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VETERINARY MEDICAL CENTER 401(K) PLAN AND TRUST 401k Plan overview

Plan NameVETERINARY MEDICAL CENTER 401(K) PLAN AND TRUST
Plan identification number 002

VETERINARY MEDICAL CENTER 401(K) PLAN AND TRUST 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.
  • 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) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

VETERINARY MEDICAL CENTER, P.A. has sponsored the creation of one or more 401k plans.

Company Name:VETERINARY MEDICAL CENTER, P.A.
Employer identification number (EIN):410991102
NAIC Classification:541940
NAIC Description:Veterinary Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VETERINARY MEDICAL CENTER 401(K) PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022022-01-01
0022021-01-01
0022020-01-01
0022019-01-01
0022018-01-01
0022017-01-01
0022016-01-01
0022015-01-01
0022014-01-01DONNA D TIMS2015-07-10
0022013-01-01PEGGY MILLER2014-10-03
0022012-01-01TRAVIS STENBERG
0022011-01-01TRAVIS STENBERG
0022010-01-01ANN LEE
0022009-01-01ANN LEE

Plan Statistics for VETERINARY MEDICAL CENTER 401(K) PLAN AND TRUST

401k plan membership statisitcs for VETERINARY MEDICAL CENTER 401(K) PLAN AND TRUST

Measure Date Value
2012: VETERINARY MEDICAL CENTER 401(K) PLAN AND TRUST 2012 401k membership
Total participants, beginning-of-year2012-01-01222
Total number of active participants reported on line 7a of the Form 55002012-01-0153
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-0153
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0153
Number of participants with account balances2012-01-0143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-011
2011: VETERINARY MEDICAL CENTER 401(K) PLAN AND TRUST 2011 401k membership
Total participants, beginning-of-year2011-01-01218
Total number of active participants reported on line 7a of the Form 55002011-01-01187
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-0131
Total of all active and inactive participants2011-01-01218
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01218
Number of participants with account balances2011-01-01213
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-011
2010: VETERINARY MEDICAL CENTER 401(K) PLAN AND TRUST 2010 401k membership
Total participants, beginning-of-year2010-01-01231
Total number of active participants reported on line 7a of the Form 55002010-01-01189
Number of retired or separated participants receiving benefits2010-01-011
Number of other retired or separated participants entitled to future benefits2010-01-0118
Total of all active and inactive participants2010-01-01208
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-011
Total participants2010-01-01209
Number of participants with account balances2010-01-01208
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-012
2009: VETERINARY MEDICAL CENTER 401(K) PLAN AND TRUST 2009 401k membership
Total participants, beginning-of-year2009-01-01212
Total number of active participants reported on line 7a of the Form 55002009-01-01196
Number of retired or separated participants receiving benefits2009-01-012
Number of other retired or separated participants entitled to future benefits2009-01-0126
Total of all active and inactive participants2009-01-01224
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-011
Total participants2009-01-01225
Number of participants with account balances2009-01-01213
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-011

Financial Data on VETERINARY MEDICAL CENTER 401(K) PLAN AND TRUST

Measure Date Value
2012 : VETERINARY MEDICAL CENTER 401(K) PLAN AND TRUST 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total transfer of assets from this plan2012-12-31$6,909,851
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$2,333
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$7,358
Total income from all sources (including contributions)2012-12-31$1,549,233
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$687,001
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$576,994
Expenses. Certain deemed distributions of participant loans2012-12-31$9,269
Value of total corrective distributions2012-12-31$2,333
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$677,478
Value of total assets at end of year2012-12-31$1,557,032
Value of total assets at beginning of year2012-12-31$7,609,676
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$98,405
Total interest from all sources2012-12-31$39,823
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$64,612
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2012-12-31$64,612
Administrative expenses professional fees incurred2012-12-31$89,199
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$500,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$478,414
Participant contributions at end of year2012-12-31$58,470
Participant contributions at beginning of year2012-12-31$165,881
Participant contributions at end of year2012-12-31$6,731
Participant contributions at beginning of year2012-12-31$17,320
Assets. Other investments not covered elsewhere at end of year2012-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2012-12-31$371,783
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$67,810
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-12-31$2,333
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$7,358
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$862,232
Value of net assets at end of year (total assets less liabilities)2012-12-31$1,554,699
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$7,602,318
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$1,341,583
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$6,445,289
Interest on participant loans2012-12-31$7,422
Interest earned on other investments2012-12-31$32,401
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$102,412
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$96,654
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$96,654
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$152,921
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$17,488
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$767,320
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$131,254
Employer contributions (assets) at end of year2012-12-31$47,836
Employer contributions (assets) at beginning of year2012-12-31$359,828
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$559,506
Contract administrator fees2012-12-31$9,206
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31ABDO, EICK & MEYERS LLP
Accountancy firm EIN2012-12-31411397419
2011 : VETERINARY MEDICAL CENTER 401(K) PLAN AND TRUST 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$7,358
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$15,832
Total income from all sources (including contributions)2011-12-31$786,119
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$1,443,081
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$1,312,811
Expenses. Certain deemed distributions of participant loans2011-12-31$5,602
Value of total corrective distributions2011-12-31$7,358
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$989,921
Value of total assets at end of year2011-12-31$7,609,676
Value of total assets at beginning of year2011-12-31$8,275,112
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$117,310
Total interest from all sources2011-12-31$10,856
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$151,095
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$151,095
Administrative expenses professional fees incurred2011-12-31$19,905
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$500,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$532,677
Participant contributions at end of year2011-12-31$165,881
Participant contributions at beginning of year2011-12-31$214,488
Participant contributions at end of year2011-12-31$17,320
Participant contributions at beginning of year2011-12-31$26,566
Assets. Other investments not covered elsewhere at end of year2011-12-31$371,783
Assets. Other investments not covered elsewhere at beginning of year2011-12-31$337,777
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$182,817
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-12-31$7,358
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-12-31$15,832
Other income not declared elsewhere2011-12-31$33,990
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-656,962
Value of net assets at end of year (total assets less liabilities)2011-12-31$7,602,318
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$8,259,280
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$6,445,289
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$7,051,853
Interest on participant loans2011-12-31$10,856
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$96,654
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$92,983
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$92,983
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$152,921
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$97,164
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$17,488
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$-399,743
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$457,244
Employer contributions (assets) at end of year2011-12-31$359,828
Employer contributions (assets) at beginning of year2011-12-31$271,464
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$1,295,323
Contract administrator fees2011-12-31$97,405
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31ABDO, EICK & MEYERS LLP
Accountancy firm EIN2011-12-31411397419
2010 : VETERINARY MEDICAL CENTER 401(K) PLAN AND TRUST 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$15,832
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total income from all sources (including contributions)2010-12-31$1,939,241
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$2,508,871
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$2,442,254
Value of total corrective distributions2010-12-31$15,832
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$1,068,678
Value of total assets at end of year2010-12-31$8,275,112
Value of total assets at beginning of year2010-12-31$8,828,910
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$50,785
Total interest from all sources2010-12-31$15,679
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$134,923
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2010-12-31$134,923
Administrative expenses professional fees incurred2010-12-31$17,500
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$500,000
If this is an individual account plan, was there a blackout period2010-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$520,697
Participant contributions at end of year2010-12-31$214,488
Participant contributions at beginning of year2010-12-31$266,650
Participant contributions at end of year2010-12-31$26,566
Assets. Other investments not covered elsewhere at end of year2010-12-31$337,777
Assets. Other investments not covered elsewhere at beginning of year2010-12-31$301,571
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$182,982
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$182,817
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2010-12-31$15,832
Other income not declared elsewhere2010-12-31$36,206
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-569,630
Value of net assets at end of year (total assets less liabilities)2010-12-31$8,259,280
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$8,828,910
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$7,051,853
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$8,051,669
Interest on participant loans2010-12-31$15,576
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$92,983
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$156,347
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$156,347
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$103
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$97,164
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$52,673
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$18,821
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$683,755
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$364,999
Employer contributions (assets) at end of year2010-12-31$271,464
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$2,423,433
Contract administrator fees2010-12-31$33,285
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31ABDO EICK & MEYERS
Accountancy firm EIN2010-12-31411397419
2009 : VETERINARY MEDICAL CENTER 401(K) PLAN AND TRUST 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for VETERINARY MEDICAL CENTER 401(K) PLAN AND TRUST

2012: VETERINARY MEDICAL CENTER 401(K) PLAN AND TRUST 2012 form 5500 responses
2012-01-01Type of plan entityMulitple 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
2012-01-01Plan benefit arrangement - TrustYes
2011: VETERINARY MEDICAL CENTER 401(K) PLAN AND TRUST 2011 form 5500 responses
2011-01-01Type of plan entityMulitple 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
2011-01-01Plan benefit arrangement - TrustYes
2010: VETERINARY MEDICAL CENTER 401(K) PLAN AND TRUST 2010 form 5500 responses
2010-01-01Type of plan entityMulitple 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
2010-01-01Plan benefit arrangement - TrustYes
2009: VETERINARY MEDICAL CENTER 401(K) PLAN AND TRUST 2009 form 5500 responses
2009-01-01Type of plan entityMulitple 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
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-B2-MG11
Policy instance 1
Insurance contract or identification numberGAP-B2-MG11
Number of Individuals Covered0
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $2,528
Total amount of fees paid to insurance companyUSD $632
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?Yes
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
Amount paid for insurance broker fees632
Additional information about fees paid to insurance brokerADMINISTRATIVE OVERRIDE
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $2,528
Insurance broker nameUS BANCORP INVESTMENTS
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0319450
Policy instance 2
Insurance contract or identification number0319450
Number of Individuals Covered0
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 $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?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
EMC NATIONAL LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 66828 )
Policy contract numberN00807183
Policy instance 3
Insurance contract or identification numberN00807183
Number of Individuals Covered0
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 $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?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 number34606
Policy instance 4
Insurance contract or identification number34606
Number of Individuals Covered0
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 $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?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
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-B2-MG11
Policy instance 3
Insurance contract or identification numberGAP-B2-MG11
Number of Individuals Covered213
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $1,007
Total amount of fees paid to insurance companyUSD $252
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?Yes
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 number34606
Policy instance 2
Insurance contract or identification number34606
Number of Individuals Covered1
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
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?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
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0319450
Policy instance 1
Insurance contract or identification number0319450
Number of Individuals Covered1
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
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?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
EMC NATIONAL LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 66828 )
Policy contract numberN00807183
Policy instance 4
Insurance contract or identification numberN00807183
Number of Individuals Covered1
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
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?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
EMC NATIONAL LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 66828 )
Policy contract numberN00807183
Policy instance 4
Insurance contract or identification numberN00807183
Number of Individuals Covered1
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
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?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 number34606
Policy instance 2
Insurance contract or identification number34606
Number of Individuals Covered1
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
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?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
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number0319450
Policy instance 1
Insurance contract or identification number0319450
Number of Individuals Covered1
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
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?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
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-B2-MG11
Policy instance 3
Insurance contract or identification numberGAP-B2-MG11
Number of Individuals Covered208
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $768
Total amount of fees paid to insurance companyUSD $192
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?Yes
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 $334
Amount paid for insurance broker fees192
Additional information about fees paid to insurance brokerADMINISTRATIVE OVERRIDE
Insurance broker organization code?3
Insurance broker nameUS BANCORP INVESTMENTS

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