VOYAGER HOLDINGS II, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan VOYAGER GROUP LP 401K PROFIT SHARING PLAN
| Measure | Date | Value |
|---|
| 2022: VOYAGER GROUP LP 401K PROFIT SHARING PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 67 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 39 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 34 |
| Total of all active and inactive participants | 2022-01-01 | 73 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2022-01-01 | 0 |
| Total participants | 2022-01-01 | 73 |
| Number of participants with account balances | 2022-01-01 | 73 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2022-01-01 | 0 |
| 2021: VOYAGER GROUP LP 401K PROFIT SHARING PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 68 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 33 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 34 |
| Total of all active and inactive participants | 2021-01-01 | 67 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2021-01-01 | 0 |
| Total participants | 2021-01-01 | 67 |
| Number of participants with account balances | 2021-01-01 | 67 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2021-01-01 | 0 |
| 2020: VOYAGER GROUP LP 401K PROFIT SHARING PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 70 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 29 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 39 |
| Total of all active and inactive participants | 2020-01-01 | 68 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2020-01-01 | 0 |
| Total participants | 2020-01-01 | 68 |
| Number of participants with account balances | 2020-01-01 | 68 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2020-01-01 | 0 |
| 2019: VOYAGER GROUP LP 401K PROFIT SHARING PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 73 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 30 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 40 |
| Total of all active and inactive participants | 2019-01-01 | 70 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2019-01-01 | 0 |
| Total participants | 2019-01-01 | 70 |
| Number of participants with account balances | 2019-01-01 | 70 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2019-01-01 | 0 |
| 2018: VOYAGER GROUP LP 401K PROFIT SHARING PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 78 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 33 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 40 |
| Total of all active and inactive participants | 2018-01-01 | 73 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2018-01-01 | 0 |
| Total participants | 2018-01-01 | 73 |
| Number of participants with account balances | 2018-01-01 | 73 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2018-01-01 | 0 |
| 2017: VOYAGER GROUP LP 401K PROFIT SHARING PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 71 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 33 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 45 |
| Total of all active and inactive participants | 2017-01-01 | 78 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2017-01-01 | 0 |
| Total participants | 2017-01-01 | 78 |
| Number of participants with account balances | 2017-01-01 | 78 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2017-01-01 | 0 |
| 2016: VOYAGER GROUP LP 401K PROFIT SHARING PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 75 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 24 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 47 |
| Total of all active and inactive participants | 2016-01-01 | 71 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2016-01-01 | 0 |
| Total participants | 2016-01-01 | 71 |
| Number of participants with account balances | 2016-01-01 | 71 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2016-01-01 | 0 |
| 2015: VOYAGER GROUP LP 401K PROFIT SHARING PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 75 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 26 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 49 |
| Total of all active and inactive participants | 2015-01-01 | 75 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2015-01-01 | 0 |
| Total participants | 2015-01-01 | 75 |
| Number of participants with account balances | 2015-01-01 | 75 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2015-01-01 | 0 |
| Measure | Date | Value |
|---|
| 2022 : VOYAGER GROUP LP 401K PROFIT SHARING PLAN 2022 401k financial data |
|---|
| Total income from all sources | 2022-12-31 | $-827,774 |
| Expenses. Total of all expenses incurred | 2022-12-31 | $102,188 |
| Benefits paid (including direct rollovers) | 2022-12-31 | $101,558 |
| Total plan assets at end of year | 2022-12-31 | $4,367,068 |
| Total plan assets at beginning of year | 2022-12-31 | $5,297,030 |
| Value of fidelity bond covering the plan | 2022-12-31 | $250,000 |
| Total contributions received or receivable from participants | 2022-12-31 | $208,258 |
| Contributions received from other sources (not participants or employers) | 2022-12-31 | $5,866 |
| Other income received | 2022-12-31 | $-1,089,542 |
| Net income (gross income less expenses) | 2022-12-31 | $-929,962 |
| Net plan assets at end of year (total assets less liabilities) | 2022-12-31 | $4,367,068 |
| Net plan assets at beginning of year (total assets less liabilities) | 2022-12-31 | $5,297,030 |
| Assets. Value of participant loans | 2022-12-31 | $90,136 |
| Total contributions received or receivable from employer(s) | 2022-12-31 | $47,644 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2022-12-31 | $630 |
| 2021 : VOYAGER GROUP LP 401K PROFIT SHARING PLAN 2021 401k financial data |
|---|
| Total income from all sources | 2021-12-31 | $800,320 |
| Expenses. Total of all expenses incurred | 2021-12-31 | $249,735 |
| Benefits paid (including direct rollovers) | 2021-12-31 | $248,840 |
| Total plan assets at end of year | 2021-12-31 | $5,297,030 |
| Total plan assets at beginning of year | 2021-12-31 | $4,746,445 |
| Value of fidelity bond covering the plan | 2021-12-31 | $250,000 |
| Total contributions received or receivable from participants | 2021-12-31 | $139,186 |
| Other income received | 2021-12-31 | $661,134 |
| Net income (gross income less expenses) | 2021-12-31 | $550,585 |
| Net plan assets at end of year (total assets less liabilities) | 2021-12-31 | $5,297,030 |
| Net plan assets at beginning of year (total assets less liabilities) | 2021-12-31 | $4,746,445 |
| Assets. Value of participant loans | 2021-12-31 | $89,865 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2021-12-31 | $895 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2021-12-31 | $0 |
| 2020 : VOYAGER GROUP LP 401K PROFIT SHARING PLAN 2020 401k financial data |
|---|
| Total income from all sources | 2020-12-31 | $1,140,862 |
| Expenses. Total of all expenses incurred | 2020-12-31 | $1,882,749 |
| Benefits paid (including direct rollovers) | 2020-12-31 | $1,881,734 |
| Total plan assets at end of year | 2020-12-31 | $4,746,445 |
| Total plan assets at beginning of year | 2020-12-31 | $5,488,332 |
| Value of fidelity bond covering the plan | 2020-12-31 | $250,000 |
| Total contributions received or receivable from participants | 2020-12-31 | $141,894 |
| Other income received | 2020-12-31 | $998,968 |
| Net income (gross income less expenses) | 2020-12-31 | $-741,887 |
| Net plan assets at end of year (total assets less liabilities) | 2020-12-31 | $4,746,445 |
| Net plan assets at beginning of year (total assets less liabilities) | 2020-12-31 | $5,488,332 |
| Assets. Value of participant loans | 2020-12-31 | $125,668 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2020-12-31 | $1,015 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2020-12-31 | $0 |
| 2019 : VOYAGER GROUP LP 401K PROFIT SHARING PLAN 2019 401k financial data |
|---|
| Total income from all sources | 2019-12-31 | $1,275,041 |
| Expenses. Total of all expenses incurred | 2019-12-31 | $310,855 |
| Benefits paid (including direct rollovers) | 2019-12-31 | $310,225 |
| Total plan assets at end of year | 2019-12-31 | $5,488,332 |
| Total plan assets at beginning of year | 2019-12-31 | $4,524,146 |
| Value of fidelity bond covering the plan | 2019-12-31 | $250,000 |
| Total contributions received or receivable from participants | 2019-12-31 | $169,168 |
| Other income received | 2019-12-31 | $1,105,873 |
| Net income (gross income less expenses) | 2019-12-31 | $964,186 |
| Net plan assets at end of year (total assets less liabilities) | 2019-12-31 | $5,488,332 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-12-31 | $4,524,146 |
| Assets. Value of participant loans | 2019-12-31 | $53,209 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2019-12-31 | $630 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2019-12-31 | $0 |
| 2018 : VOYAGER GROUP LP 401K PROFIT SHARING PLAN 2018 401k financial data |
|---|
| Total income from all sources | 2018-12-31 | $-237,520 |
| Expenses. Total of all expenses incurred | 2018-12-31 | $617,217 |
| Benefits paid (including direct rollovers) | 2018-12-31 | $616,222 |
| Total plan assets at end of year | 2018-12-31 | $4,524,146 |
| Total plan assets at beginning of year | 2018-12-31 | $5,378,883 |
| Value of fidelity bond covering the plan | 2018-12-31 | $250,000 |
| Total contributions received or receivable from participants | 2018-12-31 | $145,488 |
| Contributions received from other sources (not participants or employers) | 2018-12-31 | $41,003 |
| Other income received | 2018-12-31 | $-424,011 |
| Net income (gross income less expenses) | 2018-12-31 | $-854,737 |
| Net plan assets at end of year (total assets less liabilities) | 2018-12-31 | $4,524,146 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-12-31 | $5,378,883 |
| Assets. Value of participant loans | 2018-12-31 | $119,161 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2018-12-31 | $995 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2018-12-31 | $0 |
| 2017 : VOYAGER GROUP LP 401K PROFIT SHARING PLAN 2017 401k financial data |
|---|
| Total income from all sources | 2017-12-31 | $1,131,369 |
| Expenses. Total of all expenses incurred | 2017-12-31 | $620,297 |
| Benefits paid (including direct rollovers) | 2017-12-31 | $619,802 |
| Total plan assets at end of year | 2017-12-31 | $5,378,883 |
| Total plan assets at beginning of year | 2017-12-31 | $4,867,811 |
| Value of fidelity bond covering the plan | 2017-12-31 | $250,000 |
| Total contributions received or receivable from participants | 2017-12-31 | $109,138 |
| Contributions received from other sources (not participants or employers) | 2017-12-31 | $10,620 |
| Other income received | 2017-12-31 | $1,011,611 |
| Net income (gross income less expenses) | 2017-12-31 | $511,072 |
| Net plan assets at end of year (total assets less liabilities) | 2017-12-31 | $5,378,883 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-12-31 | $4,867,811 |
| Assets. Value of participant loans | 2017-12-31 | $94,725 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-12-31 | $495 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2017-12-31 | $0 |
| 2016 : VOYAGER GROUP LP 401K PROFIT SHARING PLAN 2016 401k financial data |
|---|
| Total income from all sources | 2016-12-31 | $426,465 |
| Expenses. Total of all expenses incurred | 2016-12-31 | $302,589 |
| Benefits paid (including direct rollovers) | 2016-12-31 | $302,384 |
| Total plan assets at end of year | 2016-12-31 | $4,867,811 |
| Total plan assets at beginning of year | 2016-12-31 | $4,743,935 |
| Value of fidelity bond covering the plan | 2016-12-31 | $250,000 |
| Total contributions received or receivable from participants | 2016-12-31 | $95,233 |
| Other income received | 2016-12-31 | $331,232 |
| Net income (gross income less expenses) | 2016-12-31 | $123,876 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-31 | $4,867,811 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-31 | $4,743,935 |
| Assets. Value of participant loans | 2016-12-31 | $33,481 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-12-31 | $205 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2016-12-31 | $0 |
| 2015 : VOYAGER GROUP LP 401K PROFIT SHARING PLAN 2015 401k financial data |
|---|
| Total income from all sources | 2015-12-31 | $66,377 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $290,616 |
| Benefits paid (including direct rollovers) | 2015-12-31 | $290,341 |
| Total plan assets at end of year | 2015-12-31 | $4,743,935 |
| Total plan assets at beginning of year | 2015-12-31 | $4,968,174 |
| Value of fidelity bond covering the plan | 2015-12-31 | $250,000 |
| Total contributions received or receivable from participants | 2015-12-31 | $89,616 |
| Other income received | 2015-12-31 | $-23,239 |
| Net income (gross income less expenses) | 2015-12-31 | $-224,239 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $4,743,935 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $4,968,174 |
| Assets. Value of participant loans | 2015-12-31 | $43,795 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-12-31 | $275 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2015-12-31 | $0 |
| 2022: VOYAGER GROUP LP 401K PROFIT SHARING PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Submission has been amended | No |
| 2022-01-01 | This submission is the final filing | No |
| 2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-01-01 | Plan is a collectively bargained plan | No |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – Trust | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement - Trust | Yes |
| 2021: VOYAGER GROUP LP 401K PROFIT SHARING PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Submission has been amended | No |
| 2021-01-01 | This submission is the final filing | No |
| 2021-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-01-01 | Plan is a collectively bargained plan | No |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – Trust | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement - Trust | Yes |
| 2020: VOYAGER GROUP LP 401K PROFIT SHARING PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Submission has been amended | No |
| 2020-01-01 | This submission is the final filing | No |
| 2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-01-01 | Plan is a collectively bargained plan | No |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – Trust | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement - Trust | Yes |
| 2019: VOYAGER GROUP LP 401K PROFIT SHARING PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Submission has been amended | No |
| 2019-01-01 | This submission is the final filing | No |
| 2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-01-01 | Plan is a collectively bargained plan | No |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – Trust | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement - Trust | Yes |
| 2018: VOYAGER GROUP LP 401K PROFIT SHARING PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Submission has been amended | No |
| 2018-01-01 | This submission is the final filing | No |
| 2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-01-01 | Plan is a collectively bargained plan | No |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – Trust | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement - Trust | Yes |
| 2017: VOYAGER GROUP LP 401K PROFIT SHARING PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | No |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – Trust | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement - Trust | Yes |
| 2016: VOYAGER GROUP LP 401K PROFIT SHARING PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – Trust | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement - Trust | Yes |
| 2015: VOYAGER GROUP LP 401K PROFIT SHARING PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Trust | Yes |
| 2015-01-01 | Plan benefit arrangement - Trust | Yes |
| PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 ) |
| Policy contract number | 074156 |
| Policy instance | 1 |
| Insurance contract or identification number | 074156 | | Number of Individuals Covered | 73 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $315 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 fees | 315 | | Additional information about fees paid to insurance broker | SERVICES TO INSURER OR PLAN | | Insurance broker organization code? | 4 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 105859 |
| Policy instance | 1 |
| Insurance contract or identification number | 105859 | | Number of Individuals Covered | 67 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $350 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 fees | 350 | | Additional information about fees paid to insurance broker | SERVICES TO INSURER OR PLAN | | Insurance broker organization code? | 4 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 105859 |
| Policy instance | 1 |
| Insurance contract or identification number | 105859 | | Number of Individuals Covered | 68 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $1,248 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 fees | 1248 | | Additional information about fees paid to insurance broker | SERVICES TO INSURER OR PLAN | | Insurance broker organization code? | 4 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 105859 |
| Policy instance | 1 |
| Insurance contract or identification number | 105859 | | Number of Individuals Covered | 70 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $1,092 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 fees | 1092 | | Additional information about fees paid to insurance broker | SERVICES TO INSURER OR PLAN | | Insurance broker organization code? | 4 |
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| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 105859 |
| Policy instance | 1 |
| Insurance contract or identification number | 105859 | | Number of Individuals Covered | 73 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $699 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 fees | 699 | | Additional information about fees paid to insurance broker | SERVICES TO INSURER OR PLAN | | Insurance broker organization code? | 4 |
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| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 105859 |
| Policy instance | 1 |
| Insurance contract or identification number | 105859 | | Number of Individuals Covered | 78 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $609 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 fees | 609 | | Additional information about fees paid to insurance broker | SERVICES TO INSURER OR PLAN | | Insurance broker organization code? | 4 | | Insurance broker name | WELLS FARGO WEALTH BROKGE INS AGCY |
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