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HRBC 401(K) PLAN FOR UFCW COLLECTIVE 401k Plan overview

Plan NameHRBC 401(K) PLAN FOR UFCW COLLECTIVE
Plan identification number 002

HRBC 401(K) PLAN FOR UFCW COLLECTIVE Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

HARRIS RANCH BEEF COMPANY has sponsored the creation of one or more 401k plans.

Company Name:HARRIS RANCH BEEF COMPANY
Employer identification number (EIN):470873490
NAIC Classification:311610
NAIC Description: Animal Slaughtering and Processing

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HRBC 401(K) PLAN FOR UFCW COLLECTIVE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022021-07-01
0022020-07-01
0022020-07-01
0022019-07-01
0022018-07-01

Plan Statistics for HRBC 401(K) PLAN FOR UFCW COLLECTIVE

401k plan membership statisitcs for HRBC 401(K) PLAN FOR UFCW COLLECTIVE

Measure Date Value
2021: HRBC 401(K) PLAN FOR UFCW COLLECTIVE 2021 401k membership
Total participants, beginning-of-year2021-07-01893
Total number of active participants reported on line 7a of the Form 55002021-07-01715
Number of retired or separated participants receiving benefits2021-07-014
Number of other retired or separated participants entitled to future benefits2021-07-01181
Total of all active and inactive participants2021-07-01900
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-07-010
Total participants2021-07-01900
Number of participants with account balances2021-07-01900
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-07-0125
2020: HRBC 401(K) PLAN FOR UFCW COLLECTIVE 2020 401k membership
Total participants, beginning-of-year2020-07-01928
Total number of active participants reported on line 7a of the Form 55002020-07-01720
Number of retired or separated participants receiving benefits2020-07-011
Number of other retired or separated participants entitled to future benefits2020-07-01172
Total of all active and inactive participants2020-07-01893
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-07-010
Total participants2020-07-01893
Number of participants with account balances2020-07-01893
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-07-0121
2019: HRBC 401(K) PLAN FOR UFCW COLLECTIVE 2019 401k membership
Total participants, beginning-of-year2019-07-01800
Total number of active participants reported on line 7a of the Form 55002019-07-01741
Number of retired or separated participants receiving benefits2019-07-011
Number of other retired or separated participants entitled to future benefits2019-07-01136
Total of all active and inactive participants2019-07-01878
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-07-010
Total participants2019-07-01878
Number of participants with account balances2019-07-01878
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-07-011
2018: HRBC 401(K) PLAN FOR UFCW COLLECTIVE 2018 401k membership
Total participants, beginning-of-year2018-07-01725
Total number of active participants reported on line 7a of the Form 55002018-07-01663
Number of retired or separated participants receiving benefits2018-07-011
Number of other retired or separated participants entitled to future benefits2018-07-01136
Total of all active and inactive participants2018-07-01800
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-07-010
Total participants2018-07-01800
Number of participants with account balances2018-07-01800
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-07-011

Financial Data on HRBC 401(K) PLAN FOR UFCW COLLECTIVE

Measure Date Value
2022 : HRBC 401(K) PLAN FOR UFCW COLLECTIVE 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-06-30$0
Total income from all sources (including contributions)2022-06-30$-907,087
Total loss/gain on sale of assets2022-06-30$0
Total of all expenses incurred2022-06-30$1,297,372
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-06-30$1,264,133
Expenses. Certain deemed distributions of participant loans2022-06-30$-14
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-06-30$1,363,490
Value of total assets at end of year2022-06-30$15,667,299
Value of total assets at beginning of year2022-06-30$17,871,758
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-06-30$33,253
Total interest from all sources2022-06-30$48,713
Total dividends received (eg from common stock, registered investment company shares)2022-06-30$127,792
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2022-06-30$127,792
Was this plan covered by a fidelity bond2022-06-30No
If this is an individual account plan, was there a blackout period2022-06-30No
Were there any nonexempt tranactions with any party-in-interest2022-06-30No
Contributions received from participants2022-06-30$394,393
Participant contributions at end of year2022-06-30$685,067
Participant contributions at beginning of year2022-06-30$516,564
Other income not declared elsewhere2022-06-30$-116,920
Administrative expenses (other) incurred2022-06-30$33,253
Total non interest bearing cash at end of year2022-06-30$0
Total non interest bearing cash at beginning of year2022-06-30$137
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-06-30No
Value of net income/loss2022-06-30$-2,204,459
Value of net assets at end of year (total assets less liabilities)2022-06-30$15,667,299
Value of net assets at beginning of year (total assets less liabilities)2022-06-30$17,871,758
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2022-06-30No
Were any leases to which the plan was party in default or uncollectible2022-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-06-30$9,788,274
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-06-30$14,914,147
Value of interest in pooled separate accounts at end of year2022-06-30$2,655,000
Value of interest in pooled separate accounts at beginning of year2022-06-30$0
Interest on participant loans2022-06-30$27,937
Interest earned on other investments2022-06-30$20,776
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-06-30$2,538,958
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-06-30$2,440,910
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-06-30$-1,741,809
Net investment gain/loss from pooled separate accounts2022-06-30$-588,353
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-06-30No
Was there a failure to transmit to the plan any participant contributions2022-06-30Yes
Has the plan failed to provide any benefit when due under the plan2022-06-30No
Contributions received in cash from employer2022-06-30$969,097
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-06-30$1,264,133
Did the plan have assets held for investment2022-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-06-30No
Opinion of an independent qualified public accountant for this plan2022-06-30Unqualified
Accountancy firm name2022-06-30HUDSON HENDERSON & COMPANY, INC.
Accountancy firm EIN2022-06-30811741762
2021 : HRBC 401(K) PLAN FOR UFCW COLLECTIVE 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-06-30$0
Total income from all sources (including contributions)2021-06-30$5,139,988
Total loss/gain on sale of assets2021-06-30$0
Total of all expenses incurred2021-06-30$916,451
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-06-30$864,559
Expenses. Certain deemed distributions of participant loans2021-06-30$19,768
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-06-30$1,288,168
Value of total assets at end of year2021-06-30$17,871,758
Value of total assets at beginning of year2021-06-30$13,648,221
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-06-30$32,124
Total interest from all sources2021-06-30$52,386
Total dividends received (eg from common stock, registered investment company shares)2021-06-30$119,875
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2021-06-30$119,875
Was this plan covered by a fidelity bond2021-06-30No
If this is an individual account plan, was there a blackout period2021-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-06-30$0
Were there any nonexempt tranactions with any party-in-interest2021-06-30No
Contributions received from participants2021-06-30$366,829
Participant contributions at end of year2021-06-30$516,564
Participant contributions at beginning of year2021-06-30$651,185
Other income not declared elsewhere2021-06-30$136
Administrative expenses (other) incurred2021-06-30$32,124
Total non interest bearing cash at end of year2021-06-30$137
Total non interest bearing cash at beginning of year2021-06-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-06-30No
Value of net income/loss2021-06-30$4,223,537
Value of net assets at end of year (total assets less liabilities)2021-06-30$17,871,758
Value of net assets at beginning of year (total assets less liabilities)2021-06-30$13,648,221
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2021-06-30No
Were any leases to which the plan was party in default or uncollectible2021-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-06-30$14,914,147
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-06-30$11,092,961
Interest on participant loans2021-06-30$30,442
Interest earned on other investments2021-06-30$21,944
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-06-30$2,440,910
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-06-30$1,904,075
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-06-30$3,679,423
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-06-30No
Was there a failure to transmit to the plan any participant contributions2021-06-30Yes
Has the plan failed to provide any benefit when due under the plan2021-06-30No
Contributions received in cash from employer2021-06-30$921,339
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-06-30$864,559
Did the plan have assets held for investment2021-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-06-30No
Opinion of an independent qualified public accountant for this plan2021-06-30Disclaimer
Accountancy firm name2021-06-30HUDSON HENDERSON & COMPANY, INC.
Accountancy firm EIN2021-06-30811741762
2020 : HRBC 401(K) PLAN FOR UFCW COLLECTIVE 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-06-30$0
Total income from all sources (including contributions)2020-06-30$1,984,083
Total loss/gain on sale of assets2020-06-30$0
Total of all expenses incurred2020-06-30$1,081,817
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-06-30$1,034,567
Expenses. Certain deemed distributions of participant loans2020-06-30$15,136
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-06-30$1,297,627
Value of total assets at end of year2020-06-30$13,648,221
Value of total assets at beginning of year2020-06-30$12,745,955
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-06-30$32,114
Total interest from all sources2020-06-30$59,442
Total dividends received (eg from common stock, registered investment company shares)2020-06-30$157,914
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2020-06-30$157,914
Was this plan covered by a fidelity bond2020-06-30No
If this is an individual account plan, was there a blackout period2020-06-30No
Were there any nonexempt tranactions with any party-in-interest2020-06-30No
Contributions received from participants2020-06-30$355,239
Participant contributions at end of year2020-06-30$651,185
Participant contributions at beginning of year2020-06-30$753,886
Income. Received or receivable in cash from other sources (including rollovers)2020-06-30$38,345
Administrative expenses (other) incurred2020-06-30$32,114
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-06-30No
Value of net income/loss2020-06-30$902,266
Value of net assets at end of year (total assets less liabilities)2020-06-30$13,648,221
Value of net assets at beginning of year (total assets less liabilities)2020-06-30$12,745,955
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2020-06-30No
Were any leases to which the plan was party in default or uncollectible2020-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-06-30$11,092,961
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-06-30$10,232,680
Interest on participant loans2020-06-30$38,009
Interest earned on other investments2020-06-30$21,433
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-06-30$1,904,075
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-06-30$1,759,389
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-06-30$469,100
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-06-30No
Was there a failure to transmit to the plan any participant contributions2020-06-30No
Has the plan failed to provide any benefit when due under the plan2020-06-30No
Contributions received in cash from employer2020-06-30$904,043
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-06-30$1,034,567
Did the plan have assets held for investment2020-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-06-30Yes
Opinion of an independent qualified public accountant for this plan2020-06-30Disclaimer
Accountancy firm name2020-06-30K-COE ISOM
Accountancy firm EIN2020-06-30480567703
2019 : HRBC 401(K) PLAN FOR UFCW COLLECTIVE 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-06-30$0
Total income from all sources (including contributions)2019-06-30$1,489,636
Total loss/gain on sale of assets2019-06-30$0
Total of all expenses incurred2019-06-30$725,550
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-06-30$687,271
Expenses. Certain deemed distributions of participant loans2019-06-30$2,921
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-06-30$796,774
Value of total assets at end of year2019-06-30$12,745,955
Value of total assets at beginning of year2019-06-30$11,981,869
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-06-30$35,358
Total interest from all sources2019-06-30$56,598
Total dividends received (eg from common stock, registered investment company shares)2019-06-30$138,889
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2019-06-30$138,889
Was this plan covered by a fidelity bond2019-06-30No
If this is an individual account plan, was there a blackout period2019-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-06-30$0
Were there any nonexempt tranactions with any party-in-interest2019-06-30No
Contributions received from participants2019-06-30$269,551
Participant contributions at end of year2019-06-30$753,886
Participant contributions at beginning of year2019-06-30$748,695
Other income not declared elsewhere2019-06-30$-4,172
Administrative expenses (other) incurred2019-06-30$35,358
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-06-30No
Value of net income/loss2019-06-30$764,086
Value of net assets at end of year (total assets less liabilities)2019-06-30$12,745,955
Value of net assets at beginning of year (total assets less liabilities)2019-06-30$11,981,869
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2019-06-30No
Were any leases to which the plan was party in default or uncollectible2019-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-06-30$10,232,680
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-06-30$9,719,198
Interest on participant loans2019-06-30$37,653
Interest earned on other investments2019-06-30$18,945
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-06-30$1,759,389
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-06-30$1,513,976
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-06-30$501,547
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-06-30No
Was there a failure to transmit to the plan any participant contributions2019-06-30No
Has the plan failed to provide any benefit when due under the plan2019-06-30No
Contributions received in cash from employer2019-06-30$527,223
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-06-30$687,271
Did the plan have assets held for investment2019-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-06-30Yes
Opinion of an independent qualified public accountant for this plan2019-06-30Disclaimer
Accountancy firm name2019-06-30K-COE ISOM
Accountancy firm EIN2019-06-30480567703

Form 5500 Responses for HRBC 401(K) PLAN FOR UFCW COLLECTIVE

2021: HRBC 401(K) PLAN FOR UFCW COLLECTIVE 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Submission has been amendedNo
2021-07-01This submission is the final filingNo
2021-07-01This return/report is a short plan year return/report (less than 12 months)No
2021-07-01Plan is a collectively bargained planYes
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan funding arrangement – TrustYes
2021-07-01Plan benefit arrangement – InsuranceYes
2021-07-01Plan benefit arrangement - TrustYes
2020: HRBC 401(K) PLAN FOR UFCW COLLECTIVE 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Submission has been amendedYes
2020-07-01This submission is the final filingNo
2020-07-01This return/report is a short plan year return/report (less than 12 months)No
2020-07-01Plan is a collectively bargained planYes
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – TrustYes
2020-07-01Plan benefit arrangement – InsuranceYes
2020-07-01Plan benefit arrangement - TrustYes
2019: HRBC 401(K) PLAN FOR UFCW COLLECTIVE 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Submission has been amendedNo
2019-07-01This submission is the final filingNo
2019-07-01This return/report is a short plan year return/report (less than 12 months)No
2019-07-01Plan is a collectively bargained planYes
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan funding arrangement – TrustYes
2019-07-01Plan benefit arrangement – InsuranceYes
2019-07-01Plan benefit arrangement - TrustYes
2018: HRBC 401(K) PLAN FOR UFCW COLLECTIVE 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Submission has been amendedNo
2018-07-01This submission is the final filingNo
2018-07-01This return/report is a short plan year return/report (less than 12 months)No
2018-07-01Plan is a collectively bargained planYes
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan funding arrangement – TrustYes
2018-07-01Plan benefit arrangement – InsuranceYes
2018-07-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number040068
Policy instance 1
Insurance contract or identification number040068
Number of Individuals Covered900
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $10,327
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
Amount paid for insurance broker fees10327
Additional information about fees paid to insurance brokerSERVICES TO INSURER OR PLAN
Insurance broker organization code?4
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number106510
Policy instance 1
Insurance contract or identification number106510
Number of Individuals Covered893
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $6,694
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
Amount paid for insurance broker fees6694
Additional information about fees paid to insurance brokerSERVICES TO INSURER OR PLAN
Insurance broker organization code?4
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number106510
Policy instance 1
Insurance contract or identification number106510
Number of Individuals Covered878
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $5,347
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
Amount paid for insurance broker fees5347
Additional information about fees paid to insurance brokerSERVICES TO INSURER OR PLAN
Insurance broker organization code?4
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number106510
Policy instance 1
Insurance contract or identification number106510
Number of Individuals Covered800
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $4,732
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees4732
Additional information about fees paid to insurance brokerSERVICES TO INSURER OR PLAN
Insurance broker organization code?4

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