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FITESA WASHOUGAL, INC. 401(K) RETIREMENT SAVINGS PLAN FOR HOURLY EMPLOYEES AT WASHOUGAL 401k Plan overview

Plan NameFITESA WASHOUGAL, INC. 401(K) RETIREMENT SAVINGS PLAN FOR HOURLY EMPLOYEES AT WASHOUGAL
Plan identification number 002

FITESA WASHOUGAL, INC. 401(K) RETIREMENT SAVINGS PLAN FOR HOURLY EMPLOYEES AT WASHOUGAL Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • 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.

401k Sponsoring company profile

FITESA WASHOUGAL, INC. has sponsored the creation of one or more 401k plans.

Company Name:FITESA WASHOUGAL, INC.
Employer identification number (EIN):270535243
NAIC Classification:339900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FITESA WASHOUGAL, INC. 401(K) RETIREMENT SAVINGS PLAN FOR HOURLY EMPLOYEES AT WASHOUGAL

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022019-01-01HAL SINGLEY2020-10-15 HAL SINGLEY2020-10-15
0022018-01-01HAL SINGLEY2019-10-11 HAL SINGLEY2019-10-11
0022017-01-01CAMILLA HAIGLER2018-10-12 CAMILLA HAIGLER2018-10-12
0022016-01-01AMY VERBOSKY2017-09-12
0022015-01-01AMY VERBOSKY AMY VERBOSKY2016-06-06
0022014-01-01AMY VERBOSKY AMY VERBOSKY2015-08-05
0022013-01-01AMY VERBOSKY
0022012-01-01AMY VERBOSKY
0022011-01-01AMY VERBOSKY AMY VERBOSKY2012-11-09

Plan Statistics for FITESA WASHOUGAL, INC. 401(K) RETIREMENT SAVINGS PLAN FOR HOURLY EMPLOYEES AT WASHOUGAL

401k plan membership statisitcs for FITESA WASHOUGAL, INC. 401(K) RETIREMENT SAVINGS PLAN FOR HOURLY EMPLOYEES AT WASHOUGAL

Measure Date Value
2015: FITESA WASHOUGAL, INC. 401(K) RETIREMENT SAVINGS PLAN FOR HOURLY EMPLOYEES AT WASHOUGAL 2015 401k membership
Total participants, beginning-of-year2015-01-0148
Total number of active participants reported on line 7a of the Form 55002015-01-0139
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-017
Total of all active and inactive participants2015-01-0146
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0146
Number of participants with account balances2015-01-0146
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: FITESA WASHOUGAL, INC. 401(K) RETIREMENT SAVINGS PLAN FOR HOURLY EMPLOYEES AT WASHOUGAL 2014 401k membership
Total participants, beginning-of-year2014-01-0144
Total number of active participants reported on line 7a of the Form 55002014-01-0137
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-019
Total of all active and inactive participants2014-01-0146
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-011
Total participants2014-01-0147
Number of participants with account balances2014-01-0147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: FITESA WASHOUGAL, INC. 401(K) RETIREMENT SAVINGS PLAN FOR HOURLY EMPLOYEES AT WASHOUGAL 2013 401k membership
Total participants, beginning-of-year2013-01-0159
Total number of active participants reported on line 7a of the Form 55002013-01-0134
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-018
Total of all active and inactive participants2013-01-0142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0142
Number of participants with account balances2013-01-0142
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: FITESA WASHOUGAL, INC. 401(K) RETIREMENT SAVINGS PLAN FOR HOURLY EMPLOYEES AT WASHOUGAL 2012 401k membership
Total participants, beginning-of-year2012-01-0151
Total number of active participants reported on line 7a of the Form 55002012-01-0136
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0116
Total of all active and inactive participants2012-01-0152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0152
Number of participants with account balances2012-01-0151
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: FITESA WASHOUGAL, INC. 401(K) RETIREMENT SAVINGS PLAN FOR HOURLY EMPLOYEES AT WASHOUGAL 2011 401k membership
Total participants, beginning-of-year2011-01-0153
Total number of active participants reported on line 7a of the Form 55002011-01-0135
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-0112
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

Financial Data on FITESA WASHOUGAL, INC. 401(K) RETIREMENT SAVINGS PLAN FOR HOURLY EMPLOYEES AT WASHOUGAL

Measure Date Value
2015 : FITESA WASHOUGAL, INC. 401(K) RETIREMENT SAVINGS PLAN FOR HOURLY EMPLOYEES AT WASHOUGAL 2015 401k financial data
Total income from all sources2015-12-31$428,912
Expenses. Total of all expenses incurred2015-12-31$491,630
Benefits paid (including direct rollovers)2015-12-31$460,882
Total plan assets at end of year2015-12-31$4,836,998
Total plan assets at beginning of year2015-12-31$4,899,716
Value of fidelity bond covering the plan2015-12-31$500,000
Total contributions received or receivable from participants2015-12-31$180,246
Expenses. Other expenses not covered elsewhere2015-12-31$30,748
Other income received2015-12-31$28,109
Net income (gross income less expenses)2015-12-31$-62,718
Net plan assets at end of year (total assets less liabilities)2015-12-31$4,836,998
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$4,899,716
Assets. Value of participant loans2015-12-31$175,494
Total contributions received or receivable from employer(s)2015-12-31$220,557
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : FITESA WASHOUGAL, INC. 401(K) RETIREMENT SAVINGS PLAN FOR HOURLY EMPLOYEES AT WASHOUGAL 2014 401k financial data
Total income from all sources2014-12-31$665,427
Expenses. Total of all expenses incurred2014-12-31$235,032
Benefits paid (including direct rollovers)2014-12-31$209,939
Total plan assets at end of year2014-12-31$4,899,716
Total plan assets at beginning of year2014-12-31$4,469,321
Value of fidelity bond covering the plan2014-12-31$1,025,000
Total contributions received or receivable from participants2014-12-31$160,061
Expenses. Other expenses not covered elsewhere2014-12-31$25,093
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$366,206
Net income (gross income less expenses)2014-12-31$430,395
Net plan assets at end of year (total assets less liabilities)2014-12-31$4,899,716
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$4,469,321
Assets. Value of participant loans2014-12-31$189,736
Total contributions received or receivable from employer(s)2014-12-31$139,160
Value of certain deemed distributions of participant loans2014-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : FITESA WASHOUGAL, INC. 401(K) RETIREMENT SAVINGS PLAN FOR HOURLY EMPLOYEES AT WASHOUGAL 2013 401k financial data
Total income from all sources2013-12-31$1,188,883
Expenses. Total of all expenses incurred2013-12-31$1,560,758
Benefits paid (including direct rollovers)2013-12-31$1,543,510
Total plan assets at end of year2013-12-31$4,469,321
Total plan assets at beginning of year2013-12-31$4,841,196
Value of fidelity bond covering the plan2013-12-31$1,025,000
Total contributions received or receivable from participants2013-12-31$149,054
Contributions received from other sources (not participants or employers)2013-12-31$1,383
Other income received2013-12-31$874,322
Net income (gross income less expenses)2013-12-31$-371,875
Net plan assets at end of year (total assets less liabilities)2013-12-31$4,469,321
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$4,841,196
Assets. Value of participant loans2013-12-31$155,571
Total contributions received or receivable from employer(s)2013-12-31$164,124
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$17,248
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : FITESA WASHOUGAL, INC. 401(K) RETIREMENT SAVINGS PLAN FOR HOURLY EMPLOYEES AT WASHOUGAL 2012 401k financial data
Total income from all sources2012-12-31$851,486
Expenses. Total of all expenses incurred2012-12-31$1,344,572
Benefits paid (including direct rollovers)2012-12-31$1,326,414
Total plan assets at end of year2012-12-31$4,841,196
Total plan assets at beginning of year2012-12-31$5,334,282
Value of fidelity bond covering the plan2012-12-31$1,025,000
Total contributions received or receivable from participants2012-12-31$150,641
Expenses. Other expenses not covered elsewhere2012-12-31$16,322
Contributions received from other sources (not participants or employers)2012-12-31$120,420
Other income received2012-12-31$421,302
Net income (gross income less expenses)2012-12-31$-493,086
Net plan assets at end of year (total assets less liabilities)2012-12-31$4,841,196
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$5,334,282
Assets. Value of participant loans2012-12-31$142,833
Total contributions received or receivable from employer(s)2012-12-31$159,123
Value of corrective distributions2012-12-31$1,836
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : FITESA WASHOUGAL, INC. 401(K) RETIREMENT SAVINGS PLAN FOR HOURLY EMPLOYEES AT WASHOUGAL 2011 401k financial data
Total income from all sources2011-12-31$276,700
Expenses. Total of all expenses incurred2011-12-31$169,866
Benefits paid (including direct rollovers)2011-12-31$153,886
Total plan assets at end of year2011-12-31$5,334,282
Total plan assets at beginning of year2011-12-31$5,227,448
Value of fidelity bond covering the plan2011-12-31$5,000,000
Total contributions received or receivable from participants2011-12-31$172,070
Expenses. Other expenses not covered elsewhere2011-12-31$15,980
Contributions received from other sources (not participants or employers)2011-12-31$8,541
Other income received2011-12-31$77,214
Net income (gross income less expenses)2011-12-31$106,834
Net plan assets at end of year (total assets less liabilities)2011-12-31$5,334,282
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$5,227,448
Assets. Value of participant loans2011-12-31$130,185
Total contributions received or receivable from employer(s)2011-12-31$18,875
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : FITESA WASHOUGAL, INC. 401(K) RETIREMENT SAVINGS PLAN FOR HOURLY EMPLOYEES AT WASHOUGAL 2010 401k financial data
Total income from all sources2010-12-31$826,457
Expenses. Total of all expenses incurred2010-12-31$485,711
Benefits paid (including direct rollovers)2010-12-31$473,105
Total plan assets at end of year2010-12-31$5,227,448
Total plan assets at beginning of year2010-12-31$4,886,702
Value of fidelity bond covering the plan2010-12-31$5,000,000
Total contributions received or receivable from participants2010-12-31$173,278
Expenses. Other expenses not covered elsewhere2010-12-31$12,606
Contributions received from other sources (not participants or employers)2010-12-31$4,344
Other income received2010-12-31$596,128
Net income (gross income less expenses)2010-12-31$340,746
Net plan assets at end of year (total assets less liabilities)2010-12-31$5,227,448
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$4,886,702
Assets. Value of participant loans2010-12-31$136,823
Total contributions received or receivable from employer(s)2010-12-31$52,707
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0

Form 5500 Responses for FITESA WASHOUGAL, INC. 401(K) RETIREMENT SAVINGS PLAN FOR HOURLY EMPLOYEES AT WASHOUGAL

2015: FITESA WASHOUGAL, INC. 401(K) RETIREMENT SAVINGS PLAN FOR HOURLY EMPLOYEES AT WASHOUGAL 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2014: FITESA WASHOUGAL, INC. 401(K) RETIREMENT SAVINGS PLAN FOR HOURLY EMPLOYEES AT WASHOUGAL 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 - TrustYes
2013: FITESA WASHOUGAL, INC. 401(K) RETIREMENT SAVINGS PLAN FOR HOURLY EMPLOYEES AT WASHOUGAL 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 - TrustYes
2012: FITESA WASHOUGAL, INC. 401(K) RETIREMENT SAVINGS PLAN FOR HOURLY EMPLOYEES AT WASHOUGAL 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 - TrustYes
2011: FITESA WASHOUGAL, INC. 401(K) RETIREMENT SAVINGS PLAN FOR HOURLY EMPLOYEES AT WASHOUGAL 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedYes
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 - TrustYes

Insurance Providers Used on plan

NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )
Policy contract number31505
Policy instance 1
Insurance contract or identification number31505
Number of Individuals Covered0
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )
Policy contract number31505
Policy instance 1
Insurance contract or identification number31505
Number of Individuals Covered15
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )
Policy contract number31505
Policy instance 1
Insurance contract or identification number31505
Number of Individuals Covered42
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )
Policy contract number31505
Policy instance 1
Insurance contract or identification number31505
Number of Individuals Covered51
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )
Policy contract number31505
Policy instance 1
Insurance contract or identification number31505
Number of Individuals Covered47
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )
Policy contract number31505
Policy instance 1
Insurance contract or identification number31505
Number of Individuals Covered51
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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