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NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN 401k Plan overview

Plan NameNICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN
Plan identification number 001

NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • 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

NICHOLAS J. MASCIOTRA MD PC has sponsored the creation of one or more 401k plans.

Company Name:NICHOLAS J. MASCIOTRA MD PC
Employer identification number (EIN):251562722
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012019-01-01
0012018-01-01
0012017-01-01NICHOLAS J. MASCIOTRA
0012016-01-01NICHOLAS J. MASCIOTRA
0012015-01-01NICHOLAS J. MASCIOTRA
0012014-01-01NICHOLAS J. MASCIOTRA
0012013-01-01NICHOLAS J. MASCIOTRA
0012012-01-01NICHOLAS J. MASCIOTRA
0012011-01-01NICHOLAS J. MASCIOTRA
0012009-01-01NICHOLAS J. MASCIOTRA

Plan Statistics for NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN

401k plan membership statisitcs for NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN

Measure Date Value
2019: NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-011
Total number of active participants reported on line 7a of the Form 55002019-01-010
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-010
Number of participants with account balances2019-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-018
Total number of active participants reported on line 7a of the Form 55002018-01-010
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-011
Total of all active and inactive participants2018-01-011
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-011
Number of participants with account balances2018-01-011
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-018
Total number of active participants reported on line 7a of the Form 55002017-01-010
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-018
Total of all active and inactive participants2017-01-018
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-018
Number of participants with account balances2017-01-018
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-017
Total number of active participants reported on line 7a of the Form 55002016-01-013
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-014
Total of all active and inactive participants2016-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-017
Number of participants with account balances2016-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-017
Total number of active participants reported on line 7a of the Form 55002015-01-012
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-015
Total of all active and inactive participants2015-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-017
Number of participants with account balances2015-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-017
Total number of active participants reported on line 7a of the Form 55002014-01-013
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-014
Total of all active and inactive participants2014-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-017
Number of participants with account balances2014-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-011
2013: NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-017
Total number of active participants reported on line 7a of the Form 55002013-01-015
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-012
Total of all active and inactive participants2013-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-017
Number of participants with account balances2013-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-017
Total number of active participants reported on line 7a of the Form 55002012-01-015
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-012
Total of all active and inactive participants2012-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-017
Number of participants with account balances2012-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-017
Total number of active participants reported on line 7a of the Form 55002011-01-015
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-012
Total of all active and inactive participants2011-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-017
Number of participants with account balances2011-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-016
Total number of active participants reported on line 7a of the Form 55002009-01-014
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-012
Total of all active and inactive participants2009-01-016
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-016
Number of participants with account balances2009-01-016

Financial Data on NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN

Measure Date Value
2019 : NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN 2019 401k financial data
Total income from all sources2019-12-31$54,042
Expenses. Total of all expenses incurred2019-12-31$1,439,742
Benefits paid (including direct rollovers)2019-12-31$1,439,582
Total plan assets at end of year2019-12-31$0
Total plan assets at beginning of year2019-12-31$1,385,700
Value of fidelity bond covering the plan2019-12-31$400,000
Expenses. Other expenses not covered elsewhere2019-12-31$6
Other income received2019-12-31$54,042
Net income (gross income less expenses)2019-12-31$-1,385,700
Net plan assets at end of year (total assets less liabilities)2019-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$1,385,700
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$154
2018 : NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN 2018 401k financial data
Total income from all sources2018-12-31$-138,439
Expenses. Total of all expenses incurred2018-12-31$3,024,389
Benefits paid (including direct rollovers)2018-12-31$3,010,461
Total plan assets at end of year2018-12-31$1,385,700
Total plan assets at beginning of year2018-12-31$4,548,528
Value of fidelity bond covering the plan2018-12-31$400,000
Expenses. Other expenses not covered elsewhere2018-12-31$6,969
Other income received2018-12-31$-145,071
Net income (gross income less expenses)2018-12-31$-3,162,828
Net plan assets at end of year (total assets less liabilities)2018-12-31$1,385,700
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$4,548,528
Total contributions received or receivable from employer(s)2018-12-31$6,632
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$6,959
2017 : NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources2017-12-31$660,090
Expenses. Total of all expenses incurred2017-12-31$57,199
Benefits paid (including direct rollovers)2017-12-31$44,079
Total plan assets at end of year2017-12-31$4,548,528
Total plan assets at beginning of year2017-12-31$3,945,637
Value of fidelity bond covering the plan2017-12-31$400,000
Expenses. Other expenses not covered elsewhere2017-12-31$6,460
Other income received2017-12-31$653,658
Net income (gross income less expenses)2017-12-31$602,891
Net plan assets at end of year (total assets less liabilities)2017-12-31$4,548,528
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$3,945,637
Total contributions received or receivable from employer(s)2017-12-31$6,432
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$6,660
2016 : NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources2016-12-31$237,075
Expenses. Total of all expenses incurred2016-12-31$12,567
Total plan assets at end of year2016-12-31$3,945,637
Total plan assets at beginning of year2016-12-31$3,721,129
Value of fidelity bond covering the plan2016-12-31$400,000
Expenses. Other expenses not covered elsewhere2016-12-31$6,440
Other income received2016-12-31$230,643
Net income (gross income less expenses)2016-12-31$224,508
Net plan assets at end of year (total assets less liabilities)2016-12-31$3,945,637
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$3,721,129
Total contributions received or receivable from employer(s)2016-12-31$6,432
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$6,127
2015 : NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources2015-12-31$8,311
Expenses. Total of all expenses incurred2015-12-31$12,706
Total plan assets at end of year2015-12-31$3,721,129
Total plan assets at beginning of year2015-12-31$3,725,524
Value of fidelity bond covering the plan2015-12-31$400,000
Expenses. Other expenses not covered elsewhere2015-12-31$6,632
Other income received2015-12-31$-10,321
Net income (gross income less expenses)2015-12-31$-4,395
Net plan assets at end of year (total assets less liabilities)2015-12-31$3,721,129
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$3,725,524
Total contributions received or receivable from employer(s)2015-12-31$18,632
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$6,074
2014 : NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources2014-12-31$263,526
Expenses. Total of all expenses incurred2014-12-31$51,323
Benefits paid (including direct rollovers)2014-12-31$38,929
Total plan assets at end of year2014-12-31$3,725,524
Total plan assets at beginning of year2014-12-31$3,513,321
Value of fidelity bond covering the plan2014-12-31$250,000
Expenses. Other expenses not covered elsewhere2014-12-31$6,632
Other income received2014-12-31$241,894
Net income (gross income less expenses)2014-12-31$212,203
Net plan assets at end of year (total assets less liabilities)2014-12-31$3,725,524
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$3,513,321
Total contributions received or receivable from employer(s)2014-12-31$21,632
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$5,762
2013 : NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources2013-12-31$638,544
Expenses. Total of all expenses incurred2013-12-31$20,109
Benefits paid (including direct rollovers)2013-12-31$11,603
Total plan assets at end of year2013-12-31$3,513,321
Total plan assets at beginning of year2013-12-31$2,894,886
Value of fidelity bond covering the plan2013-12-31$250,000
Expenses. Other expenses not covered elsewhere2013-12-31$6,792
Other income received2013-12-31$616,752
Net income (gross income less expenses)2013-12-31$618,435
Net plan assets at end of year (total assets less liabilities)2013-12-31$3,513,321
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$2,894,886
Total contributions received or receivable from employer(s)2013-12-31$21,792
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$1,714
2012 : NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources2012-12-31$382,779
Expenses. Total of all expenses incurred2012-12-31$8,390
Total plan assets at end of year2012-12-31$2,894,886
Total plan assets at beginning of year2012-12-31$2,520,497
Value of fidelity bond covering the plan2012-12-31$250,000
Expenses. Other expenses not covered elsewhere2012-12-31$6,792
Other income received2012-12-31$360,987
Net income (gross income less expenses)2012-12-31$374,389
Net plan assets at end of year (total assets less liabilities)2012-12-31$2,894,886
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$2,520,497
Total contributions received or receivable from employer(s)2012-12-31$21,792
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$1,598
2011 : NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources2011-12-31$10,614
Expenses. Total of all expenses incurred2011-12-31$8,371
Total plan assets at end of year2011-12-31$2,520,497
Total plan assets at beginning of year2011-12-31$2,518,254
Value of fidelity bond covering the plan2011-12-31$250,000
Expenses. Other expenses not covered elsewhere2011-12-31$6,792
Other income received2011-12-31$-11,178
Net income (gross income less expenses)2011-12-31$2,243
Net plan assets at end of year (total assets less liabilities)2011-12-31$2,520,497
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$2,518,254
Total contributions received or receivable from employer(s)2011-12-31$21,792
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$1,579
2010 : NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN 2010 401k financial data
Total income from all sources2010-12-31$269,273
Expenses. Total of all expenses incurred2010-12-31$8,766
Total plan assets at end of year2010-12-31$2,518,254
Total plan assets at beginning of year2010-12-31$2,257,747
Value of fidelity bond covering the plan2010-12-31$250,000
Expenses. Other expenses not covered elsewhere2010-12-31$6,792
Other income received2010-12-31$204,231
Net income (gross income less expenses)2010-12-31$260,507
Net plan assets at end of year (total assets less liabilities)2010-12-31$2,518,254
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$2,257,747
Assets. Value of assets in partnership/joint-venture interests2010-12-31$-14,986
Total contributions received or receivable from employer(s)2010-12-31$65,042
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$1,974

Form 5500 Responses for NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN

2019: NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01This submission is the final filingYes
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: NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING 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: NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING 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: NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING 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: NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING 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: NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING 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: NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING 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: NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING 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: NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedYes
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: NICHOLAS J. MASCIOTRA, MD, PC PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
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

NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number29195
Policy instance 1
Insurance contract or identification number29195
Number of Individuals Covered1
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerSERVICING AGENT
Insurance broker organization code?3
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number29195
Policy instance 1
Insurance contract or identification number29195
Number of Individuals Covered1
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerSERVICING AGENT 3
Insurance broker organization code?3
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number29195
Policy instance 1
Insurance contract or identification number29195
Number of Individuals Covered1
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerSERVICING AGENT 3
Insurance broker organization code?3
Insurance broker nameCRAIG B. FIEDLER
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number29195
Policy instance 1
Insurance contract or identification number29195
Number of Individuals Covered1
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerSERVICING AGENT 3
Insurance broker organization code?3
Insurance broker nameCRAIG B. FIEDLER
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number29195
Policy instance 1
Insurance contract or identification number29195
Number of Individuals Covered1
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Are there contracts with allocated funds for individual policies?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerSERVICING AGENT 3
Insurance broker organization code?3
Insurance broker nameCRAIG B. FIEDLER
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number29195
Policy instance 1
Insurance contract or identification number29195
Number of Individuals Covered1
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Are there contracts with allocated funds for individual policies?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerSERVICING AGENT 3
Insurance broker organization code?3
Insurance broker nameCRAIG B. FIEDLER
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number29195
Policy instance 1
Insurance contract or identification number29195
Number of Individuals Covered1
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Are there contracts with allocated funds for individual policies?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerSERVICING AGENT 3
Insurance broker organization code?3
Insurance broker nameCOMFREY S. ICKES JR
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number29195
Policy instance 1
Insurance contract or identification number29195
Number of Individuals Covered1
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Are there contracts with allocated funds for individual policies?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number29195
Policy instance 1
Insurance contract or identification number29195
Number of Individuals Covered1
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Are there contracts with allocated funds for individual policies?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerSERVICING AGENT
Insurance broker organization code?3
Insurance broker nameCOMFREY S. ICKES

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