PREPARED MANAGERS, LLC has sponsored the creation of one or more 401k plans.
| Measure | Date | Value |
|---|
| 2016: PREPARED 401(K) PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 40 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 30 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 6 |
| Total of all active and inactive participants | 2016-01-01 | 38 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2016-01-01 | 0 |
| Total participants | 2016-01-01 | 38 |
| Number of participants with account balances | 2016-01-01 | 26 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2016-01-01 | 0 |
| 2015: PREPARED 401(K) PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 32 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 34 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 5 |
| Total of all active and inactive participants | 2015-01-01 | 39 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2015-01-01 | 0 |
| Total participants | 2015-01-01 | 39 |
| Number of participants with account balances | 2015-01-01 | 28 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2015-01-01 | 0 |
| 2014: PREPARED 401(K) PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 25 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 28 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 2 |
| Total of all active and inactive participants | 2014-01-01 | 32 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-01-01 | 0 |
| Total participants | 2014-01-01 | 32 |
| Number of participants with account balances | 2014-01-01 | 24 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2014-01-01 | 0 |
| 2013: PREPARED 401(K) PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 19 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 21 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 3 |
| Total of all active and inactive participants | 2013-01-01 | 24 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-01-01 | 0 |
| Total participants | 2013-01-01 | 24 |
| Number of participants with account balances | 2013-01-01 | 19 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-01-01 | 0 |
| 2012: PREPARED 401(K) PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 15 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 14 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 2 |
| Total of all active and inactive participants | 2012-01-01 | 16 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-01-01 | 0 |
| Total participants | 2012-01-01 | 16 |
| Number of participants with account balances | 2012-01-01 | 9 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-01-01 | 0 |
| 2011: PREPARED 401(K) PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 13 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 14 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 1 |
| Total of all active and inactive participants | 2011-01-01 | 15 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-01-01 | 0 |
| Total participants | 2011-01-01 | 15 |
| Number of participants with account balances | 2011-01-01 | 9 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2011-01-01 | 0 |
| 2010: PREPARED 401(K) PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 5 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 12 |
| Number of retired or separated participants receiving benefits | 2010-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2010-01-01 | 1 |
| Total of all active and inactive participants | 2010-01-01 | 13 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2010-01-01 | 0 |
| Total participants | 2010-01-01 | 13 |
| Number of participants with account balances | 2010-01-01 | 8 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2010-01-01 | 0 |
| 2009: PREPARED 401(K) PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 5 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 0 |
| Total of all active and inactive participants | 2009-01-01 | 5 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-01-01 | 0 |
| Total participants | 2009-01-01 | 5 |
| Number of participants with account balances | 2009-01-01 | 4 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-01-01 | 0 |
| Measure | Date | Value |
|---|
| 2016 : PREPARED 401(K) PLAN 2016 401k financial data |
|---|
| Total income from all sources | 2016-12-31 | $235,691 |
| Expenses. Total of all expenses incurred | 2016-12-31 | $59,810 |
| Benefits paid (including direct rollovers) | 2016-12-31 | $59,536 |
| Total plan assets at end of year | 2016-12-31 | $929,584 |
| Total plan assets at beginning of year | 2016-12-31 | $753,703 |
| Value of fidelity bond covering the plan | 2016-12-31 | $10,000 |
| Total contributions received or receivable from participants | 2016-12-31 | $122,978 |
| Other income received | 2016-12-31 | $43,699 |
| Net income (gross income less expenses) | 2016-12-31 | $175,881 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-31 | $929,584 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-31 | $753,703 |
| Assets. Value of participant loans | 2016-12-31 | $65,461 |
| Total contributions received or receivable from employer(s) | 2016-12-31 | $69,014 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-12-31 | $274 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2016-12-31 | $0 |
| 2015 : PREPARED 401(K) PLAN 2015 401k financial data |
|---|
| Total income from all sources | 2015-12-31 | $184,536 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $138 |
| Total plan assets at end of year | 2015-12-31 | $753,703 |
| Total plan assets at beginning of year | 2015-12-31 | $569,305 |
| Value of fidelity bond covering the plan | 2015-12-31 | $10,000 |
| Total contributions received or receivable from participants | 2015-12-31 | $122,137 |
| Contributions received from other sources (not participants or employers) | 2015-12-31 | $-4,795 |
| Other income received | 2015-12-31 | $-12,717 |
| Net income (gross income less expenses) | 2015-12-31 | $184,398 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $753,703 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $569,305 |
| Assets. Value of participant loans | 2015-12-31 | $93,305 |
| Total contributions received or receivable from employer(s) | 2015-12-31 | $79,911 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-12-31 | $138 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2015-12-31 | $0 |
| 2014 : PREPARED 401(K) PLAN 2014 401k financial data |
|---|
| Total income from all sources | 2014-12-31 | $189,150 |
| Expenses. Total of all expenses incurred | 2014-12-31 | $93,984 |
| Benefits paid (including direct rollovers) | 2014-12-31 | $90,737 |
| Total plan assets at end of year | 2014-12-31 | $569,305 |
| Total plan assets at beginning of year | 2014-12-31 | $474,139 |
| Value of fidelity bond covering the plan | 2014-12-31 | $10,000 |
| Total contributions received or receivable from participants | 2014-12-31 | $91,467 |
| Contributions received from other sources (not participants or employers) | 2014-12-31 | $11,442 |
| Other income received | 2014-12-31 | $19,780 |
| Net income (gross income less expenses) | 2014-12-31 | $95,166 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $569,305 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $474,139 |
| Assets. Value of participant loans | 2014-12-31 | $86,484 |
| Total contributions received or receivable from employer(s) | 2014-12-31 | $66,461 |
| Value of corrective distributions | 2014-12-31 | $3,100 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2014-12-31 | $147 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2014-12-31 | $0 |
| 2013 : PREPARED 401(K) PLAN 2013 401k financial data |
|---|
| Total income from all sources | 2013-12-31 | $204,890 |
| Expenses. Total of all expenses incurred | 2013-12-31 | $18 |
| Total plan assets at end of year | 2013-12-31 | $474,139 |
| Total plan assets at beginning of year | 2013-12-31 | $269,267 |
| Value of fidelity bond covering the plan | 2013-12-31 | $10,000 |
| Total contributions received or receivable from participants | 2013-12-31 | $70,919 |
| Contributions received from other sources (not participants or employers) | 2013-12-31 | $24,045 |
| Other income received | 2013-12-31 | $58,196 |
| Net income (gross income less expenses) | 2013-12-31 | $204,872 |
| Net plan assets at end of year (total assets less liabilities) | 2013-12-31 | $474,139 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-12-31 | $269,267 |
| Assets. Value of participant loans | 2013-12-31 | $14,750 |
| Total contributions received or receivable from employer(s) | 2013-12-31 | $51,730 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2013-12-31 | $18 |
| 2012 : PREPARED 401(K) PLAN 2012 401k financial data |
|---|
| Total income from all sources | 2012-12-31 | $102,032 |
| Expenses. Total of all expenses incurred | 2012-12-31 | $0 |
| Total plan assets at end of year | 2012-12-31 | $269,267 |
| Total plan assets at beginning of year | 2012-12-31 | $167,235 |
| Value of fidelity bond covering the plan | 2012-12-31 | $10,000 |
| Total contributions received or receivable from participants | 2012-12-31 | $31,957 |
| Contributions received from other sources (not participants or employers) | 2012-12-31 | $24,773 |
| Other income received | 2012-12-31 | $21,477 |
| Net income (gross income less expenses) | 2012-12-31 | $102,032 |
| Net plan assets at end of year (total assets less liabilities) | 2012-12-31 | $269,267 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-12-31 | $167,235 |
| Total contributions received or receivable from employer(s) | 2012-12-31 | $23,825 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2012-12-31 | $0 |
| 2011 : PREPARED 401(K) PLAN 2011 401k financial data |
|---|
| Total income from all sources | 2011-12-31 | $122,675 |
| Expenses. Total of all expenses incurred | 2011-12-31 | $24,427 |
| Benefits paid (including direct rollovers) | 2011-12-31 | $24,402 |
| Total plan assets at end of year | 2011-12-31 | $167,235 |
| Total plan assets at beginning of year | 2011-12-31 | $68,987 |
| Value of fidelity bond covering the plan | 2011-12-31 | $10,000 |
| Total contributions received or receivable from participants | 2011-12-31 | $39,391 |
| Expenses. Other expenses not covered elsewhere | 2011-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2011-12-31 | $40,666 |
| Other income received | 2011-12-31 | $19,355 |
| Noncash contributions received | 2011-12-31 | $0 |
| Net income (gross income less expenses) | 2011-12-31 | $98,248 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-31 | $167,235 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-31 | $68,987 |
| Total contributions received or receivable from employer(s) | 2011-12-31 | $23,263 |
| Value of certain deemed distributions of participant loans | 2011-12-31 | $0 |
| Value of corrective distributions | 2011-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2011-12-31 | $25 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2011-12-31 | $0 |
| 2010 : PREPARED 401(K) PLAN 2010 401k financial data |
|---|
| Total income from all sources | 2010-12-31 | $49,861 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $0 |
| Benefits paid (including direct rollovers) | 2010-12-31 | $0 |
| Total plan assets at end of year | 2010-12-31 | $68,987 |
| Total plan assets at beginning of year | 2010-12-31 | $19,126 |
| Value of fidelity bond covering the plan | 2010-12-31 | $10,000 |
| Total contributions received or receivable from participants | 2010-12-31 | $45,838 |
| Expenses. Other expenses not covered elsewhere | 2010-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2010-12-31 | $0 |
| Other income received | 2010-12-31 | $4,023 |
| Noncash contributions received | 2010-12-31 | $0 |
| Net income (gross income less expenses) | 2010-12-31 | $49,861 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $68,987 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $19,126 |
| Total contributions received or receivable from employer(s) | 2010-12-31 | $0 |
| Value of certain deemed distributions of participant loans | 2010-12-31 | $0 |
| Value of corrective distributions | 2010-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2010-12-31 | $0 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2010-12-31 | $0 |
| 2009 : PREPARED 401(K) PLAN 2009 401k financial data |
|---|
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2009-12-31 | $0 |
| 2016: PREPARED 401(K) PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – Trust | Yes |
| 2016-01-01 | Plan benefit arrangement - Trust | Yes |
| 2015: PREPARED 401(K) PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – Trust | Yes |
| 2015-01-01 | Plan benefit arrangement - Trust | Yes |
| 2014: PREPARED 401(K) PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Submission has been amended | No |
| 2014-01-01 | This submission is the final filing | No |
| 2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-01-01 | Plan is a collectively bargained plan | No |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – Trust | Yes |
| 2014-01-01 | Plan benefit arrangement - Trust | Yes |
| 2013: PREPARED 401(K) PLAN 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Submission has been amended | No |
| 2013-01-01 | This submission is the final filing | No |
| 2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-01-01 | Plan is a collectively bargained plan | No |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – Trust | Yes |
| 2013-01-01 | Plan benefit arrangement - Trust | Yes |
| 2012: PREPARED 401(K) PLAN 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Submission has been amended | No |
| 2012-01-01 | This submission is the final filing | No |
| 2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-01-01 | Plan is a collectively bargained plan | No |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – Trust | Yes |
| 2012-01-01 | Plan benefit arrangement - Trust | Yes |
| 2011: PREPARED 401(K) PLAN 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Submission has been amended | No |
| 2011-01-01 | This submission is the final filing | No |
| 2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-01-01 | Plan is a collectively bargained plan | No |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan funding arrangement – Trust | Yes |
| 2011-01-01 | Plan benefit arrangement - Trust | Yes |
| 2010: PREPARED 401(K) PLAN 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Submission has been amended | No |
| 2010-01-01 | This submission is the final filing | No |
| 2010-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-01-01 | Plan is a collectively bargained plan | No |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan funding arrangement – Trust | Yes |
| 2010-01-01 | Plan benefit arrangement - Trust | Yes |
| 2009: PREPARED 401(K) PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | First time form 5500 has been submitted | Yes |
| 2009-01-01 | Submission has been amended | No |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan funding arrangement – Trust | Yes |
| 2009-01-01 | Plan benefit arrangement - Trust | Yes |
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-819350 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-819350 | | Number of Individuals Covered | 26 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $2,594 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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? | Yes | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Broker | USD $2,358 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE | | Insurance broker organization code? | 3 | | Insurance broker name | AMERICAN PENSION SERVICES, LLC |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-819350 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-819350 | | Number of Individuals Covered | 21 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $2,265 | | Total amount of fees paid to insurance company | USD $226 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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? | Yes | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Broker | USD $1,620 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 | | Insurance broker name | AMERICAN PENSION SERVICES, LLC |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-819350 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-819350 | | Number of Individuals Covered | 19 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $1,496 | | Total amount of fees paid to insurance company | USD $150 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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? | Yes | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Broker | USD $1,496 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 | | Insurance broker name | AMERICAN PENSION SERVICES, LLC |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-819350 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-819350 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $846 | | Total amount of fees paid to insurance company | USD $85 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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? | Yes | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Broker | USD $846 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 | | Insurance broker name | AMERICAN PENSION SERVICES, LLC |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-819350 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-819350 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $400 | | Total amount of fees paid to insurance company | USD $40 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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? | Yes | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 |
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| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-819350 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-819350 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $395 | | Total amount of fees paid to insurance company | USD $14 | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | Yes | | Commission paid to Insurance Broker | USD $395 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 14 | | Additional information about fees paid to insurance broker | SALES/ADMINISTRATION | | Insurance broker name | AMERICAN PENSION SERVICES, LLC |
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