401k Plan data: COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN plan

COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN 401k Plan overview

Plan Name	COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN
Plan identification number	003

COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

COLUMBIA NATIONAL GROUP, INC. has sponsored the creation of one or more 401k plans.

Company Name: COLUMBIA NATIONAL GROUP, INC.

Employer identification number (EIN): 341507580

NAIC Classification: 551112
NAIC Description: Offices of Other Holding Companies

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2022-01-01 JOHN KRESILA 2023-09-07 JOHN KRESILA 2023-09-07
003 2021-01-01 JOHN KRESILA 2022-09-14 JOHN KRESILA 2022-09-14
003 2020-01-01 JOHN KRESILA 2021-08-24 JOHN KRESILA 2021-08-24
003 2019-01-01 JOHN KRESILA 2020-09-08 JOHN KRESILA 2020-09-08
003 2018-01-01 JOHN KRESILA 2019-08-29 JOHN KRESILA 2019-08-29
003 2017-01-01 JOHN KRESILA 2018-09-19 JOHN KRESILA 2018-09-19
003 2016-01-01 JOHN KRESILA 2017-10-16 JOHN KRESILA 2017-10-16
003 2015-01-01 JOHN KRESILA JOHN KRESILA 2016-10-04
003 2014-01-01 JOHN KRESILA JOHN KRESILA 2015-10-15
003 2013-01-01 JOHN KRESILA JOHN KRESILA 2014-10-13
003 2012-01-01 JOHN KRESILA
003 2011-01-01 JOHN KRESILA
003 2009-01-01 JOHN KRESILA

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
003	2022-01-01	JOHN KRESILA	2023-09-07	JOHN KRESILA	2023-09-07
003	2021-01-01	JOHN KRESILA	2022-09-14	JOHN KRESILA	2022-09-14
003	2020-01-01	JOHN KRESILA	2021-08-24	JOHN KRESILA	2021-08-24
003	2019-01-01	JOHN KRESILA	2020-09-08	JOHN KRESILA	2020-09-08
003	2018-01-01	JOHN KRESILA	2019-08-29	JOHN KRESILA	2019-08-29
003	2017-01-01	JOHN KRESILA	2018-09-19	JOHN KRESILA	2018-09-19
003	2016-01-01	JOHN KRESILA	2017-10-16	JOHN KRESILA	2017-10-16
003	2015-01-01	JOHN KRESILA		JOHN KRESILA	2016-10-04
003	2014-01-01	JOHN KRESILA		JOHN KRESILA	2015-10-15
003	2013-01-01	JOHN KRESILA		JOHN KRESILA	2014-10-13
003	2012-01-01	JOHN KRESILA
003	2011-01-01	JOHN KRESILA
003	2009-01-01	JOHN KRESILA

Plan Statistics for COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN

401k plan membership statisitcs for COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN

Measure Date Value
2015: COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 61
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 44
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 16
Total of all active and inactive participants 2015-01-01 60
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 60
Number of participants with account balances 2015-01-01 54
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 73
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 42
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 18
Total of all active and inactive participants 2014-01-01 60
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 60
Number of participants with account balances 2014-01-01 60
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 2
2013: COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 73
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 58
Number of other retired or separated participants entitled to future benefits 2013-01-01 15
Total of all active and inactive participants 2013-01-01 73
Total participants 2013-01-01 73
Number of participants with account balances 2013-01-01 73
2012: COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 74
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 55
Number of other retired or separated participants entitled to future benefits 2012-01-01 18
Total of all active and inactive participants 2012-01-01 73
Total participants 2012-01-01 73
Number of participants with account balances 2012-01-01 73
2011: COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 70
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 55
Number of other retired or separated participants entitled to future benefits 2011-01-01 19
Total of all active and inactive participants 2011-01-01 74
Total participants 2011-01-01 74
Number of participants with account balances 2011-01-01 64
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 1
2009: COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 68
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 52
Number of other retired or separated participants entitled to future benefits 2009-01-01 18
Total of all active and inactive participants 2009-01-01 70
Total participants 2009-01-01 70
Number of participants with account balances 2009-01-01 65
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2015: COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	61
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	44
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	16
Total of all active and inactive participants	2015-01-01	60
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	60
Number of participants with account balances	2015-01-01	54
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	73
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	42
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	18
Total of all active and inactive participants	2014-01-01	60
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	60
Number of participants with account balances	2014-01-01	60
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	2
2013: COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	73
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	58
Number of other retired or separated participants entitled to future benefits	2013-01-01	15
Total of all active and inactive participants	2013-01-01	73
Total participants	2013-01-01	73
Number of participants with account balances	2013-01-01	73
2012: COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	74
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	55
Number of other retired or separated participants entitled to future benefits	2012-01-01	18
Total of all active and inactive participants	2012-01-01	73
Total participants	2012-01-01	73
Number of participants with account balances	2012-01-01	73
2011: COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	70
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	55
Number of other retired or separated participants entitled to future benefits	2011-01-01	19
Total of all active and inactive participants	2011-01-01	74
Total participants	2011-01-01	74
Number of participants with account balances	2011-01-01	64
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	1
2009: COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	68
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	52
Number of other retired or separated participants entitled to future benefits	2009-01-01	18
Total of all active and inactive participants	2009-01-01	70
Total participants	2009-01-01	70
Number of participants with account balances	2009-01-01	65
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN

Measure	Date	Value
2015 : COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$189,366
Expenses. Total of all expenses incurred	2015-12-31	$833,338
Benefits paid (including direct rollovers)	2015-12-31	$831,541
Total plan assets at end of year	2015-12-31	$6,337,499
Total plan assets at beginning of year	2015-12-31	$6,981,471
Value of fidelity bond covering the plan	2015-12-31	$2,500,000
Total contributions received or receivable from participants	2015-12-31	$324,844
Other income received	2015-12-31	$-170,563
Net income (gross income less expenses)	2015-12-31	$-643,972
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$6,337,499
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$6,981,471
Assets. Value of participant loans	2015-12-31	$136,045
Total contributions received or receivable from employer(s)	2015-12-31	$35,085
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$1,797
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$704,606
Expenses. Total of all expenses incurred	2014-12-31	$678,145
Benefits paid (including direct rollovers)	2014-12-31	$618,133
Total plan assets at end of year	2014-12-31	$6,981,471
Total plan assets at beginning of year	2014-12-31	$6,955,010
Value of fidelity bond covering the plan	2014-12-31	$2,500,000
Total contributions received or receivable from participants	2014-12-31	$345,770
Expenses. Other expenses not covered elsewhere	2014-12-31	$3,048
Contributions received from other sources (not participants or employers)	2014-12-31	$9,878
Other income received	2014-12-31	$308,891
Net income (gross income less expenses)	2014-12-31	$26,461
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$6,981,471
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$6,955,010
Assets. Value of participant loans	2014-12-31	$109,714
Total contributions received or receivable from employer(s)	2014-12-31	$40,067
Value of certain deemed distributions of participant loans	2014-12-31	$56,925
Value of corrective distributions	2014-12-31	$39
2013 : COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$1,599,226
Expenses. Total of all expenses incurred	2013-12-31	$278,639
Benefits paid (including direct rollovers)	2013-12-31	$275,626
Total plan assets at end of year	2013-12-31	$6,955,010
Total plan assets at beginning of year	2013-12-31	$5,634,423
Value of fidelity bond covering the plan	2013-12-31	$2,500,000
Total contributions received or receivable from participants	2013-12-31	$349,140
Expenses. Other expenses not covered elsewhere	2013-12-31	$1,680
Contributions received from other sources (not participants or employers)	2013-12-31	$41,966
Other income received	2013-12-31	$1,163,698
Net income (gross income less expenses)	2013-12-31	$1,320,587
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$6,955,010
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$5,634,423
Assets. Value of participant loans	2013-12-31	$162,500
Total contributions received or receivable from employer(s)	2013-12-31	$44,422
Value of corrective distributions	2013-12-31	$1,333
2012 : COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$1,158,359
Expenses. Total of all expenses incurred	2012-12-31	$761,116
Benefits paid (including direct rollovers)	2012-12-31	$750,655
Total plan assets at end of year	2012-12-31	$5,634,423
Total plan assets at beginning of year	2012-12-31	$5,237,180
Value of fidelity bond covering the plan	2012-12-31	$2,500,000
Total contributions received or receivable from participants	2012-12-31	$394,939
Expenses. Other expenses not covered elsewhere	2012-12-31	$10,461
Contributions received from other sources (not participants or employers)	2012-12-31	$77,834
Other income received	2012-12-31	$644,867
Net income (gross income less expenses)	2012-12-31	$397,243
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$5,634,423
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$5,237,180
Assets. Value of participant loans	2012-12-31	$73,477
Total contributions received or receivable from employer(s)	2012-12-31	$40,719
2011 : COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$473,567
Expenses. Total of all expenses incurred	2011-12-31	$597,751
Benefits paid (including direct rollovers)	2011-12-31	$438,943
Total plan assets at end of year	2011-12-31	$5,237,180
Total plan assets at beginning of year	2011-12-31	$5,361,364
Value of fidelity bond covering the plan	2011-12-31	$2,500,000
Total contributions received or receivable from participants	2011-12-31	$367,064
Expenses. Other expenses not covered elsewhere	2011-12-31	$158,808
Other income received	2011-12-31	$64,719
Net income (gross income less expenses)	2011-12-31	$-124,184
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$5,237,180
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$5,361,364
Assets. Value of participant loans	2011-12-31	$82,973
Total contributions received or receivable from employer(s)	2011-12-31	$41,784
2010 : COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$917,875
Expenses. Total of all expenses incurred	2010-12-31	$27,267
Benefits paid (including direct rollovers)	2010-12-31	$22,399
Total plan assets at end of year	2010-12-31	$5,361,364
Total plan assets at beginning of year	2010-12-31	$4,470,756
Value of fidelity bond covering the plan	2010-12-31	$2,500,000
Total contributions received or receivable from participants	2010-12-31	$318,694
Expenses. Other expenses not covered elsewhere	2010-12-31	$4,868
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$559,555
Net income (gross income less expenses)	2010-12-31	$890,608
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$5,361,364
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$4,470,756
Assets. Value of participant loans	2010-12-31	$57,404
Total contributions received or receivable from employer(s)	2010-12-31	$39,626

Form 5500 Responses for COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN

2015: COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: COLUMBIA NATIONAL GROUP, INC. SAVINGS AND INVESTMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )

Policy contract number

031908

Policy instance

Insurance contract or identification number	031908
Number of Individuals Covered	60
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $8,679
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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
Amount paid for insurance broker fees	8679
Additional information about fees paid to insurance broker	SERVICES TO INSURER OR PLAN
Insurance broker organization code?	4
Insurance broker name	LPL FINANCIAL LLC,

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )

Policy contract number

031908

Policy instance

Insurance contract or identification number	031908
Number of Individuals Covered	60
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )

Policy contract number

031908

Policy instance

Insurance contract or identification number	031908
Number of Individuals Covered	73
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of fees paid to insurance company	USD $10,703
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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
Amount paid for insurance broker fees	10703
Additional information about fees paid to insurance broker	SERVICE TO INSURER OF PLAN
Insurance broker name	LPL FINANCIAL LLC

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )

Policy contract number

031908

Policy instance

Insurance contract or identification number	031908
Number of Individuals Covered	73
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of fees paid to insurance company	USD $11,190
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	11190
Additional information about fees paid to insurance broker	SERVICES TO INSURER OR PLAN
Insurance broker name	LPL FINANCIAL LLC

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )

Policy contract number

031908

Policy instance

Insurance contract or identification number	031908
Number of Individuals Covered	74
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of fees paid to insurance company	USD $13,547
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )

Policy contract number

31908

Policy instance

Insurance contract or identification number	31908
Number of Individuals Covered	67
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of fees paid to insurance company	USD $11,791
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	COLUMBIA NATIONAL GROUP, INC.
Employer identification number (EIN):	341507580
NAIC Classification:	551112
NAIC Description:	Offices of Other Holding Companies