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KOHL BUILDING PRODUCTS 401(K) PLAN 401k Plan overview

Plan NameKOHL BUILDING PRODUCTS 401(K) PLAN
Plan identification number 002

KOHL BUILDING PRODUCTS 401(K) 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.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • 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

KOHL BUILDING PRODUCTS LLC. has sponsored the creation of one or more 401k plans.

Company Name:KOHL BUILDING PRODUCTS LLC.
Employer identification number (EIN):461566038
NAIC Classification:423300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KOHL BUILDING PRODUCTS 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022017-01-01DEBORAH KEARSE
0022016-01-01DEBORAH KEARSE
0022015-01-01CURTIS WALLACE
0022014-01-01CURTIS WALLACE

Plan Statistics for KOHL BUILDING PRODUCTS 401(K) PLAN

401k plan membership statisitcs for KOHL BUILDING PRODUCTS 401(K) PLAN

Measure Date Value
2017: KOHL BUILDING PRODUCTS 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01165
Total number of active participants reported on line 7a of the Form 55002017-01-010
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-010
Number of participants with account balances2017-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: KOHL BUILDING PRODUCTS 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01197
Total number of active participants reported on line 7a of the Form 55002016-01-01148
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0116
Total of all active and inactive participants2016-01-01164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01164
Number of participants with account balances2016-01-01143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-017
2015: KOHL BUILDING PRODUCTS 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01197
Total number of active participants reported on line 7a of the Form 55002015-01-01152
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0144
Total of all active and inactive participants2015-01-01196
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01196
Number of participants with account balances2015-01-01170
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-013
2014: KOHL BUILDING PRODUCTS 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01200
Total number of active participants reported on line 7a of the Form 55002014-01-01154
Number of retired or separated participants receiving benefits2014-01-013
Number of other retired or separated participants entitled to future benefits2014-01-0139
Total of all active and inactive participants2014-01-01196
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-011
Total participants2014-01-01197
Number of participants with account balances2014-01-01157
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-012

Financial Data on KOHL BUILDING PRODUCTS 401(K) PLAN

Measure Date Value
2017 : KOHL BUILDING PRODUCTS 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$640,153
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$6,951,007
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$6,925,906
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$158,752
Value of total assets at end of year2017-12-31$0
Value of total assets at beginning of year2017-12-31$6,310,854
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$25,101
Total interest from all sources2017-12-31$2,104
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$25,863
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2017-12-31$0
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$130,765
Participant contributions at end of year2017-12-31$0
Participant contributions at beginning of year2017-12-31$134,300
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$-6,310,854
Value of net assets at end of year (total assets less liabilities)2017-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$6,310,854
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$5,339,166
Interest on participant loans2017-12-31$2,069
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$35
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$837,388
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$453,434
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$27,987
Income. Dividends from common stock2017-12-31$25,863
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$6,925,906
Contract administrator fees2017-12-31$25,101
Did the plan have assets held for investment2017-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31STANILLA SIEGEL AND MASTER LLC
Accountancy firm EIN2017-12-31461196981
2016 : KOHL BUILDING PRODUCTS 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total income from all sources (including contributions)2016-12-31$884,817
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$727,319
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$692,636
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$451,746
Value of total assets at end of year2016-12-31$6,310,854
Value of total assets at beginning of year2016-12-31$6,153,356
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$34,683
Total interest from all sources2016-12-31$4,981
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$178,942
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$178,942
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$309,699
Participant contributions at end of year2016-12-31$134,300
Participant contributions at beginning of year2016-12-31$101,225
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$33,564
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$157,498
Value of net assets at end of year (total assets less liabilities)2016-12-31$6,310,854
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$6,153,356
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$5,339,166
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$5,292,488
Income. Interest from loans (other than to participants)2016-12-31$4,981
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$837,388
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$759,643
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$249,148
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$108,483
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$692,636
Contract administrator fees2016-12-31$34,683
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31STANILLA SIEGEL AND MASTER LLC
Accountancy firm EIN2016-12-31461196981
2015 : KOHL BUILDING PRODUCTS 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$377,446
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$771,518
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$712,461
Expenses. Certain deemed distributions of participant loans2015-12-31$24,730
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$374,807
Value of total assets at end of year2015-12-31$6,153,356
Value of total assets at beginning of year2015-12-31$6,547,428
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$34,327
Total interest from all sources2015-12-31$4,415
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$240,495
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$240,495
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$275,637
Participant contributions at end of year2015-12-31$101,225
Participant contributions at beginning of year2015-12-31$124,410
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-394,072
Value of net assets at end of year (total assets less liabilities)2015-12-31$6,153,356
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$6,547,428
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$5,292,488
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$5,663,539
Interest on participant loans2015-12-31$4,415
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$759,643
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$759,479
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-242,271
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$99,170
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$712,461
Contract administrator fees2015-12-31$34,327
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-12-31No
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31STANILLA SIEGEL AND MASTER LLC
Accountancy firm EIN2015-12-31461196981
2014 : KOHL BUILDING PRODUCTS 401(K) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$690,647
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$363,386
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$315,028
Expenses. Certain deemed distributions of participant loans2014-12-31$27,908
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$379,202
Value of total assets at end of year2014-12-31$6,547,428
Value of total assets at beginning of year2014-12-31$6,220,167
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$20,450
Total interest from all sources2014-12-31$5,946
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$277,656
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2014-12-31$277,656
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
If this is an individual account plan, was there a blackout period2014-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$277,008
Participant contributions at end of year2014-12-31$124,410
Participant contributions at beginning of year2014-12-31$159,362
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$4,626
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$327,261
Value of net assets at end of year (total assets less liabilities)2014-12-31$6,547,428
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$6,220,167
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$5,663,539
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$0
Value of interest in pooled separate accounts at end of year2014-12-31$0
Value of interest in pooled separate accounts at beginning of year2014-12-31$5,126,741
Interest on participant loans2014-12-31$5,946
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$759,479
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$934,064
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$-101,972
Net investment gain/loss from pooled separate accounts2014-12-31$129,815
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$97,568
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$315,028
Contract administrator fees2014-12-31$20,450
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-12-31Yes
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31STANILLA SIEGEL AND MASTER LLC
Accountancy firm EIN2014-12-31461196981

Form 5500 Responses for KOHL BUILDING PRODUCTS 401(K) PLAN

2017: KOHL BUILDING PRODUCTS 401(K) 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 filingYes
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: KOHL BUILDING PRODUCTS 401(K) 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: KOHL BUILDING PRODUCTS 401(K) 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
2014: KOHL BUILDING PRODUCTS 401(K) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number959-80002
Policy instance 1
Insurance contract or identification number959-80002
Number of Individuals Covered0
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $361
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?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 $361
Insurance broker organization code?3
Insurance broker nameBRAD SMALL
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number959-80002
Policy instance 1
Insurance contract or identification number959-80002
Number of Individuals Covered170
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $396
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?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 $396
Insurance broker organization code?3
Insurance broker nameBRAD SMALL
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number800857
Policy instance 1
Insurance contract or identification number800857
Number of Individuals Covered0
Insurance policy start date2014-01-01
Insurance policy end date2014-08-05
Total amount of commissions paid to insurance brokerUSD $8,960
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 $4,480
Insurance broker organization code?3
Insurance broker nameBRAD SMALL
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number959-80002
Policy instance 2
Insurance contract or identification number959-80002
Number of Individuals Covered57
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $5,750
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?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?Yes
Commission paid to Insurance BrokerUSD $2,875
Insurance broker organization code?3
Insurance broker nameBRAD SMALL

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