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THE FISHER HOUSING COMPANIES, INC. 401(K) PLAN 401k Plan overview

Plan NameTHE FISHER HOUSING COMPANIES, INC. 401(K) PLAN
Plan identification number 001

THE FISHER HOUSING COMPANIES, INC. 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

THE FISHER HOUSING COMPANIES INC has sponsored the creation of one or more 401k plans.

Company Name:THE FISHER HOUSING COMPANIES INC
Employer identification number (EIN):562241059
NAIC Classification:441228
NAIC Description:Motorcycle, ATV, and All Other Motor Vehicle Dealers

Additional information about THE FISHER HOUSING COMPANIES INC

Jurisdiction of Incorporation: North Carolina Secretary of State
Incorporation Date:
Company Identification Number: 0581175

More information about THE FISHER HOUSING COMPANIES INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE FISHER HOUSING COMPANIES, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012018-01-01DONALD FISHER2019-04-17
0012017-01-01DONALD FISHER2018-04-24
0012016-01-01DONALD FISHER2017-03-29
0012015-01-01
0012014-01-01DONNA J. WHEELER DONALD D. FISHER2015-07-15
0012013-01-01DONNA WHEELER
0012012-01-01DONNA WHEELER
0012011-01-01DONNA WHEELER
0012009-01-01DONNA WHEELER
0012009-01-01DONNA WHEELER DONALD D. FISHER, JR.2010-07-16
0012009-01-01DONNA WHEELER DONALD D. FISHER, JR.2010-07-16

Plan Statistics for THE FISHER HOUSING COMPANIES, INC. 401(K) PLAN

401k plan membership statisitcs for THE FISHER HOUSING COMPANIES, INC. 401(K) PLAN

Measure Date Value
2015: THE FISHER HOUSING COMPANIES, INC. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0119
Total number of active participants reported on line 7a of the Form 55002015-01-017
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-014
Total of all active and inactive participants2015-01-0111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0111
Number of participants with account balances2015-01-0111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: THE FISHER HOUSING COMPANIES, INC. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0119
Total number of active participants reported on line 7a of the Form 55002014-01-015
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0114
Total of all active and inactive participants2014-01-0119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0119
Number of participants with account balances2014-01-0119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: THE FISHER HOUSING COMPANIES, INC. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0123
Total number of active participants reported on line 7a of the Form 55002013-01-018
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0113
Total of all active and inactive participants2013-01-0121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0121
Number of participants with account balances2013-01-0121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: THE FISHER HOUSING COMPANIES, INC. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0124
Total number of active participants reported on line 7a of the Form 55002012-01-0110
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0115
Total of all active and inactive participants2012-01-0125
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0125
Number of participants with account balances2012-01-0110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: THE FISHER HOUSING COMPANIES, INC. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0127
Total number of active participants reported on line 7a of the Form 55002011-01-0111
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-0116
Total of all active and inactive participants2011-01-0127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0127
Number of participants with account balances2011-01-0127
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: THE FISHER HOUSING COMPANIES, INC. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0155
Total number of active participants reported on line 7a of the Form 55002009-01-0121
Number of retired or separated participants receiving benefits2009-01-011
Number of other retired or separated participants entitled to future benefits2009-01-0121
Total of all active and inactive participants2009-01-0143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0143
Number of participants with account balances2009-01-0140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-011

Financial Data on THE FISHER HOUSING COMPANIES, INC. 401(K) PLAN

Measure Date Value
2015 : THE FISHER HOUSING COMPANIES, INC. 401(K) PLAN 2015 401k financial data
Total income from all sources2015-12-31$-8,228
Expenses. Total of all expenses incurred2015-12-31$32,559
Benefits paid (including direct rollovers)2015-12-31$22,118
Total plan assets at end of year2015-12-31$951,367
Total plan assets at beginning of year2015-12-31$992,154
Value of fidelity bond covering the plan2015-12-31$100,000
Total contributions received or receivable from participants2015-12-31$22,728
Other income received2015-12-31$-30,956
Net income (gross income less expenses)2015-12-31$-40,787
Net plan assets at end of year (total assets less liabilities)2015-12-31$951,367
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$992,154
Assets. Value of participant loans2015-12-31$50,119
Total contributions received or receivable from employer(s)2015-12-31$0
Value of certain deemed distributions of participant loans2015-12-31$8,101
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$2,340
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : THE FISHER HOUSING COMPANIES, INC. 401(K) PLAN 2014 401k financial data
Transfers to/from the plan2014-12-31$0
Total income from all sources2014-12-31$97,574
Expenses. Total of all expenses incurred2014-12-31$290,172
Benefits paid (including direct rollovers)2014-12-31$289,907
Total plan assets at end of year2014-12-31$992,154
Total plan assets at beginning of year2014-12-31$1,184,752
Value of fidelity bond covering the plan2014-12-31$100,000
Total contributions received or receivable from participants2014-12-31$23,628
Expenses. Other expenses not covered elsewhere2014-12-31$265
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$73,946
Net income (gross income less expenses)2014-12-31$-192,598
Net plan assets at end of year (total assets less liabilities)2014-12-31$992,154
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$1,184,752
Assets. Value of participant loans2014-12-31$70,308
Total contributions received or receivable from employer(s)2014-12-31$0
Value of certain deemed distributions of participant loans2014-12-31$0
Value of corrective distributions2014-12-31$0
Funding deficiency by the employer to the plan for this plan year2014-12-31$0
Minimum employer required contribution for this plan year2014-12-31$0
Amount contributed by the employer to the plan for this plan year2014-12-31$0
2013 : THE FISHER HOUSING COMPANIES, INC. 401(K) PLAN 2013 401k financial data
Transfers to/from the plan2013-12-31$0
Total income from all sources2013-12-31$314,095
Expenses. Total of all expenses incurred2013-12-31$215,398
Benefits paid (including direct rollovers)2013-12-31$215,147
Total plan assets at end of year2013-12-31$1,184,753
Total plan assets at beginning of year2013-12-31$1,086,056
Value of fidelity bond covering the plan2013-12-31$100,000
Total contributions received or receivable from participants2013-12-31$57,482
Expenses. Other expenses not covered elsewhere2013-12-31$222
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$256,613
Net income (gross income less expenses)2013-12-31$98,697
Net plan assets at end of year (total assets less liabilities)2013-12-31$1,184,753
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$1,086,056
Assets. Value of participant loans2013-12-31$26,882
Total contributions received or receivable from employer(s)2013-12-31$0
Value of certain deemed distributions of participant loans2013-12-31$0
Value of corrective distributions2013-12-31$29
Funding deficiency by the employer to the plan for this plan year2013-12-31$0
Minimum employer required contribution for this plan year2013-12-31$0
Amount contributed by the employer to the plan for this plan year2013-12-31$0
2012 : THE FISHER HOUSING COMPANIES, INC. 401(K) PLAN 2012 401k financial data
Transfers to/from the plan2012-12-31$0
Total income from all sources2012-12-31$198,977
Expenses. Total of all expenses incurred2012-12-31$171,529
Benefits paid (including direct rollovers)2012-12-31$171,277
Total plan assets at end of year2012-12-31$1,086,056
Total plan assets at beginning of year2012-12-31$1,058,609
Value of fidelity bond covering the plan2012-12-31$100,000
Total contributions received or receivable from participants2012-12-31$72,409
Expenses. Other expenses not covered elsewhere2012-12-31$252
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$126,568
Net income (gross income less expenses)2012-12-31$27,448
Net plan assets at end of year (total assets less liabilities)2012-12-31$1,086,056
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$1,058,609
Assets. Value of participant loans2012-12-31$32,637
Total contributions received or receivable from employer(s)2012-12-31$0
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$0
Funding deficiency by the employer to the plan for this plan year2012-12-31$0
Minimum employer required contribution for this plan year2012-12-31$0
Amount contributed by the employer to the plan for this plan year2012-12-31$0
2011 : THE FISHER HOUSING COMPANIES, INC. 401(K) PLAN 2011 401k financial data
Transfers to/from the plan2011-12-31$0
Total income from all sources2011-12-31$24,547
Expenses. Total of all expenses incurred2011-12-31$53,729
Benefits paid (including direct rollovers)2011-12-31$53,354
Total plan assets at end of year2011-12-31$1,058,608
Total plan assets at beginning of year2011-12-31$1,087,790
Value of fidelity bond covering the plan2011-12-31$100,000
Total contributions received or receivable from participants2011-12-31$67,341
Expenses. Other expenses not covered elsewhere2011-12-31$375
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-42,794
Net income (gross income less expenses)2011-12-31$-29,182
Net plan assets at end of year (total assets less liabilities)2011-12-31$1,058,608
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$1,087,790
Assets. Value of participant loans2011-12-31$42,375
Total contributions received or receivable from employer(s)2011-12-31$0
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$0
Funding deficiency by the employer to the plan for this plan year2011-12-31$0
Minimum employer required contribution for this plan year2011-12-31$0
Amount contributed by the employer to the plan for this plan year2011-12-31$0
2010 : THE FISHER HOUSING COMPANIES, INC. 401(K) PLAN 2010 401k financial data
Transfers to/from the plan2010-12-31$0
Total income from all sources2010-12-31$207,603
Expenses. Total of all expenses incurred2010-12-31$165,979
Benefits paid (including direct rollovers)2010-12-31$153,550
Total plan assets at end of year2010-12-31$1,087,790
Total plan assets at beginning of year2010-12-31$1,046,166
Value of fidelity bond covering the plan2010-12-31$100,000
Total contributions received or receivable from participants2010-12-31$73,978
Expenses. Other expenses not covered elsewhere2010-12-31$442
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$133,625
Net income (gross income less expenses)2010-12-31$41,624
Net plan assets at end of year (total assets less liabilities)2010-12-31$1,087,790
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$1,046,166
Assets. Value of participant loans2010-12-31$29,812
Total contributions received or receivable from employer(s)2010-12-31$0
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$11,987
Funding deficiency by the employer to the plan for this plan year2010-12-31$0
Minimum employer required contribution for this plan year2010-12-31$0
Amount contributed by the employer to the plan for this plan year2010-12-31$0
2009 : THE FISHER HOUSING COMPANIES, INC. 401(K) PLAN 2009 401k financial data
Funding deficiency by the employer to the plan for this plan year2009-12-31$0
Minimum employer required contribution for this plan year2009-12-31$0
Amount contributed by the employer to the plan for this plan year2009-12-31$0

Form 5500 Responses for THE FISHER HOUSING COMPANIES, INC. 401(K) PLAN

2015: THE FISHER HOUSING COMPANIES, INC. 401(K) PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: THE FISHER HOUSING COMPANIES, INC. 401(K) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: THE FISHER HOUSING COMPANIES, INC. 401(K) PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: THE FISHER HOUSING COMPANIES, INC. 401(K) PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: THE FISHER HOUSING COMPANIES, INC. 401(K) PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: THE FISHER HOUSING COMPANIES, INC. 401(K) PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberGP-29259
Policy instance 1
Insurance contract or identification numberGP-29259
Number of Individuals Covered18
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $9,543
Total amount of fees paid to insurance companyUSD $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 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
Commission paid to Insurance BrokerUSD $9,543
Insurance broker organization code?3
Insurance broker nameWOODBURY FINANCIAL SERVICES
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-008029
Policy instance 1
Insurance contract or identification numberGA-008029
Number of Individuals Covered19
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $3,444
Total amount of fees paid to insurance companyUSD $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 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
Commission paid to Insurance BrokerUSD $3,444
Insurance broker organization code?3
Insurance broker nameWOODBURY FIN SVCS INC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-008029
Policy instance 1
Insurance contract or identification numberGA-008029
Number of Individuals Covered21
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $3,242
Total amount of fees paid to insurance companyUSD $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 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
Commission paid to Insurance BrokerUSD $3,242
Insurance broker organization code?3
Insurance broker nameCAPITAL INVESTMENT GROUP INC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-008029
Policy instance 1
Insurance contract or identification numberGA-008029
Number of Individuals Covered10
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $3,039
Total amount of fees paid to insurance companyUSD $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 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
Commission paid to Insurance BrokerUSD $3,039
Insurance broker organization code?3
Insurance broker nameCAPITAL INVESTMENT GROUP INC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-008029
Policy instance 1
Insurance contract or identification numberGA-008029
Number of Individuals Covered27
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $3,182
Total amount of fees paid to insurance companyUSD $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 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
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-008029
Policy instance 1
Insurance contract or identification numberGA-008029
Number of Individuals Covered34
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $3,076
Total amount of fees paid to insurance companyUSD $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 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
Commission paid to Insurance BrokerUSD $3,076
Insurance broker organization code?3
Insurance broker nameCAPITAL INVESTMENT GROUP INC

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