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ACCESS THERAPIES 401(K) PLAN 401k Plan overview

Plan NameACCESS THERAPIES 401(K) PLAN
Plan identification number 101

ACCESS THERAPIES 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.
  • 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

ACCESS THERAPIES has sponsored the creation of one or more 401k plans.

Company Name:ACCESS THERAPIES
Employer identification number (EIN):300245072
NAIC Classification:621340
NAIC Description:Offices of Physical, Occupational and Speech Therapists, and Audiologists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ACCESS THERAPIES 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
1012016-01-01PHIL TISUE
1012016-01-01
1012016-01-01PHIL TISUE2017-01-06
1012015-01-01PHIL TISUE
1012015-01-01PHIL TISUE
1012014-01-01PHIL TISUE
1012014-01-01PHIL TISUE
1012013-01-01PHIL TISUE
1012012-01-01PHIL TISUE2014-11-06

Plan Statistics for ACCESS THERAPIES 401(K) PLAN

401k plan membership statisitcs for ACCESS THERAPIES 401(K) PLAN

Measure Date Value
2016: ACCESS THERAPIES 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01113
Total number of active participants reported on line 7a of the Form 55002016-01-010
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-010
Number of participants with account balances2016-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: ACCESS THERAPIES 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01136
Total number of active participants reported on line 7a of the Form 55002015-01-0134
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0179
Total of all active and inactive participants2015-01-01113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01113
Number of participants with account balances2015-01-0193
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-014
2014: ACCESS THERAPIES 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01167
Total number of active participants reported on line 7a of the Form 55002014-01-0158
Number of retired or separated participants receiving benefits2014-01-016
Number of other retired or separated participants entitled to future benefits2014-01-0172
Total of all active and inactive participants2014-01-01136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01136
Number of participants with account balances2014-01-01106
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-0111
2013: ACCESS THERAPIES 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01172
Total number of active participants reported on line 7a of the Form 55002013-01-01118
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0149
Total of all active and inactive participants2013-01-01167
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01167
Number of participants with account balances2013-01-0188
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-0117

Financial Data on ACCESS THERAPIES 401(K) PLAN

Measure Date Value
2016 : ACCESS THERAPIES 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-04-08$0
Total transfer of assets from this plan2016-04-08$552,123
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-04-08$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-04-08$0
Total income from all sources (including contributions)2016-04-08$7,507
Total loss/gain on sale of assets2016-04-08$0
Total of all expenses incurred2016-04-08$7,197
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-04-08$5,431
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-04-08$4,581
Value of total assets at end of year2016-04-08$0
Value of total assets at beginning of year2016-04-08$551,813
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-04-08$1,766
Total interest from all sources2016-04-08$210
Total dividends received (eg from common stock, registered investment company shares)2016-04-08$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-04-08Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2016-04-08$0
Was this plan covered by a fidelity bond2016-04-08Yes
Value of fidelity bond cover2016-04-08$500,000
If this is an individual account plan, was there a blackout period2016-04-08No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-04-08$0
Were there any nonexempt tranactions with any party-in-interest2016-04-08No
Contributions received from participants2016-04-08$4,581
Participant contributions at end of year2016-04-08$0
Participant contributions at beginning of year2016-04-08$1,129
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-04-08No
Value of net income/loss2016-04-08$310
Value of net assets at end of year (total assets less liabilities)2016-04-08$0
Value of net assets at beginning of year (total assets less liabilities)2016-04-08$551,813
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-04-08No
Were any loans by the plan or fixed income obligations due to the plan in default2016-04-08No
Were any leases to which the plan was party in default or uncollectible2016-04-08No
Value of interest in pooled separate accounts at end of year2016-04-08$0
Value of interest in pooled separate accounts at beginning of year2016-04-08$457,213
Interest earned on other investments2016-04-08$210
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-04-08$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-04-08$60,558
Net investment gain/loss from pooled separate accounts2016-04-08$2,716
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-04-08No
Was there a failure to transmit to the plan any participant contributions2016-04-08No
Has the plan failed to provide any benefit when due under the plan2016-04-08No
Employer contributions (assets) at end of year2016-04-08$0
Employer contributions (assets) at beginning of year2016-04-08$32,913
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-04-08$5,431
Contract administrator fees2016-04-08$1,766
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-04-08No
Did the plan have assets held for investment2016-04-08No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-04-08No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-04-08Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-04-08Yes
Opinion of an independent qualified public accountant for this plan2016-04-08Disclaimer
Accountancy firm name2016-04-08COULTER & JUSTUS
Accountancy firm EIN2016-04-08621532536
2015 : ACCESS THERAPIES 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$46,701
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$89,821
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$81,871
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$51,647
Value of total assets at end of year2015-12-31$551,813
Value of total assets at beginning of year2015-12-31$594,933
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$7,950
Total interest from all sources2015-12-31$840
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
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$40,603
Participant contributions at end of year2015-12-31$1,129
Participant contributions at beginning of year2015-12-31$1,088
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-43,120
Value of net assets at end of year (total assets less liabilities)2015-12-31$551,813
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$594,933
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
Value of interest in pooled separate accounts at end of year2015-12-31$457,213
Value of interest in pooled separate accounts at beginning of year2015-12-31$526,449
Interest earned on other investments2015-12-31$840
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$60,558
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$45,527
Net investment gain/loss from pooled separate accounts2015-12-31$-5,786
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 contributions2015-12-31Yes
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$11,044
Employer contributions (assets) at end of year2015-12-31$32,913
Employer contributions (assets) at beginning of year2015-12-31$21,869
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$81,871
Contract administrator fees2015-12-31$7,950
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-12-31No
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 name2015-12-31COULTER & JUSTUS
Accountancy firm EIN2015-12-31621532536
2014 : ACCESS THERAPIES 401(K) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total transfer of assets from this plan2014-12-31$11,431
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$121,562
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$72,923
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$66,436
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$92,928
Value of total assets at end of year2014-12-31$573,064
Value of total assets at beginning of year2014-12-31$524,425
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$6,487
Total interest from all sources2014-12-31$464
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
If this is an individual account plan, was there a blackout period2014-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$84,490
Participant contributions at end of year2014-12-31$1,088
Participant contributions at beginning of year2014-12-31$4,155
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$48,639
Value of net assets at end of year (total assets less liabilities)2014-12-31$573,064
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$524,425
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in pooled separate accounts at end of year2014-12-31$526,449
Value of interest in pooled separate accounts at beginning of year2014-12-31$444,344
Interest earned on other investments2014-12-31$464
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$45,527
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$18,944
Net investment gain/loss from pooled separate accounts2014-12-31$28,170
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31Yes
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$8,438
Employer contributions (assets) at end of year2014-12-31$0
Employer contributions (assets) at beginning of year2014-12-31$56,982
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$66,436
Contract administrator fees2014-12-31$6,487
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31COULTER & JUSTUS
Accountancy firm EIN2014-12-31621532536
2013 : ACCESS THERAPIES 401(K) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total income from all sources (including contributions)2013-12-31$168,948
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$44,820
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$39,134
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$99,762
Value of total assets at end of year2013-12-31$499,439
Value of total assets at beginning of year2013-12-31$375,311
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$5,686
Total interest from all sources2013-12-31$189
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$500,000
If this is an individual account plan, was there a blackout period2013-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$99,762
Participant contributions at end of year2013-12-31$3,953
Participant contributions at beginning of year2013-12-31$3,769
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$124,128
Value of net assets at end of year (total assets less liabilities)2013-12-31$499,439
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$375,311
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in pooled separate accounts at end of year2013-12-31$444,344
Value of interest in pooled separate accounts at beginning of year2013-12-31$300,870
Interest earned on other investments2013-12-31$189
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$18,944
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$7,407
Net investment gain/loss from pooled separate accounts2013-12-31$68,997
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$24,784
Employer contributions (assets) at end of year2013-12-31$32,198
Employer contributions (assets) at beginning of year2013-12-31$63,265
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$39,134
Contract administrator fees2013-12-31$5,686
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31COULTER & JUSTUS
Accountancy firm EIN2013-12-31621532536

Form 5500 Responses for ACCESS THERAPIES 401(K) PLAN

2016: ACCESS THERAPIES 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 filingYes
2016-01-01This return/report is a short plan year return/report (less than 12 months)Yes
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 – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: ACCESS THERAPIES 401(K) PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedYes
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 – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: ACCESS THERAPIES 401(K) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedYes
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: ACCESS THERAPIES 401(K) PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedYes
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number931061-145
Policy instance 1
Insurance contract or identification number931061-145
Number of Individuals Covered0
Insurance policy start date2016-01-01
Insurance policy end date2016-04-08
Total amount of commissions paid to insurance brokerUSD $516
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $516
Amount paid for insurance broker fees0
Additional information about fees paid to insurance broker0
Insurance broker organization code?3
Insurance broker namePHIL E TISUE
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number931061-145
Policy instance 1
Insurance contract or identification number931061-145
Number of Individuals Covered113
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $2,178
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,178
Amount paid for insurance broker fees0
Additional information about fees paid to insurance broker0
Insurance broker organization code?3
Insurance broker namePHIL E TISUE
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number931061-145
Policy instance 1
Insurance contract or identification number931061-145
Number of Individuals Covered136
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $2,054
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,054
Amount paid for insurance broker fees0
Additional information about fees paid to insurance broker0
Insurance broker organization code?3
Insurance broker namePHIL E TISUE
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number931061-145
Policy instance 1
Insurance contract or identification number931061-145
Number of Individuals Covered167
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,527
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,527
Insurance broker organization code?3
Insurance broker namePHIL E TISUE

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