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CHRISTOFFERSON INC. RETIREMENT PLAN 401k Plan overview

Plan NameCHRISTOFFERSON INC. RETIREMENT PLAN
Plan identification number 001

CHRISTOFFERSON INC. RETIREMENT 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

CHRISTOFFERSON, INC. has sponsored the creation of one or more 401k plans.

Company Name:CHRISTOFFERSON, INC.
Employer identification number (EIN):391050874
NAIC Classification:484200
NAIC Description: Specialized Freight Trucking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CHRISTOFFERSON INC. RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01CASEY CHRISTOFFERSON2023-10-16
0012020-01-01CASEY CHRISTOFFERSON2021-10-11 CASEY CHRISTOFFERSON2021-10-11
0012019-01-01CASEY CHRISTOFFERSON2020-10-15 CASEY CHRISTOFFERSON2020-10-15
0012018-01-01CASEY CHRISTOFFERSON2019-10-11
0012017-01-01CASEY C CHRISTOFFERSON2018-10-11 CASEY C CHRISTOFFERSON2018-10-11
0012016-01-01CASEY CHRISTOFFERSON2017-10-13 CASEY CHRISTOFFERSON2017-10-13
0012015-01-01CASEY CHRISTOFFERSON
0012014-01-01CASEY CHRISTOFFERSON
0012013-01-01CASEY C CHRISTOFFERSON
0012012-01-01CASEY C CHRISTOFFERSON
0012011-01-01CASEY CHRISTOFFERSON CASEY CHRISTOFFERSON2012-10-12
0012010-01-01CASEY C CHRISTOFFERSON CASEY C CHRISTOFFERSON2011-10-14
0012009-01-01CASEY CHRISTOFFERSON CASEY CHRISTOFFERSON2010-10-06

Plan Statistics for CHRISTOFFERSON INC. RETIREMENT PLAN

401k plan membership statisitcs for CHRISTOFFERSON INC. RETIREMENT PLAN

Measure Date Value
2015: CHRISTOFFERSON INC. RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0139
Total number of active participants reported on line 7a of the Form 55002015-01-0131
Number of retired or separated participants receiving benefits2015-01-011
Number of other retired or separated participants entitled to future benefits2015-01-0111
Total of all active and inactive participants2015-01-0143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0143
Number of participants with account balances2015-01-0143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: CHRISTOFFERSON INC. RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0138
Total number of active participants reported on line 7a of the Form 55002014-01-0129
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-016
Total of all active and inactive participants2014-01-0135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0135
Number of participants with account balances2014-01-0134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-011
2013: CHRISTOFFERSON INC. RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0138
Total number of active participants reported on line 7a of the Form 55002013-01-0131
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-015
Total of all active and inactive participants2013-01-0136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-011
Total participants2013-01-0137
Number of participants with account balances2013-01-0135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: CHRISTOFFERSON INC. RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0135
Total number of active participants reported on line 7a of the Form 55002012-01-0132
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-016
Total of all active and inactive participants2012-01-0138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0138
Number of participants with account balances2012-01-0135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: CHRISTOFFERSON INC. RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0136
Total number of active participants reported on line 7a of the Form 55002011-01-0130
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-015
Total of all active and inactive participants2011-01-0135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0135
Number of participants with account balances2011-01-0135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: CHRISTOFFERSON INC. RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0137
Total number of active participants reported on line 7a of the Form 55002010-01-0130
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-013
Total of all active and inactive participants2010-01-0133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0133
Number of participants with account balances2010-01-0133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: CHRISTOFFERSON INC. RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0131
Total number of active participants reported on line 7a of the Form 55002009-01-0126
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-017
Total of all active and inactive participants2009-01-0133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0133
Number of participants with account balances2009-01-0133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on CHRISTOFFERSON INC. RETIREMENT PLAN

Measure Date Value
2015 : CHRISTOFFERSON INC. RETIREMENT PLAN 2015 401k financial data
Total income from all sources2015-12-31$413,679
Expenses. Total of all expenses incurred2015-12-31$543,286
Benefits paid (including direct rollovers)2015-12-31$542,541
Total plan assets at end of year2015-12-31$8,169,436
Total plan assets at beginning of year2015-12-31$8,299,043
Value of fidelity bond covering the plan2015-12-31$1,000,000
Total contributions received or receivable from participants2015-12-31$71,350
Other income received2015-12-31$63,535
Net income (gross income less expenses)2015-12-31$-129,607
Net plan assets at end of year (total assets less liabilities)2015-12-31$8,169,436
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$8,299,043
Assets. Value of participant loans2015-12-31$59,362
Total contributions received or receivable from employer(s)2015-12-31$278,794
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$745
2014 : CHRISTOFFERSON INC. RETIREMENT PLAN 2014 401k financial data
Transfers to/from the plan2014-12-31$0
Total income from all sources2014-12-31$663,870
Expenses. Total of all expenses incurred2014-12-31$217,839
Benefits paid (including direct rollovers)2014-12-31$217,311
Total plan assets at end of year2014-12-31$8,299,043
Total plan assets at beginning of year2014-12-31$7,853,012
Value of fidelity bond covering the plan2014-12-31$1,000,000
Total contributions received or receivable from participants2014-12-31$26,199
Other income received2014-12-31$405,371
Net income (gross income less expenses)2014-12-31$446,031
Net plan assets at end of year (total assets less liabilities)2014-12-31$8,299,043
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$7,853,012
Assets. Value of participant loans2014-12-31$62,416
Total contributions received or receivable from employer(s)2014-12-31$232,300
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$528
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : CHRISTOFFERSON INC. RETIREMENT PLAN 2013 401k financial data
Total income from all sources2013-12-31$1,437,901
Expenses. Total of all expenses incurred2013-12-31$672,510
Benefits paid (including direct rollovers)2013-12-31$672,075
Total plan assets at end of year2013-12-31$7,853,012
Total plan assets at beginning of year2013-12-31$7,087,621
Value of fidelity bond covering the plan2013-12-31$1,000,000
Total contributions received or receivable from participants2013-12-31$24,297
Other income received2013-12-31$1,208,353
Net income (gross income less expenses)2013-12-31$765,391
Net plan assets at end of year (total assets less liabilities)2013-12-31$7,853,012
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$7,087,621
Assets. Value of participant loans2013-12-31$31,442
Total contributions received or receivable from employer(s)2013-12-31$205,251
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$435
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : CHRISTOFFERSON INC. RETIREMENT PLAN 2012 401k financial data
Total income from all sources2012-12-31$871,028
Expenses. Total of all expenses incurred2012-12-31$190,299
Benefits paid (including direct rollovers)2012-12-31$190,056
Total plan assets at end of year2012-12-31$7,087,621
Total plan assets at beginning of year2012-12-31$6,406,892
Value of fidelity bond covering the plan2012-12-31$1,000,000
Other income received2012-12-31$647,562
Net income (gross income less expenses)2012-12-31$680,729
Net plan assets at end of year (total assets less liabilities)2012-12-31$7,087,621
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$6,406,892
Assets. Value of participant loans2012-12-31$32,435
Total contributions received or receivable from employer(s)2012-12-31$223,466
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$243
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : CHRISTOFFERSON INC. RETIREMENT PLAN 2011 401k financial data
Total income from all sources2011-12-31$-30,808
Expenses. Total of all expenses incurred2011-12-31$30,682
Benefits paid (including direct rollovers)2011-12-31$30,205
Total plan assets at end of year2011-12-31$6,406,892
Total plan assets at beginning of year2011-12-31$6,468,382
Value of fidelity bond covering the plan2011-12-31$1,000,000
Total contributions received or receivable from participants2011-12-31$0
Expenses. Other expenses not covered elsewhere2011-12-31$477
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-259,774
Net income (gross income less expenses)2011-12-31$-61,490
Net plan assets at end of year (total assets less liabilities)2011-12-31$6,406,892
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$6,468,382
Assets. Value of participant loans2011-12-31$88,469
Total contributions received or receivable from employer(s)2011-12-31$228,966
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$0
Funding deficiency by the employer to the plan for this plan year2011-12-31$0
Minimum employer required contribution for this plan year2011-12-31$0
Amount contributed by the employer to the plan for this plan year2011-12-31$0
2010 : CHRISTOFFERSON INC. RETIREMENT PLAN 2010 401k financial data
Transfers to/from the plan2010-12-31$0
Total income from all sources2010-12-31$793,878
Expenses. Total of all expenses incurred2010-12-31$303,297
Benefits paid (including direct rollovers)2010-12-31$303,060
Total plan assets at end of year2010-12-31$6,468,382
Total plan assets at beginning of year2010-12-31$5,977,801
Value of fidelity bond covering the plan2010-12-31$500,000
Total contributions received or receivable from participants2010-12-31$0
Expenses. Other expenses not covered elsewhere2010-12-31$237
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$581,266
Net income (gross income less expenses)2010-12-31$490,581
Net plan assets at end of year (total assets less liabilities)2010-12-31$6,468,382
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$5,977,801
Assets. Value of participant loans2010-12-31$22,556
Total contributions received or receivable from employer(s)2010-12-31$212,612
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$0
Funding deficiency by the employer to the plan for this plan year2010-12-31$0
Minimum employer required contribution for this plan year2010-12-31$0
Amount contributed by the employer to the plan for this plan year2010-12-31$0
2009 : CHRISTOFFERSON INC. RETIREMENT PLAN 2009 401k financial data
Funding deficiency by the employer to the plan for this plan year2009-12-31$0
Minimum employer required contribution for this plan year2009-12-31$0
Amount contributed by the employer to the plan for this plan year2009-12-31$0

Form 5500 Responses for CHRISTOFFERSON INC. RETIREMENT PLAN

2015: CHRISTOFFERSON INC. RETIREMENT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: CHRISTOFFERSON INC. RETIREMENT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: CHRISTOFFERSON INC. RETIREMENT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: CHRISTOFFERSON INC. RETIREMENT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: CHRISTOFFERSON INC. RETIREMENT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: CHRISTOFFERSON INC. RETIREMENT PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: CHRISTOFFERSON INC. RETIREMENT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-828204
Policy instance 1
Insurance contract or identification numberGA-828204
Number of Individuals Covered43
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $20,406
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,406
Insurance broker organization code?3
Insurance broker nameLPL FINANCIAL CORPORATION
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-828204
Policy instance 1
Insurance contract or identification numberGA-828204
Number of Individuals Covered34
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $19,941
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,941
Insurance broker organization code?3
Insurance broker nameLPL FINANCIAL CORPORATION
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-828204
Policy instance 1
Insurance contract or identification numberGA-828204
Number of Individuals Covered35
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $18,408
Total amount of fees paid to insurance companyUSD $54
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,408
Insurance broker organization code?3
Amount paid for insurance broker fees54
Additional information about fees paid to insurance brokerSALES/MARKETING
Insurance broker nameLPL FINANCIAL LLC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-828204
Policy instance 1
Insurance contract or identification numberGA-828204
Number of Individuals Covered32
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $19,233
Total amount of fees paid to insurance companyUSD $74
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,233
Insurance broker organization code?3
Amount paid for insurance broker fees74
Additional information about fees paid to insurance brokerSALES/MARKETING
Insurance broker nameLPL FINANCIAL LLC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-828204
Policy instance 1
Insurance contract or identification numberGA-828204
Number of Individuals Covered35
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $26,282
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-815137
Policy instance 1
Insurance contract or identification numberGA-815137
Number of Individuals Covered33
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $23,413
Total amount of fees paid to insurance companyUSD $3,927
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,413
Insurance broker organization code?3
Amount paid for insurance broker fees3927
Additional information about fees paid to insurance brokerSALES/MARKETING
Insurance broker nameMERRILL LYNCH PIERCE FENNER SMITH I

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