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GRANDFATHER MOUNTAIN STEWARDSHIP FOUNDATION 401(K) PLAN 401k Plan overview

Plan NameGRANDFATHER MOUNTAIN STEWARDSHIP FOUNDATION 401(K) PLAN
Plan identification number 001

GRANDFATHER MOUNTAIN STEWARDSHIP FOUNDATION 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • 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

GRANDFATHER MOUNTAIN STEWARDSHIP FOUNDATION INC. has sponsored the creation of one or more 401k plans.

Company Name:GRANDFATHER MOUNTAIN STEWARDSHIP FOUNDATION INC.
Employer identification number (EIN):264812778
NAIC Classification:713900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GRANDFATHER MOUNTAIN STEWARDSHIP FOUNDATION 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01KIM RUPARD2023-06-22
0012021-01-01KIM RUPARD2022-05-20
0012020-01-01KIM RUPARD2021-04-28
0012018-01-01KIM RUPARD2019-05-02
0012017-01-01KIM RUPARD2018-05-22
0012016-01-01KIM RUPARD2017-05-24
0012015-01-01KIM RUPARD2016-06-16
0012014-01-01SANDY WILKINS SANDY WILKINS2015-07-21
0012013-01-01SANDY WILKINS SANDY WILKINS2014-06-19
0012012-01-01SANDY WILKINS SANDY WILKINS2013-06-18
0012011-01-01SANDY WILKINS
0012010-01-01SANDY WILKINS
0012009-01-01SANDY WILKINS SANDY WILKINS2010-07-30

Plan Statistics for GRANDFATHER MOUNTAIN STEWARDSHIP FOUNDATION 401(K) PLAN

401k plan membership statisitcs for GRANDFATHER MOUNTAIN STEWARDSHIP FOUNDATION 401(K) PLAN

Measure Date Value
2014: GRANDFATHER MOUNTAIN STEWARDSHIP FOUNDATION 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0143
Total number of active participants reported on line 7a of the Form 55002014-01-0127
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0118
Total of all active and inactive participants2014-01-0145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0145
Number of participants with account balances2014-01-0140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-0113
2013: GRANDFATHER MOUNTAIN STEWARDSHIP FOUNDATION 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0144
Total number of active participants reported on line 7a of the Form 55002013-01-0128
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0117
Total of all active and inactive participants2013-01-0145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0145
Number of participants with account balances2013-01-0142
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-0113
2012: GRANDFATHER MOUNTAIN STEWARDSHIP FOUNDATION 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0146
Total number of active participants reported on line 7a of the Form 55002012-01-0134
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0115
Total of all active and inactive participants2012-01-0149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0149
Number of participants with account balances2012-01-0134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-0114
2011: GRANDFATHER MOUNTAIN STEWARDSHIP FOUNDATION 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0144
Total number of active participants reported on line 7a of the Form 55002011-01-0134
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-0113
Total of all active and inactive participants2011-01-0147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0147
Number of participants with account balances2011-01-0147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: GRANDFATHER MOUNTAIN STEWARDSHIP FOUNDATION 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0145
Total number of active participants reported on line 7a of the Form 55002010-01-0135
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-0114
Total of all active and inactive participants2010-01-0149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0149
Number of participants with account balances2010-01-0145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: GRANDFATHER MOUNTAIN STEWARDSHIP FOUNDATION 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0156
Total number of active participants reported on line 7a of the Form 55002009-01-0137
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0114
Total of all active and inactive participants2009-01-0151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-015
Total participants2009-01-0156
Number of participants with account balances2009-01-0156
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on GRANDFATHER MOUNTAIN STEWARDSHIP FOUNDATION 401(K) PLAN

Measure Date Value
2014 : GRANDFATHER MOUNTAIN STEWARDSHIP FOUNDATION 401(K) PLAN 2014 401k financial data
Transfers to/from the plan2014-12-31$15,342
Total income from all sources2014-12-31$117,640
Expenses. Total of all expenses incurred2014-12-31$32,551
Benefits paid (including direct rollovers)2014-12-31$32,551
Total plan assets at end of year2014-12-31$1,160,652
Total plan assets at beginning of year2014-12-31$1,060,221
Value of fidelity bond covering the plan2014-12-31$100,000
Total contributions received or receivable from participants2014-12-31$24,538
Expenses. Other expenses not covered elsewhere2014-12-31$0
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$68,102
Net income (gross income less expenses)2014-12-31$85,089
Net plan assets at end of year (total assets less liabilities)2014-12-31$1,160,652
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$1,060,221
Assets. Value of participant loans2014-12-31$0
Total contributions received or receivable from employer(s)2014-12-31$25,000
Value of certain deemed distributions of participant loans2014-12-31$0
Value of corrective distributions2014-12-31$0
Funding deficiency by the employer to the plan for this plan year2014-12-31$0
Minimum employer required contribution for this plan year2014-12-31$0
Amount contributed by the employer to the plan for this plan year2014-12-31$0
2013 : GRANDFATHER MOUNTAIN STEWARDSHIP FOUNDATION 401(K) PLAN 2013 401k financial data
Transfers to/from the plan2013-12-31$0
Total income from all sources2013-12-31$366,122
Expenses. Total of all expenses incurred2013-12-31$776,056
Benefits paid (including direct rollovers)2013-12-31$776,056
Total plan assets at end of year2013-12-31$1,060,221
Total plan assets at beginning of year2013-12-31$1,470,155
Value of fidelity bond covering the plan2013-12-31$100,000
Total contributions received or receivable from participants2013-12-31$24,555
Expenses. Other expenses not covered elsewhere2013-12-31$0
Contributions received from other sources (not participants or employers)2013-12-31$1,402
Other income received2013-12-31$315,165
Net income (gross income less expenses)2013-12-31$-409,934
Net plan assets at end of year (total assets less liabilities)2013-12-31$1,060,221
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$1,470,155
Assets. Value of participant loans2013-12-31$0
Total contributions received or receivable from employer(s)2013-12-31$25,000
Value of certain deemed distributions of participant loans2013-12-31$0
Value of corrective distributions2013-12-31$0
Funding deficiency by the employer to the plan for this plan year2013-12-31$0
Minimum employer required contribution for this plan year2013-12-31$0
Amount contributed by the employer to the plan for this plan year2013-12-31$0
2012 : GRANDFATHER MOUNTAIN STEWARDSHIP FOUNDATION 401(K) PLAN 2012 401k financial data
Transfers to/from the plan2012-12-31$-2,299
Total income from all sources2012-12-31$221,766
Expenses. Total of all expenses incurred2012-12-31$50,920
Benefits paid (including direct rollovers)2012-12-31$50,920
Total plan assets at end of year2012-12-31$1,470,155
Total plan assets at beginning of year2012-12-31$1,301,608
Value of fidelity bond covering the plan2012-12-31$100,000
Total contributions received or receivable from participants2012-12-31$22,904
Expenses. Other expenses not covered elsewhere2012-12-31$0
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$171,563
Net income (gross income less expenses)2012-12-31$170,846
Net plan assets at end of year (total assets less liabilities)2012-12-31$1,470,155
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$1,301,608
Assets. Value of participant loans2012-12-31$0
Total contributions received or receivable from employer(s)2012-12-31$27,299
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$0
Funding deficiency by the employer to the plan for this plan year2012-12-31$0
Minimum employer required contribution for this plan year2012-12-31$0
Amount contributed by the employer to the plan for this plan year2012-12-31$0
2011 : GRANDFATHER MOUNTAIN STEWARDSHIP FOUNDATION 401(K) PLAN 2011 401k financial data
Transfers to/from the plan2011-12-31$0
Total income from all sources2011-12-31$-8,038
Expenses. Total of all expenses incurred2011-12-31$81,007
Benefits paid (including direct rollovers)2011-12-31$81,007
Total plan assets at end of year2011-12-31$1,301,608
Total plan assets at beginning of year2011-12-31$1,390,653
Value of fidelity bond covering the plan2011-12-31$100,000
Total contributions received or receivable from participants2011-12-31$21,422
Expenses. Other expenses not covered elsewhere2011-12-31$0
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-60,976
Net income (gross income less expenses)2011-12-31$-89,045
Net plan assets at end of year (total assets less liabilities)2011-12-31$1,301,608
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$1,390,653
Assets. Value of participant loans2011-12-31$0
Total contributions received or receivable from employer(s)2011-12-31$31,516
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$0
Funding deficiency by the employer to the plan for this plan year2011-12-31$0
Minimum employer required contribution for this plan year2011-12-31$0
Amount contributed by the employer to the plan for this plan year2011-12-31$0
2010 : GRANDFATHER MOUNTAIN STEWARDSHIP FOUNDATION 401(K) PLAN 2010 401k financial data
Transfers to/from the plan2010-12-31$0
Total income from all sources2010-12-31$206,542
Expenses. Total of all expenses incurred2010-12-31$75,996
Benefits paid (including direct rollovers)2010-12-31$75,996
Total plan assets at end of year2010-12-31$1,390,653
Total plan assets at beginning of year2010-12-31$1,260,107
Value of fidelity bond covering the plan2010-12-31$100,000
Total contributions received or receivable from participants2010-12-31$29,357
Expenses. Other expenses not covered elsewhere2010-12-31$0
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$152,185
Net income (gross income less expenses)2010-12-31$130,546
Net plan assets at end of year (total assets less liabilities)2010-12-31$1,390,653
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$1,260,107
Total contributions received or receivable from employer(s)2010-12-31$25,000
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Funding deficiency by the employer to the plan for this plan year2010-12-31$0
Minimum employer required contribution for this plan year2010-12-31$0
Amount contributed by the employer to the plan for this plan year2010-12-31$0
2009 : GRANDFATHER MOUNTAIN STEWARDSHIP FOUNDATION 401(K) PLAN 2009 401k financial data
Funding deficiency by the employer to the plan for this plan year2009-12-31$0
Minimum employer required contribution for this plan year2009-12-31$0
Amount contributed by the employer to the plan for this plan year2009-12-31$0

Form 5500 Responses for GRANDFATHER MOUNTAIN STEWARDSHIP FOUNDATION 401(K) PLAN

2014: GRANDFATHER MOUNTAIN STEWARDSHIP FOUNDATION 401(K) 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
2013: GRANDFATHER MOUNTAIN STEWARDSHIP FOUNDATION 401(K) PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: GRANDFATHER MOUNTAIN STEWARDSHIP FOUNDATION 401(K) PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: GRANDFATHER MOUNTAIN STEWARDSHIP FOUNDATION 401(K) PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: GRANDFATHER MOUNTAIN STEWARDSHIP FOUNDATION 401(K) PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: GRANDFATHER MOUNTAIN STEWARDSHIP FOUNDATION 401(K) PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-008579
Policy instance 1
Insurance contract or identification numberGA-008579
Number of Individuals Covered40
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $4,333
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
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 $4,333
Insurance broker organization code?3
Insurance broker nameCAPITAL INVESTMENT GROUP INC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-008579
Policy instance 1
Insurance contract or identification numberGA-008579
Number of Individuals Covered42
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $5,955
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
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 $5,955
Insurance broker organization code?3
Insurance broker nameCAPITAL INVESTMENT GROUP INC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-008579
Policy instance 1
Insurance contract or identification numberGA-008579
Number of Individuals Covered34
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $5,327
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
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 $5,327
Insurance broker organization code?3
Insurance broker nameCAPITAL INVESTMENT GROUP INC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-008579
Policy instance 1
Insurance contract or identification numberGA-008579
Number of Individuals Covered47
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $5,349
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
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
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-008579
Policy instance 1
Insurance contract or identification numberGA-008579
Number of Individuals Covered45
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $2,308
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
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 $1,763
Insurance broker organization code?3
Insurance broker nameWELLS FARGO WEALTH BRKG INS AGY

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