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INTERLOCAL COMMUNITY ACTION PROGRAM 401(K) PLAN 401k Plan overview

Plan NameINTERLOCAL COMMUNITY ACTION PROGRAM 401(K) PLAN
Plan identification number 002

INTERLOCAL COMMUNITY ACTION PROGRAM 401(K) PLAN Benefits

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

401k Sponsoring company profile

INTERLOCAL COMMUNITY ACTION PROGRAM, INC has sponsored the creation of one or more 401k plans.

Company Name:INTERLOCAL COMMUNITY ACTION PROGRAM, INC
Employer identification number (EIN):351116629
NAIC Classification:624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan INTERLOCAL COMMUNITY ACTION PROGRAM 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022022-01-01
0022021-01-01
0022021-01-01
0022021-01-01
0022021-01-01
0022021-01-01
0022020-01-01
0022019-01-01
0022018-01-01WENDY PADGETT
0022018-01-01
0022017-01-01WENDY PADGETT2018-07-24 WENDY PADGETT2018-07-24
0022016-01-01KEVIN P POLIVICK2017-06-05 KEVIN P POLIVICK2017-06-05
0022015-01-01KEVIN P POLIVICK2016-07-25 KEVIN P POLIVICK2016-07-25
0022014-01-01KEVIN P POLIVICK2015-05-11 KEVIN P POLIVICK2015-05-11
0022013-01-01KEVIN P POLIVICK2014-06-10 KEVIN P POLIVICK2014-06-10
0022012-01-01KEVIN P POLIVICK2013-06-07 KEVIN P POLIVICK2013-06-07
0022011-01-01KEVIN POLIVICK2012-06-05 KEVIN POLIVICK2012-06-05
0022010-01-01KEVIN POLIVICK2011-07-20

Plan Statistics for INTERLOCAL COMMUNITY ACTION PROGRAM 401(K) PLAN

401k plan membership statisitcs for INTERLOCAL COMMUNITY ACTION PROGRAM 401(K) PLAN

Measure Date Value
2022: INTERLOCAL COMMUNITY ACTION PROGRAM 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-010
Total number of active participants reported on line 7a of the Form 55002022-01-0191
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0147
Total of all active and inactive participants2022-01-01138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01138
Number of participants with account balances2022-01-01109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: INTERLOCAL COMMUNITY ACTION PROGRAM 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01115
Total number of active participants reported on line 7a of the Form 55002021-01-0183
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0131
Total of all active and inactive participants2021-01-01114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-013
Total participants2021-01-01117
Number of participants with account balances2021-01-01114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: INTERLOCAL COMMUNITY ACTION PROGRAM 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01117
Total number of active participants reported on line 7a of the Form 55002020-01-0195
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0118
Total of all active and inactive participants2020-01-01113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-012
Total participants2020-01-01115
Number of participants with account balances2020-01-01107
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: INTERLOCAL COMMUNITY ACTION PROGRAM 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01108
Total number of active participants reported on line 7a of the Form 55002019-01-0186
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0130
Total of all active and inactive participants2019-01-01116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-011
Total participants2019-01-01117
Number of participants with account balances2019-01-01117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: INTERLOCAL COMMUNITY ACTION PROGRAM 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01103
Total number of active participants reported on line 7a of the Form 55002018-01-0181
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0126
Total of all active and inactive participants2018-01-01107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-011
Total participants2018-01-01108
Number of participants with account balances2018-01-01107
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010

Financial Data on INTERLOCAL COMMUNITY ACTION PROGRAM 401(K) PLAN

Measure Date Value
2022 : INTERLOCAL COMMUNITY ACTION PROGRAM 401(K) PLAN 2022 401k financial data
Total plan liabilities at beginning of year2022-12-31$0
Total income from all sources2022-12-31$-118,466
Expenses. Total of all expenses incurred2022-12-31$93,439
Benefits paid (including direct rollovers)2022-12-31$92,710
Total plan assets at end of year2022-12-31$1,579,118
Total plan assets at beginning of year2022-12-31$1,791,023
Value of fidelity bond covering the plan2022-12-31$300,000
Total contributions received or receivable from participants2022-12-31$72,175
Expenses. Other expenses not covered elsewhere2022-12-31$729
Contributions received from other sources (not participants or employers)2022-12-31$1,876
Other income received2022-12-31$-261,250
Net income (gross income less expenses)2022-12-31$-211,905
Net plan assets at end of year (total assets less liabilities)2022-12-31$1,579,118
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$1,791,023
Total contributions received or receivable from employer(s)2022-12-31$68,733
2021 : INTERLOCAL COMMUNITY ACTION PROGRAM 401(K) PLAN 2021 401k financial data
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$397,709
Total of all expenses incurred2021-12-31$153,542
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$148,684
Expenses. Certain deemed distributions of participant loans2021-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$183,451
Value of total assets at end of year2021-12-31$1,791,023
Value of total assets at beginning of year2021-12-31$1,546,856
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$4,858
Total interest from all sources2021-12-31$3,851
Transfers to/from the plan2021-12-31$0
Total plan liabilities at end of year2021-12-31$0
Total plan liabilities at beginning of year2021-12-31$0
Total income from all sources2021-12-31$0
Expenses. Total of all expenses incurred2021-12-31$0
Benefits paid (including direct rollovers)2021-12-31$148,684
Total plan assets at end of year2021-12-31$1,791,023
Total plan assets at beginning of year2021-12-31$1,546,856
Value of fidelity bond covering the plan2021-12-31$300,000
Total contributions received or receivable from participants2021-12-31$80,535
Expenses. Other expenses not covered elsewhere2021-12-31$4,858
Contributions received from other sources (not participants or employers)2021-12-31$31,329
Other income received2021-12-31$212,447
Net income (gross income less expenses)2021-12-31$0
Net plan assets at end of year (total assets less liabilities)2021-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$1,546,856
Assets. Value of participant loans2021-12-31$57,556
Total contributions received or receivable from employer(s)2021-12-31$73,398
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31No
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$80,535
Participant contributions at end of year2021-12-31$57,556
Participant contributions at beginning of year2021-12-31$22,121
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$29,518
Other income not declared elsewhere2021-12-31$0
Administrative expenses (other) incurred2021-12-31$4,858
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$244,167
Value of net assets at end of year (total assets less liabilities)2021-12-31$1,791,023
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$1,546,856
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$1,510,224
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$1,343,141
Interest on participant loans2021-12-31$1,811
Interest earned on other investments2021-12-31$2,040
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$223,243
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$181,594
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$0
Net investment gain/loss from pooled separate accounts2021-12-31$210,407
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$73,398
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$148,684
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 plan2021-12-31Disclaimer
2020 : INTERLOCAL COMMUNITY ACTION PROGRAM 401(K) PLAN 2020 401k financial data
Transfers to/from the plan2020-12-31$0
Total plan liabilities at end of year2020-12-31$0
Total plan liabilities at beginning of year2020-12-31$0
Total income from all sources2020-12-31$456,598
Expenses. Total of all expenses incurred2020-12-31$105,976
Benefits paid (including direct rollovers)2020-12-31$101,366
Total plan assets at end of year2020-12-31$1,546,856
Total plan assets at beginning of year2020-12-31$1,196,234
Value of fidelity bond covering the plan2020-12-31$300,000
Total contributions received or receivable from participants2020-12-31$80,031
Expenses. Other expenses not covered elsewhere2020-12-31$4,610
Contributions received from other sources (not participants or employers)2020-12-31$144,506
Other income received2020-12-31$152,841
Net income (gross income less expenses)2020-12-31$350,622
Net plan assets at end of year (total assets less liabilities)2020-12-31$1,546,856
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$1,196,234
Assets. Value of participant loans2020-12-31$22,121
Total contributions received or receivable from employer(s)2020-12-31$79,220
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
2019 : INTERLOCAL COMMUNITY ACTION PROGRAM 401(K) PLAN 2019 401k financial data
Transfers to/from the plan2019-12-31$0
Total plan liabilities at end of year2019-12-31$0
Total plan liabilities at beginning of year2019-12-31$0
Total income from all sources2019-12-31$334,734
Expenses. Total of all expenses incurred2019-12-31$52,652
Benefits paid (including direct rollovers)2019-12-31$52,192
Total plan assets at end of year2019-12-31$1,196,234
Total plan assets at beginning of year2019-12-31$914,152
Value of fidelity bond covering the plan2019-12-31$300,000
Total contributions received or receivable from participants2019-12-31$80,840
Expenses. Other expenses not covered elsewhere2019-12-31$460
Contributions received from other sources (not participants or employers)2019-12-31$5,546
Other income received2019-12-31$171,211
Net income (gross income less expenses)2019-12-31$282,082
Net plan assets at end of year (total assets less liabilities)2019-12-31$1,196,234
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$914,152
Assets. Value of participant loans2019-12-31$23,096
Total contributions received or receivable from employer(s)2019-12-31$77,137
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
2018 : INTERLOCAL COMMUNITY ACTION PROGRAM 401(K) PLAN 2018 401k financial data
Transfers to/from the plan2018-12-31$0
Total plan liabilities at end of year2018-12-31$0
Total plan liabilities at beginning of year2018-12-31$0
Total income from all sources2018-12-31$122,910
Expenses. Total of all expenses incurred2018-12-31$107,194
Benefits paid (including direct rollovers)2018-12-31$100,360
Total plan assets at end of year2018-12-31$914,152
Total plan assets at beginning of year2018-12-31$898,436
Value of fidelity bond covering the plan2018-12-31$300,000
Total contributions received or receivable from participants2018-12-31$85,127
Expenses. Other expenses not covered elsewhere2018-12-31$6,834
Contributions received from other sources (not participants or employers)2018-12-31$34,203
Other income received2018-12-31$-63,311
Net income (gross income less expenses)2018-12-31$15,716
Net plan assets at end of year (total assets less liabilities)2018-12-31$914,152
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$898,436
Total contributions received or receivable from employer(s)2018-12-31$66,891
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0

Form 5500 Responses for INTERLOCAL COMMUNITY ACTION PROGRAM 401(K) PLAN

2022: INTERLOCAL COMMUNITY ACTION PROGRAM 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 benefit arrangement – InsuranceYes
2021: INTERLOCAL COMMUNITY ACTION PROGRAM 401(K) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedYes
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 benefit arrangement – InsuranceYes
2020: INTERLOCAL COMMUNITY ACTION PROGRAM 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 benefit arrangement – InsuranceYes
2019: INTERLOCAL COMMUNITY ACTION PROGRAM 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 benefit arrangement – InsuranceYes
2018: INTERLOCAL COMMUNITY ACTION PROGRAM 401(K) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedYes
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 benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number060083
Policy instance 1
Insurance contract or identification number060083
Number of Individuals Covered0
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $408
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees408
Additional information about fees paid to insurance brokerINCENTIVE COMPENSATION
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number060083K
Policy instance 1
Insurance contract or identification number060083K
Number of Individuals Covered117
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $219
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees219
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number060083K
Policy instance 1
Insurance contract or identification number060083K
Number of Individuals Covered115
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $219
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees219
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number060083K
Policy instance 1
Insurance contract or identification number060083K
Number of Individuals Covered128
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $297
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees297
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number060083K
Policy instance 1
Insurance contract or identification number060083K
Number of Individuals Covered108
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $1,323
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees1323
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3

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