 403(B) PLAN

401k plan membership statisitcs for WESBURY HILLSIDE HOME 403(B) PLAN

Measure Date Value
2022: WESBURY HILLSIDE HOME 403(B) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0115
Number of other retired or separated participants entitled to future benefits2022-01-0115
Total of all active and inactive participants2022-01-0115
Total participants2022-01-0115
Number of participants with account balances2022-01-0115
2021: WESBURY HILLSIDE HOME 403(B) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0117
Number of other retired or separated participants entitled to future benefits2021-01-0115
Total of all active and inactive participants2021-01-0115
Total participants2021-01-0115
Number of participants with account balances2021-01-0115
2020: WESBURY HILLSIDE HOME 403(B) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0121
Number of other retired or separated participants entitled to future benefits2020-01-0117
Total of all active and inactive participants2020-01-0117
Total participants2020-01-0117
Number of participants with account balances2020-01-0117
2019: WESBURY HILLSIDE HOME 403(B) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0123
Number of other retired or separated participants entitled to future benefits2019-01-0121
Total of all active and inactive participants2019-01-0121
Total participants2019-01-0121
Number of participants with account balances2019-01-0121
2018: WESBURY HILLSIDE HOME 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0126
Number of other retired or separated participants entitled to future benefits2018-01-0123
Total of all active and inactive participants2018-01-0123
Total participants2018-01-0123
Number of participants with account balances2018-01-0123
2017: WESBURY HILLSIDE HOME 403(B) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0161
Number of other retired or separated participants entitled to future benefits2017-01-0126
Total of all active and inactive participants2017-01-0126
Total participants2017-01-0126
Number of participants with account balances2017-01-0126
2016: WESBURY HILLSIDE HOME 403(B) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0145
Total number of active participants reported on line 7a of the Form 55002016-01-0136
Number of other retired or separated participants entitled to future benefits2016-01-0125
Total of all active and inactive participants2016-01-0161
Total participants2016-01-0161
Number of participants with account balances2016-01-0139
2015: WESBURY HILLSIDE HOME 403(B) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0145
Total number of active participants reported on line 7a of the Form 55002015-01-0131
Number of other retired or separated participants entitled to future benefits2015-01-0114
Total of all active and inactive participants2015-01-0145
Total participants2015-01-0145
Number of participants with account balances2015-01-0137
2014: WESBURY HILLSIDE HOME 403(B) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0150
Total number of active participants reported on line 7a of the Form 55002014-01-0130
Number of other retired or separated participants entitled to future benefits2014-01-0115
Total of all active and inactive participants2014-01-0145
Total participants2014-01-0145
Number of participants with account balances2014-01-0138
2013: WESBURY HILLSIDE HOME 403(B) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0148
Total number of active participants reported on line 7a of the Form 55002013-01-0136
Number of other retired or separated participants entitled to future benefits2013-01-0114
Total of all active and inactive participants2013-01-0150
Total participants2013-01-0150
Number of participants with account balances2013-01-0136
2012: WESBURY HILLSIDE HOME 403(B) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0141
Total number of active participants reported on line 7a of the Form 55002012-01-0137
Number of other retired or separated participants entitled to future benefits2012-01-0111
Total of all active and inactive participants2012-01-0148
Total participants2012-01-0148
Number of participants with account balances2012-01-0138
2011: WESBURY HILLSIDE HOME 403(B) PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0141
Total number of active participants reported on line 7a of the Form 55002011-01-0141
Number of other retired or separated participants entitled to future benefits2011-01-0110
Total of all active and inactive participants2011-01-0151
Total participants2011-01-0151
Number of participants with account balances2011-01-0138
2010: WESBURY HILLSIDE HOME 403(B) PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0141
Total number of active participants reported on line 7a of the Form 55002010-01-0132
Number of other retired or separated participants entitled to future benefits2010-01-0111
Total of all active and inactive participants2010-01-0143
Total participants2010-01-0143
Number of participants with account balances2010-01-0141
2009: WESBURY HILLSIDE HOME 403(B) PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0138
Total number of active participants reported on line 7a of the Form 55002009-01-0133
Number of other retired or separated participants entitled to future benefits2009-01-018
Total of all active and inactive participants2009-01-0141
Total participants2009-01-0141
Number of participants with account balances2009-01-0140

Financial Data on WESBURY HILLSIDE HOME 403(B) PLAN

Measure Date Value
2022 : WESBURY HILLSIDE HOME 403(B) PLAN 2022 401k financial data
Total income from all sources2022-12-31$1,076
Expenses. Total of all expenses incurred2022-12-31$418
Benefits paid (including direct rollovers)2022-12-31$388
Total plan assets at end of year2022-12-31$37,674
Total plan assets at beginning of year2022-12-31$37,016
Value of fidelity bond covering the plan2022-12-31$500,000
Other income received2022-12-31$1,076
Net income (gross income less expenses)2022-12-31$658
Net plan assets at end of year (total assets less liabilities)2022-12-31$37,674
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$37,016
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$30
2021 : WESBURY HILLSIDE HOME 403(B) PLAN 2021 401k financial data
Total income from all sources2021-12-31$1,368
Expenses. Total of all expenses incurred2021-12-31$944
Benefits paid (including direct rollovers)2021-12-31$914
Total plan assets at end of year2021-12-31$37,016
Total plan assets at beginning of year2021-12-31$36,592
Value of fidelity bond covering the plan2021-12-31$500,000
Other income received2021-12-31$1,368
Net income (gross income less expenses)2021-12-31$424
Net plan assets at end of year (total assets less liabilities)2021-12-31$37,016
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$36,592
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$30
2020 : WESBURY HILLSIDE HOME 403(B) PLAN 2020 401k financial data
Total income from all sources2020-12-31$-5,111
Expenses. Total of all expenses incurred2020-12-31$79,308
Benefits paid (including direct rollovers)2020-12-31$79,263
Total plan assets at end of year2020-12-31$36,592
Total plan assets at beginning of year2020-12-31$121,011
Value of fidelity bond covering the plan2020-12-31$500,000
Other income received2020-12-31$-5,111
Net income (gross income less expenses)2020-12-31$-84,419
Net plan assets at end of year (total assets less liabilities)2020-12-31$36,592
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$121,011
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$45
2019 : WESBURY HILLSIDE HOME 403(B) PLAN 2019 401k financial data
Total income from all sources2019-12-31$19,215
Expenses. Total of all expenses incurred2019-12-31$27,531
Benefits paid (including direct rollovers)2019-12-31$27,434
Total plan assets at end of year2019-12-31$121,011
Total plan assets at beginning of year2019-12-31$129,327
Value of fidelity bond covering the plan2019-12-31$500,000
Other income received2019-12-31$19,215
Net income (gross income less expenses)2019-12-31$-8,316
Net plan assets at end of year (total assets less liabilities)2019-12-31$121,011
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$129,327
Total contributions received or receivable from employer(s)2019-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$97
2018 : WESBURY HILLSIDE HOME 403(B) PLAN 2018 401k financial data
Total income from all sources2018-12-31$-6,319
Expenses. Total of all expenses incurred2018-12-31$3,172
Benefits paid (including direct rollovers)2018-12-31$3,052
Total plan assets at end of year2018-12-31$129,327
Total plan assets at beginning of year2018-12-31$138,818
Value of fidelity bond covering the plan2018-12-31$500,000
Other income received2018-12-31$-6,269
Net income (gross income less expenses)2018-12-31$-9,491
Net plan assets at end of year (total assets less liabilities)2018-12-31$129,327
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$138,818
Total contributions received or receivable from employer(s)2018-12-31$-50
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$120
2017 : WESBURY HILLSIDE HOME 403(B) PLAN 2017 401k financial data
Total income from all sources2017-12-31$36,887
Expenses. Total of all expenses incurred2017-12-31$138,772
Benefits paid (including direct rollovers)2017-12-31$138,503
Total plan assets at end of year2017-12-31$138,818
Total plan assets at beginning of year2017-12-31$240,703
Value of fidelity bond covering the plan2017-12-31$500,000
Total contributions received or receivable from participants2017-12-31$6,895
Other income received2017-12-31$28,800
Net income (gross income less expenses)2017-12-31$-101,885
Net plan assets at end of year (total assets less liabilities)2017-12-31$138,818
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$240,703
Total contributions received or receivable from employer(s)2017-12-31$1,192
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$269
2016 : WESBURY HILLSIDE HOME 403(B) PLAN 2016 401k financial data
Total income from all sources2016-12-31$32,156
Expenses. Total of all expenses incurred2016-12-31$34,147
Benefits paid (including direct rollovers)2016-12-31$33,838
Total plan assets at end of year2016-12-31$240,703
Total plan assets at beginning of year2016-12-31$242,694
Value of fidelity bond covering the plan2016-12-31$500,000
Total contributions received or receivable from participants2016-12-31$12,108
Other income received2016-12-31$16,983
Net income (gross income less expenses)2016-12-31$-1,991
Net plan assets at end of year (total assets less liabilities)2016-12-31$240,703
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$242,694
Total contributions received or receivable from employer(s)2016-12-31$3,065
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$309
2015 : WESBURY HILLSIDE HOME 403(B) PLAN 2015 401k financial data
Total income from all sources2015-12-31$15,307
Expenses. Total of all expenses incurred2015-12-31$19,102
Benefits paid (including direct rollovers)2015-12-31$18,859
Total plan assets at end of year2015-12-31$242,694
Total plan assets at beginning of year2015-12-31$246,489
Value of fidelity bond covering the plan2015-12-31$500,000
Total contributions received or receivable from participants2015-12-31$12,861
Other income received2015-12-31$-733
Net income (gross income less expenses)2015-12-31$-3,795
Net plan assets at end of year (total assets less liabilities)2015-12-31$242,694
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$246,489
Total contributions received or receivable from employer(s)2015-12-31$3,179
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$243
2014 : WESBURY HILLSIDE HOME 403(B) PLAN 2014 401k financial data
Total income from all sources2014-12-31$29,981
Expenses. Total of all expenses incurred2014-12-31$40,579
Benefits paid (including direct rollovers)2014-12-31$40,339
Total plan assets at end of year2014-12-31$246,489
Total plan assets at beginning of year2014-12-31$257,087
Value of fidelity bond covering the plan2014-12-31$500,000
Total contributions received or receivable from participants2014-12-31$13,069
Other income received2014-12-31$13,890
Net income (gross income less expenses)2014-12-31$-10,598
Net plan assets at end of year (total assets less liabilities)2014-12-31$246,489
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$257,087
Total contributions received or receivable from employer(s)2014-12-31$3,022
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$240
2013 : WESBURY HILLSIDE HOME 403(B) PLAN 2013 401k financial data
Total income from all sources2013-12-31$54,410
Expenses. Total of all expenses incurred2013-12-31$16,279
Benefits paid (including direct rollovers)2013-12-31$16,024
Total plan assets at end of year2013-12-31$257,087
Total plan assets at beginning of year2013-12-31$218,956
Value of fidelity bond covering the plan2013-12-31$500,000
Total contributions received or receivable from participants2013-12-31$17,387
Other income received2013-12-31$33,502
Net income (gross income less expenses)2013-12-31$38,131
Net plan assets at end of year (total assets less liabilities)2013-12-31$257,087
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$218,956
Assets. Value of participant loans2013-12-31$1,228
Total contributions received or receivable from employer(s)2013-12-31$3,521
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$255
2012 : WESBURY HILLSIDE HOME 403(B) PLAN 2012 401k financial data
Total income from all sources2012-12-31$40,106
Expenses. Total of all expenses incurred2012-12-31$5,320
Benefits paid (including direct rollovers)2012-12-31$5,050
Total plan assets at end of year2012-12-31$218,956
Total plan assets at beginning of year2012-12-31$184,170
Value of fidelity bond covering the plan2012-12-31$500,000
Total contributions received or receivable from participants2012-12-31$19,143
Other income received2012-12-31$17,058
Net income (gross income less expenses)2012-12-31$34,786
Net plan assets at end of year (total assets less liabilities)2012-12-31$218,956
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$184,170
Assets. Value of participant loans2012-12-31$3,024
Total contributions received or receivable from employer(s)2012-12-31$3,905
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$270
2011 : WESBURY HILLSIDE HOME 403(B) PLAN 2011 401k financial data
Total income from all sources2011-12-31$21,963
Expenses. Total of all expenses incurred2011-12-31$17,113
Benefits paid (including direct rollovers)2011-12-31$16,843
Total plan assets at end of year2011-12-31$184,170
Total plan assets at beginning of year2011-12-31$179,320
Value of fidelity bond covering the plan2011-12-31$500,000
Total contributions received or receivable from participants2011-12-31$17,790
Other income received2011-12-31$-696
Net income (gross income less expenses)2011-12-31$4,850
Net plan assets at end of year (total assets less liabilities)2011-12-31$184,170
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$179,320
Total contributions received or receivable from employer(s)2011-12-31$4,869
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$270
2010 : WESBURY HILLSIDE HOME 403(B) PLAN 2010 401k financial data
Total income from all sources2010-12-31$41,955
Expenses. Total of all expenses incurred2010-12-31$1,678
Benefits paid (including direct rollovers)2010-12-31$1,408
Total plan assets at end of year2010-12-31$179,320
Total plan assets at beginning of year2010-12-31$139,043
Value of fidelity bond covering the plan2010-12-31$500,000
Total contributions received or receivable from participants2010-12-31$23,834
Other income received2010-12-31$12,300
Net income (gross income less expenses)2010-12-31$40,277
Net plan assets at end of year (total assets less liabilities)2010-12-31$179,320
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$139,043
Total contributions received or receivable from employer(s)2010-12-31$5,821
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$270

Form 5500 Responses for WESBURY HILLSIDE HOME 403(B) PLAN

2022: WESBURY HILLSIDE HOME 403(B) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
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: WESBURY HILLSIDE HOME 403(B) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
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: WESBURY HILLSIDE HOME 403(B) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: WESBURY HILLSIDE HOME 403(B) PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: WESBURY HILLSIDE HOME 403(B) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
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: WESBURY HILLSIDE HOME 403(B) PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
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: WESBURY HILLSIDE HOME 403(B) PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
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: WESBURY HILLSIDE HOME 403(B) PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
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: WESBURY HILLSIDE HOME 403(B) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
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: WESBURY HILLSIDE HOME 403(B) PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
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: WESBURY HILLSIDE HOME 403(B) PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
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: WESBURY HILLSIDE HOME 403(B) PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: WESBURY HILLSIDE HOME 403(B) PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: WESBURY HILLSIDE HOME 403(B) PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number936141
Policy instance 1
Insurance contract or identification number936141
Number of Individuals Covered15
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number936141
Policy instance 1
Insurance contract or identification number936141
Number of Individuals Covered15
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 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
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number936141
Policy instance 1
Insurance contract or identification number936141
Number of Individuals Covered17
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 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
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number936141
Policy instance 1
Insurance contract or identification number936141
Number of Individuals Covered21
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $434
Total amount of fees paid to insurance companyUSD $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
Commission paid to Insurance BrokerUSD $434
Insurance broker organization code?4
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number936141
Policy instance 1
Insurance contract or identification number936141
Number of Individuals Covered23
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $2
Total amount of fees paid to insurance companyUSD $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
Commission paid to Insurance BrokerUSD $2
Insurance broker organization code?4
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number936141
Policy instance 1
Insurance contract or identification number936141
Number of Individuals Covered26
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $366
Total amount of fees paid to insurance companyUSD $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
Commission paid to Insurance BrokerUSD $366
Insurance broker organization code?4
Insurance broker nameGARY B HAIBACH & ASSOCIATES
METLIFE INVESTORS (National Association of Insurance Commissioners NAIC id number: 80950 )
Policy contract number936141
Policy instance 1
Insurance contract or identification number936141
Number of Individuals Covered40
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $711
Total amount of fees paid to insurance companyUSD $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
Commission paid to Insurance BrokerUSD $711
Insurance broker organization code?4
Insurance broker nameGARY B HAIBACH & ASSOCIATES
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number936141
Policy instance 1
Insurance contract or identification number936141
Number of Individuals Covered40
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $708
Total amount of fees paid to insurance companyUSD $0
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 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 BrokerUSD $708
Insurance broker organization code?4
Insurance broker nameGARY B HAIBACH & ASSOCIATES
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number936141
Policy instance 1
Insurance contract or identification number936141
Number of Individuals Covered36
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $859
Total amount of fees paid to insurance companyUSD $0
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 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 BrokerUSD $859
Insurance broker organization code?4
Insurance broker nameGARY B HAIBACH & ASSOCIATES
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number936141
Policy instance 1
Insurance contract or identification number936141
Number of Individuals Covered38
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $945
Total amount of fees paid to insurance companyUSD $0
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 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 BrokerUSD $945
Insurance broker organization code?4
Insurance broker nameGARY B HAIBACH & ASSOCIATES
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number936141
Policy instance 1
Insurance contract or identification number936141
Number of Individuals Covered38
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $896
Total amount of fees paid to insurance companyUSD $0
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 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
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number936141
Policy instance 1
Insurance contract or identification number936141
Number of Individuals Covered41
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $1,206
Total amount of fees paid to insurance companyUSD $0
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 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 BrokerUSD $1,206
Insurance broker organization code?4
Insurance broker nameGARY B HAIBACH & ASSOCIATES

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