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IBSS 401(K) PLAN 401k Plan overview

Plan NameIBSS 401(K) PLAN
Plan identification number 001

IBSS 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.
  • 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

INTERNATIONAL BUSINESS SALES & SERVICES CORP. has sponsored the creation of one or more 401k plans.

Company Name:INTERNATIONAL BUSINESS SALES & SERVICES CORP.
Employer identification number (EIN):521765836
NAIC Classification:541990
NAIC Description:All Other Professional, Scientific, and Technical Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan IBSS 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-05-01
0012022-05-01
0012021-05-01
0012020-05-01
0012019-05-01
0012018-05-01BRUCE ARVAND2019-11-08
0012017-05-01BRUCE ARVAND2018-11-29
0012016-05-01BRUCE ARVAND2018-01-25
0012015-05-01BRUCE ARVAND2016-10-05
0012014-05-01BRUCE ARVAND2015-12-17
0012013-05-01BRUCE ARVAND2015-01-24
0012012-05-01BRUCE ARVAND2013-06-24
0012011-05-01BEHROUZ HADAEGH2012-11-30 BEHROUZ HADAEGH2012-11-30
0012010-05-01BEHROUZ HADAEGH2011-10-05 BEHROUZ HADAEGH2011-10-05

Plan Statistics for IBSS 401(K) PLAN

401k plan membership statisitcs for IBSS 401(K) PLAN

Measure Date Value
2022: IBSS 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-05-01263
Total number of active participants reported on line 7a of the Form 55002022-05-01228
Number of retired or separated participants receiving benefits2022-05-010
Number of other retired or separated participants entitled to future benefits2022-05-0185
Total of all active and inactive participants2022-05-01313
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-05-010
Total participants2022-05-01313
Number of participants with account balances2022-05-01223
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-05-010
2021: IBSS 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-05-01225
Total number of active participants reported on line 7a of the Form 55002021-05-01186
Number of retired or separated participants receiving benefits2021-05-010
Number of other retired or separated participants entitled to future benefits2021-05-0177
Total of all active and inactive participants2021-05-01263
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-05-010
Total participants2021-05-01263
Number of participants with account balances2021-05-01201
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-05-010
2020: IBSS 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-05-01148
Total number of active participants reported on line 7a of the Form 55002020-05-01164
Number of retired or separated participants receiving benefits2020-05-010
Number of other retired or separated participants entitled to future benefits2020-05-0161
Total of all active and inactive participants2020-05-01225
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-05-010
Total participants2020-05-01225
Number of participants with account balances2020-05-01165
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-05-010
2019: IBSS 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-05-01124
Total number of active participants reported on line 7a of the Form 55002019-05-01121
Number of retired or separated participants receiving benefits2019-05-010
Number of other retired or separated participants entitled to future benefits2019-05-0127
Total of all active and inactive participants2019-05-01148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-05-010
Total participants2019-05-01148
Number of participants with account balances2019-05-01114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-05-010

Financial Data on IBSS 401(K) PLAN

Measure Date Value
2023 : IBSS 401(K) PLAN 2023 401k financial data
Total unrealized appreciation/depreciation of assets2023-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-04-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-04-30$0
Total income from all sources (including contributions)2023-04-30$1,504,041
Total loss/gain on sale of assets2023-04-30$0
Total of all expenses incurred2023-04-30$433,215
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-04-30$408,554
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-04-30$1,459,723
Value of total assets at end of year2023-04-30$7,191,002
Value of total assets at beginning of year2023-04-30$6,120,176
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-04-30$24,661
Total interest from all sources2023-04-30$545
Total dividends received (eg from common stock, registered investment company shares)2023-04-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-04-30No
Was this plan covered by a fidelity bond2023-04-30Yes
Value of fidelity bond cover2023-04-30$500,000
If this is an individual account plan, was there a blackout period2023-04-30No
Were there any nonexempt tranactions with any party-in-interest2023-04-30No
Contributions received from participants2023-04-30$900,531
Participant contributions at end of year2023-04-30$28,678
Participant contributions at beginning of year2023-04-30$21,952
Income. Received or receivable in cash from other sources (including rollovers)2023-04-30$137,112
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-04-30No
Value of net income/loss2023-04-30$1,070,826
Value of net assets at end of year (total assets less liabilities)2023-04-30$7,191,002
Value of net assets at beginning of year (total assets less liabilities)2023-04-30$6,120,176
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2023-04-30No
Were any leases to which the plan was party in default or uncollectible2023-04-30No
Value of interest in pooled separate accounts at end of year2023-04-30$5,355,073
Value of interest in pooled separate accounts at beginning of year2023-04-30$4,319,843
Interest on participant loans2023-04-30$545
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2023-04-30$1,807,251
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2023-04-30$1,778,381
Net investment gain/loss from registered investment companies (e.g. mutual funds)2023-04-30$18,739
Net investment gain/loss from pooled separate accounts2023-04-30$25,034
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-04-30No
Was there a failure to transmit to the plan any participant contributions2023-04-30No
Has the plan failed to provide any benefit when due under the plan2023-04-30No
Contributions received in cash from employer2023-04-30$422,080
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-04-30$408,554
Contract administrator fees2023-04-30$24,661
Did the plan have assets held for investment2023-04-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-04-30No
Opinion of an independent qualified public accountant for this plan2023-04-30Unqualified
Accountancy firm name2023-04-30PENSION ASSURANCE LLP
Accountancy firm EIN2023-04-30300840934
2022 : IBSS 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-04-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-04-30$0
Total income from all sources (including contributions)2022-04-30$1,236,980
Total loss/gain on sale of assets2022-04-30$0
Total of all expenses incurred2022-04-30$690,969
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-04-30$666,604
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-04-30$1,449,548
Value of total assets at end of year2022-04-30$6,120,176
Value of total assets at beginning of year2022-04-30$5,574,165
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-04-30$24,365
Total interest from all sources2022-04-30$590
Total dividends received (eg from common stock, registered investment company shares)2022-04-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-04-30No
Was this plan covered by a fidelity bond2022-04-30Yes
Value of fidelity bond cover2022-04-30$500,000
If this is an individual account plan, was there a blackout period2022-04-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2022-04-30$0
Were there any nonexempt tranactions with any party-in-interest2022-04-30No
Contributions received from participants2022-04-30$909,259
Participant contributions at end of year2022-04-30$21,952
Participant contributions at beginning of year2022-04-30$22,311
Income. Received or receivable in cash from other sources (including rollovers)2022-04-30$121,400
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-04-30No
Value of net income/loss2022-04-30$546,011
Value of net assets at end of year (total assets less liabilities)2022-04-30$6,120,176
Value of net assets at beginning of year (total assets less liabilities)2022-04-30$5,574,165
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2022-04-30No
Were any leases to which the plan was party in default or uncollectible2022-04-30No
Value of interest in pooled separate accounts at end of year2022-04-30$4,319,843
Value of interest in pooled separate accounts at beginning of year2022-04-30$3,894,993
Interest on participant loans2022-04-30$590
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-04-30$1,778,381
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-04-30$1,656,861
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-04-30$14,614
Net investment gain/loss from pooled separate accounts2022-04-30$-227,772
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-04-30No
Was there a failure to transmit to the plan any participant contributions2022-04-30No
Has the plan failed to provide any benefit when due under the plan2022-04-30No
Contributions received in cash from employer2022-04-30$418,889
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-04-30$666,604
Contract administrator fees2022-04-30$24,365
Did the plan have assets held for investment2022-04-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-04-30No
Opinion of an independent qualified public accountant for this plan2022-04-30Disclaimer
Accountancy firm name2022-04-30OWINGS AND COMPANY PLLC
Accountancy firm EIN2022-04-30471066660
2021 : IBSS 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-04-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-04-30$0
Total income from all sources (including contributions)2021-04-30$2,261,445
Total loss/gain on sale of assets2021-04-30$0
Total of all expenses incurred2021-04-30$369,240
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-04-30$352,958
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-04-30$1,170,983
Value of total assets at end of year2021-04-30$5,574,165
Value of total assets at beginning of year2021-04-30$3,681,960
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-04-30$16,282
Total interest from all sources2021-04-30$1,768
Total dividends received (eg from common stock, registered investment company shares)2021-04-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-04-30No
Was this plan covered by a fidelity bond2021-04-30Yes
Value of fidelity bond cover2021-04-30$500,000
If this is an individual account plan, was there a blackout period2021-04-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-04-30$0
Were there any nonexempt tranactions with any party-in-interest2021-04-30No
Contributions received from participants2021-04-30$693,813
Participant contributions at end of year2021-04-30$22,311
Participant contributions at beginning of year2021-04-30$48,823
Income. Received or receivable in cash from other sources (including rollovers)2021-04-30$144,344
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-04-30No
Value of net income/loss2021-04-30$1,892,205
Value of net assets at end of year (total assets less liabilities)2021-04-30$5,574,165
Value of net assets at beginning of year (total assets less liabilities)2021-04-30$3,681,960
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2021-04-30No
Were any leases to which the plan was party in default or uncollectible2021-04-30No
Value of interest in pooled separate accounts at end of year2021-04-30$3,894,993
Value of interest in pooled separate accounts at beginning of year2021-04-30$2,215,119
Interest on participant loans2021-04-30$1,768
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-04-30$1,656,861
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-04-30$1,418,018
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-04-30$13,857
Net investment gain/loss from pooled separate accounts2021-04-30$1,074,837
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-04-30No
Was there a failure to transmit to the plan any participant contributions2021-04-30No
Has the plan failed to provide any benefit when due under the plan2021-04-30No
Contributions received in cash from employer2021-04-30$332,826
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-04-30$352,958
Contract administrator fees2021-04-30$16,282
Did the plan have assets held for investment2021-04-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-04-30No
Opinion of an independent qualified public accountant for this plan2021-04-30Disclaimer
Accountancy firm name2021-04-30OWINGS AND COMPANY PLLC
Accountancy firm EIN2021-04-30471066660
2020 : IBSS 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-04-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-04-30$0
Total income from all sources (including contributions)2020-04-30$529,699
Total loss/gain on sale of assets2020-04-30$0
Total of all expenses incurred2020-04-30$286,894
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-04-30$277,521
Value of total corrective distributions2020-04-30$89
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-04-30$847,357
Value of total assets at end of year2020-04-30$3,681,960
Value of total assets at beginning of year2020-04-30$3,439,155
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-04-30$9,284
Total interest from all sources2020-04-30$3,069
Total dividends received (eg from common stock, registered investment company shares)2020-04-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-04-30No
Was this plan covered by a fidelity bond2020-04-30Yes
Value of fidelity bond cover2020-04-30$500,000
If this is an individual account plan, was there a blackout period2020-04-30No
Were there any nonexempt tranactions with any party-in-interest2020-04-30No
Contributions received from participants2020-04-30$566,505
Participant contributions at end of year2020-04-30$48,823
Participant contributions at beginning of year2020-04-30$35,922
Income. Received or receivable in cash from other sources (including rollovers)2020-04-30$2,944
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-04-30No
Value of net income/loss2020-04-30$242,805
Value of net assets at end of year (total assets less liabilities)2020-04-30$3,681,960
Value of net assets at beginning of year (total assets less liabilities)2020-04-30$3,439,155
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2020-04-30No
Were any leases to which the plan was party in default or uncollectible2020-04-30No
Value of interest in pooled separate accounts at end of year2020-04-30$2,215,119
Value of interest in pooled separate accounts at beginning of year2020-04-30$2,974,897
Interest on participant loans2020-04-30$3,069
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-04-30$1,418,018
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-04-30$428,336
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-04-30$6,820
Net investment gain/loss from pooled separate accounts2020-04-30$-327,547
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-04-30No
Was there a failure to transmit to the plan any participant contributions2020-04-30No
Has the plan failed to provide any benefit when due under the plan2020-04-30No
Contributions received in cash from employer2020-04-30$277,908
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-04-30$277,521
Contract administrator fees2020-04-30$9,284
Did the plan have assets held for investment2020-04-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-04-30Yes
Opinion of an independent qualified public accountant for this plan2020-04-30Disclaimer
Accountancy firm name2020-04-30OWINGS AND COMPANY PLLC
Accountancy firm EIN2020-04-30471066660

Form 5500 Responses for IBSS 401(K) PLAN

2022: IBSS 401(K) PLAN 2022 form 5500 responses
2022-05-01Type of plan entitySingle employer plan
2022-05-01Submission has been amendedNo
2022-05-01This submission is the final filingNo
2022-05-01This return/report is a short plan year return/report (less than 12 months)No
2022-05-01Plan is a collectively bargained planNo
2022-05-01Plan funding arrangement – InsuranceYes
2022-05-01Plan funding arrangement – TrustYes
2022-05-01Plan benefit arrangement – InsuranceYes
2022-05-01Plan benefit arrangement - TrustYes
2021: IBSS 401(K) PLAN 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01Submission has been amendedNo
2021-05-01This submission is the final filingNo
2021-05-01This return/report is a short plan year return/report (less than 12 months)No
2021-05-01Plan is a collectively bargained planNo
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan funding arrangement – TrustYes
2021-05-01Plan benefit arrangement – InsuranceYes
2021-05-01Plan benefit arrangement - TrustYes
2020: IBSS 401(K) PLAN 2020 form 5500 responses
2020-05-01Type of plan entitySingle employer plan
2020-05-01Submission has been amendedNo
2020-05-01This submission is the final filingNo
2020-05-01This return/report is a short plan year return/report (less than 12 months)No
2020-05-01Plan is a collectively bargained planNo
2020-05-01Plan funding arrangement – InsuranceYes
2020-05-01Plan funding arrangement – TrustYes
2020-05-01Plan benefit arrangement – InsuranceYes
2020-05-01Plan benefit arrangement - TrustYes
2019: IBSS 401(K) PLAN 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01Submission has been amendedNo
2019-05-01This submission is the final filingNo
2019-05-01This return/report is a short plan year return/report (less than 12 months)No
2019-05-01Plan is a collectively bargained planNo
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan funding arrangement – TrustYes
2019-05-01Plan benefit arrangement – InsuranceYes
2019-05-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberSAVE-16898
Policy instance 1
Insurance contract or identification numberSAVE-16898
Number of Individuals Covered223
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $15,931
Total amount of fees paid to insurance companyUSD $3,186
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 $15,931
Insurance broker organization code?3
Amount paid for insurance broker fees3186
Additional information about fees paid to insurance brokerFEES
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberSAVE-16898
Policy instance 1
Insurance contract or identification numberSAVE-16898
Number of Individuals Covered201
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $15,151
Total amount of fees paid to insurance companyUSD $3,030
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 $15,151
Insurance broker organization code?3
Amount paid for insurance broker fees3030
Additional information about fees paid to insurance brokerFEES
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberSAVE-16898
Policy instance 1
Insurance contract or identification numberSAVE-16898
Number of Individuals Covered165
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $11,081
Total amount of fees paid to insurance companyUSD $2,216
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 $11,081
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberSAVE-16898
Policy instance 1
Insurance contract or identification numberSAVE-16898
Number of Individuals Covered112
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $8,963
Total amount of fees paid to insurance companyUSD $1,793
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 $8,963
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSION
Insurance broker organization code?3

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