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CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 401k Plan overview

Plan NameCORNELIA NIXON DAVIS, INC. RETIREMENT PLAN
Plan identification number 001

CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.

401k Sponsoring company profile

CORNELIA NIXON DAVIS, INC. has sponsored the creation of one or more 401k plans.

Company Name:CORNELIA NIXON DAVIS, INC.
Employer identification number (EIN):566065223
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01PAMELA BARRETT2019-10-15
0012017-01-01
0012017-01-01
0012016-01-01CHARLES LONG CHARLES LONG2017-09-12
0012015-01-01CHARLES LONG CHARLES LONG2016-07-29
0012014-01-01CHARLES LONG CHARLES LONG2015-10-13
0012013-01-01CHARLES LONG
0012012-01-01CHARLES LONG
0012011-01-01CHARLES LONG
0012010-01-01CHARLES LONG CHARLES LONG2011-10-13
0012009-01-01CHARLES LONG

Plan Statistics for CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN

401k plan membership statisitcs for CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN

Measure Date Value
2022: CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01214
Total number of active participants reported on line 7a of the Form 55002022-01-01275
Number of retired or separated participants receiving benefits2022-01-012
Number of other retired or separated participants entitled to future benefits2022-01-0192
Total of all active and inactive participants2022-01-01369
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01369
Number of participants with account balances2022-01-01205
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-014
2021: CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01511
Total number of active participants reported on line 7a of the Form 55002021-01-01125
Number of retired or separated participants receiving benefits2021-01-011
Number of other retired or separated participants entitled to future benefits2021-01-0188
Total of all active and inactive participants2021-01-01214
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01214
Number of participants with account balances2021-01-01212
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-012
2020: CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01546
Total number of active participants reported on line 7a of the Form 55002020-01-01420
Number of retired or separated participants receiving benefits2020-01-0129
Number of other retired or separated participants entitled to future benefits2020-01-0162
Total of all active and inactive participants2020-01-01511
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01511
Number of participants with account balances2020-01-01233
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-015
2019: CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01501
Total number of active participants reported on line 7a of the Form 55002019-01-01463
Number of retired or separated participants receiving benefits2019-01-0139
Number of other retired or separated participants entitled to future benefits2019-01-0152
Total of all active and inactive participants2019-01-01554
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01554
Number of participants with account balances2019-01-01258
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-014
2018: CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01520
Total number of active participants reported on line 7a of the Form 55002018-01-01422
Number of retired or separated participants receiving benefits2018-01-0141
Number of other retired or separated participants entitled to future benefits2018-01-0149
Total of all active and inactive participants2018-01-01512
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-011
Total participants2018-01-01513
Number of participants with account balances2018-01-01255
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-012
2017: CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01643
Total number of active participants reported on line 7a of the Form 55002017-01-01445
Number of retired or separated participants receiving benefits2017-01-0145
Number of other retired or separated participants entitled to future benefits2017-01-0143
Total of all active and inactive participants2017-01-01533
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01533
Number of participants with account balances2017-01-01255
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-0115
2016: CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01642
Total number of active participants reported on line 7a of the Form 55002016-01-01419
Number of retired or separated participants receiving benefits2016-01-01162
Number of other retired or separated participants entitled to future benefits2016-01-0168
Total of all active and inactive participants2016-01-01649
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01649
Number of participants with account balances2016-01-01433
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-0113
2015: CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01614
Total number of active participants reported on line 7a of the Form 55002015-01-01423
Number of retired or separated participants receiving benefits2015-01-01175
Number of other retired or separated participants entitled to future benefits2015-01-0153
Total of all active and inactive participants2015-01-01651
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01651
Number of participants with account balances2015-01-01438
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-0120
2014: CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01620
Total number of active participants reported on line 7a of the Form 55002014-01-01387
Number of retired or separated participants receiving benefits2014-01-01182
Number of other retired or separated participants entitled to future benefits2014-01-0137
Total of all active and inactive participants2014-01-01606
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01606
Number of participants with account balances2014-01-01462
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-0134
2013: CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01600
Total number of active participants reported on line 7a of the Form 55002013-01-01425
Number of retired or separated participants receiving benefits2013-01-01195
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01620
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01620
Number of participants with account balances2013-01-01454
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-0120
2012: CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01561
Total number of active participants reported on line 7a of the Form 55002012-01-01474
Number of other retired or separated participants entitled to future benefits2012-01-01136
Total of all active and inactive participants2012-01-01610
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01610
Number of participants with account balances2012-01-01423
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-0117
2011: CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01530
Total number of active participants reported on line 7a of the Form 55002011-01-01296
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-01149
Total of all active and inactive participants2011-01-01445
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01445
Number of participants with account balances2011-01-01386
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-0117
2010: CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01539
Total number of active participants reported on line 7a of the Form 55002010-01-01400
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-01140
Total of all active and inactive participants2010-01-01540
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-01540
Number of participants with account balances2010-01-01376
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-0114
2009: CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01516
Total number of active participants reported on line 7a of the Form 55002009-01-01388
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-01148
Total of all active and inactive participants2009-01-01536
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01536
Number of participants with account balances2009-01-01371
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-0116

Financial Data on CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN

Measure Date Value
2022 : CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$-453,537
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$551,652
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$512,814
Value of total corrective distributions2022-12-31$2,047
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$317,316
Value of total assets at end of year2022-12-31$3,270,187
Value of total assets at beginning of year2022-12-31$4,275,376
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$36,791
Total interest from all sources2022-12-31$2,104
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$187,968
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$187,968
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$1,000,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$316,802
Administrative expenses (other) incurred2022-12-31$36,791
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-1,005,189
Value of net assets at end of year (total assets less liabilities)2022-12-31$3,270,187
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$4,275,376
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$3,065,533
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$4,020,818
Interest earned on other investments2022-12-31$2,104
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$204,654
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$254,558
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-960,925
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$514
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$512,814
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31FORVIS, LLP
Accountancy firm EIN2022-12-31440160260
2021 : CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
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$3,082
Total income from all sources (including contributions)2021-12-31$878,524
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$727,205
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$704,887
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$387,767
Value of total assets at end of year2021-12-31$4,275,376
Value of total assets at beginning of year2021-12-31$4,127,139
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$22,318
Total interest from all sources2021-12-31$1,422
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$251,753
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$251,753
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$1,000,000
If this is an individual account plan, was there a blackout period2021-12-31Yes
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$239,401
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$148,366
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$3,082
Administrative expenses (other) incurred2021-12-31$22,318
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$151,319
Value of net assets at end of year (total assets less liabilities)2021-12-31$4,275,376
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$4,124,057
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
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
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$4,020,818
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$4,060,039
Interest earned on other investments2021-12-31$1,422
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$254,558
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$237,582
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
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Employer contributions (assets) at beginning of year2021-12-31$67,100
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$704,887
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32021-12-31Yes
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31FORVIS, LLP
Accountancy firm EIN2021-12-31440160260
2020 : CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$3,082
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$3,318
Total income from all sources (including contributions)2020-12-31$808,413
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$736,646
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$692,173
Value of total corrective distributions2020-12-31$3,082
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$305,751
Value of total assets at end of year2020-12-31$4,127,139
Value of total assets at beginning of year2020-12-31$4,055,608
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$41,391
Total interest from all sources2020-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$1,000,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$238,651
Participant contributions at end of year2020-12-31$0
Participant contributions at beginning of year2020-12-31$8,175
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$3,082
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$3,318
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$71,767
Value of net assets at end of year (total assets less liabilities)2020-12-31$4,124,057
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$4,052,290
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
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$30,299
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$4,060,039
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$3,989,111
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$502,662
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$67,100
Employer contributions (assets) at end of year2020-12-31$67,100
Employer contributions (assets) at beginning of year2020-12-31$58,322
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$692,173
Contract administrator fees2020-12-31$11,092
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31DIXON HUGHES GOODMAN, LLP
Accountancy firm EIN2020-12-31560074798
2019 : CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$3,318
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$2,151
Total income from all sources (including contributions)2019-12-31$1,101,038
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$277,324
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$233,335
Value of total corrective distributions2019-12-31$3,318
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$399,575
Value of total assets at end of year2019-12-31$4,055,608
Value of total assets at beginning of year2019-12-31$3,230,727
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$40,671
Total interest from all sources2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$1,000,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$244,490
Participant contributions at end of year2019-12-31$8,175
Participant contributions at beginning of year2019-12-31$8,957
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$96,763
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$3,318
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$2,151
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$823,714
Value of net assets at end of year (total assets less liabilities)2019-12-31$4,052,290
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$3,228,576
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
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$31,548
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$3,989,111
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$3,157,257
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$701,463
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$58,322
Employer contributions (assets) at end of year2019-12-31$58,322
Employer contributions (assets) at beginning of year2019-12-31$64,513
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$233,335
Contract administrator fees2019-12-31$9,123
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31DIXON HUGHES GOODMAN, LLP
Accountancy firm EIN2019-12-31560074798
2018 : CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2018 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$2,151
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$3,137
Total income from all sources (including contributions)2018-12-31$110,571
Total of all expenses incurred2018-12-31$439,747
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$429,120
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$367,230
Value of total assets at end of year2018-12-31$3,230,727
Value of total assets at beginning of year2018-12-31$3,560,889
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$10,627
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$1,000,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$262,405
Participant contributions at end of year2018-12-31$8,957
Participant contributions at beginning of year2018-12-31$10,863
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$40,312
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$2,151
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$3,137
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-329,176
Value of net assets at end of year (total assets less liabilities)2018-12-31$3,228,576
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$3,557,752
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
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
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$3,157,257
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$3,509,011
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-256,659
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$64,513
Employer contributions (assets) at end of year2018-12-31$64,513
Employer contributions (assets) at beginning of year2018-12-31$41,015
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$429,120
Contract administrator fees2018-12-31$10,627
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31No
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31DIXON HUGHES GOODMAN LLP
Accountancy firm EIN2018-12-31560747981
2017 : CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2017 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$3,137
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$2,436
Total income from all sources (including contributions)2017-12-31$750,282
Total of all expenses incurred2017-12-31$361,154
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$341,413
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$293,377
Value of total assets at end of year2017-12-31$3,560,889
Value of total assets at beginning of year2017-12-31$3,171,060
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$19,741
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$1,000,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$252,362
Participant contributions at end of year2017-12-31$10,863
Participant contributions at beginning of year2017-12-31$9,061
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$3,137
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$2,436
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$389,128
Value of net assets at end of year (total assets less liabilities)2017-12-31$3,557,752
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$3,168,624
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
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$3,509,011
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$3,103,349
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$456,905
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$41,015
Employer contributions (assets) at end of year2017-12-31$41,015
Employer contributions (assets) at beginning of year2017-12-31$58,650
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$341,413
Contract administrator fees2017-12-31$19,741
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31DIXON HUGHES GOODMAN LLP
Accountancy firm EIN2017-12-31560747981
2016 : CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$2,436
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$2,316
Total income from all sources (including contributions)2016-12-31$562,427
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$345,928
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$303,632
Value of total corrective distributions2016-12-31$2,436
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$318,205
Value of total assets at end of year2016-12-31$3,171,060
Value of total assets at beginning of year2016-12-31$2,954,441
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$39,860
Total interest from all sources2016-12-31$-675
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
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$1,000,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$231,207
Participant contributions at end of year2016-12-31$9,061
Participant contributions at beginning of year2016-12-31$8,018
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$28,348
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$2,436
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$2,316
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$216,499
Value of net assets at end of year (total assets less liabilities)2016-12-31$3,168,624
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$2,952,125
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
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
Investment advisory and management fees2016-12-31$25,569
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$3,103,349
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$2,736,681
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$155,865
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$155,865
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$-675
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$244,897
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$58,650
Employer contributions (assets) at end of year2016-12-31$58,650
Employer contributions (assets) at beginning of year2016-12-31$53,877
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$303,632
Contract administrator fees2016-12-31$14,291
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31CLIFTON LARSEN ALLEN
Accountancy firm EIN2016-12-31410746749
2015 : CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$2,316
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$2,941
Total income from all sources (including contributions)2015-12-31$264,465
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$330,347
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$288,099
Value of total corrective distributions2015-12-31$2,316
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$292,243
Value of total assets at end of year2015-12-31$2,954,441
Value of total assets at beginning of year2015-12-31$3,020,948
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$39,932
Total interest from all sources2015-12-31$-1,456
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$1,000,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$238,786
Participant contributions at end of year2015-12-31$8,018
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$2,316
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$2,941
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-65,882
Value of net assets at end of year (total assets less liabilities)2015-12-31$2,952,125
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$3,018,007
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Investment advisory and management fees2015-12-31$26,101
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$2,736,681
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$2,700,371
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$155,865
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$189,272
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$189,272
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$-1,456
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-26,322
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$53,457
Employer contributions (assets) at end of year2015-12-31$53,877
Employer contributions (assets) at beginning of year2015-12-31$131,305
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$288,099
Contract administrator fees2015-12-31$13,831
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31CLIFTON LARSEN ALLEN
Accountancy firm EIN2015-12-31410746749
2014 : CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$2,941
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$3,355
Total income from all sources (including contributions)2014-12-31$459,571
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$361,598
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$318,680
Value of total corrective distributions2014-12-31$2,941
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$337,307
Value of total assets at end of year2014-12-31$3,020,948
Value of total assets at beginning of year2014-12-31$2,923,389
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$39,977
Total interest from all sources2014-12-31$-1,909
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$1,000,000
If this is an individual account plan, was there a blackout period2014-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$206,001
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$2,941
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-12-31$3,355
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$97,973
Value of net assets at end of year (total assets less liabilities)2014-12-31$3,018,007
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$2,920,034
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Investment advisory and management fees2014-12-31$25,548
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$2,700,371
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$2,515,691
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$189,272
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$258,145
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$258,145
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$-1,909
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$124,173
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$131,306
Employer contributions (assets) at end of year2014-12-31$131,305
Employer contributions (assets) at beginning of year2014-12-31$149,553
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$318,680
Contract administrator fees2014-12-31$14,429
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31CLIFTON LARSEN ALLEN
Accountancy firm EIN2014-12-31410746749
2013 : CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$3,355
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$2,531
Total income from all sources (including contributions)2013-12-31$677,345
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$297,271
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$295,044
Expenses. Certain deemed distributions of participant loans2013-12-31$0
Value of total corrective distributions2013-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$344,278
Value of total assets at end of year2013-12-31$2,923,389
Value of total assets at beginning of year2013-12-31$2,542,491
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$2,227
Total interest from all sources2013-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$1,000,000
If this is an individual account plan, was there a blackout period2013-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$197,566
Participant contributions at beginning of year2013-12-31$7,076
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-12-31$3,355
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$2,531
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$380,074
Value of net assets at end of year (total assets less liabilities)2013-12-31$2,920,034
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$2,539,960
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$2,515,691
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$2,114,013
Interest on participant loans2013-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$258,145
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$280,731
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$280,731
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$333,067
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31Yes
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$146,712
Employer contributions (assets) at end of year2013-12-31$149,553
Employer contributions (assets) at beginning of year2013-12-31$140,671
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$295,044
Contract administrator fees2013-12-31$2,227
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31CLIFTON LARSON ALLEN
Accountancy firm EIN2013-12-31410746749
2012 : CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$2,531
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$1,455
Total income from all sources (including contributions)2012-12-31$526,078
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$442,501
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$442,501
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$331,048
Value of total assets at end of year2012-12-31$2,542,491
Value of total assets at beginning of year2012-12-31$2,457,838
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$0
Total interest from all sources2012-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$1,000,000
If this is an individual account plan, was there a blackout period2012-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$184,773
Participant contributions at end of year2012-12-31$7,076
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$7,906
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-12-31$2,531
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$1,455
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$83,577
Value of net assets at end of year (total assets less liabilities)2012-12-31$2,539,960
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$2,456,383
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$2,114,013
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$1,815,769
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$280,731
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$507,939
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$507,939
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$195,030
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31Yes
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$138,369
Employer contributions (assets) at end of year2012-12-31$140,671
Employer contributions (assets) at beginning of year2012-12-31$134,130
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$442,501
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31CLIFTON LARSON ALLEN, LLP
Accountancy firm EIN2012-12-31410746749
2011 : CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total income from all sources (including contributions)2011-12-31$311,391
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$150,338
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$149,516
Value of total corrective distributions2011-12-31$822
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$351,341
Value of total assets at end of year2011-12-31$2,457,838
Value of total assets at beginning of year2011-12-31$2,296,785
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$0
Total interest from all sources2011-12-31$-6,168
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$1,000,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$196,056
Participant contributions at beginning of year2011-12-31$6,971
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$14,719
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$161,053
Value of net assets at end of year (total assets less liabilities)2011-12-31$2,457,838
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$2,296,785
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$1,815,769
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$1,624,470
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$507,939
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$526,457
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$526,457
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$-6,168
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$-33,782
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$140,566
Employer contributions (assets) at end of year2011-12-31$134,130
Employer contributions (assets) at beginning of year2011-12-31$138,887
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$149,516
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2011-12-31410746749
2010 : CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$670
Total income from all sources (including contributions)2010-12-31$461,488
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$189,861
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$187,511
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$331,561
Value of total assets at end of year2010-12-31$2,296,785
Value of total assets at beginning of year2010-12-31$2,025,828
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$2,350
Total interest from all sources2010-12-31$-6,189
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Administrative expenses professional fees incurred2010-12-31$2,350
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$248,588
If this is an individual account plan, was there a blackout period2010-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$188,344
Participant contributions at end of year2010-12-31$6,971
Participant contributions at beginning of year2010-12-31$6,271
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$4,329
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$271,627
Value of net assets at end of year (total assets less liabilities)2010-12-31$2,296,785
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$2,025,158
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$1,624,470
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$1,372,414
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$526,457
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$527,578
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$527,578
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$-6,189
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$136,116
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$138,888
Employer contributions (assets) at end of year2010-12-31$138,887
Employer contributions (assets) at beginning of year2010-12-31$119,565
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$187,511
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$670
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31LARSON ALLEN LLP
Accountancy firm EIN2010-12-31410746749
2009 : CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN

2022: CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
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
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
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
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
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
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: CORNELIA NIXON DAVIS, INC. RETIREMENT 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 – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2014: CORNELIA NIXON DAVIS, INC. RETIREMENT 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 – TrustYes
2014-01-01Plan benefit arrangement - TrustYes
2013: CORNELIA NIXON DAVIS, INC. RETIREMENT 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 – TrustYes
2013-01-01Plan benefit arrangement - TrustYes
2012: CORNELIA NIXON DAVIS, INC. RETIREMENT 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 – TrustYes
2012-01-01Plan benefit arrangement - TrustYes
2011: CORNELIA NIXON DAVIS, INC. RETIREMENT 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 – TrustYes
2011-01-01Plan benefit arrangement - TrustYes
2010: CORNELIA NIXON DAVIS, INC. RETIREMENT PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement - TrustYes
2009: CORNELIA NIXON DAVIS, INC. RETIREMENT 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 – TrustYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number664FH9
Policy instance 1
Insurance contract or identification number664FH9
Number of Individuals Covered369
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number664FH9
Policy instance 1
Insurance contract or identification number664FH9
Number of Individuals Covered311
Insurance policy start date2021-06-02
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-B2-FS4J
Policy instance 2
Insurance contract or identification numberGAP-B2-FS4J
Number of Individuals Covered0
Insurance policy start date2021-01-01
Insurance policy end date2021-06-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-B2-FS4J
Policy instance 1
Insurance contract or identification numberGAP-B2-FS4J
Number of Individuals Covered233
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $51
Total amount of fees paid to insurance companyUSD $0
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
Commission paid to Insurance BrokerUSD $51
Amount paid for insurance broker fees0
Insurance broker organization code?7
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-B2-FS4J
Policy instance 1
Insurance contract or identification numberGAP-B2-FS4J
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $9
Total amount of fees paid to insurance companyUSD $0
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
Commission paid to Insurance BrokerUSD $9
Amount paid for insurance broker fees0
Insurance broker organization code?7
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-B2-FS4J
Policy instance 1
Insurance contract or identification numberGAP-B2-FS4J
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $7
Total amount of fees paid to insurance companyUSD $0
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7
Insurance broker organization code?7
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-B2-FS4J
Policy instance 1
Insurance contract or identification numberGAP-B2-FS4J
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $2
Total amount of fees paid to insurance companyUSD $0
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2
Insurance broker organization code?7
Insurance broker nameWELLS FARGO ADVISORS

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