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HEATTEK, INC. SAVINGS AND RETIREMENT PLAN 401k Plan overview

Plan NameHEATTEK, INC. SAVINGS AND RETIREMENT PLAN
Plan identification number 001

HEATTEK, INC. SAVINGS AND 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.
  • Plan sponsor(s) received services of leased employees, as defined in Code section 414(n), during the plan year.

401k Sponsoring company profile

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

Company Name:HEATTEK, INC.
Employer identification number (EIN):392031247
NAIC Classification:333200

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEATTEK, INC. SAVINGS AND RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01DYAN BRINKMAN
0012017-01-01DYAN BRINKMAN
0012017-01-01DYAN BRINKMAN
0012016-01-01DYAN BRINKMAN
0012015-01-01DYAN BRINKMAN
0012014-01-01DYAN BRINKMAN2016-01-07 DYAN BRINKMAN2016-01-07
0012013-01-01DYAN BRINKMAN2014-07-03 DYAN BRINKMAN2014-07-03
0012012-01-01DYAN BRINKMAN2013-04-25 DYAN BRINKMAN2013-04-25
0012011-01-01DYAN BRINKMAN2012-04-05 DYAN BRINKMAN2012-04-05
0012010-01-01DYAN BRINKMAN2011-04-25 DYAN BRINKMAN2011-04-25

Plan Statistics for HEATTEK, INC. SAVINGS AND RETIREMENT PLAN

401k plan membership statisitcs for HEATTEK, INC. SAVINGS AND RETIREMENT PLAN

Measure Date Value
2022: HEATTEK, INC. SAVINGS AND RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0195
Total number of active participants reported on line 7a of the Form 55002022-01-0180
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0117
Total of all active and inactive participants2022-01-0197
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-0197
Number of participants with account balances2022-01-0179
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: HEATTEK, INC. SAVINGS AND RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0177
Total number of active participants reported on line 7a of the Form 55002021-01-0184
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0111
Total of all active and inactive participants2021-01-0195
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-0195
Number of participants with account balances2021-01-0177
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: HEATTEK, INC. SAVINGS AND RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0163
Total number of active participants reported on line 7a of the Form 55002020-01-0170
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-017
Total of all active and inactive participants2020-01-0177
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-0177
Number of participants with account balances2020-01-0166
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: HEATTEK, INC. SAVINGS AND RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0164
Total number of active participants reported on line 7a of the Form 55002019-01-0159
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-014
Total of all active and inactive participants2019-01-0163
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0163
Number of participants with account balances2019-01-0159
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: HEATTEK, INC. SAVINGS AND RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0156
Total number of active participants reported on line 7a of the Form 55002018-01-0159
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-015
Total of all active and inactive participants2018-01-0164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0164
Number of participants with account balances2018-01-0157
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: HEATTEK, INC. SAVINGS AND RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0149
Total number of active participants reported on line 7a of the Form 55002017-01-0152
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-014
Total of all active and inactive participants2017-01-0156
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0156
Number of participants with account balances2017-01-0147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: HEATTEK, INC. SAVINGS AND RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0145
Total number of active participants reported on line 7a of the Form 55002016-01-0147
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-012
Total of all active and inactive participants2016-01-0149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0149
Number of participants with account balances2016-01-0141
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: HEATTEK, INC. SAVINGS AND RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0139
Total number of active participants reported on line 7a of the Form 55002015-01-0143
Number of other retired or separated participants entitled to future benefits2015-01-012
Total of all active and inactive participants2015-01-0145
Total participants2015-01-0145
Number of participants with account balances2015-01-0138

Financial Data on HEATTEK, INC. SAVINGS AND RETIREMENT PLAN

Measure Date Value
2022 : HEATTEK, INC. SAVINGS AND RETIREMENT PLAN 2022 401k financial data
Transfers to/from the plan2022-12-31$0
Total plan liabilities at end of year2022-12-31$0
Total plan liabilities at beginning of year2022-12-31$0
Total income from all sources2022-12-31$-1,136,376
Expenses. Total of all expenses incurred2022-12-31$717,302
Benefits paid (including direct rollovers)2022-12-31$659,907
Total plan assets at end of year2022-12-31$8,947,167
Total plan assets at beginning of year2022-12-31$10,800,845
Value of fidelity bond covering the plan2022-12-31$375,000
Total contributions received or receivable from participants2022-12-31$601,115
Expenses. Other expenses not covered elsewhere2022-12-31$0
Contributions received from other sources (not participants or employers)2022-12-31$107,315
Other income received2022-12-31$-1,971,230
Noncash contributions received2022-12-31$0
Net income (gross income less expenses)2022-12-31$-1,853,678
Net plan assets at end of year (total assets less liabilities)2022-12-31$8,947,167
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$10,800,845
Assets. Value of participant loans2022-12-31$29,588
Total contributions received or receivable from employer(s)2022-12-31$126,424
Value of certain deemed distributions of participant loans2022-12-31$0
Value of corrective distributions2022-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$57,395
2021 : HEATTEK, INC. SAVINGS AND RETIREMENT PLAN 2021 401k financial data
Transfers to/from the plan2021-12-31$0
Total plan liabilities at end of year2021-12-31$0
Total plan liabilities at beginning of year2021-12-31$0
Total income from all sources2021-12-31$2,231,920
Expenses. Total of all expenses incurred2021-12-31$942,205
Benefits paid (including direct rollovers)2021-12-31$886,388
Total plan assets at end of year2021-12-31$10,800,845
Total plan assets at beginning of year2021-12-31$9,511,130
Value of fidelity bond covering the plan2021-12-31$375,000
Total contributions received or receivable from participants2021-12-31$541,514
Expenses. Other expenses not covered elsewhere2021-12-31$0
Contributions received from other sources (not participants or employers)2021-12-31$65,916
Other income received2021-12-31$1,508,372
Noncash contributions received2021-12-31$0
Net income (gross income less expenses)2021-12-31$1,289,715
Net plan assets at end of year (total assets less liabilities)2021-12-31$10,800,845
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$9,511,130
Assets. Value of participant loans2021-12-31$1,507
Total contributions received or receivable from employer(s)2021-12-31$116,118
Value of certain deemed distributions of participant loans2021-12-31$0
Value of corrective distributions2021-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$55,817
2020 : HEATTEK, INC. SAVINGS AND RETIREMENT PLAN 2020 401k financial data
Transfers to/from the plan2020-12-31$0
Total plan liabilities at end of year2020-12-31$0
Total plan liabilities at beginning of year2020-12-31$0
Total income from all sources2020-12-31$1,967,301
Expenses. Total of all expenses incurred2020-12-31$391,684
Benefits paid (including direct rollovers)2020-12-31$341,690
Total plan assets at end of year2020-12-31$9,511,130
Total plan assets at beginning of year2020-12-31$7,935,513
Value of fidelity bond covering the plan2020-12-31$375,000
Total contributions received or receivable from participants2020-12-31$468,828
Expenses. Other expenses not covered elsewhere2020-12-31$0
Contributions received from other sources (not participants or employers)2020-12-31$71,271
Other income received2020-12-31$1,323,954
Noncash contributions received2020-12-31$0
Net income (gross income less expenses)2020-12-31$1,575,617
Net plan assets at end of year (total assets less liabilities)2020-12-31$9,511,130
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$7,935,513
Assets. Value of participant loans2020-12-31$7,536
Total contributions received or receivable from employer(s)2020-12-31$103,248
Value of certain deemed distributions of participant loans2020-12-31$0
Value of corrective distributions2020-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$49,994
2019 : HEATTEK, INC. SAVINGS AND RETIREMENT PLAN 2019 401k financial data
Transfers to/from the plan2019-12-31$0
Total plan liabilities at end of year2019-12-31$0
Total plan liabilities at beginning of year2019-12-31$0
Total income from all sources2019-12-31$1,984,670
Expenses. Total of all expenses incurred2019-12-31$235,476
Benefits paid (including direct rollovers)2019-12-31$216,032
Total plan assets at end of year2019-12-31$7,935,513
Total plan assets at beginning of year2019-12-31$6,186,319
Value of fidelity bond covering the plan2019-12-31$375,000
Total contributions received or receivable from participants2019-12-31$438,492
Expenses. Other expenses not covered elsewhere2019-12-31$0
Contributions received from other sources (not participants or employers)2019-12-31$14,944
Other income received2019-12-31$1,439,321
Noncash contributions received2019-12-31$0
Net income (gross income less expenses)2019-12-31$1,749,194
Net plan assets at end of year (total assets less liabilities)2019-12-31$7,935,513
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$6,186,319
Assets. Value of participant loans2019-12-31$24,808
Total contributions received or receivable from employer(s)2019-12-31$91,913
Value of certain deemed distributions of participant loans2019-12-31$0
Value of corrective distributions2019-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$19,444
2018 : HEATTEK, INC. SAVINGS AND RETIREMENT PLAN 2018 401k financial data
Transfers to/from the plan2018-12-31$0
Total plan liabilities at end of year2018-12-31$0
Total plan liabilities at beginning of year2018-12-31$0
Total income from all sources2018-12-31$182,813
Expenses. Total of all expenses incurred2018-12-31$108,251
Benefits paid (including direct rollovers)2018-12-31$100,408
Total plan assets at end of year2018-12-31$6,186,319
Total plan assets at beginning of year2018-12-31$6,111,757
Value of fidelity bond covering the plan2018-12-31$375,000
Total contributions received or receivable from participants2018-12-31$414,736
Expenses. Other expenses not covered elsewhere2018-12-31$0
Contributions received from other sources (not participants or employers)2018-12-31$158,656
Other income received2018-12-31$-475,895
Noncash contributions received2018-12-31$0
Net income (gross income less expenses)2018-12-31$74,562
Net plan assets at end of year (total assets less liabilities)2018-12-31$6,186,319
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$6,111,757
Assets. Value of participant loans2018-12-31$44,258
Total contributions received or receivable from employer(s)2018-12-31$85,316
Value of certain deemed distributions of participant loans2018-12-31$0
Value of corrective distributions2018-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$7,843
2017 : HEATTEK, INC. SAVINGS AND RETIREMENT PLAN 2017 401k financial data
Transfers to/from the plan2017-12-31$0
Total plan liabilities at end of year2017-12-31$0
Total plan liabilities at beginning of year2017-12-31$0
Total income from all sources2017-12-31$1,417,495
Expenses. Total of all expenses incurred2017-12-31$96,390
Benefits paid (including direct rollovers)2017-12-31$90,350
Total plan assets at end of year2017-12-31$6,111,757
Total plan assets at beginning of year2017-12-31$4,790,652
Value of fidelity bond covering the plan2017-12-31$375,000
Total contributions received or receivable from participants2017-12-31$325,025
Expenses. Other expenses not covered elsewhere2017-12-31$0
Contributions received from other sources (not participants or employers)2017-12-31$145,410
Other income received2017-12-31$880,963
Noncash contributions received2017-12-31$0
Net income (gross income less expenses)2017-12-31$1,321,105
Net plan assets at end of year (total assets less liabilities)2017-12-31$6,111,757
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$4,790,652
Assets. Value of participant loans2017-12-31$68,306
Total contributions received or receivable from employer(s)2017-12-31$66,097
Value of certain deemed distributions of participant loans2017-12-31$0
Value of corrective distributions2017-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$6,040
2016 : HEATTEK, INC. SAVINGS AND RETIREMENT PLAN 2016 401k financial data
Transfers to/from the plan2016-12-31$0
Total plan liabilities at end of year2016-12-31$0
Total plan liabilities at beginning of year2016-12-31$0
Total income from all sources2016-12-31$880,152
Expenses. Total of all expenses incurred2016-12-31$5,722
Benefits paid (including direct rollovers)2016-12-31$0
Total plan assets at end of year2016-12-31$4,790,652
Total plan assets at beginning of year2016-12-31$3,916,222
Value of fidelity bond covering the plan2016-12-31$375,000
Total contributions received or receivable from participants2016-12-31$275,793
Expenses. Other expenses not covered elsewhere2016-12-31$0
Contributions received from other sources (not participants or employers)2016-12-31$217,270
Other income received2016-12-31$326,365
Noncash contributions received2016-12-31$0
Net income (gross income less expenses)2016-12-31$874,430
Net plan assets at end of year (total assets less liabilities)2016-12-31$4,790,652
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$3,916,222
Assets. Value of participant loans2016-12-31$66,927
Total contributions received or receivable from employer(s)2016-12-31$60,724
Value of certain deemed distributions of participant loans2016-12-31$0
Value of corrective distributions2016-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$5,722
2015 : HEATTEK, INC. SAVINGS AND RETIREMENT PLAN 2015 401k financial data
Transfers to/from the plan2015-12-31$0
Total plan liabilities at end of year2015-12-31$0
Total plan liabilities at beginning of year2015-12-31$0
Total income from all sources2015-12-31$338,017
Expenses. Total of all expenses incurred2015-12-31$7,936
Benefits paid (including direct rollovers)2015-12-31$0
Total plan assets at end of year2015-12-31$3,916,222
Total plan assets at beginning of year2015-12-31$3,586,141
Value of fidelity bond covering the plan2015-12-31$375,000
Total contributions received or receivable from participants2015-12-31$283,733
Expenses. Other expenses not covered elsewhere2015-12-31$0
Contributions received from other sources (not participants or employers)2015-12-31$13,687
Other income received2015-12-31$-24,019
Noncash contributions received2015-12-31$0
Net income (gross income less expenses)2015-12-31$330,081
Net plan assets at end of year (total assets less liabilities)2015-12-31$3,916,222
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$3,586,141
Assets. Value of participant loans2015-12-31$50,002
Total contributions received or receivable from employer(s)2015-12-31$64,616
Value of certain deemed distributions of participant loans2015-12-31$0
Value of corrective distributions2015-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$7,936

Form 5500 Responses for HEATTEK, INC. SAVINGS AND RETIREMENT PLAN

2022: HEATTEK, INC. SAVINGS AND RETIREMENT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01This submission is the final filingNo
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: HEATTEK, INC. SAVINGS AND RETIREMENT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: HEATTEK, INC. SAVINGS AND RETIREMENT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01This submission is the final filingNo
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: HEATTEK, INC. SAVINGS AND RETIREMENT 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 – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: HEATTEK, INC. SAVINGS AND RETIREMENT 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 – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: HEATTEK, INC. SAVINGS AND RETIREMENT 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 – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: HEATTEK, INC. SAVINGS AND RETIREMENT 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 – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: HEATTEK, INC. SAVINGS AND 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
2015-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number63526
Policy instance 1
Insurance contract or identification number63526
Number of Individuals Covered12
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract numberGA-063526
Policy instance 1
Insurance contract or identification numberGA-063526
Number of Individuals Covered12
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract numberGA-063526
Policy instance 1
Insurance contract or identification numberGA-063526
Number of Individuals Covered11
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract numberGA-063526
Policy instance 1
Insurance contract or identification numberGA-063526
Number of Individuals Covered13
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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?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
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract numberGA-063526
Policy instance 1
Insurance contract or identification numberGA-063526
Number of Individuals Covered12
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract numberGA-063526
Policy instance 1
Insurance contract or identification numberGA-063526
Number of Individuals Covered13
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
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number705663
Policy instance 1
Insurance contract or identification number705663
Number of Individuals Covered0
Insurance policy start date2015-01-01
Insurance policy end date2015-05-29
Total amount of commissions paid to insurance brokerUSD $3,933
Total amount of fees paid to insurance companyUSD $371
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,933
Amount paid for insurance broker fees371
Additional information about fees paid to insurance brokerREFERRAL/SERVICE FEE AND PRORATED INCENTIVE NOT DEDUCTED FROM PLAN
Insurance broker organization code?3
Insurance broker nameMALONE, RANDALL J
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract numberGA-063526
Policy instance 2
Insurance contract or identification numberGA-063526
Number of Individuals Covered12
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 $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 $0
Amount paid for insurance broker fees0
Insurance broker name

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