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SCHMUESER & ASSOCIATES, LLC 401(K) PLAN 401k Plan overview

Plan NameSCHMUESER & ASSOCIATES, LLC 401(K) PLAN
Plan identification number 004

SCHMUESER & ASSOCIATES, LLC 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • 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

SCHMUESER & ASSOCIATES, LLC has sponsored the creation of one or more 401k plans.

Company Name:SCHMUESER & ASSOCIATES, LLC
Employer identification number (EIN):475638973
NAIC Classification:237990
NAIC Description:Other Heavy and Civil Engineering Construction

Additional information about SCHMUESER & ASSOCIATES, LLC

Jurisdiction of Incorporation: Colorado Department of State
Incorporation Date: 2016-02-03
Company Identification Number: 20161089465
Legal Registered Office Address: 811 22 Rd

Grand Junction
United States of America (USA)
81505

More information about SCHMUESER & ASSOCIATES, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SCHMUESER & ASSOCIATES, LLC 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0042022-01-01LEONA DILLON2023-07-19 LEONA DILLON2023-07-19
0042021-01-01
0042020-01-01
0042019-01-01
0042018-01-01
0042017-01-012018-10-11
0042016-06-01GREGORY HAILEY
0042015-06-01GREGORY HAILEY

Plan Statistics for SCHMUESER & ASSOCIATES, LLC 401(K) PLAN

401k plan membership statisitcs for SCHMUESER & ASSOCIATES, LLC 401(K) PLAN

Measure Date Value
2020: SCHMUESER & ASSOCIATES, LLC 401(K) PLAN 2020 401k membership
Total of all active and inactive participants2020-01-010
2016: SCHMUESER & ASSOCIATES, LLC 401(K) PLAN 2016 401k membership
Total of all active and inactive participants2016-06-010
2015: SCHMUESER & ASSOCIATES, LLC 401(K) PLAN 2015 401k membership
Total of all active and inactive participants2015-06-010

Financial Data on SCHMUESER & ASSOCIATES, LLC 401(K) PLAN

Measure Date Value
2021 : SCHMUESER & ASSOCIATES, LLC 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total transfer of assets to this plan2021-12-31$30,634
Total transfer of assets from this plan2021-12-31$1,061,314
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$217,811
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$7,689
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$0
Value of total assets at end of year2021-12-31$1,267,644
Value of total assets at beginning of year2021-12-31$2,088,202
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$7,689
Total interest from all sources2021-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$0
Value of net income/loss2021-12-31$210,122
Value of net assets at end of year (total assets less liabilities)2021-12-31$1,267,644
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$2,088,202
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Investment advisory and management fees2021-12-31$3,903
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$1,267,644
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$2,088,202
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$217,811
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Contract administrator fees2021-12-31$3,786
Did the plan have assets held for investment2021-12-31Yes
2020 : SCHMUESER & ASSOCIATES, LLC 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total transfer of assets to this plan2020-12-31$97,662
Total transfer of assets from this plan2020-12-31$1,463,946
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$274,902
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$6,629
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$0
Value of total assets at end of year2020-12-31$2,088,202
Value of total assets at beginning of year2020-12-31$3,186,213
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$6,629
Total interest from all sources2020-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$0
Value of net income/loss2020-12-31$268,273
Value of net assets at end of year (total assets less liabilities)2020-12-31$2,088,202
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$3,186,213
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Investment advisory and management fees2020-12-31$3,645
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$2,088,202
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$3,186,213
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$274,902
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Contract administrator fees2020-12-31$2,984
Did the plan have assets held for investment2020-12-31Yes
2019 : SCHMUESER & ASSOCIATES, LLC 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total transfer of assets to this plan2019-12-31$249,786
Total transfer of assets from this plan2019-12-31$863,639
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$598,080
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$9,545
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$0
Value of total assets at end of year2019-12-31$3,186,213
Value of total assets at beginning of year2019-12-31$3,211,531
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$9,545
Total interest from all sources2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$0
Other income not declared elsewhere2019-12-31$598,080
Value of net income/loss2019-12-31$588,535
Value of net assets at end of year (total assets less liabilities)2019-12-31$3,186,213
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$3,211,531
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Investment advisory and management fees2019-12-31$5,712
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$3,186,213
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$3,211,531
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Contract administrator fees2019-12-31$3,833
Did the plan have assets held for investment2019-12-31Yes
2018 : SCHMUESER & ASSOCIATES, LLC 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total transfer of assets to this plan2018-12-31$257,934
Total transfer of assets from this plan2018-12-31$64,319
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$-345,176
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$9,842
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$0
Value of total assets at end of year2018-12-31$3,211,531
Value of total assets at beginning of year2018-12-31$3,372,934
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$9,842
Total interest from all sources2018-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$0
Value of net income/loss2018-12-31$-355,018
Value of net assets at end of year (total assets less liabilities)2018-12-31$3,211,531
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$3,372,934
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Investment advisory and management fees2018-12-31$5,721
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$3,211,531
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$3,372,934
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-345,176
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Contract administrator fees2018-12-31$4,121
Did the plan have assets held for investment2018-12-31Yes
2017 : SCHMUESER & ASSOCIATES, LLC 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$521,935
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$0
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$0
Value of total assets at end of year2017-12-31$3,372,934
Value of total assets at beginning of year2017-12-31$2,850,999
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$0
Total interest from all sources2017-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$119
Administrative expenses (other) incurred2017-12-31$0
Value of net income/loss2017-12-31$521,935
Value of net assets at end of year (total assets less liabilities)2017-12-31$3,372,934
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$2,850,999
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$3,372,934
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$2,717,575
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$133,305
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$521,935
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Did the plan have assets held for investment2017-12-31Yes
2016 : SCHMUESER & ASSOCIATES, LLC 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total transfer of assets to this plan2016-12-31$61,611
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total income from all sources (including contributions)2016-12-31$134,290
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$1,360
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$0
Value of total assets at end of year2016-12-31$2,830,107
Value of total assets at beginning of year2016-12-31$2,635,566
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$1,360
Total interest from all sources2016-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$119
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$144
Administrative expenses (other) incurred2016-12-31$1,360
Value of net income/loss2016-12-31$132,930
Value of net assets at end of year (total assets less liabilities)2016-12-31$2,830,107
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$2,635,566
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$2,798,936
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$2,604,658
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$31,052
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$30,764
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$134,290
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Did the plan have assets held for investment2016-12-31Yes
Total unrealized appreciation/depreciation of assets2016-05-31$0
Total transfer of assets from this plan2016-05-31$175,526
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-05-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-05-31$0
Total income from all sources (including contributions)2016-05-31$-65,692
Total loss/gain on sale of assets2016-05-31$0
Total of all expenses incurred2016-05-31$1,929
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-05-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-05-31$0
Value of total assets at end of year2016-05-31$2,635,566
Value of total assets at beginning of year2016-05-31$2,878,713
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-05-31$1,929
Total interest from all sources2016-05-31$0
Total dividends received (eg from common stock, registered investment company shares)2016-05-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-05-31No
Were there any nonexempt tranactions with any party-in-interest2016-05-31No
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-05-31$144
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-05-31$179
Administrative expenses (other) incurred2016-05-31$1,929
Value of net income/loss2016-05-31$-67,621
Value of net assets at end of year (total assets less liabilities)2016-05-31$2,635,566
Value of net assets at beginning of year (total assets less liabilities)2016-05-31$2,878,713
Were any loans by the plan or fixed income obligations due to the plan in default2016-05-31No
Were any leases to which the plan was party in default or uncollectible2016-05-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-05-31$2,604,658
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-05-31$2,795,563
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-05-31$30,764
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-05-31$82,971
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-05-31$-65,692
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-05-31No
Did the plan have assets held for investment2016-05-31Yes

Form 5500 Responses for SCHMUESER & ASSOCIATES, LLC 401(K) PLAN

2021: SCHMUESER & ASSOCIATES, LLC 401(K) PLAN 2021 form 5500 responses
2021-01-01Type of plan entityDFE (Diect Filing Entity)
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2020: SCHMUESER & ASSOCIATES, LLC 401(K) PLAN 2020 form 5500 responses
2020-01-01Type of plan entityDFE (Diect Filing Entity)
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2019: SCHMUESER & ASSOCIATES, LLC 401(K) PLAN 2019 form 5500 responses
2019-01-01Type of plan entityDFE (Diect Filing Entity)
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2018: SCHMUESER & ASSOCIATES, LLC 401(K) PLAN 2018 form 5500 responses
2018-01-01Type of plan entityDFE (Diect Filing Entity)
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2017: SCHMUESER & ASSOCIATES, LLC 401(K) PLAN 2017 form 5500 responses
2017-01-01Type of plan entityDFE (Diect Filing Entity)
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2016: SCHMUESER & ASSOCIATES, LLC 401(K) PLAN 2016 form 5500 responses
2016-06-01Type of plan entityDFE (Diect Filing Entity)
2016-06-01Submission has been amendedNo
2016-06-01This submission is the final filingNo
2016-06-01This return/report is a short plan year return/report (less than 12 months)Yes
2016-06-01Plan is a collectively bargained planNo
2015: SCHMUESER & ASSOCIATES, LLC 401(K) PLAN 2015 form 5500 responses
2015-06-01Type of plan entityDFE (Diect Filing Entity)
2015-06-01Submission has been amendedNo
2015-06-01This submission is the final filingNo
2015-06-01This return/report is a short plan year return/report (less than 12 months)No
2015-06-01Plan is a collectively bargained planNo

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-B2-XW45
Policy instance 1
Insurance contract or identification numberGAP-B2-XW45
Number of Individuals Covered0
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $87
Total amount of fees paid to insurance companyUSD $22
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $87
Insurance broker organization code?3
Amount paid for insurance broker fees22
Additional information about fees paid to insurance brokerADMINISTRATIVE FEES PAID BY NATIONWIDE LIFE INSURANCE COMPANY
Insurance broker nameNATHAN CARLSON

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