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NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 401k Plan overview

Plan NameNORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST
Plan identification number 002

NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing

401k Sponsoring company profile

NORTHWEST OB-GYN ASSOCIATES PC has sponsored the creation of one or more 401k plans.

Company Name:NORTHWEST OB-GYN ASSOCIATES PC
Employer identification number (EIN):382043132
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022021-07-01
0022020-07-01
0022019-07-01
0022018-07-01
0022017-07-01
0022016-07-01LEON HOCHMAN
0022015-07-01LEON HOCHMAN
0022014-07-01LEON HOCHMAN
0022013-07-01LEON HOCHMAN
0022012-07-01LEON HOCHMAN
0022011-07-01LEON HOCHMAN
0022010-07-01LEON HOCHMAN
0022009-07-01LEON HOCHMAN

Plan Statistics for NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST

401k plan membership statisitcs for NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST

Measure Date Value
2021: NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2021 401k membership
Total participants, beginning-of-year2021-07-012
Total number of active participants reported on line 7a of the Form 55002021-07-010
Number of retired or separated participants receiving benefits2021-07-011
Number of other retired or separated participants entitled to future benefits2021-07-011
Total of all active and inactive participants2021-07-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-07-010
Total participants2021-07-012
Number of participants with account balances2021-07-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-07-010
2020: NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2020 401k membership
Total participants, beginning-of-year2020-07-012
Total number of active participants reported on line 7a of the Form 55002020-07-010
Number of retired or separated participants receiving benefits2020-07-011
Number of other retired or separated participants entitled to future benefits2020-07-011
Total of all active and inactive participants2020-07-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-07-010
Total participants2020-07-012
Number of participants with account balances2020-07-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-07-010
2019: NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2019 401k membership
Total participants, beginning-of-year2019-07-012
Total number of active participants reported on line 7a of the Form 55002019-07-010
Number of retired or separated participants receiving benefits2019-07-011
Number of other retired or separated participants entitled to future benefits2019-07-011
Total of all active and inactive participants2019-07-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-07-010
Total participants2019-07-012
Number of participants with account balances2019-07-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-07-010
2018: NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2018 401k membership
Total participants, beginning-of-year2018-07-012
Total number of active participants reported on line 7a of the Form 55002018-07-011
Number of retired or separated participants receiving benefits2018-07-010
Number of other retired or separated participants entitled to future benefits2018-07-011
Total of all active and inactive participants2018-07-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-07-010
Total participants2018-07-012
Number of participants with account balances2018-07-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-07-010
2017: NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2017 401k membership
Total participants, beginning-of-year2017-07-012
Total number of active participants reported on line 7a of the Form 55002017-07-012
Number of retired or separated participants receiving benefits2017-07-010
Number of other retired or separated participants entitled to future benefits2017-07-010
Total of all active and inactive participants2017-07-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-07-010
Total participants2017-07-012
Number of participants with account balances2017-07-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-07-010
2016: NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2016 401k membership
Total participants, beginning-of-year2016-07-012
Total number of active participants reported on line 7a of the Form 55002016-07-012
Number of retired or separated participants receiving benefits2016-07-010
Number of other retired or separated participants entitled to future benefits2016-07-010
Total of all active and inactive participants2016-07-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-07-010
Total participants2016-07-012
Number of participants with account balances2016-07-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-07-010
2015: NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2015 401k membership
Total participants, beginning-of-year2015-07-012
Total number of active participants reported on line 7a of the Form 55002015-07-012
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-010
Total of all active and inactive participants2015-07-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-07-010
Total participants2015-07-012
Number of participants with account balances2015-07-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-07-010
2014: NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2014 401k membership
Total participants, beginning-of-year2014-07-012
Total number of active participants reported on line 7a of the Form 55002014-07-012
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-010
Total of all active and inactive participants2014-07-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-07-010
Total participants2014-07-012
Number of participants with account balances2014-07-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-07-010
2013: NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2013 401k membership
Total participants, beginning-of-year2013-07-012
Total number of active participants reported on line 7a of the Form 55002013-07-012
Number of retired or separated participants receiving benefits2013-07-010
Number of other retired or separated participants entitled to future benefits2013-07-011
Total of all active and inactive participants2013-07-013
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-07-010
Total participants2013-07-013
Number of participants with account balances2013-07-013
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-07-010
2012: NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2012 401k membership
Total participants, beginning-of-year2012-07-012
Total number of active participants reported on line 7a of the Form 55002012-07-012
Number of retired or separated participants receiving benefits2012-07-010
Number of other retired or separated participants entitled to future benefits2012-07-010
Total of all active and inactive participants2012-07-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-07-010
Total participants2012-07-012
Number of participants with account balances2012-07-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-07-010
2011: NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2011 401k membership
Total participants, beginning-of-year2011-07-012
Total number of active participants reported on line 7a of the Form 55002011-07-012
Number of retired or separated participants receiving benefits2011-07-010
Number of other retired or separated participants entitled to future benefits2011-07-010
Total of all active and inactive participants2011-07-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-07-010
Total participants2011-07-012
Number of participants with account balances2011-07-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-07-010
2010: NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2010 401k membership
Total participants, beginning-of-year2010-07-012
Total number of active participants reported on line 7a of the Form 55002010-07-012
Number of retired or separated participants receiving benefits2010-07-010
Number of other retired or separated participants entitled to future benefits2010-07-010
Total of all active and inactive participants2010-07-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-07-010
Total participants2010-07-012
Number of participants with account balances2010-07-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-07-010
2009: NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2009 401k membership
Total participants, beginning-of-year2009-07-012
Total number of active participants reported on line 7a of the Form 55002009-07-012
Number of retired or separated participants receiving benefits2009-07-010
Number of other retired or separated participants entitled to future benefits2009-07-010
Total of all active and inactive participants2009-07-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-07-010
Total participants2009-07-012
Number of participants with account balances2009-07-012

Financial Data on NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST

Measure Date Value
2022 : NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2022 401k financial data
Total income from all sources2022-06-30$-488,983
Expenses. Total of all expenses incurred2022-06-30$220,933
Benefits paid (including direct rollovers)2022-06-30$188,000
Total plan assets at end of year2022-06-30$2,944,391
Total plan assets at beginning of year2022-06-30$3,654,307
Value of fidelity bond covering the plan2022-06-30$350,000
Other income received2022-06-30$-488,983
Net income (gross income less expenses)2022-06-30$-709,916
Net plan assets at end of year (total assets less liabilities)2022-06-30$2,944,391
Net plan assets at beginning of year (total assets less liabilities)2022-06-30$3,654,307
Expenses. Administrative service providers (salaries,fees and commissions)2022-06-30$32,933
2021 : NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2021 401k financial data
Total income from all sources2021-06-30$829,348
Expenses. Total of all expenses incurred2021-06-30$310,681
Benefits paid (including direct rollovers)2021-06-30$237,500
Total plan assets at end of year2021-06-30$3,654,307
Total plan assets at beginning of year2021-06-30$3,135,640
Value of fidelity bond covering the plan2021-06-30$350,000
Expenses. Other expenses not covered elsewhere2021-06-30$35,000
Other income received2021-06-30$829,348
Net income (gross income less expenses)2021-06-30$518,667
Net plan assets at end of year (total assets less liabilities)2021-06-30$3,654,307
Net plan assets at beginning of year (total assets less liabilities)2021-06-30$3,135,640
Expenses. Administrative service providers (salaries,fees and commissions)2021-06-30$38,181
2020 : NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2020 401k financial data
Total income from all sources2020-06-30$72,832
Expenses. Total of all expenses incurred2020-06-30$182,050
Benefits paid (including direct rollovers)2020-06-30$132,466
Total plan assets at end of year2020-06-30$3,135,640
Total plan assets at beginning of year2020-06-30$3,244,858
Value of fidelity bond covering the plan2020-06-30$350,000
Expenses. Other expenses not covered elsewhere2020-06-30$17,500
Other income received2020-06-30$72,832
Net income (gross income less expenses)2020-06-30$-109,218
Net plan assets at end of year (total assets less liabilities)2020-06-30$3,135,640
Net plan assets at beginning of year (total assets less liabilities)2020-06-30$3,244,858
Expenses. Administrative service providers (salaries,fees and commissions)2020-06-30$32,084
2019 : NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2019 401k financial data
Total income from all sources2019-06-30$159,267
Expenses. Total of all expenses incurred2019-06-30$194,784
Benefits paid (including direct rollovers)2019-06-30$141,588
Total plan assets at end of year2019-06-30$3,244,858
Total plan assets at beginning of year2019-06-30$3,280,375
Value of fidelity bond covering the plan2019-06-30$350,000
Expenses. Other expenses not covered elsewhere2019-06-30$17,500
Other income received2019-06-30$159,267
Net income (gross income less expenses)2019-06-30$-35,517
Net plan assets at end of year (total assets less liabilities)2019-06-30$3,244,858
Net plan assets at beginning of year (total assets less liabilities)2019-06-30$3,280,375
Expenses. Administrative service providers (salaries,fees and commissions)2019-06-30$35,696
2017 : NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2017 401k financial data
Total income from all sources2017-06-30$355,986
Expenses. Total of all expenses incurred2017-06-30$173,770
Benefits paid (including direct rollovers)2017-06-30$121,000
Total plan assets at end of year2017-06-30$3,228,288
Total plan assets at beginning of year2017-06-30$3,046,072
Value of fidelity bond covering the plan2017-06-30$350,000
Expenses. Other expenses not covered elsewhere2017-06-30$25,752
Other income received2017-06-30$355,986
Net income (gross income less expenses)2017-06-30$182,216
Net plan assets at end of year (total assets less liabilities)2017-06-30$3,228,288
Net plan assets at beginning of year (total assets less liabilities)2017-06-30$3,046,072
Assets. Value of participant loans2017-06-30$9,265
Assets. Value of assets in partnership/joint-venture interests2017-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2017-06-30$27,018
2016 : NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2016 401k financial data
Total income from all sources2016-06-30$169,606
Expenses. Total of all expenses incurred2016-06-30$223,009
Benefits paid (including direct rollovers)2016-06-30$157,000
Total plan assets at end of year2016-06-30$3,046,072
Total plan assets at beginning of year2016-06-30$3,099,475
Value of fidelity bond covering the plan2016-06-30$350,000
Expenses. Other expenses not covered elsewhere2016-06-30$41,500
Contributions received from other sources (not participants or employers)2016-06-30$189,262
Other income received2016-06-30$-19,656
Net income (gross income less expenses)2016-06-30$-53,403
Net plan assets at end of year (total assets less liabilities)2016-06-30$3,046,072
Net plan assets at beginning of year (total assets less liabilities)2016-06-30$3,099,475
Assets. Value of participant loans2016-06-30$19,714
Assets. Value of assets in partnership/joint-venture interests2016-06-30$2,551
Expenses. Administrative service providers (salaries,fees and commissions)2016-06-30$24,509
2015 : NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2015 401k financial data
Total income from all sources2015-06-30$126,423
Expenses. Total of all expenses incurred2015-06-30$220,581
Benefits paid (including direct rollovers)2015-06-30$137,000
Total plan assets at end of year2015-06-30$3,099,475
Total plan assets at beginning of year2015-06-30$3,193,633
Value of fidelity bond covering the plan2015-06-30$350,000
Expenses. Other expenses not covered elsewhere2015-06-30$52,551
Other income received2015-06-30$126,423
Net income (gross income less expenses)2015-06-30$-94,158
Net plan assets at end of year (total assets less liabilities)2015-06-30$3,099,475
Net plan assets at beginning of year (total assets less liabilities)2015-06-30$3,193,633
Assets. Value of assets in partnership/joint-venture interests2015-06-30$2,731
Expenses. Administrative service providers (salaries,fees and commissions)2015-06-30$31,030
2014 : NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2014 401k financial data
Total income from all sources2014-06-30$431,390
Expenses. Total of all expenses incurred2014-06-30$301,399
Benefits paid (including direct rollovers)2014-06-30$219,425
Total plan assets at end of year2014-06-30$3,193,634
Total plan assets at beginning of year2014-06-30$3,063,643
Value of fidelity bond covering the plan2014-06-30$350,000
Expenses. Other expenses not covered elsewhere2014-06-30$50,397
Other income received2014-06-30$430,390
Net income (gross income less expenses)2014-06-30$129,991
Net plan assets at end of year (total assets less liabilities)2014-06-30$3,193,634
Net plan assets at beginning of year (total assets less liabilities)2014-06-30$3,063,643
Assets. Value of assets in partnership/joint-venture interests2014-06-30$2,512
Total contributions received or receivable from employer(s)2014-06-30$1,000
Expenses. Administrative service providers (salaries,fees and commissions)2014-06-30$31,577
2013 : NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2013 401k financial data
Total income from all sources2013-06-30$389,280
Expenses. Total of all expenses incurred2013-06-30$129,074
Total plan assets at end of year2013-06-30$3,063,643
Total plan assets at beginning of year2013-06-30$2,803,437
Value of fidelity bond covering the plan2013-06-30$350,000
Expenses. Other expenses not covered elsewhere2013-06-30$97,610
Other income received2013-06-30$389,280
Net income (gross income less expenses)2013-06-30$260,206
Net plan assets at end of year (total assets less liabilities)2013-06-30$3,063,643
Net plan assets at beginning of year (total assets less liabilities)2013-06-30$2,803,437
Assets. Value of assets in partnership/joint-venture interests2013-06-30$2,426
Expenses. Administrative service providers (salaries,fees and commissions)2013-06-30$31,464
2012 : NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2012 401k financial data
Total income from all sources2012-06-30$-68,128
Expenses. Total of all expenses incurred2012-06-30$83,306
Total plan assets at end of year2012-06-30$2,803,437
Total plan assets at beginning of year2012-06-30$2,954,871
Value of fidelity bond covering the plan2012-06-30$200,000
Expenses. Other expenses not covered elsewhere2012-06-30$83,306
Other income received2012-06-30$-68,128
Net income (gross income less expenses)2012-06-30$-151,434
Net plan assets at end of year (total assets less liabilities)2012-06-30$2,803,437
Net plan assets at beginning of year (total assets less liabilities)2012-06-30$2,954,871
Assets. Value of assets in partnership/joint-venture interests2012-06-30$3,768
2011 : NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2011 401k financial data
Total income from all sources2011-06-30$731,337
Expenses. Total of all expenses incurred2011-06-30$79,342
Total plan assets at end of year2011-06-30$2,954,871
Total plan assets at beginning of year2011-06-30$2,302,876
Value of fidelity bond covering the plan2011-06-30$200,000
Expenses. Other expenses not covered elsewhere2011-06-30$79,342
Other income received2011-06-30$731,337
Net income (gross income less expenses)2011-06-30$651,995
Net plan assets at end of year (total assets less liabilities)2011-06-30$2,954,871
Net plan assets at beginning of year (total assets less liabilities)2011-06-30$2,302,876
Assets. Value of assets in partnership/joint-venture interests2011-06-30$3,768

Form 5500 Responses for NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST

2021: NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan funding arrangement – TrustYes
2021-07-01Plan benefit arrangement – InsuranceYes
2021-07-01Plan benefit arrangement - TrustYes
2020: NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – TrustYes
2020-07-01Plan benefit arrangement – InsuranceYes
2020-07-01Plan benefit arrangement - TrustYes
2019: NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan funding arrangement – TrustYes
2019-07-01Plan benefit arrangement – InsuranceYes
2019-07-01Plan benefit arrangement - TrustYes
2018: NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan funding arrangement – TrustYes
2018-07-01Plan benefit arrangement – InsuranceYes
2018-07-01Plan benefit arrangement - TrustYes
2017: NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan funding arrangement – TrustYes
2017-07-01Plan benefit arrangement – InsuranceYes
2017-07-01Plan benefit arrangement - TrustYes
2016: NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan funding arrangement – TrustYes
2016-07-01Plan benefit arrangement – InsuranceYes
2016-07-01Plan benefit arrangement - TrustYes
2015: NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan funding arrangement – TrustYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-07-01Plan benefit arrangement - TrustYes
2014: NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan funding arrangement – TrustYes
2014-07-01Plan benefit arrangement – InsuranceYes
2014-07-01Plan benefit arrangement - TrustYes
2013: NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan funding arrangement – TrustYes
2013-07-01Plan benefit arrangement – InsuranceYes
2013-07-01Plan benefit arrangement - TrustYes
2012: NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan funding arrangement – TrustYes
2012-07-01Plan benefit arrangement – InsuranceYes
2012-07-01Plan benefit arrangement - TrustYes
2011: NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan funding arrangement – TrustYes
2011-07-01Plan benefit arrangement – InsuranceYes
2011-07-01Plan benefit arrangement - TrustYes
2010: NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2010 form 5500 responses
2010-07-01Type of plan entitySingle employer plan
2010-07-01Plan funding arrangement – InsuranceYes
2010-07-01Plan funding arrangement – TrustYes
2010-07-01Plan benefit arrangement – InsuranceYes
2010-07-01Plan benefit arrangement - TrustYes
2009: NORTHWEST OBGYN ASSOCIATES PROFIT SHARING TRUST 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan funding arrangement – TrustYes
2009-07-01Plan benefit arrangement – InsuranceYes
2009-07-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NATIONWIDE (National Association of Insurance Commissioners NAIC id number: 92657 )
Policy contract numberB501377890
Policy instance 3
Insurance contract or identification numberB501377890
Number of Individuals Covered1
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number6157165
Policy instance 2
Insurance contract or identification number6157165
Number of Individuals Covered1
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number15600733
Policy instance 1
Insurance contract or identification number15600733
Number of Individuals Covered1
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONWIDE (National Association of Insurance Commissioners NAIC id number: 92657 )
Policy contract numberB501377890
Policy instance 3
Insurance contract or identification numberB501377890
Number of Individuals Covered1
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number15 600 733
Policy instance 1
Insurance contract or identification number15 600 733
Number of Individuals Covered1
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number6157165
Policy instance 2
Insurance contract or identification number6157165
Number of Individuals Covered1
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number6157165
Policy instance 2
Insurance contract or identification number6157165
Number of Individuals Covered1
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
NATIONWIDE (National Association of Insurance Commissioners NAIC id number: 92657 )
Policy contract numberB501377890
Policy instance 3
Insurance contract or identification numberB501377890
Number of Individuals Covered1
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number15 600 733
Policy instance 1
Insurance contract or identification number15 600 733
Number of Individuals Covered1
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number6157165
Policy instance 2
Insurance contract or identification number6157165
Number of Individuals Covered1
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
NATIONWIDE (National Association of Insurance Commissioners NAIC id number: 92657 )
Policy contract numberB501377890
Policy instance 3
Insurance contract or identification numberB501377890
Number of Individuals Covered1
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number15 600 733
Policy instance 1
Insurance contract or identification number15 600 733
Number of Individuals Covered1
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number6157165
Policy instance 2
Insurance contract or identification number6157165
Number of Individuals Covered1
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONWIDE (National Association of Insurance Commissioners NAIC id number: 92657 )
Policy contract numberB501377890
Policy instance 3
Insurance contract or identification numberB501377890
Number of Individuals Covered1
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number15 600 733
Policy instance 1
Insurance contract or identification number15 600 733
Number of Individuals Covered1
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONWIDE (National Association of Insurance Commissioners NAIC id number: 92657 )
Policy contract numberB501377890
Policy instance 4
Insurance contract or identification numberB501377890
Number of Individuals Covered1
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $13,125
Total amount of fees paid to insurance companyUSD $10
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,125
Amount paid for insurance broker fees10
Insurance broker nameBRIAN NEMES
NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )
Policy contract numberP46668
Policy instance 2
Insurance contract or identification numberP46668
Number of Individuals Covered1
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $2,609
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,609
Insurance broker nameDENNIS DALE RICHARDSON
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number15 600 733
Policy instance 1
Insurance contract or identification number15 600 733
Number of Individuals Covered1
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker nameWILLIAM KRAUSE
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number6157165
Policy instance 3
Insurance contract or identification number6157165
Number of Individuals Covered1
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker nameDENNIS D RICHARDSON
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number6157165
Policy instance 3
Insurance contract or identification number6157165
Number of Individuals Covered1
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker nameDENNIS D RICHARDSON
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number15 600 733
Policy instance 1
Insurance contract or identification number15 600 733
Number of Individuals Covered1
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker nameWILLIAM KRAUSE
NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )
Policy contract numberP8300211
Policy instance 2
Insurance contract or identification numberP8300211
Number of Individuals Covered1
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker nameDENNIS DALE RICHARDSON
NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )
Policy contract numberP8300211
Policy instance 2
Insurance contract or identification numberP8300211
Number of Individuals Covered1
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker nameDENNIS DALE RICHARDSON
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number6157165
Policy instance 3
Insurance contract or identification number6157165
Number of Individuals Covered1
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker nameDENNIS D RICHARDSON
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number15 600 733
Policy instance 1
Insurance contract or identification number15 600 733
Number of Individuals Covered1
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance broker3
Insurance broker nameWILLIAM KRAUSE
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number20054280
Policy instance 1
Insurance contract or identification number20054280
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker nameFROMMER AGENCY
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number6157165
Policy instance 4
Insurance contract or identification number6157165
Number of Individuals Covered1
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker nameDENNIS D RICHARDSON
NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )
Policy contract numberP8300211
Policy instance 3
Insurance contract or identification numberP8300211
Number of Individuals Covered1
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker nameDENNIS DALE RICHARDSON
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number15 600 733
Policy instance 2
Insurance contract or identification number15 600 733
Number of Individuals Covered1
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance broker3
Insurance broker nameWILLIAM KRAUSE
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number15 600 733
Policy instance 2
Insurance contract or identification number15 600 733
Number of Individuals Covered1
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number20054280
Policy instance 1
Insurance contract or identification number20054280
Number of Individuals Covered1
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $988
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number15 600 733
Policy instance 2
Insurance contract or identification number15 600 733
Number of Individuals Covered1
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number20054280
Policy instance 1
Insurance contract or identification number20054280
Number of Individuals Covered1
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $1,417
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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