401k Plan data: DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN plan

DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN 401k Plan overview

Plan Name	DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN
Plan identification number	004

DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Money purchase (other than target benefit)
Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

DUANE R. WEENIG, DDS, PC has sponsored the creation of one or more 401k plans.

Company Name: DUANE R. WEENIG, DDS, PC

Employer identification number (EIN): 470878338

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
004 2022-01-01 JANET WEENIG 2023-09-05
004 2021-01-01 JANET WEENIG 2022-09-21
004 2020-01-01 DUANE R WEENIG DDS PC 2021-09-15
004 2019-01-01 DUANE R WEENIG DDS 2020-09-17
004 2018-01-01 DUANE R WEENIG DDS PC 2019-09-30
004 2017-01-01 DUANE R WEENIG DDS PC 2018-10-01
004 2016-01-01 DUANE R WEENIG DDS PC 2017-10-12
004 2015-01-01 DUANE R WEENIG DDS PC 2016-09-26
004 2014-01-01 DUANE R WEENIG DDS
004 2013-01-01 DUANE WEENIG
004 2012-01-01 DUANE WEENIG DUANE WEENIG 2013-10-14
004 2011-01-01 DUANE WEENIG
004 2009-01-01 DUANE WEENIG

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
004	2022-01-01	JANET WEENIG	2023-09-05
004	2021-01-01	JANET WEENIG	2022-09-21
004	2020-01-01	DUANE R WEENIG DDS PC	2021-09-15
004	2019-01-01	DUANE R WEENIG DDS	2020-09-17
004	2018-01-01	DUANE R WEENIG DDS PC	2019-09-30
004	2017-01-01	DUANE R WEENIG DDS PC	2018-10-01
004	2016-01-01	DUANE R WEENIG DDS PC	2017-10-12
004	2015-01-01	DUANE R WEENIG DDS PC	2016-09-26
004	2014-01-01	DUANE R WEENIG DDS
004	2013-01-01	DUANE WEENIG
004	2012-01-01	DUANE WEENIG		DUANE WEENIG	2013-10-14
004	2011-01-01	DUANE WEENIG
004	2009-01-01	DUANE WEENIG

Plan Statistics for DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN

401k plan membership statisitcs for DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN

Measure Date Value
2014: DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 10
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 9
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 1
Total of all active and inactive participants 2014-01-01 10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 10
Number of participants with account balances 2014-01-01 10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 10
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 11
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 11
Number of participants with account balances 2013-01-01 10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 11
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 10
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 10
Number of participants with account balances 2012-01-01 10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 11
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 11
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 11
Number of participants with account balances 2011-01-01 11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 9
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 10
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 2
Total of all active and inactive participants 2009-01-01 12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 12
Number of participants with account balances 2009-01-01 12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2014: DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	10
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	9
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	1
Total of all active and inactive participants	2014-01-01	10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	10
Number of participants with account balances	2014-01-01	10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	10
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	11
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	11
Number of participants with account balances	2013-01-01	10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	11
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	10
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	10
Number of participants with account balances	2012-01-01	10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	11
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	11
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	11
Number of participants with account balances	2011-01-01	11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	9
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	10
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	2
Total of all active and inactive participants	2009-01-01	12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	12
Number of participants with account balances	2009-01-01	12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN

Measure	Date	Value
2014 : DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN 2014 401k financial data
Transfers to/from the plan	2014-12-31	$0
Total income from all sources	2014-12-31	$98,215
Expenses. Total of all expenses incurred	2014-12-31	$12,231
Benefits paid (including direct rollovers)	2014-12-31	$12,079
Total plan assets at end of year	2014-12-31	$1,135,766
Total plan assets at beginning of year	2014-12-31	$1,049,782
Value of fidelity bond covering the plan	2014-12-31	$50,000
Total contributions received or receivable from participants	2014-12-31	$20,888
Expenses. Other expenses not covered elsewhere	2014-12-31	$152
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$61,304
Net income (gross income less expenses)	2014-12-31	$85,984
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$1,135,766
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$1,049,782
Assets. Value of participant loans	2014-12-31	$71,865
Total contributions received or receivable from employer(s)	2014-12-31	$16,023
Value of certain deemed distributions of participant loans	2014-12-31	$0
Value of corrective distributions	2014-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2014-12-31	$0
Minimum employer required contribution for this plan year	2014-12-31	$0
Amount contributed by the employer to the plan for this plan year	2014-12-31	$0
2013 : DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN 2013 401k financial data
Transfers to/from the plan	2013-12-31	$0
Total income from all sources	2013-12-31	$206,577
Expenses. Total of all expenses incurred	2013-12-31	$1,299
Benefits paid (including direct rollovers)	2013-12-31	$1,209
Total plan assets at end of year	2013-12-31	$1,049,782
Total plan assets at beginning of year	2013-12-31	$844,504
Value of fidelity bond covering the plan	2013-12-31	$50,000
Total contributions received or receivable from participants	2013-12-31	$27,046
Expenses. Other expenses not covered elsewhere	2013-12-31	$90
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$162,059
Net income (gross income less expenses)	2013-12-31	$205,278
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$1,049,782
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$844,504
Assets. Value of participant loans	2013-12-31	$32,410
Total contributions received or receivable from employer(s)	2013-12-31	$17,472
Value of certain deemed distributions of participant loans	2013-12-31	$0
Value of corrective distributions	2013-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2013-12-31	$0
Minimum employer required contribution for this plan year	2013-12-31	$0
Amount contributed by the employer to the plan for this plan year	2013-12-31	$0
2012 : DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN 2012 401k financial data
Transfers to/from the plan	2012-12-31	$0
Total income from all sources	2012-12-31	$148,426
Expenses. Total of all expenses incurred	2012-12-31	$58,692
Benefits paid (including direct rollovers)	2012-12-31	$58,598
Total plan assets at end of year	2012-12-31	$844,504
Total plan assets at beginning of year	2012-12-31	$754,770
Value of fidelity bond covering the plan	2012-12-31	$50,000
Total contributions received or receivable from participants	2012-12-31	$36,030
Expenses. Other expenses not covered elsewhere	2012-12-31	$94
Contributions received from other sources (not participants or employers)	2012-12-31	$0
Other income received	2012-12-31	$95,803
Net income (gross income less expenses)	2012-12-31	$89,734
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$844,504
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$754,770
Assets. Value of participant loans	2012-12-31	$15,590
Total contributions received or receivable from employer(s)	2012-12-31	$16,593
Value of certain deemed distributions of participant loans	2012-12-31	$0
Value of corrective distributions	2012-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2012-12-31	$0
Minimum employer required contribution for this plan year	2012-12-31	$0
Amount contributed by the employer to the plan for this plan year	2012-12-31	$0
2011 : DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN 2011 401k financial data
Transfers to/from the plan	2011-12-31	$0
Total income from all sources	2011-12-31	$32,400
Expenses. Total of all expenses incurred	2011-12-31	$32
Benefits paid (including direct rollovers)	2011-12-31	$0
Total plan assets at end of year	2011-12-31	$754,770
Total plan assets at beginning of year	2011-12-31	$722,402
Value of fidelity bond covering the plan	2011-12-31	$50,000
Total contributions received or receivable from participants	2011-12-31	$37,139
Expenses. Other expenses not covered elsewhere	2011-12-31	$32
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$-23,087
Net income (gross income less expenses)	2011-12-31	$32,368
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$754,770
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$722,402
Assets. Value of participant loans	2011-12-31	$20,634
Total contributions received or receivable from employer(s)	2011-12-31	$18,348
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2011-12-31	$0
Minimum employer required contribution for this plan year	2011-12-31	$0
Amount contributed by the employer to the plan for this plan year	2011-12-31	$0
2010 : DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN 2010 401k financial data
Transfers to/from the plan	2010-12-31	$0
Total income from all sources	2010-12-31	$125,330
Expenses. Total of all expenses incurred	2010-12-31	$7,112
Benefits paid (including direct rollovers)	2010-12-31	$7,080
Total plan assets at end of year	2010-12-31	$722,402
Total plan assets at beginning of year	2010-12-31	$604,184
Value of fidelity bond covering the plan	2010-12-31	$50,000
Total contributions received or receivable from participants	2010-12-31	$43,009
Expenses. Other expenses not covered elsewhere	2010-12-31	$32
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$64,578
Net income (gross income less expenses)	2010-12-31	$118,218
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$722,402
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$604,184
Assets. Value of participant loans	2010-12-31	$28,543
Total contributions received or receivable from employer(s)	2010-12-31	$17,743
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2010-12-31	$0
Minimum employer required contribution for this plan year	2010-12-31	$0
Amount contributed by the employer to the plan for this plan year	2010-12-31	$0
2009 : DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN 2009 401k financial data
Funding deficiency by the employer to the plan for this plan year	2009-12-31	$0
Minimum employer required contribution for this plan year	2009-12-31	$0
Amount contributed by the employer to the plan for this plan year	2009-12-31	$0

Form 5500 Responses for DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN

2014: DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: DUANE R. WEENIG, DDS, PC PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-812851

Policy instance

Insurance contract or identification number	GA-812851
Number of Individuals Covered	10
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $2,951
Total amount of fees paid to insurance company	USD $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 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
Commission paid to Insurance Broker	USD $2,951
Insurance broker organization code?	3
Insurance broker name	EDWARD D JONES & CO L P.

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-812851

Policy instance

Insurance contract or identification number	GA-812851
Number of Individuals Covered	10
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $2,639
Total amount of fees paid to insurance company	USD $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 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
Commission paid to Insurance Broker	USD $2,639
Insurance broker organization code?	3
Insurance broker name	EDWARD D JONES & CO

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-812851

Policy instance

Insurance contract or identification number	GA-812851
Number of Individuals Covered	10
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $2,460
Total amount of fees paid to insurance company	USD $777
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 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
Commission paid to Insurance Broker	USD $2,460
Insurance broker organization code?	3
Amount paid for insurance broker fees	777
Additional information about fees paid to insurance broker	SALES/MARKETING
Insurance broker name	EDWARD D JONES & CO

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-812851

Policy instance

Insurance contract or identification number	GA-812851
Number of Individuals Covered	11
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $2,334
Total amount of fees paid to insurance company	USD $715
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 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

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-812851

Policy instance

Insurance contract or identification number	GA-812851
Number of Individuals Covered	10
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $1,706
Total amount of fees paid to insurance company	USD $436
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 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
Commission paid to Insurance Broker	USD $1,706
Insurance broker organization code?	3
Amount paid for insurance broker fees	436
Additional information about fees paid to insurance broker	SALES/MARKETING
Insurance broker name	EDWARD D JONES & CO

Potentially related plans

DUANE R. DARNELL, D.O. PROFESSIONAL CORPORATION 401(K) PROFIT SHARING PLAN [EIN = 710945813]

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Company Name:	DUANE R. WEENIG, DDS, PC
Employer identification number (EIN):	470878338
NAIC Classification:	621210
NAIC Description:	Offices of Dentists