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COASTAL AUTOMATION SERVICES, INC. 401(K) PLAN 401k Plan overview

Plan NameCOASTAL AUTOMATION SERVICES, INC. 401(K) PLAN
Plan identification number 001

COASTAL AUTOMATION SERVICES, INC. 401(K) PLAN 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.
  • 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

COASTAL AUTOMATION SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name:COASTAL AUTOMATION SERVICES, INC.
Employer identification number (EIN):271039973
NAIC Classification:541330
NAIC Description:Engineering Services

Additional information about COASTAL AUTOMATION SERVICES, INC.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2009-09-29
Company Identification Number: 0801175784
Legal Registered Office Address: 2295 DELAWARE ST

BEAUMONT
United States of America (USA)
77703

More information about COASTAL AUTOMATION SERVICES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COASTAL AUTOMATION SERVICES, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01SIDNEY BERTRAND2022-09-25
0012020-01-01SIDNEY BERTRAND2021-09-29
0012019-01-01SIDNEY BERTRAND2020-10-11
0012018-01-01KYLE GRIMMER2019-10-11
0012017-01-01
0012016-01-01
0012015-01-01

Plan Statistics for COASTAL AUTOMATION SERVICES, INC. 401(K) PLAN

401k plan membership statisitcs for COASTAL AUTOMATION SERVICES, INC. 401(K) PLAN

Measure Date Value
2021: COASTAL AUTOMATION SERVICES, INC. 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01109
Total number of active participants reported on line 7a of the Form 55002021-01-0150
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0143
Total of all active and inactive participants2021-01-0193
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-011
Total participants2021-01-0194
Number of participants with account balances2021-01-0186
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: COASTAL AUTOMATION SERVICES, INC. 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01116
Total number of active participants reported on line 7a of the Form 55002020-01-0166
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0144
Total of all active and inactive participants2020-01-01110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01110
Number of participants with account balances2020-01-0197
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: COASTAL AUTOMATION SERVICES, INC. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01126
Total number of active participants reported on line 7a of the Form 55002019-01-0182
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0126
Total of all active and inactive participants2019-01-01108
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01108
Number of participants with account balances2019-01-0195
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: COASTAL AUTOMATION SERVICES, INC. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01122
Total number of active participants reported on line 7a of the Form 55002018-01-0199
Number of retired or separated participants receiving benefits2018-01-012
Number of other retired or separated participants entitled to future benefits2018-01-0125
Total of all active and inactive participants2018-01-01126
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01126
Number of participants with account balances2018-01-0191
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010

Financial Data on COASTAL AUTOMATION SERVICES, INC. 401(K) PLAN

Measure Date Value
2021 : COASTAL AUTOMATION SERVICES, INC. 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$1,330,044
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$1,468,156
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$1,465,736
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$637,606
Value of total assets at end of year2021-12-31$6,816,790
Value of total assets at beginning of year2021-12-31$6,954,902
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$2,420
Total interest from all sources2021-12-31$18,488
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$589,905
Participant contributions at end of year2021-12-31$149,288
Participant contributions at beginning of year2021-12-31$224,580
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$8,659
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$-138,112
Value of net assets at end of year (total assets less liabilities)2021-12-31$6,816,790
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$6,954,902
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in pooled separate accounts at end of year2021-12-31$5,127,636
Value of interest in pooled separate accounts at beginning of year2021-12-31$4,614,296
Interest on participant loans2021-12-31$7,413
Interest earned on other investments2021-12-31$11,075
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$1,539,866
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$2,116,026
Net investment gain/loss from pooled separate accounts2021-12-31$673,950
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$39,042
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$1,465,736
Contract administrator fees2021-12-31$2,420
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31WATHEN, DESHONG & JUNCKER, LLP
Accountancy firm EIN2021-12-31741694817
2020 : COASTAL AUTOMATION SERVICES, INC. 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$1,813,374
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$698,369
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$695,434
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$1,055,871
Value of total assets at end of year2020-12-31$6,954,902
Value of total assets at beginning of year2020-12-31$5,839,897
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$2,935
Total interest from all sources2020-12-31$20,069
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$748,329
Participant contributions at end of year2020-12-31$224,580
Participant contributions at beginning of year2020-12-31$218,263
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$1,115,005
Value of net assets at end of year (total assets less liabilities)2020-12-31$6,954,902
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$5,839,897
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in pooled separate accounts at end of year2020-12-31$4,614,296
Value of interest in pooled separate accounts at beginning of year2020-12-31$4,696,180
Interest on participant loans2020-12-31$10,779
Interest earned on other investments2020-12-31$9,290
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$2,116,026
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$925,454
Net investment gain/loss from pooled separate accounts2020-12-31$737,434
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$307,542
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$695,434
Contract administrator fees2020-12-31$2,935
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31WATHEN, DESHONG & JUNCKER, LLP
Accountancy firm EIN2020-12-31741694817
2019 : COASTAL AUTOMATION SERVICES, INC. 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$2,064,541
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$1,712,337
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$1,707,784
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$1,244,782
Value of total assets at end of year2019-12-31$5,839,897
Value of total assets at beginning of year2019-12-31$5,487,693
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$4,553
Total interest from all sources2019-12-31$16,656
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$864,126
Participant contributions at end of year2019-12-31$218,263
Participant contributions at beginning of year2019-12-31$164,549
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$2,234
Other income not declared elsewhere2019-12-31$10,470
Total non interest bearing cash at beginning of year2019-12-31$5,323,144
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$352,204
Value of net assets at end of year (total assets less liabilities)2019-12-31$5,839,897
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$5,487,693
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in pooled separate accounts at end of year2019-12-31$4,696,180
Value of interest in pooled separate accounts at beginning of year2019-12-31$0
Interest on participant loans2019-12-31$9,387
Interest earned on other investments2019-12-31$7,269
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$925,454
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$0
Net investment gain/loss from pooled separate accounts2019-12-31$792,633
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$378,422
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$1,707,784
Contract administrator fees2019-12-31$4,553
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31WATHEN, DESHONG & JUNCKER, LLP
Accountancy firm EIN2019-12-31741694817
2018 : COASTAL AUTOMATION SERVICES, INC. 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$1,102,380
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$777,149
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$764,767
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$1,437,327
Value of total assets at end of year2018-12-31$5,487,693
Value of total assets at beginning of year2018-12-31$5,162,462
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$12,382
Total interest from all sources2018-12-31$8,092
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$175,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$742,659
Participant contributions at end of year2018-12-31$164,549
Participant contributions at beginning of year2018-12-31$178,314
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$360,975
Administrative expenses (other) incurred2018-12-31$10,518
Total non interest bearing cash at end of year2018-12-31$5,323,144
Total non interest bearing cash at beginning of year2018-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$325,231
Value of net assets at end of year (total assets less liabilities)2018-12-31$5,487,693
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$5,162,462
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in pooled separate accounts at end of year2018-12-31$0
Value of interest in pooled separate accounts at beginning of year2018-12-31$4,584,128
Interest on participant loans2018-12-31$8,092
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$400,020
Net investment gain/loss from pooled separate accounts2018-12-31$-343,039
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$333,693
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$764,767
Contract administrator fees2018-12-31$1,864
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31No
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31WATHEN, DESHONG & JUNCKER, LLP
Accountancy firm EIN2018-12-31741694817

Form 5500 Responses for COASTAL AUTOMATION SERVICES, INC. 401(K) PLAN

2021: COASTAL AUTOMATION SERVICES, INC. 401(K) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: COASTAL AUTOMATION SERVICES, INC. 401(K) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: COASTAL AUTOMATION SERVICES, INC. 401(K) PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
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: COASTAL AUTOMATION SERVICES, INC. 401(K) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number812833
Policy instance 1
Insurance contract or identification number812833
Number of Individuals Covered86
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $18,784
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
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 Administration1
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
Commission paid to Insurance BrokerUSD $18,784
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number812833
Policy instance 1
Insurance contract or identification number812833
Number of Individuals Covered110
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $16,494
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
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 Administration1
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
Commission paid to Insurance BrokerUSD $16,494
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number812833
Policy instance 1
Insurance contract or identification number812833
Number of Individuals Covered108
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $29,347
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
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 Administration1
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
Commission paid to Insurance BrokerUSD $29,347
Insurance broker organization code?3
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-831160
Policy instance 1
Insurance contract or identification numberGA-831160
Number of Individuals Covered0
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $27,435
Total amount of fees paid to insurance companyUSD $1,936
Are there contracts with allocated funds for individual policies?0
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?Yes
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
Commission paid to Insurance BrokerUSD $27,435
Insurance broker organization code?4
Amount paid for insurance broker fees1936
Additional information about fees paid to insurance brokerADMINISTRATIVE FEES

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