MOD INTERIORS INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan MOD INTERIORS INC. SAVINGS & RETIREMENT PLAN
401k plan membership statisitcs for MOD INTERIORS INC. SAVINGS & RETIREMENT PLAN
| Measure | Date | Value |
|---|
| 2014: MOD INTERIORS INC. SAVINGS & RETIREMENT PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-03-01 | 33 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-03-01 | 26 |
| Number of retired or separated participants receiving benefits | 2014-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-03-01 | 8 |
| Total of all active and inactive participants | 2014-03-01 | 34 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-03-01 | 0 |
| Total participants | 2014-03-01 | 34 |
| Number of participants with account balances | 2014-03-01 | 31 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2014-03-01 | 5 |
| 2013: MOD INTERIORS INC. SAVINGS & RETIREMENT PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-03-01 | 31 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-03-01 | 27 |
| Number of retired or separated participants receiving benefits | 2013-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-03-01 | 7 |
| Total of all active and inactive participants | 2013-03-01 | 34 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-03-01 | 0 |
| Total participants | 2013-03-01 | 34 |
| Number of participants with account balances | 2013-03-01 | 30 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-03-01 | 2 |
| 2012: MOD INTERIORS INC. SAVINGS & RETIREMENT PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-03-01 | 23 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-03-01 | 19 |
| Number of retired or separated participants receiving benefits | 2012-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-03-01 | 4 |
| Total of all active and inactive participants | 2012-03-01 | 23 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-03-01 | 0 |
| Total participants | 2012-03-01 | 23 |
| Number of participants with account balances | 2012-03-01 | 19 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-03-01 | 2 |
| 2011: MOD INTERIORS INC. SAVINGS & RETIREMENT PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-03-01 | 23 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-03-01 | 18 |
| Number of retired or separated participants receiving benefits | 2011-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-03-01 | 0 |
| Total of all active and inactive participants | 2011-03-01 | 18 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-03-01 | 0 |
| Total participants | 2011-03-01 | 18 |
| Number of participants with account balances | 2011-03-01 | 18 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2011-03-01 | 0 |
| 2010: MOD INTERIORS INC. SAVINGS & RETIREMENT PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-03-01 | 23 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-03-01 | 16 |
| Number of retired or separated participants receiving benefits | 2010-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2010-03-01 | 0 |
| Total of all active and inactive participants | 2010-03-01 | 16 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2010-03-01 | 0 |
| Total participants | 2010-03-01 | 16 |
| Number of participants with account balances | 2010-03-01 | 16 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2010-03-01 | 0 |
| 2009: MOD INTERIORS INC. SAVINGS & RETIREMENT PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-03-01 | 27 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-03-01 | 14 |
| Number of retired or separated participants receiving benefits | 2009-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-03-01 | 3 |
| Total of all active and inactive participants | 2009-03-01 | 17 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-03-01 | 0 |
| Total participants | 2009-03-01 | 17 |
| Number of participants with account balances | 2009-03-01 | 17 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-03-01 | 0 |
| Measure | Date | Value |
|---|
| 2015 : MOD INTERIORS INC. SAVINGS & RETIREMENT PLAN 2015 401k financial data |
|---|
| Transfers to/from the plan | 2015-02-28 | $0 |
| Total income from all sources | 2015-02-28 | $78,142 |
| Expenses. Total of all expenses incurred | 2015-02-28 | $628 |
| Benefits paid (including direct rollovers) | 2015-02-28 | $328 |
| Total plan assets at end of year | 2015-02-28 | $608,372 |
| Total plan assets at beginning of year | 2015-02-28 | $530,858 |
| Value of fidelity bond covering the plan | 2015-02-28 | $50,000 |
| Total contributions received or receivable from participants | 2015-02-28 | $27,416 |
| Expenses. Other expenses not covered elsewhere | 2015-02-28 | $300 |
| Contributions received from other sources (not participants or employers) | 2015-02-28 | $0 |
| Other income received | 2015-02-28 | $35,726 |
| Net income (gross income less expenses) | 2015-02-28 | $77,514 |
| Net plan assets at end of year (total assets less liabilities) | 2015-02-28 | $608,372 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-02-28 | $530,858 |
| Assets. Value of participant loans | 2015-02-28 | $0 |
| Total contributions received or receivable from employer(s) | 2015-02-28 | $15,000 |
| Value of certain deemed distributions of participant loans | 2015-02-28 | $0 |
| Value of corrective distributions | 2015-02-28 | $0 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2015-02-28 | $0 |
| 2014 : MOD INTERIORS INC. SAVINGS & RETIREMENT PLAN 2014 401k financial data |
|---|
| Transfers to/from the plan | 2014-02-28 | $0 |
| Total income from all sources | 2014-02-28 | $119,080 |
| Expenses. Total of all expenses incurred | 2014-02-28 | $1,245 |
| Benefits paid (including direct rollovers) | 2014-02-28 | $1,045 |
| Total plan assets at end of year | 2014-02-28 | $530,858 |
| Total plan assets at beginning of year | 2014-02-28 | $413,023 |
| Value of fidelity bond covering the plan | 2014-02-28 | $50,000 |
| Total contributions received or receivable from participants | 2014-02-28 | $26,608 |
| Expenses. Other expenses not covered elsewhere | 2014-02-28 | $200 |
| Contributions received from other sources (not participants or employers) | 2014-02-28 | $0 |
| Other income received | 2014-02-28 | $70,592 |
| Net income (gross income less expenses) | 2014-02-28 | $117,835 |
| Net plan assets at end of year (total assets less liabilities) | 2014-02-28 | $530,858 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-02-28 | $413,023 |
| Assets. Value of participant loans | 2014-02-28 | $0 |
| Total contributions received or receivable from employer(s) | 2014-02-28 | $21,880 |
| Value of certain deemed distributions of participant loans | 2014-02-28 | $0 |
| Value of corrective distributions | 2014-02-28 | $0 |
| Funding deficiency by the employer to the plan for this plan year | 2014-02-28 | $0 |
| Minimum employer required contribution for this plan year | 2014-02-28 | $0 |
| Amount contributed by the employer to the plan for this plan year | 2014-02-28 | $0 |
| 2013 : MOD INTERIORS INC. SAVINGS & RETIREMENT PLAN 2013 401k financial data |
|---|
| Transfers to/from the plan | 2013-02-28 | $0 |
| Total income from all sources | 2013-02-28 | $35,548 |
| Expenses. Total of all expenses incurred | 2013-02-28 | $49,586 |
| Benefits paid (including direct rollovers) | 2013-02-28 | $49,454 |
| Total plan assets at end of year | 2013-02-28 | $413,023 |
| Total plan assets at beginning of year | 2013-02-28 | $427,061 |
| Value of fidelity bond covering the plan | 2013-02-28 | $50,000 |
| Total contributions received or receivable from participants | 2013-02-28 | $14,409 |
| Expenses. Other expenses not covered elsewhere | 2013-02-28 | $132 |
| Contributions received from other sources (not participants or employers) | 2013-02-28 | $0 |
| Other income received | 2013-02-28 | $21,139 |
| Net income (gross income less expenses) | 2013-02-28 | $-14,038 |
| Net plan assets at end of year (total assets less liabilities) | 2013-02-28 | $413,023 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-02-28 | $427,061 |
| Assets. Value of participant loans | 2013-02-28 | $0 |
| Total contributions received or receivable from employer(s) | 2013-02-28 | $0 |
| Value of certain deemed distributions of participant loans | 2013-02-28 | $0 |
| Value of corrective distributions | 2013-02-28 | $0 |
| Funding deficiency by the employer to the plan for this plan year | 2013-02-28 | $0 |
| Minimum employer required contribution for this plan year | 2013-02-28 | $0 |
| Amount contributed by the employer to the plan for this plan year | 2013-02-28 | $0 |
| 2012 : MOD INTERIORS INC. SAVINGS & RETIREMENT PLAN 2012 401k financial data |
|---|
| Transfers to/from the plan | 2012-02-29 | $0 |
| Total income from all sources | 2012-02-29 | $-8,347 |
| Expenses. Total of all expenses incurred | 2012-02-29 | $28,327 |
| Benefits paid (including direct rollovers) | 2012-02-29 | $27,968 |
| Total plan assets at end of year | 2012-02-29 | $427,061 |
| Total plan assets at beginning of year | 2012-02-29 | $463,735 |
| Value of fidelity bond covering the plan | 2012-02-29 | $50,000 |
| Total contributions received or receivable from participants | 2012-02-29 | $15,759 |
| Expenses. Other expenses not covered elsewhere | 2012-02-29 | $160 |
| Contributions received from other sources (not participants or employers) | 2012-02-29 | $0 |
| Other income received | 2012-02-29 | $-24,106 |
| Net income (gross income less expenses) | 2012-02-29 | $-36,674 |
| Net plan assets at end of year (total assets less liabilities) | 2012-02-29 | $427,061 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-02-29 | $463,735 |
| Assets. Value of participant loans | 2012-02-29 | $0 |
| Total contributions received or receivable from employer(s) | 2012-02-29 | $0 |
| Value of certain deemed distributions of participant loans | 2012-02-29 | $0 |
| Value of corrective distributions | 2012-02-29 | $199 |
| Funding deficiency by the employer to the plan for this plan year | 2012-02-29 | $0 |
| Minimum employer required contribution for this plan year | 2012-02-29 | $0 |
| Amount contributed by the employer to the plan for this plan year | 2012-02-29 | $0 |
| 2011 : MOD INTERIORS INC. SAVINGS & RETIREMENT PLAN 2011 401k financial data |
|---|
| Transfers to/from the plan | 2011-02-28 | $0 |
| Total income from all sources | 2011-02-28 | $87,742 |
| Expenses. Total of all expenses incurred | 2011-02-28 | $49,714 |
| Benefits paid (including direct rollovers) | 2011-02-28 | $49,549 |
| Total plan assets at end of year | 2011-02-28 | $463,735 |
| Total plan assets at beginning of year | 2011-02-28 | $425,707 |
| Value of fidelity bond covering the plan | 2011-02-28 | $50,000 |
| Total contributions received or receivable from participants | 2011-02-28 | $21,186 |
| Expenses. Other expenses not covered elsewhere | 2011-02-28 | $165 |
| Contributions received from other sources (not participants or employers) | 2011-02-28 | $0 |
| Other income received | 2011-02-28 | $63,593 |
| Net income (gross income less expenses) | 2011-02-28 | $38,028 |
| Net plan assets at end of year (total assets less liabilities) | 2011-02-28 | $463,735 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-02-28 | $425,707 |
| Assets. Value of participant loans | 2011-02-28 | $0 |
| Total contributions received or receivable from employer(s) | 2011-02-28 | $2,963 |
| Value of certain deemed distributions of participant loans | 2011-02-28 | $0 |
| Value of corrective distributions | 2011-02-28 | $0 |
| Funding deficiency by the employer to the plan for this plan year | 2011-02-28 | $0 |
| Minimum employer required contribution for this plan year | 2011-02-28 | $0 |
| Amount contributed by the employer to the plan for this plan year | 2011-02-28 | $0 |
| 2010 : MOD INTERIORS INC. SAVINGS & RETIREMENT PLAN 2010 401k financial data |
|---|
| Funding deficiency by the employer to the plan for this plan year | 2010-02-28 | $0 |
| Minimum employer required contribution for this plan year | 2010-02-28 | $0 |
| Amount contributed by the employer to the plan for this plan year | 2010-02-28 | $0 |
| 2014: MOD INTERIORS INC. SAVINGS & RETIREMENT PLAN 2014 form 5500 responses |
|---|
| 2014-03-01 | Type of plan entity | Single employer plan |
| 2014-03-01 | Submission has been amended | No |
| 2014-03-01 | This submission is the final filing | No |
| 2014-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-03-01 | Plan is a collectively bargained plan | No |
| 2014-03-01 | Plan funding arrangement – Insurance | Yes |
| 2014-03-01 | Plan funding arrangement – Trust | Yes |
| 2014-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: MOD INTERIORS INC. SAVINGS & RETIREMENT PLAN 2013 form 5500 responses |
|---|
| 2013-03-01 | Type of plan entity | Single employer plan |
| 2013-03-01 | Submission has been amended | No |
| 2013-03-01 | This submission is the final filing | No |
| 2013-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-03-01 | Plan is a collectively bargained plan | No |
| 2013-03-01 | Plan funding arrangement – Insurance | Yes |
| 2013-03-01 | Plan funding arrangement – Trust | Yes |
| 2013-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: MOD INTERIORS INC. SAVINGS & RETIREMENT PLAN 2012 form 5500 responses |
|---|
| 2012-03-01 | Type of plan entity | Single employer plan |
| 2012-03-01 | Submission has been amended | No |
| 2012-03-01 | This submission is the final filing | No |
| 2012-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-03-01 | Plan is a collectively bargained plan | No |
| 2012-03-01 | Plan funding arrangement – Insurance | Yes |
| 2012-03-01 | Plan funding arrangement – Trust | Yes |
| 2012-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: MOD INTERIORS INC. SAVINGS & RETIREMENT PLAN 2011 form 5500 responses |
|---|
| 2011-03-01 | Type of plan entity | Single employer plan |
| 2011-03-01 | Submission has been amended | No |
| 2011-03-01 | This submission is the final filing | No |
| 2011-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-03-01 | Plan is a collectively bargained plan | No |
| 2011-03-01 | Plan funding arrangement – Insurance | Yes |
| 2011-03-01 | Plan funding arrangement – Trust | Yes |
| 2011-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: MOD INTERIORS INC. SAVINGS & RETIREMENT PLAN 2010 form 5500 responses |
|---|
| 2010-03-01 | Type of plan entity | Single employer plan |
| 2010-03-01 | Submission has been amended | No |
| 2010-03-01 | This submission is the final filing | No |
| 2010-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-03-01 | Plan is a collectively bargained plan | No |
| 2010-03-01 | Plan funding arrangement – Insurance | Yes |
| 2010-03-01 | Plan funding arrangement – Trust | Yes |
| 2010-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: MOD INTERIORS INC. SAVINGS & RETIREMENT PLAN 2009 form 5500 responses |
|---|
| 2009-03-01 | Type of plan entity | Single employer plan |
| 2009-03-01 | Submission has been amended | No |
| 2009-03-01 | This submission is the final filing | No |
| 2009-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-03-01 | Plan is a collectively bargained plan | No |
| 2009-03-01 | Plan funding arrangement – Insurance | Yes |
| 2009-03-01 | Plan funding arrangement – Trust | Yes |
| 2009-03-01 | Plan benefit arrangement – Insurance | Yes |
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-804788 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-804788 | | Number of Individuals Covered | 31 | | Insurance policy start date | 2014-03-01 | | Insurance policy end date | 2015-02-28 | | Total amount of commissions paid to insurance broker | USD $1,752 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | Yes | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,752 | | Insurance broker organization code? | 3 | | Insurance broker name | SIGMA FINANCIAL CORPORATION |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-804788 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-804788 | | Number of Individuals Covered | 30 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $1,497 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | Yes | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,449 | | Insurance broker organization code? | 3 | | Insurance broker name | SIGMA FINANCIAL CORP |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-804788 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-804788 | | Number of Individuals Covered | 19 | | Insurance policy start date | 2012-03-01 | | Insurance policy end date | 2013-02-28 | | Total amount of commissions paid to insurance broker | USD $1,117 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | Yes | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,117 | | Insurance broker organization code? | 3 | | Insurance broker name | WUNDERLICH SECURITIES INC |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-804788 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-804788 | | Number of Individuals Covered | 18 | | Insurance policy start date | 2011-03-01 | | Insurance policy end date | 2012-02-29 | | Total amount of commissions paid to insurance broker | USD $1,264 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | Yes | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-804788 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-804788 | | Number of Individuals Covered | 16 | | Insurance policy start date | 2010-03-01 | | Insurance policy end date | 2011-02-28 | | Total amount of commissions paid to insurance broker | USD $1,343 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | Yes | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $362 | | Insurance broker organization code? | 3 | | Insurance broker name | WUNDERLICH SECURITIES INC |
|
