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PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING PLAN 401k Plan overview

Plan NamePEDIATRIC HEALTHCARE, S.C. PROFIT SHARING PLAN
Plan identification number 001

PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING 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.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • 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

PEDIATRIC HEALTHCARE, S.C. has sponsored the creation of one or more 401k plans.

Company Name:PEDIATRIC HEALTHCARE, S.C.
Employer identification number (EIN):391547413
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012020-01-01DAVID PIKNA2020-11-01
0012019-01-01
0012018-01-01DAVID PIKNA
0012017-01-01DAVID PIKNA
0012016-01-01DAVID PIKNA
0012015-01-01DAVID PIKNA
0012014-01-01DAVID PIKNA
0012013-01-01DAVID PIKNA
0012012-01-01DAVID PIKNA
0012011-01-01DAVID PINKA2012-10-08 DAVID PIKNA2012-10-08
0012010-01-01DAVID PINKA2011-10-15 DAVID PIKNA2011-10-15

Plan Statistics for PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING PLAN

401k plan membership statisitcs for PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING PLAN

Measure Date Value
2019: PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0116
Total number of active participants reported on line 7a of the Form 55002019-01-0113
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-011
Total of all active and inactive participants2019-01-0114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0114
Number of participants with account balances2019-01-0114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0116
Total number of active participants reported on line 7a of the Form 55002018-01-0112
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-014
Total of all active and inactive participants2018-01-0116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0116
Number of participants with account balances2018-01-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-011
2017: PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0117
Total number of active participants reported on line 7a of the Form 55002017-01-0114
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-012
Total of all active and inactive participants2017-01-0116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0116
Number of participants with account balances2017-01-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0117
Total number of active participants reported on line 7a of the Form 55002016-01-0113
Number of retired or separated participants receiving benefits2016-01-011
Number of other retired or separated participants entitled to future benefits2016-01-013
Total of all active and inactive participants2016-01-0117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0117
Number of participants with account balances2016-01-0117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-012
2015: PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0118
Total number of active participants reported on line 7a of the Form 55002015-01-0116
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-011
Total of all active and inactive participants2015-01-0117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0117
Number of participants with account balances2015-01-0117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0118
Total number of active participants reported on line 7a of the Form 55002014-01-0116
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-011
Total of all active and inactive participants2014-01-0117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0117
Number of participants with account balances2014-01-0117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0117
Total number of active participants reported on line 7a of the Form 55002013-01-0115
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-013
Total of all active and inactive participants2013-01-0118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0118
Number of participants with account balances2013-01-0118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0115
Total number of active participants reported on line 7a of the Form 55002012-01-0113
Number of retired or separated participants receiving benefits2012-01-011
Number of other retired or separated participants entitled to future benefits2012-01-011
Total of all active and inactive participants2012-01-0115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0115
Number of participants with account balances2012-01-0115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-011

Financial Data on PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING PLAN

Measure Date Value
2019 : PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING PLAN 2019 401k financial data
Total income from all sources2019-12-31$1,430,270
Expenses. Total of all expenses incurred2019-12-31$692,546
Benefits paid (including direct rollovers)2019-12-31$672,420
Total plan assets at end of year2019-12-31$7,550,464
Total plan assets at beginning of year2019-12-31$6,812,740
Value of fidelity bond covering the plan2019-12-31$500,000
Total contributions received or receivable from participants2019-12-31$102,175
Other income received2019-12-31$1,166,184
Net income (gross income less expenses)2019-12-31$737,724
Net plan assets at end of year (total assets less liabilities)2019-12-31$7,550,464
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$6,812,740
Total contributions received or receivable from employer(s)2019-12-31$161,911
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$20,126
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
2018 : PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING PLAN 2018 401k financial data
Total income from all sources2018-12-31$-24,312
Expenses. Total of all expenses incurred2018-12-31$288,190
Benefits paid (including direct rollovers)2018-12-31$265,222
Total plan assets at end of year2018-12-31$6,812,740
Total plan assets at beginning of year2018-12-31$7,125,242
Value of fidelity bond covering the plan2018-12-31$500,000
Total contributions received or receivable from participants2018-12-31$118,818
Other income received2018-12-31$-302,274
Net income (gross income less expenses)2018-12-31$-312,502
Net plan assets at end of year (total assets less liabilities)2018-12-31$6,812,740
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$7,125,242
Assets. Value of participant loans2018-12-31$0
Total contributions received or receivable from employer(s)2018-12-31$159,144
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$22,968
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
2017 : PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources2017-12-31$1,210,163
Expenses. Total of all expenses incurred2017-12-31$36,046
Benefits paid (including direct rollovers)2017-12-31$11,544
Total plan assets at end of year2017-12-31$7,125,242
Total plan assets at beginning of year2017-12-31$5,951,125
Value of fidelity bond covering the plan2017-12-31$500,000
Total contributions received or receivable from participants2017-12-31$108,326
Other income received2017-12-31$932,193
Net income (gross income less expenses)2017-12-31$1,174,117
Net plan assets at end of year (total assets less liabilities)2017-12-31$7,125,242
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$5,951,125
Assets. Value of participant loans2017-12-31$52,086
Total contributions received or receivable from employer(s)2017-12-31$169,644
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$24,502
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources2016-12-31$609,905
Expenses. Total of all expenses incurred2016-12-31$1,010,731
Benefits paid (including direct rollovers)2016-12-31$987,439
Total plan assets at end of year2016-12-31$5,951,125
Total plan assets at beginning of year2016-12-31$6,351,951
Value of fidelity bond covering the plan2016-12-31$460,000
Total contributions received or receivable from participants2016-12-31$108,587
Other income received2016-12-31$329,249
Net income (gross income less expenses)2016-12-31$-400,826
Net plan assets at end of year (total assets less liabilities)2016-12-31$5,951,125
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$6,351,951
Assets. Value of participant loans2016-12-31$5,200
Total contributions received or receivable from employer(s)2016-12-31$172,069
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$23,292
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources2015-12-31$56,956
Expenses. Total of all expenses incurred2015-12-31$18,741
Total plan assets at end of year2015-12-31$6,351,951
Total plan assets at beginning of year2015-12-31$6,313,736
Value of fidelity bond covering the plan2015-12-31$460,000
Total contributions received or receivable from participants2015-12-31$110,628
Other income received2015-12-31$-235,193
Net income (gross income less expenses)2015-12-31$38,215
Net plan assets at end of year (total assets less liabilities)2015-12-31$6,351,951
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$6,313,736
Assets. Value of participant loans2015-12-31$7,703
Total contributions received or receivable from employer(s)2015-12-31$181,521
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$18,741
2014 : PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources2014-12-31$477,371
Expenses. Total of all expenses incurred2014-12-31$155,942
Benefits paid (including direct rollovers)2014-12-31$135,072
Total plan assets at end of year2014-12-31$6,313,736
Total plan assets at beginning of year2014-12-31$5,992,307
Value of fidelity bond covering the plan2014-12-31$460,000
Total contributions received or receivable from participants2014-12-31$86,783
Contributions received from other sources (not participants or employers)2014-12-31$77,586
Other income received2014-12-31$150,014
Net income (gross income less expenses)2014-12-31$321,429
Net plan assets at end of year (total assets less liabilities)2014-12-31$6,313,736
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$5,992,307
Assets. Value of participant loans2014-12-31$10,209
Total contributions received or receivable from employer(s)2014-12-31$162,988
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$20,870
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources2013-12-31$1,009,804
Expenses. Total of all expenses incurred2013-12-31$18,161
Total plan assets at end of year2013-12-31$5,992,307
Total plan assets at beginning of year2013-12-31$5,000,664
Value of fidelity bond covering the plan2013-12-31$460,000
Total contributions received or receivable from participants2013-12-31$61,809
Expenses. Other expenses not covered elsewhere2013-12-31$11,448
Other income received2013-12-31$802,229
Net income (gross income less expenses)2013-12-31$991,643
Net plan assets at end of year (total assets less liabilities)2013-12-31$5,992,307
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$5,000,664
Assets. Value of participant loans2013-12-31$12,610
Total contributions received or receivable from employer(s)2013-12-31$145,766
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$6,713
2012 : PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources2012-12-31$678,844
Expenses. Total of all expenses incurred2012-12-31$15,934
Total plan assets at end of year2012-12-31$5,000,664
Total plan assets at beginning of year2012-12-31$4,337,754
Value of fidelity bond covering the plan2012-12-31$460,000
Total contributions received or receivable from participants2012-12-31$89,776
Expenses. Other expenses not covered elsewhere2012-12-31$11,448
Other income received2012-12-31$435,933
Net income (gross income less expenses)2012-12-31$662,910
Net plan assets at end of year (total assets less liabilities)2012-12-31$5,000,664
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$4,337,754
Assets. Value of participant loans2012-12-31$0
Total contributions received or receivable from employer(s)2012-12-31$153,135
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$4,486

Form 5500 Responses for PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING PLAN

2019: PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement - TrustYes
2018: PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement - TrustYes
2017: PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement - TrustYes
2016: PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING 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 – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2014: PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING 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 – TrustYes
2014-01-01Plan benefit arrangement - TrustYes
2013: PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING 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 – TrustYes
2013-01-01Plan benefit arrangement - TrustYes
2012: PEDIATRIC HEALTHCARE, S.C. PROFIT SHARING 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 – TrustYes
2012-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number33399
Policy instance 1
Insurance contract or identification number33399
Number of Individuals Covered0
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit 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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number33399
Policy instance 1
Insurance contract or identification number33399
Number of Individuals Covered2
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit 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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number33399
Policy instance 1
Insurance contract or identification number33399
Number of Individuals Covered2
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit 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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number33399
Policy instance 1
Insurance contract or identification number33399
Number of Individuals Covered2
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $229
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $11,448
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees229
Additional information about fees paid to insurance brokerPERSISTENCY FEES
Insurance broker organization code?3
Insurance broker nameMICHAEL J. SLUTZKY
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number33399
Policy instance 1
Insurance contract or identification number33399
Number of Individuals Covered2
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $286
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $11,448
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees286
Additional information about fees paid to insurance brokerPERSISTENCY FEES
Insurance broker organization code?3
Insurance broker nameMICHAEL J. SLUTZKY
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number33399
Policy instance 1
Insurance contract or identification number33399
Number of Individuals Covered2
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $286
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $11,448
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees286
Additional information about fees paid to insurance brokerPERSISTENCY FEES
Insurance broker organization code?3
Insurance broker nameMICHAEL J. SLUTZKY
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number33399
Policy instance 1
Insurance contract or identification number33399
Number of Individuals Covered2
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $286
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $11,448
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees286
Additional information about fees paid to insurance brokerPERSISTENCY FEES
Insurance broker organization code?3
Insurance broker nameMICHAEL J. SLUTZKY

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