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CATALYST OILFIELD SERVICES 2016 LLC 401(K) PLAN 401k Plan overview

Plan NameCATALYST OILFIELD SERVICES 2016 LLC 401(K) PLAN
Plan identification number 001

CATALYST OILFIELD SERVICES 2016 LLC 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

CATALYST OILFIELD SERVICES 2016 LLC has sponsored the creation of one or more 401k plans.

Company Name:CATALYST OILFIELD SERVICES 2016 LLC
Employer identification number (EIN):352565667
NAIC Classification:325900
NAIC Description:Other Chemical Product and Preparation Manufacturing

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CATALYST OILFIELD SERVICES 2016 LLC 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012019-01-01
0012019-01-01
0012018-01-01
0012017-01-01VERN DISNEY
0012017-01-01VERN DISNEY
0012016-11-23TREY WOMACK

Plan Statistics for CATALYST OILFIELD SERVICES 2016 LLC 401(K) PLAN

401k plan membership statisitcs for CATALYST OILFIELD SERVICES 2016 LLC 401(K) PLAN

Measure Date Value
2019: CATALYST OILFIELD SERVICES 2016 LLC 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01306
Total number of active participants reported on line 7a of the Form 55002019-01-010
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-010
Number of participants with account balances2019-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: CATALYST OILFIELD SERVICES 2016 LLC 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01230
Total number of active participants reported on line 7a of the Form 55002018-01-01248
Number of retired or separated participants receiving benefits2018-01-0113
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01261
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01261
Number of participants with account balances2018-01-01163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-0110
2017: CATALYST OILFIELD SERVICES 2016 LLC 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01151
Total number of active participants reported on line 7a of the Form 55002017-01-01183
Number of retired or separated participants receiving benefits2017-01-0113
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01196
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01196
Number of participants with account balances2017-01-01136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-0120
2016: CATALYST OILFIELD SERVICES 2016 LLC 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-11-23138
Total number of active participants reported on line 7a of the Form 55002016-11-23137
Number of retired or separated participants receiving benefits2016-11-231
Number of other retired or separated participants entitled to future benefits2016-11-230
Total of all active and inactive participants2016-11-23138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-11-230
Total participants2016-11-23138
Number of participants with account balances2016-11-23102
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-11-231

Financial Data on CATALYST OILFIELD SERVICES 2016 LLC 401(K) PLAN

Measure Date Value
2019 : CATALYST OILFIELD SERVICES 2016 LLC 401(K) PLAN 2019 401k financial data
Total transfer of assets from this plan2019-05-20$4,971,304
Total transfer of assets from this plan2019-05-20$4,971,304
Total income from all sources (including contributions)2019-05-20$952,774
Total income from all sources (including contributions)2019-05-20$952,774
Total of all expenses incurred2019-05-20$70,750
Total of all expenses incurred2019-05-20$70,750
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-05-20$58,600
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-05-20$58,600
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-05-20$510,406
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-05-20$510,406
Value of total assets at end of year2019-05-20$0
Value of total assets at end of year2019-05-20$0
Value of total assets at beginning of year2019-05-20$4,089,280
Value of total assets at beginning of year2019-05-20$4,089,280
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-05-20$12,150
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-05-20$12,150
Total interest from all sources2019-05-20$921
Total interest from all sources2019-05-20$921
Total dividends received (eg from common stock, registered investment company shares)2019-05-20$21,086
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-05-20No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-05-20No
Total dividends received from registered investment company shares (eg mutual funds)2019-05-20$21,086
Was this plan covered by a fidelity bond2019-05-20Yes
Was this plan covered by a fidelity bond2019-05-20Yes
Value of fidelity bond cover2019-05-20$500,000
Value of fidelity bond cover2019-05-20$500,000
If this is an individual account plan, was there a blackout period2019-05-20Yes
If this is an individual account plan, was there a blackout period2019-05-20Yes
Were there any nonexempt tranactions with any party-in-interest2019-05-20No
Were there any nonexempt tranactions with any party-in-interest2019-05-20No
Contributions received from participants2019-05-20$309,481
Contributions received from participants2019-05-20$309,481
Participant contributions at end of year2019-05-20$0
Participant contributions at end of year2019-05-20$0
Participant contributions at beginning of year2019-05-20$54,570
Participant contributions at beginning of year2019-05-20$54,570
Participant contributions at end of year2019-05-20$0
Participant contributions at end of year2019-05-20$0
Participant contributions at beginning of year2019-05-20$155
Participant contributions at beginning of year2019-05-20$155
Income. Received or receivable in cash from other sources (including rollovers)2019-05-20$5,603
Income. Received or receivable in cash from other sources (including rollovers)2019-05-20$5,603
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-05-20No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-05-20No
Value of net income/loss2019-05-20$882,024
Value of net income/loss2019-05-20$882,024
Value of net assets at end of year (total assets less liabilities)2019-05-20$0
Value of net assets at end of year (total assets less liabilities)2019-05-20$0
Value of net assets at beginning of year (total assets less liabilities)2019-05-20$4,089,280
Value of net assets at beginning of year (total assets less liabilities)2019-05-20$4,089,280
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-05-20No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-05-20No
Were any loans by the plan or fixed income obligations due to the plan in default2019-05-20No
Were any loans by the plan or fixed income obligations due to the plan in default2019-05-20No
Were any leases to which the plan was party in default or uncollectible2019-05-20No
Were any leases to which the plan was party in default or uncollectible2019-05-20No
Investment advisory and management fees2019-05-20$12,150
Investment advisory and management fees2019-05-20$12,150
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-05-20$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-05-20$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-05-20$4,023,309
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-05-20$4,023,309
Interest on participant loans2019-05-20$921
Interest on participant loans2019-05-20$921
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-05-20$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-05-20$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-05-20$11,233
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-05-20$11,233
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-05-20$441,447
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-05-20$441,447
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-05-20No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-05-20No
Was there a failure to transmit to the plan any participant contributions2019-05-20No
Was there a failure to transmit to the plan any participant contributions2019-05-20No
Has the plan failed to provide any benefit when due under the plan2019-05-20No
Has the plan failed to provide any benefit when due under the plan2019-05-20No
Contributions received in cash from employer2019-05-20$195,322
Contributions received in cash from employer2019-05-20$195,322
Employer contributions (assets) at end of year2019-05-20$0
Employer contributions (assets) at end of year2019-05-20$0
Employer contributions (assets) at beginning of year2019-05-20$13
Employer contributions (assets) at beginning of year2019-05-20$13
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-05-20$58,600
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-05-20$58,600
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-05-20Yes
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-05-20Yes
Did the plan have assets held for investment2019-05-20Yes
Did the plan have assets held for investment2019-05-20Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-05-20No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-05-20No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-05-20Yes
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-05-20Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-05-20Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-05-20Yes
Opinion of an independent qualified public accountant for this plan2019-05-20Disclaimer
Opinion of an independent qualified public accountant for this plan2019-05-20Disclaimer
Accountancy firm name2019-05-20ADAMSBROWN, LLC
Accountancy firm name2019-05-20ADAMSBROWN, LLC
Accountancy firm EIN2019-05-20481040139
Accountancy firm EIN2019-05-20481040139
2018 : CATALYST OILFIELD SERVICES 2016 LLC 401(K) PLAN 2018 401k financial data
Total income from all sources (including contributions)2018-12-31$877,179
Total of all expenses incurred2018-12-31$123,933
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$93,697
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$1,127,529
Value of total assets at end of year2018-12-31$4,089,280
Value of total assets at beginning of year2018-12-31$3,336,034
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$30,236
Total interest from all sources2018-12-31$3,003
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$708,427
Participant contributions at end of year2018-12-31$54,570
Participant contributions at beginning of year2018-12-31$30,788
Participant contributions at end of year2018-12-31$155
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$753,246
Value of net assets at end of year (total assets less liabilities)2018-12-31$4,089,280
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$3,336,034
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$30,236
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$4,023,309
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$3,299,383
Interest on participant loans2018-12-31$3,003
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$11,233
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$5,863
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-253,353
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$419,102
Employer contributions (assets) at end of year2018-12-31$13
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$93,697
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31No
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
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 name2018-12-31ADAMS, BROWN, BERAN & BALL CHTD.
Accountancy firm EIN2018-12-31481040139
2017 : CATALYST OILFIELD SERVICES 2016 LLC 401(K) PLAN 2017 401k financial data
Total income from all sources (including contributions)2017-12-31$3,309,143
Total of all expenses incurred2017-12-31$83,185
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$61,330
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$2,948,216
Value of total assets at end of year2017-12-31$3,336,034
Value of total assets at beginning of year2017-12-31$110,076
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$21,855
Total interest from all sources2017-12-31$933
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31No
Value of fidelity bond cover2017-12-31$500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$615,147
Participant contributions at end of year2017-12-31$30,788
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$1,974,632
Total non interest bearing cash at end of year2017-12-31$0
Total non interest bearing cash at beginning of year2017-12-31$280
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$3,225,958
Value of net assets at end of year (total assets less liabilities)2017-12-31$3,336,034
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$110,076
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$21,855
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$3,299,383
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$109,196
Interest on participant loans2017-12-31$933
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$5,863
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$600
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$359,994
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$358,437
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$61,330
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
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 name2017-12-31ADAMS, BROWN, BERAN & BALL CHTD.
Accountancy firm EIN2017-12-31481040139
2016 : CATALYST OILFIELD SERVICES 2016 LLC 401(K) PLAN 2016 401k financial data
Total income from all sources (including contributions)2016-12-31$110,422
Total of all expenses incurred2016-12-31$346
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$346
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$109,878
Value of total assets at end of year2016-12-31$110,076
Value of total assets at beginning of year2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31No
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$71,636
Total non interest bearing cash at end of year2016-12-31$280
Total non interest bearing cash at beginning of year2016-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$110,076
Value of net assets at end of year (total assets less liabilities)2016-12-31$110,076
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$0
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
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$109,196
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$600
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$544
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$38,242
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$346
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
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

Form 5500 Responses for CATALYST OILFIELD SERVICES 2016 LLC 401(K) PLAN

2019: CATALYST OILFIELD SERVICES 2016 LLC 401(K) PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedYes
2019-01-01This submission is the final filingYes
2019-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: CATALYST OILFIELD SERVICES 2016 LLC 401(K) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: CATALYST OILFIELD SERVICES 2016 LLC 401(K) PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: CATALYST OILFIELD SERVICES 2016 LLC 401(K) PLAN 2016 form 5500 responses
2016-11-23Type of plan entitySingle employer plan
2016-11-23First time form 5500 has been submittedYes
2016-11-23This return/report is a short plan year return/report (less than 12 months)Yes
2016-11-23Plan funding arrangement – InsuranceYes
2016-11-23Plan funding arrangement – TrustYes
2016-11-23Plan benefit arrangement – InsuranceYes
2016-11-23Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-CP-JM4I
Policy instance 1
Insurance contract or identification numberGAP-CP-JM4I
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $9
Total amount of fees paid to insurance companyUSD $0
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9
Insurance broker organization code?3
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-CP-JM4I
Policy instance 1
Insurance contract or identification numberGAP-CP-JM4I
Number of Individuals Covered1
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $23
Total amount of fees paid to insurance companyUSD $0
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20
Insurance broker organization code?3
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-CP-JM4I
Policy instance 1
Insurance contract or identification numberGAP-CP-JM4I
Number of Individuals Covered1
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $10
Total amount of fees paid to insurance companyUSD $0
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10
Insurance broker organization code?3
Insurance broker nameSECURITIES AMERICA, INC.

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