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CAPTIVE RESOURCES 401(K) PLAN 401k Plan overview

Plan NameCAPTIVE RESOURCES 401(K) PLAN
Plan identification number 001

CAPTIVE RESOURCES 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.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • 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.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

CAPTIVE RESOURCES, LLC has sponsored the creation of one or more 401k plans.

Company Name:CAPTIVE RESOURCES, LLC
Employer identification number (EIN):300073596
NAIC Classification:524210
NAIC Description:Insurance Agencies and Brokerages

Additional information about CAPTIVE RESOURCES, LLC

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 3510572

More information about CAPTIVE RESOURCES, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CAPTIVE RESOURCES 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01DONNA DREUTH
0012017-01-01DONNA DREUTH
0012016-01-01DONNA DREUTH
0012016-01-01
0012015-01-01DONNA DREUTH
0012014-01-01ERNEST C. ACHTIEN2015-03-26
0012013-01-01ERNEST C. ACHTIEN2014-07-09
0012012-01-01ERNEST ACHTIEN2013-02-07 ERNEST ACHTIEN2013-02-07
0012011-01-01ERNEST ACHTIEN2012-02-16 ERNEST ACHTIEN2012-02-16
0012010-01-01ERNEST ACHTIEN2011-04-05 ERNEST ACHTIEN2011-04-05
0012008-01-01ROSE FRIERI
0012007-01-01ROSE FRIERI

Plan Statistics for CAPTIVE RESOURCES 401(K) PLAN

401k plan membership statisitcs for CAPTIVE RESOURCES 401(K) PLAN

Measure Date Value
2022: CAPTIVE RESOURCES 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01309
Total number of active participants reported on line 7a of the Form 55002022-01-01313
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0139
Total of all active and inactive participants2022-01-01352
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01352
Number of participants with account balances2022-01-01347
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-0115
2021: CAPTIVE RESOURCES 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01261
Total number of active participants reported on line 7a of the Form 55002021-01-01275
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0134
Total of all active and inactive participants2021-01-01309
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01309
Number of participants with account balances2021-01-01306
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-0113
2020: CAPTIVE RESOURCES 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01241
Total number of active participants reported on line 7a of the Form 55002020-01-01231
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0130
Total of all active and inactive participants2020-01-01261
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01261
Number of participants with account balances2020-01-01261
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-0115
2019: CAPTIVE RESOURCES 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01240
Total number of active participants reported on line 7a of the Form 55002019-01-01215
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 participants2019-01-01241
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01241
Number of participants with account balances2019-01-01241
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-016
2018: CAPTIVE RESOURCES 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01214
Total number of active participants reported on line 7a of the Form 55002018-01-01201
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0131
Total of all active and inactive participants2018-01-01232
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01232
Number of participants with account balances2018-01-01231
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-0116
2017: CAPTIVE RESOURCES 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01192
Total number of active participants reported on line 7a of the Form 55002017-01-01178
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0124
Total of all active and inactive participants2017-01-01202
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01202
Number of participants with account balances2017-01-01202
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-019
2016: CAPTIVE RESOURCES 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01192
Total number of active participants reported on line 7a of the Form 55002016-01-01178
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0114
Total of all active and inactive participants2016-01-01192
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01192
Number of participants with account balances2016-01-01191
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-018
2015: CAPTIVE RESOURCES 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01161
Total number of active participants reported on line 7a of the Form 55002015-01-01179
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-018
Total of all active and inactive participants2015-01-01187
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01187
Number of participants with account balances2015-01-01187
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-014
2008: CAPTIVE RESOURCES 401(K) PLAN 2008 401k membership
Total participants, beginning-of-year2008-01-0198
Total number of active participants reported on line 7a of the Form 55002008-01-0198
Number of other retired or separated participants entitled to future benefits2008-01-012
Total of all active and inactive participants2008-01-01100
Total participants2008-01-01100
Number of participants with account balances2008-01-0199
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2008-01-011
2007: CAPTIVE RESOURCES 401(K) PLAN 2007 401k membership
Total participants, beginning-of-year2007-01-0195
Total number of active participants reported on line 7a of the Form 55002007-01-0198
Number of other retired or separated participants entitled to future benefits2007-01-011
Total of all active and inactive participants2007-01-0199
Total participants2007-01-0199
Number of participants with account balances2007-01-0197

Financial Data on CAPTIVE RESOURCES 401(K) PLAN

Measure Date Value
2022 : CAPTIVE RESOURCES 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$-6,799,776
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$2,680,008
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$2,602,482
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$6,360,028
Value of total assets at end of year2022-12-31$64,898,311
Value of total assets at beginning of year2022-12-31$74,378,095
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$77,526
Total interest from all sources2022-12-31$26,653
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$1,134,683
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$1,134,683
Administrative expenses professional fees incurred2022-12-31$11,200
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$3,842,986
Participant contributions at end of year2022-12-31$494,880
Participant contributions at beginning of year2022-12-31$581,385
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$652,787
Administrative expenses (other) incurred2022-12-31$1,650
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-9,479,784
Value of net assets at end of year (total assets less liabilities)2022-12-31$64,898,311
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$74,378,095
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Investment advisory and management fees2022-12-31$50,618
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$62,126,149
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$70,511,246
Value of interest in pooled separate accounts at end of year2022-12-31$2,277,282
Value of interest in pooled separate accounts at beginning of year2022-12-31$3,285,464
Interest on participant loans2022-12-31$26,653
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-14,373,241
Net investment gain/loss from pooled separate accounts2022-12-31$52,101
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$1,864,255
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$2,602,482
Contract administrator fees2022-12-31$14,058
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31MILLER COOPER & CO., LTD.
Accountancy firm EIN2022-12-31362897372
2021 : CAPTIVE RESOURCES 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$16,064,587
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$3,327,403
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$3,250,463
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$6,317,062
Value of total assets at end of year2021-12-31$74,378,095
Value of total assets at beginning of year2021-12-31$61,640,911
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$76,940
Total interest from all sources2021-12-31$36,580
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$1,086,274
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$1,086,274
Administrative expenses professional fees incurred2021-12-31$10,700
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$3,096,847
Participant contributions at end of year2021-12-31$581,385
Participant contributions at beginning of year2021-12-31$751,062
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$1,741,927
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$12,737,184
Value of net assets at end of year (total assets less liabilities)2021-12-31$74,378,095
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$61,640,911
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
Investment advisory and management fees2021-12-31$54,230
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$70,511,246
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$57,245,348
Value of interest in pooled separate accounts at end of year2021-12-31$3,285,464
Value of interest in pooled separate accounts at beginning of year2021-12-31$3,644,501
Interest on participant loans2021-12-31$36,580
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$8,566,627
Net investment gain/loss from pooled separate accounts2021-12-31$58,044
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$1,478,288
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$3,250,463
Contract administrator fees2021-12-31$12,010
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 name2021-12-31MILLER COOPER & CO., LTD.
Accountancy firm EIN2021-12-31362897372
2020 : CAPTIVE RESOURCES 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$12,199,481
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$1,686,166
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$1,613,117
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$4,675,773
Value of total assets at end of year2020-12-31$61,640,911
Value of total assets at beginning of year2020-12-31$51,127,596
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$73,049
Total interest from all sources2020-12-31$38,926
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$708,468
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$708,468
Administrative expenses professional fees incurred2020-12-31$10,600
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$2,724,959
Participant contributions at end of year2020-12-31$751,062
Participant contributions at beginning of year2020-12-31$539,256
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$683,096
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$10,513,315
Value of net assets at end of year (total assets less liabilities)2020-12-31$61,640,911
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$51,127,596
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
Investment advisory and management fees2020-12-31$50,000
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$57,245,348
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$47,627,662
Value of interest in pooled separate accounts at end of year2020-12-31$3,644,501
Value of interest in pooled separate accounts at beginning of year2020-12-31$2,960,678
Interest on participant loans2020-12-31$38,926
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$6,712,699
Net investment gain/loss from pooled separate accounts2020-12-31$63,615
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$1,267,718
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$1,613,117
Contract administrator fees2020-12-31$12,449
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 plan2020-12-31Unqualified
Accountancy firm name2020-12-31MILLER COOPER & CO., LTD.
Accountancy firm EIN2020-12-31362897372
2019 : CAPTIVE RESOURCES 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$13,755,341
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$4,070,098
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$4,009,520
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$4,422,664
Value of total assets at end of year2019-12-31$51,127,596
Value of total assets at beginning of year2019-12-31$41,442,353
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$60,578
Total interest from all sources2019-12-31$27,327
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$849,878
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$849,878
Administrative expenses professional fees incurred2019-12-31$10,500
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 period2019-12-31No
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$2,580,742
Participant contributions at end of year2019-12-31$539,256
Participant contributions at beginning of year2019-12-31$436,961
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$617,745
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$9,685,243
Value of net assets at end of year (total assets less liabilities)2019-12-31$51,127,596
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$41,442,353
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
Investment advisory and management fees2019-12-31$39,250
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$47,627,662
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$38,790,313
Value of interest in pooled separate accounts at end of year2019-12-31$2,960,678
Value of interest in pooled separate accounts at beginning of year2019-12-31$2,215,079
Interest on participant loans2019-12-31$27,327
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$8,402,573
Net investment gain/loss from pooled separate accounts2019-12-31$52,899
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$1,224,177
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$4,009,520
Contract administrator fees2019-12-31$10,828
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 name2019-12-31MILLER COOPER & CO., LTD.
Accountancy firm EIN2019-12-31362897372
2018 : CAPTIVE RESOURCES 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$1,133,250
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$788,817
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$713,869
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$3,999,942
Value of total assets at end of year2018-12-31$41,442,353
Value of total assets at beginning of year2018-12-31$41,097,920
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$74,948
Total interest from all sources2018-12-31$19,890
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$1,477,239
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$1,477,239
Administrative expenses professional fees incurred2018-12-31$10,300
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
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$2,283,275
Participant contributions at end of year2018-12-31$436,961
Participant contributions at beginning of year2018-12-31$349,549
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$152,058
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$344,433
Value of net assets at end of year (total assets less liabilities)2018-12-31$41,442,353
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$41,097,920
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
Investment advisory and management fees2018-12-31$42,139
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$38,790,313
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$38,728,672
Value of interest in pooled separate accounts at end of year2018-12-31$2,215,079
Value of interest in pooled separate accounts at beginning of year2018-12-31$2,019,699
Interest on participant loans2018-12-31$19,890
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-4,405,085
Net investment gain/loss from pooled separate accounts2018-12-31$41,264
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$1,564,609
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$713,869
Contract administrator fees2018-12-31$22,509
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 PBGC2018-12-31No
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 name2018-12-31MILLER COOPER & CO., LTD.
Accountancy firm EIN2018-12-31362897372
2017 : CAPTIVE RESOURCES 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$9,962,937
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$2,701,811
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$2,631,682
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$3,858,855
Value of total assets at end of year2017-12-31$41,097,920
Value of total assets at beginning of year2017-12-31$33,836,794
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$70,129
Total interest from all sources2017-12-31$16,898
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$1,160,164
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$1,160,164
Administrative expenses professional fees incurred2017-12-31$9,800
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$2,151,344
Participant contributions at end of year2017-12-31$349,549
Participant contributions at beginning of year2017-12-31$396,143
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$236,825
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$7,261,126
Value of net assets at end of year (total assets less liabilities)2017-12-31$41,097,920
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$33,836,794
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Investment advisory and management fees2017-12-31$45,000
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$38,728,672
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$31,704,037
Value of interest in pooled separate accounts at end of year2017-12-31$2,019,699
Value of interest in pooled separate accounts at beginning of year2017-12-31$1,736,614
Interest on participant loans2017-12-31$16,898
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$4,897,286
Net investment gain/loss from pooled separate accounts2017-12-31$29,734
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$1,470,686
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$2,631,682
Contract administrator fees2017-12-31$15,329
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31MILLER COOPER & CO., LTD.
Accountancy firm EIN2017-12-31362897372
2016 : CAPTIVE RESOURCES 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total income from all sources (including contributions)2016-12-31$6,383,164
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$1,443,204
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$1,373,478
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$3,824,246
Value of total assets at end of year2016-12-31$33,836,794
Value of total assets at beginning of year2016-12-31$28,896,834
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$69,726
Total interest from all sources2016-12-31$20,465
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$835,285
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$835,285
Administrative expenses professional fees incurred2016-12-31$9,500
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$2,101,511
Participant contributions at end of year2016-12-31$396,143
Participant contributions at beginning of year2016-12-31$433,274
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$291,789
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$4,939,960
Value of net assets at end of year (total assets less liabilities)2016-12-31$33,836,794
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$28,896,834
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Investment advisory and management fees2016-12-31$32,000
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$31,704,037
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$26,629,291
Value of interest in pooled separate accounts at end of year2016-12-31$1,736,614
Value of interest in pooled separate accounts at beginning of year2016-12-31$1,834,269
Interest on participant loans2016-12-31$20,465
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$1,676,206
Net investment gain/loss from pooled separate accounts2016-12-31$26,962
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$1,430,946
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$1,373,478
Contract administrator fees2016-12-31$28,226
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31MILLER COOPER & CO., LTD.
Accountancy firm EIN2016-12-31362897372
2015 : CAPTIVE RESOURCES 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$2,858,270
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$1,083,205
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$1,039,123
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$2,865,867
Value of total assets at end of year2015-12-31$28,896,834
Value of total assets at beginning of year2015-12-31$27,121,769
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$44,082
Total interest from all sources2015-12-31$16,942
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$1,135,384
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$1,135,384
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$1,857,651
Participant contributions at end of year2015-12-31$433,274
Participant contributions at beginning of year2015-12-31$375,957
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$140,167
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$1,775,065
Value of net assets at end of year (total assets less liabilities)2015-12-31$28,896,834
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$27,121,769
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Investment advisory and management fees2015-12-31$574
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$26,629,291
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$25,585,548
Value of interest in pooled separate accounts at end of year2015-12-31$1,834,269
Value of interest in pooled separate accounts at beginning of year2015-12-31$1,160,264
Interest on participant loans2015-12-31$16,942
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-1,181,300
Net investment gain/loss from pooled separate accounts2015-12-31$21,377
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$868,049
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$1,039,123
Contract administrator fees2015-12-31$43,508
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31MILLER COOPER
Accountancy firm EIN2015-12-31362897372

Form 5500 Responses for CAPTIVE RESOURCES 401(K) PLAN

2022: CAPTIVE RESOURCES 401(K) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement - TrustYes
2021: CAPTIVE RESOURCES 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 - TrustYes
2020: CAPTIVE RESOURCES 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 - TrustYes
2019: CAPTIVE RESOURCES 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 - TrustYes
2018: CAPTIVE RESOURCES 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 - TrustYes
2017: CAPTIVE RESOURCES 401(K) PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement - TrustYes
2016: CAPTIVE RESOURCES 401(K) PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedYes
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: CAPTIVE RESOURCES 401(K) PLAN 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 planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2008: CAPTIVE RESOURCES 401(K) PLAN 2008 form 5500 responses
2008-01-01Type of plan entitySingle employer plan
2008-01-01Submission has been amendedNo
2008-01-01This submission is the final filingNo
2008-01-01This return/report is a short plan year return/report (less than 12 months)No
2008-01-01Plan is a collectively bargained planNo
2008-01-01Plan funding arrangement – InsuranceYes
2008-01-01Plan funding arrangement – TrustYes
2008-01-01Plan benefit arrangement – InsuranceYes
2008-01-01Plan benefit arrangement - TrustYes
2007: CAPTIVE RESOURCES 401(K) PLAN 2007 form 5500 responses
2007-01-01Type of plan entitySingle employer plan
2007-01-01Submission has been amendedNo
2007-01-01This submission is the final filingNo
2007-01-01This return/report is a short plan year return/report (less than 12 months)No
2007-01-01Plan is a collectively bargained planNo
2007-01-01Plan funding arrangement – InsuranceYes
2007-01-01Plan funding arrangement – TrustYes
2007-01-01Plan benefit arrangement – InsuranceYes
2007-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )
Policy contract number30500
Policy instance 1
Insurance contract or identification number30500
Number of Individuals Covered347
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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?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 number30500
Policy instance 1
Insurance contract or identification number30500
Number of Individuals Covered306
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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?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 number30500
Policy instance 1
Insurance contract or identification number30500
Number of Individuals Covered261
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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?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 number30500
Policy instance 1
Insurance contract or identification number30500
Number of Individuals Covered241
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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?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 number30500
Policy instance 1
Insurance contract or identification number30500
Number of Individuals Covered231
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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?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 number30500
Policy instance 1
Insurance contract or identification number30500
Number of Individuals Covered202
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
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?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 number30500
Policy instance 1
Insurance contract or identification number30500
Number of Individuals Covered187
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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

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