SOUTHERN OB-GYN ASSOCIATES, P.C. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN
401k plan membership statisitcs for SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN
| Measure | Date | Value |
|---|
| 2018: SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 93 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 82 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 10 |
| Total of all active and inactive participants | 2018-01-01 | 92 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2018-01-01 | 0 |
| Total participants | 2018-01-01 | 92 |
| Number of participants with account balances | 2018-01-01 | 92 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2018-01-01 | 5 |
| 2017: SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 95 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 80 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 13 |
| Total of all active and inactive participants | 2017-01-01 | 93 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2017-01-01 | 0 |
| Total participants | 2017-01-01 | 93 |
| Number of participants with account balances | 2017-01-01 | 93 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2017-01-01 | 6 |
| 2016: SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 86 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 86 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 9 |
| Total of all active and inactive participants | 2016-01-01 | 95 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2016-01-01 | 0 |
| Total participants | 2016-01-01 | 95 |
| Number of participants with account balances | 2016-01-01 | 95 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2016-01-01 | 1 |
| 2015: SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 92 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 79 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 7 |
| Total of all active and inactive participants | 2015-01-01 | 86 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2015-01-01 | 0 |
| Total participants | 2015-01-01 | 86 |
| Number of participants with account balances | 2015-01-01 | 86 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2015-01-01 | 5 |
| 2014: SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 95 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 84 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 8 |
| Total of all active and inactive participants | 2014-01-01 | 92 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-01-01 | 0 |
| Total participants | 2014-01-01 | 92 |
| Number of participants with account balances | 2014-01-01 | 90 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2014-01-01 | 4 |
| 2013: SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 91 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 88 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 7 |
| Total of all active and inactive participants | 2013-01-01 | 95 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-01-01 | 0 |
| Total participants | 2013-01-01 | 95 |
| Number of participants with account balances | 2013-01-01 | 95 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-01-01 | 2 |
| 2012: SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 93 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 86 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 5 |
| Total of all active and inactive participants | 2012-01-01 | 91 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-01-01 | 0 |
| Total participants | 2012-01-01 | 91 |
| Number of participants with account balances | 2012-01-01 | 91 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-01-01 | 3 |
| 2011: SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 91 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 78 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 15 |
| Total of all active and inactive participants | 2011-01-01 | 93 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-01-01 | 0 |
| Total participants | 2011-01-01 | 93 |
| Number of participants with account balances | 2011-01-01 | 93 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2011-01-01 | 6 |
| 2009: SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 83 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 87 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 5 |
| Total of all active and inactive participants | 2009-01-01 | 92 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-01-01 | 0 |
| Total participants | 2009-01-01 | 92 |
| Number of participants with account balances | 2009-01-01 | 92 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-01-01 | 2 |
| Measure | Date | Value |
|---|
| 2018 : SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN 2018 401k financial data |
|---|
| Total plan liabilities at end of year | 2018-12-31 | $0 |
| Total plan liabilities at beginning of year | 2018-12-31 | $0 |
| Total income from all sources | 2018-12-31 | $-490,634 |
| Expenses. Total of all expenses incurred | 2018-12-31 | $829,231 |
| Benefits paid (including direct rollovers) | 2018-12-31 | $810,035 |
| Total plan assets at end of year | 2018-12-31 | $18,600,435 |
| Total plan assets at beginning of year | 2018-12-31 | $19,920,300 |
| Value of fidelity bond covering the plan | 2018-12-31 | $1,100,000 |
| Total contributions received or receivable from participants | 2018-12-31 | $333,725 |
| Expenses. Other expenses not covered elsewhere | 2018-12-31 | $6,305 |
| Contributions received from other sources (not participants or employers) | 2018-12-31 | $43,370 |
| Other income received | 2018-12-31 | $-1,373,915 |
| Net income (gross income less expenses) | 2018-12-31 | $-1,319,865 |
| Net plan assets at end of year (total assets less liabilities) | 2018-12-31 | $18,600,435 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-12-31 | $19,920,300 |
| Assets. Value of participant loans | 2018-12-31 | $185,671 |
| Total contributions received or receivable from employer(s) | 2018-12-31 | $506,186 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2018-12-31 | $12,891 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2018-12-31 | $0 |
| 2017 : SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN 2017 401k financial data |
|---|
| Total plan liabilities at end of year | 2017-12-31 | $0 |
| Total plan liabilities at beginning of year | 2017-12-31 | $0 |
| Total income from all sources | 2017-12-31 | $3,564,691 |
| Expenses. Total of all expenses incurred | 2017-12-31 | $490,342 |
| Benefits paid (including direct rollovers) | 2017-12-31 | $477,427 |
| Total plan assets at end of year | 2017-12-31 | $19,920,300 |
| Total plan assets at beginning of year | 2017-12-31 | $16,845,951 |
| Value of fidelity bond covering the plan | 2017-12-31 | $1,100,000 |
| Total contributions received or receivable from participants | 2017-12-31 | $313,664 |
| Contributions received from other sources (not participants or employers) | 2017-12-31 | $13,151 |
| Other income received | 2017-12-31 | $2,731,313 |
| Net income (gross income less expenses) | 2017-12-31 | $3,074,349 |
| Net plan assets at end of year (total assets less liabilities) | 2017-12-31 | $19,920,300 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-12-31 | $16,845,951 |
| Assets. Value of participant loans | 2017-12-31 | $199,585 |
| Total contributions received or receivable from employer(s) | 2017-12-31 | $506,563 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-12-31 | $12,915 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2017-12-31 | $0 |
| 2016 : SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN 2016 401k financial data |
|---|
| Transfers to/from the plan | 2016-12-31 | $0 |
| Total plan liabilities at end of year | 2016-12-31 | $0 |
| Total plan liabilities at beginning of year | 2016-12-31 | $0 |
| Total income from all sources | 2016-12-31 | $1,933,420 |
| Expenses. Total of all expenses incurred | 2016-12-31 | $129,274 |
| Benefits paid (including direct rollovers) | 2016-12-31 | $118,347 |
| Total plan assets at end of year | 2016-12-31 | $16,845,951 |
| Total plan assets at beginning of year | 2016-12-31 | $15,041,805 |
| Value of fidelity bond covering the plan | 2016-12-31 | $1,100,000 |
| Total contributions received or receivable from participants | 2016-12-31 | $313,297 |
| Contributions received from other sources (not participants or employers) | 2016-12-31 | $6,414 |
| Other income received | 2016-12-31 | $1,115,005 |
| Net income (gross income less expenses) | 2016-12-31 | $1,804,146 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-31 | $16,845,951 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-31 | $15,041,805 |
| Assets. Value of participant loans | 2016-12-31 | $207,650 |
| Total contributions received or receivable from employer(s) | 2016-12-31 | $498,704 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-12-31 | $10,927 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2016-12-31 | $0 |
| 2015 : SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN 2015 401k financial data |
|---|
| Transfers to/from the plan | 2015-12-31 | $0 |
| Total plan liabilities at end of year | 2015-12-31 | $0 |
| Total plan liabilities at beginning of year | 2015-12-31 | $0 |
| Total income from all sources | 2015-12-31 | $390,221 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $315,784 |
| Benefits paid (including direct rollovers) | 2015-12-31 | $304,025 |
| Total plan assets at end of year | 2015-12-31 | $15,041,805 |
| Total plan assets at beginning of year | 2015-12-31 | $14,967,368 |
| Value of fidelity bond covering the plan | 2015-12-31 | $1,100,000 |
| Total contributions received or receivable from participants | 2015-12-31 | $293,150 |
| Other income received | 2015-12-31 | $-387,248 |
| Net income (gross income less expenses) | 2015-12-31 | $74,437 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $15,041,805 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $14,967,368 |
| Assets. Value of participant loans | 2015-12-31 | $197,466 |
| Assets. Value of assets in partnership/joint-venture interests | 2015-12-31 | $100,592 |
| Total contributions received or receivable from employer(s) | 2015-12-31 | $484,319 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-12-31 | $11,759 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2015-12-31 | $0 |
| 2014 : SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN 2014 401k financial data |
|---|
| Total plan liabilities at end of year | 2014-12-31 | $0 |
| Total plan liabilities at beginning of year | 2014-12-31 | $0 |
| Total income from all sources | 2014-12-31 | $1,200,477 |
| Expenses. Total of all expenses incurred | 2014-12-31 | $30,811 |
| Benefits paid (including direct rollovers) | 2014-12-31 | $18,828 |
| Total plan assets at end of year | 2014-12-31 | $14,967,368 |
| Total plan assets at beginning of year | 2014-12-31 | $13,797,702 |
| Value of fidelity bond covering the plan | 2014-12-31 | $1,100,000 |
| Total contributions received or receivable from participants | 2014-12-31 | $278,472 |
| Contributions received from other sources (not participants or employers) | 2014-12-31 | $3,476 |
| Other income received | 2014-12-31 | $434,682 |
| Net income (gross income less expenses) | 2014-12-31 | $1,169,666 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $14,967,368 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $13,797,702 |
| Assets. Value of participant loans | 2014-12-31 | $203,282 |
| Assets. Value of assets in partnership/joint-venture interests | 2014-12-31 | $93,630 |
| Total contributions received or receivable from employer(s) | 2014-12-31 | $483,847 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2014-12-31 | $11,983 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2014-12-31 | $0 |
| 2013 : SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN 2013 401k financial data |
|---|
| Transfers to/from the plan | 2013-12-31 | $0 |
| Total plan liabilities at end of year | 2013-12-31 | $0 |
| Total plan liabilities at beginning of year | 2013-12-31 | $0 |
| Total income from all sources | 2013-12-31 | $2,223,569 |
| Expenses. Total of all expenses incurred | 2013-12-31 | $67,674 |
| Benefits paid (including direct rollovers) | 2013-12-31 | $56,109 |
| Total plan assets at end of year | 2013-12-31 | $13,797,702 |
| Total plan assets at beginning of year | 2013-12-31 | $11,641,807 |
| Value of fidelity bond covering the plan | 2013-12-31 | $1,100,000 |
| Total contributions received or receivable from participants | 2013-12-31 | $285,067 |
| Expenses. Other expenses not covered elsewhere | 2013-12-31 | $6,277 |
| Other income received | 2013-12-31 | $1,450,467 |
| Net income (gross income less expenses) | 2013-12-31 | $2,155,895 |
| Net plan assets at end of year (total assets less liabilities) | 2013-12-31 | $13,797,702 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-12-31 | $11,641,807 |
| Assets. Value of participant loans | 2013-12-31 | $210,958 |
| Assets. Value of assets in partnership/joint-venture interests | 2013-12-31 | $84,590 |
| Total contributions received or receivable from employer(s) | 2013-12-31 | $488,035 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2013-12-31 | $5,288 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2013-12-31 | $0 |
| 2012 : SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN 2012 401k financial data |
|---|
| Transfers to/from the plan | 2012-12-31 | $0 |
| Total plan liabilities at end of year | 2012-12-31 | $0 |
| Total plan liabilities at beginning of year | 2012-12-31 | $0 |
| Total income from all sources | 2012-12-31 | $1,884,271 |
| Expenses. Total of all expenses incurred | 2012-12-31 | $286,749 |
| Benefits paid (including direct rollovers) | 2012-12-31 | $274,373 |
| Total plan assets at end of year | 2012-12-31 | $11,641,807 |
| Total plan assets at beginning of year | 2012-12-31 | $10,044,285 |
| Value of fidelity bond covering the plan | 2012-12-31 | $1,100,000 |
| Total contributions received or receivable from participants | 2012-12-31 | $273,673 |
| Expenses. Other expenses not covered elsewhere | 2012-12-31 | $7,932 |
| Other income received | 2012-12-31 | $1,137,538 |
| Net income (gross income less expenses) | 2012-12-31 | $1,597,522 |
| Net plan assets at end of year (total assets less liabilities) | 2012-12-31 | $11,641,807 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-12-31 | $10,044,285 |
| Assets. Value of participant loans | 2012-12-31 | $150,184 |
| Assets. Value of assets in partnership/joint-venture interests | 2012-12-31 | $76,980 |
| Total contributions received or receivable from employer(s) | 2012-12-31 | $473,060 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2012-12-31 | $4,444 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2012-12-31 | $0 |
| 2011 : SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN 2011 401k financial data |
|---|
| Transfers to/from the plan | 2011-12-31 | $0 |
| Total plan liabilities at end of year | 2011-12-31 | $0 |
| Total plan liabilities at beginning of year | 2011-12-31 | $0 |
| Total income from all sources | 2011-12-31 | $-21,551 |
| Expenses. Total of all expenses incurred | 2011-12-31 | $54,095 |
| Benefits paid (including direct rollovers) | 2011-12-31 | $43,502 |
| Total plan assets at end of year | 2011-12-31 | $10,044,285 |
| Total plan assets at beginning of year | 2011-12-31 | $10,119,931 |
| Value of fidelity bond covering the plan | 2011-12-31 | $1,100,000 |
| Total contributions received or receivable from participants | 2011-12-31 | $264,077 |
| Assets. Value of loans (other than to participants) | 2011-12-31 | $0 |
| Expenses. Other expenses not covered elsewhere | 2011-12-31 | $7,238 |
| Other income received | 2011-12-31 | $-747,602 |
| Net income (gross income less expenses) | 2011-12-31 | $-75,646 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-31 | $10,044,285 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-31 | $10,119,931 |
| Assets. Value of participant loans | 2011-12-31 | $207,889 |
| Assets. Value of assets in partnership/joint-venture interests | 2011-12-31 | $78,530 |
| Total contributions received or receivable from employer(s) | 2011-12-31 | $461,974 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2011-12-31 | $3,355 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2011-12-31 | $0 |
| 2010 : SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN 2010 401k financial data |
|---|
| Total plan liabilities at end of year | 2010-12-31 | $0 |
| Total plan liabilities at beginning of year | 2010-12-31 | $0 |
| Total income from all sources | 2010-12-31 | $1,499,311 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $47,786 |
| Benefits paid (including direct rollovers) | 2010-12-31 | $38,420 |
| Total plan assets at end of year | 2010-12-31 | $10,119,931 |
| Total plan assets at beginning of year | 2010-12-31 | $8,668,406 |
| Value of fidelity bond covering the plan | 2010-12-31 | $1,100,000 |
| Total contributions received or receivable from participants | 2010-12-31 | $250,043 |
| Assets. Value of loans (other than to participants) | 2010-12-31 | $510,000 |
| Contributions received from other sources (not participants or employers) | 2010-12-31 | $4,689 |
| Other income received | 2010-12-31 | $779,245 |
| Net income (gross income less expenses) | 2010-12-31 | $1,451,525 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $10,119,931 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $8,668,406 |
| Assets. Value of participant loans | 2010-12-31 | $202,378 |
| Assets. Value of assets in partnership/joint-venture interests | 2010-12-31 | $86,396 |
| Total contributions received or receivable from employer(s) | 2010-12-31 | $465,334 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2010-12-31 | $9,366 |
| 2009 : SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN 2009 401k financial data |
|---|
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2009-12-31 | $0 |
| 2018: SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Submission has been amended | No |
| 2018-01-01 | This submission is the final filing | No |
| 2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-01-01 | Plan is a collectively bargained plan | No |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – Trust | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement - Trust | Yes |
| 2017: SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | No |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – Trust | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement - Trust | Yes |
| 2016: SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – Trust | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement - Trust | Yes |
| 2015: SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – Trust | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement - Trust | Yes |
| 2014: SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Submission has been amended | No |
| 2014-01-01 | This submission is the final filing | No |
| 2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-01-01 | Plan is a collectively bargained plan | No |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – Trust | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement - Trust | Yes |
| 2013: SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Submission has been amended | No |
| 2013-01-01 | This submission is the final filing | No |
| 2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-01-01 | Plan is a collectively bargained plan | No |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – Trust | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement - Trust | Yes |
| 2012: SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Submission has been amended | No |
| 2012-01-01 | This submission is the final filing | No |
| 2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-01-01 | Plan is a collectively bargained plan | No |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – Trust | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement - Trust | Yes |
| 2011: SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Submission has been amended | No |
| 2011-01-01 | This submission is the final filing | No |
| 2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-01-01 | Plan is a collectively bargained plan | No |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan funding arrangement – Trust | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement - Trust | Yes |
| 2009: SOUTHERN OB-GYN ASSOCIATES, P.C. RETIREMENT SAVINGS PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Submission has been amended | No |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan funding arrangement – Trust | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement - Trust | Yes |
| PRUCO LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79227 ) |
| Policy contract number | 128 979 |
| Policy instance | 3 |
| Insurance contract or identification number | 128 979 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $2,912 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| PRUCO LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79227 ) |
| Policy contract number | L-4 125 137 |
| Policy instance | 2 |
| Insurance contract or identification number | L-4 125 137 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,205 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 98386 |
| Policy instance | 1 |
| Insurance contract or identification number | 98386 | | Number of Individuals Covered | 102 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $76,708 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 68403 | | Additional information about fees paid to insurance broker | BROKER COMMISSION | | Insurance broker organization code? | 3 |
|
| PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88536 ) |
| Policy contract number | B00169154 |
| Policy instance | 2 |
| Insurance contract or identification number | B00169154 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $62 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 62 | | Additional information about fees paid to insurance broker | CONTRACT ADMINISTRATION | | Insurance broker organization code? | 3 | | Insurance broker name | JOHN CLONINGER |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 98386 |
| Policy instance | 1 |
| Insurance contract or identification number | 98386 | | Number of Individuals Covered | 102 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $72,808 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 62128 | | Additional information about fees paid to insurance broker | BROKER COMMISSION | | Insurance broker organization code? | 3 | | Insurance broker name | DAME, WALKER, HUGHES & CO LLC |
|
| PRUCO LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79227 ) |
| Policy contract number | 128 979 |
| Policy instance | 4 |
| Insurance contract or identification number | 128 979 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $2,912 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| PRUCO LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79227 ) |
| Policy contract number | L-4 125 137 |
| Policy instance | 3 |
| Insurance contract or identification number | L-4 125 137 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,205 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| PRUCO LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79227 ) |
| Policy contract number | 128 979 |
| Policy instance | 4 |
| Insurance contract or identification number | 128 979 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $2,988 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| PRUCO LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79227 ) |
| Policy contract number | L-4 125 137 |
| Policy instance | 3 |
| Insurance contract or identification number | L-4 125 137 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,205 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88536 ) |
| Policy contract number | B00169154 |
| Policy instance | 2 |
| Insurance contract or identification number | B00169154 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $49 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 49 | | Additional information about fees paid to insurance broker | CONTRACT ADMINISTRATION | | Insurance broker organization code? | 3 | | Insurance broker name | JOHN CLONINGER |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 98386 |
| Policy instance | 1 |
| Insurance contract or identification number | 98386 | | Number of Individuals Covered | 98 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $65,224 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 57212 | | Additional information about fees paid to insurance broker | BROKER COMMISSION | | Insurance broker organization code? | 3 | | Insurance broker name | DAME, WALKER, HUGHES & CO., LLC |
|
| PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88536 ) |
| Policy contract number | B00169154 |
| Policy instance | 1 |
| Insurance contract or identification number | B00169154 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $44 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 44 | | Additional information about fees paid to insurance broker | CONTRACT ADMINISTRATION | | Insurance broker organization code? | 3 | | Insurance broker name | JOHN CLONINGER |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 98386 |
| Policy instance | 4 |
| Insurance contract or identification number | 98386 | | Number of Individuals Covered | 94 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $71,321 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 64455 | | Additional information about fees paid to insurance broker | BROKER COMMISSION | | Insurance broker organization code? | 3 | | Insurance broker name | DAME, WALKER, HUGHES & CO., LLC |
|
| PRUCO LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79227 ) |
| Policy contract number | 128 979 |
| Policy instance | 3 |
| Insurance contract or identification number | 128 979 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,388 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| PRUCO LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79227 ) |
| Policy contract number | L-4 125 137 |
| Policy instance | 2 |
| Insurance contract or identification number | L-4 125 137 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,205 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 98386 |
| Policy instance | 4 |
| Insurance contract or identification number | 98386 | | Number of Individuals Covered | 94 | | Insurance policy start date | 2013-09-24 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $63,096 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 55381 | | Additional information about fees paid to insurance broker | BROKER COMMISSION | | Insurance broker organization code? | 3 | | Insurance broker name | DAME, WALKER, HUGHES & CO., LLC |
|
| PRUCO LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79227 ) |
| Policy contract number | 128 979 |
| Policy instance | 3 |
| Insurance contract or identification number | 128 979 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $2,988 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| PRUCO LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79227 ) |
| Policy contract number | L-4 125 137 |
| Policy instance | 2 |
| Insurance contract or identification number | L-4 125 137 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,205 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88536 ) |
| Policy contract number | B00169154 |
| Policy instance | 1 |
| Insurance contract or identification number | B00169154 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88536 ) |
| Policy contract number | B00169154 |
| Policy instance | 1 |
| Insurance contract or identification number | B00169154 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | SC2318460W |
| Policy instance | 2 |
| Insurance contract or identification number | SC2318460W | | Number of Individuals Covered | 1 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,655 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUCO LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79227 ) |
| Policy contract number | L-4 125 137 |
| Policy instance | 3 |
| Insurance contract or identification number | L-4 125 137 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,205 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 98386 |
| Policy instance | 5 |
| Insurance contract or identification number | 98386 | | Number of Individuals Covered | 92 | | Insurance policy start date | 2012-09-24 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $55,556 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 48849 | | Additional information about fees paid to insurance broker | BROKER COMMISSION | | Insurance broker organization code? | 3 | | Insurance broker name | DAME, WALKER, HUGHES & CO., LLC |
|
| PRUCO LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79227 ) |
| Policy contract number | 128 979 |
| Policy instance | 4 |
| Insurance contract or identification number | 128 979 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $2,988 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| PRUCO LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79227 ) |
| Policy contract number | 128 979 |
| Policy instance | 4 |
| Insurance contract or identification number | 128 979 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $2,294 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| PRUCO LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79227 ) |
| Policy contract number | L-4 125 137 |
| Policy instance | 3 |
| Insurance contract or identification number | L-4 125 137 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,205 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88536 ) |
| Policy contract number | B00169154 |
| Policy instance | 2 |
| Insurance contract or identification number | B00169154 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 98386 |
| Policy instance | 1 |
| Insurance contract or identification number | 98386 | | Insurance policy start date | 2011-09-24 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $59,973 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | SC2318460W |
| Policy instance | 5 |
| Insurance contract or identification number | SC2318460W | | Number of Individuals Covered | 1 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,655 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88536 ) |
| Policy contract number | B00169154 |
| Policy instance | 2 |
| Insurance contract or identification number | B00169154 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,653 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUCO LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79227 ) |
| Policy contract number | L-4 125 137 |
| Policy instance | 3 |
| Insurance contract or identification number | L-4 125 137 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,205 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | SC2318460W |
| Policy instance | 5 |
| Insurance contract or identification number | SC2318460W | | Number of Individuals Covered | 1 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,655 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUCO LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79227 ) |
| Policy contract number | 128 979 |
| Policy instance | 4 |
| Insurance contract or identification number | 128 979 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $3,683 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 98386 |
| Policy instance | 1 |
| Insurance contract or identification number | 98386 | | Number of Individuals Covered | 91 | | Insurance policy start date | 2010-09-24 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $19,560 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Amount paid for insurance broker fees | 10565 | | Additional information about fees paid to insurance broker | BROKER COMMISSION | | Insurance broker organization code? | 3 | | Insurance broker name | DAME, WALKER, HUGHES & CO., LLC |
|
