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GEORGIA HIGHLANDS MEDICAL SERVICES, INC 403(B) RETIREMENT PLAN 401k Plan overview

Plan NameGEORGIA HIGHLANDS MEDICAL SERVICES, INC 403(B) RETIREMENT PLAN
Plan identification number 001

GEORGIA HIGHLANDS MEDICAL SERVICES, INC 403(B) RETIREMENT PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

GEORGIA HIGHLANDS MEDICAL SERVICES, INC has sponsored the creation of one or more 401k plans.

Company Name:GEORGIA HIGHLANDS MEDICAL SERVICES, INC
Employer identification number (EIN):581338038
NAIC Classification:621498
NAIC Description:All Other Outpatient Care Centers

Additional information about GEORGIA HIGHLANDS MEDICAL SERVICES, INC

Jurisdiction of Incorporation: Georgia Department of States Corporations Division
Incorporation Date:
Company Identification Number: 576814

More information about GEORGIA HIGHLANDS MEDICAL SERVICES, INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GEORGIA HIGHLANDS MEDICAL SERVICES, INC 403(B) RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-06-01
0012021-06-01
0012020-06-01
0012019-06-01
0012018-06-01
0012017-06-01STEPHEN BROWN2019-09-30
0012016-06-01STEPHEN BROWN2017-11-20
0012015-06-01LINDA HOWELL2016-09-21
0012014-06-01LINDA HOWELL2015-10-13
0012013-06-01LINDA HOWELL2014-09-23
0012012-06-01LINDA HOWELL2013-12-02
0012011-06-01LINDA HOWELL2012-10-04 LINDA HOWELL2012-10-04
0012010-06-01LINDA HOWELL2012-10-04 LINDA HOWELL2012-10-04

Plan Statistics for GEORGIA HIGHLANDS MEDICAL SERVICES, INC 403(B) RETIREMENT PLAN

401k plan membership statisitcs for GEORGIA HIGHLANDS MEDICAL SERVICES, INC 403(B) RETIREMENT PLAN

Measure Date Value
2022: GEORGIA HIGHLANDS MEDICAL SERVICES, INC 403(B) RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year2022-06-01192
Total number of active participants reported on line 7a of the Form 55002022-06-01160
Number of retired or separated participants receiving benefits2022-06-010
Number of other retired or separated participants entitled to future benefits2022-06-0126
Total of all active and inactive participants2022-06-01186
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-06-010
Total participants2022-06-01186
Number of participants with account balances2022-06-01100
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-06-017
2021: GEORGIA HIGHLANDS MEDICAL SERVICES, INC 403(B) RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year2021-06-01149
Total number of active participants reported on line 7a of the Form 55002021-06-01159
Number of retired or separated participants receiving benefits2021-06-010
Number of other retired or separated participants entitled to future benefits2021-06-0133
Total of all active and inactive participants2021-06-01192
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-06-010
Total participants2021-06-01192
Number of participants with account balances2021-06-01105
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-06-019
2020: GEORGIA HIGHLANDS MEDICAL SERVICES, INC 403(B) RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year2020-06-01155
Total number of active participants reported on line 7a of the Form 55002020-06-01123
Number of retired or separated participants receiving benefits2020-06-010
Number of other retired or separated participants entitled to future benefits2020-06-0125
Total of all active and inactive participants2020-06-01148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-06-010
Total participants2020-06-01148
Number of participants with account balances2020-06-0199
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-06-018
2019: GEORGIA HIGHLANDS MEDICAL SERVICES, INC 403(B) RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year2019-06-01128
Total number of active participants reported on line 7a of the Form 55002019-06-01124
Number of retired or separated participants receiving benefits2019-06-010
Number of other retired or separated participants entitled to future benefits2019-06-0131
Total of all active and inactive participants2019-06-01155
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-06-010
Total participants2019-06-01155
Number of participants with account balances2019-06-01104
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-06-016
2018: GEORGIA HIGHLANDS MEDICAL SERVICES, INC 403(B) RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year2018-06-01124
Total number of active participants reported on line 7a of the Form 55002018-06-01113
Number of retired or separated participants receiving benefits2018-06-010
Number of other retired or separated participants entitled to future benefits2018-06-0115
Total of all active and inactive participants2018-06-01128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-06-010
Total participants2018-06-01128
Number of participants with account balances2018-06-01105
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-06-015

Financial Data on GEORGIA HIGHLANDS MEDICAL SERVICES, INC 403(B) RETIREMENT PLAN

Measure Date Value
2023 : GEORGIA HIGHLANDS MEDICAL SERVICES, INC 403(B) RETIREMENT PLAN 2023 401k financial data
Total unrealized appreciation/depreciation of assets2023-05-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-05-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-05-31$0
Total income from all sources (including contributions)2023-05-31$663,135
Total loss/gain on sale of assets2023-05-31$0
Total of all expenses incurred2023-05-31$414,805
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-05-31$382,786
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-05-31$653,923
Value of total assets at end of year2023-05-31$5,340,032
Value of total assets at beginning of year2023-05-31$5,091,702
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-05-31$32,019
Total interest from all sources2023-05-31$12,525
Total dividends received (eg from common stock, registered investment company shares)2023-05-31$117,488
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-05-31No
Total dividends received from registered investment company shares (eg mutual funds)2023-05-31$117,488
Was this plan covered by a fidelity bond2023-05-31Yes
Value of fidelity bond cover2023-05-31$500,000
If this is an individual account plan, was there a blackout period2023-05-31No
Were there any nonexempt tranactions with any party-in-interest2023-05-31No
Contributions received from participants2023-05-31$393,659
Participant contributions at end of year2023-05-31$59,083
Participant contributions at beginning of year2023-05-31$81,664
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-05-31No
Value of net income/loss2023-05-31$248,330
Value of net assets at end of year (total assets less liabilities)2023-05-31$5,340,032
Value of net assets at beginning of year (total assets less liabilities)2023-05-31$5,091,702
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-05-31No
Were any leases to which the plan was party in default or uncollectible2023-05-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2023-05-31$4,889,656
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2023-05-31$4,652,951
Interest on participant loans2023-05-31$3,012
Interest earned on other investments2023-05-31$9,513
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2023-05-31$391,293
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2023-05-31$357,087
Net investment gain/loss from registered investment companies (e.g. mutual funds)2023-05-31$-120,801
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-05-31No
Was there a failure to transmit to the plan any participant contributions2023-05-31No
Has the plan failed to provide any benefit when due under the plan2023-05-31No
Contributions received in cash from employer2023-05-31$260,264
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-05-31$382,786
Contract administrator fees2023-05-31$32,019
Did the plan have assets held for investment2023-05-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-05-31No
Opinion of an independent qualified public accountant for this plan2023-05-31Disclaimer
Accountancy firm name2023-05-31JONES AND KOLB, CPAS
Accountancy firm EIN2023-05-31581763570
2022 : GEORGIA HIGHLANDS MEDICAL SERVICES, INC 403(B) RETIREMENT PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-05-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-05-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-05-31$0
Total income from all sources (including contributions)2022-05-31$248,909
Total loss/gain on sale of assets2022-05-31$0
Total of all expenses incurred2022-05-31$226,276
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-05-31$181,961
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-05-31$585,684
Value of total assets at end of year2022-05-31$5,091,702
Value of total assets at beginning of year2022-05-31$5,069,069
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-05-31$44,315
Total interest from all sources2022-05-31$12,837
Total dividends received (eg from common stock, registered investment company shares)2022-05-31$526,637
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-05-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-05-31$526,637
Was this plan covered by a fidelity bond2022-05-31Yes
Value of fidelity bond cover2022-05-31$500,000
If this is an individual account plan, was there a blackout period2022-05-31No
Were there any nonexempt tranactions with any party-in-interest2022-05-31No
Contributions received from participants2022-05-31$351,134
Participant contributions at end of year2022-05-31$81,664
Participant contributions at beginning of year2022-05-31$90,211
Income. Received or receivable in cash from other sources (including rollovers)2022-05-31$4,490
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-05-31No
Value of net income/loss2022-05-31$22,633
Value of net assets at end of year (total assets less liabilities)2022-05-31$5,091,702
Value of net assets at beginning of year (total assets less liabilities)2022-05-31$5,069,069
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-05-31No
Were any leases to which the plan was party in default or uncollectible2022-05-31No
Investment advisory and management fees2022-05-31$3,700
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-05-31$4,652,951
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-05-31$4,588,746
Interest on participant loans2022-05-31$3,636
Interest earned on other investments2022-05-31$9,201
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-05-31$357,087
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-05-31$390,112
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-05-31$-876,249
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-05-31No
Was there a failure to transmit to the plan any participant contributions2022-05-31No
Has the plan failed to provide any benefit when due under the plan2022-05-31No
Contributions received in cash from employer2022-05-31$230,060
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-05-31$181,961
Contract administrator fees2022-05-31$40,615
Did the plan have assets held for investment2022-05-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-05-31No
Opinion of an independent qualified public accountant for this plan2022-05-31Disclaimer
Accountancy firm name2022-05-31JONES AND KOLB, CPAS
Accountancy firm EIN2022-05-31581763570
2021 : GEORGIA HIGHLANDS MEDICAL SERVICES, INC 403(B) RETIREMENT PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-05-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-05-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-05-31$0
Total income from all sources (including contributions)2021-05-31$1,724,048
Total loss/gain on sale of assets2021-05-31$0
Total of all expenses incurred2021-05-31$192,907
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-05-31$160,590
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-05-31$548,947
Value of total assets at end of year2021-05-31$5,069,069
Value of total assets at beginning of year2021-05-31$3,537,928
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-05-31$32,317
Total interest from all sources2021-05-31$12,049
Total dividends received (eg from common stock, registered investment company shares)2021-05-31$90,320
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-05-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-05-31$90,320
Was this plan covered by a fidelity bond2021-05-31Yes
Value of fidelity bond cover2021-05-31$500,000
If this is an individual account plan, was there a blackout period2021-05-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-05-31$0
Were there any nonexempt tranactions with any party-in-interest2021-05-31No
Contributions received from participants2021-05-31$331,083
Participant contributions at end of year2021-05-31$90,211
Participant contributions at beginning of year2021-05-31$58,721
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-05-31No
Value of net income/loss2021-05-31$1,531,141
Value of net assets at end of year (total assets less liabilities)2021-05-31$5,069,069
Value of net assets at beginning of year (total assets less liabilities)2021-05-31$3,537,928
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-05-31No
Were any leases to which the plan was party in default or uncollectible2021-05-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-05-31$4,588,746
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-05-31$3,186,357
Interest on participant loans2021-05-31$3,046
Interest earned on other investments2021-05-31$9,003
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-05-31$390,112
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-05-31$292,850
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-05-31$1,072,732
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-05-31No
Was there a failure to transmit to the plan any participant contributions2021-05-31Yes
Has the plan failed to provide any benefit when due under the plan2021-05-31No
Contributions received in cash from employer2021-05-31$217,864
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-05-31$160,590
Contract administrator fees2021-05-31$32,317
Did the plan have assets held for investment2021-05-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-05-31No
Opinion of an independent qualified public accountant for this plan2021-05-31Disclaimer
Accountancy firm name2021-05-31JONES AND KOLB, CPAS
Accountancy firm EIN2021-05-31581763570
2020 : GEORGIA HIGHLANDS MEDICAL SERVICES, INC 403(B) RETIREMENT PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-05-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-05-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-05-31$0
Total income from all sources (including contributions)2020-05-31$658,383
Total loss/gain on sale of assets2020-05-31$0
Total of all expenses incurred2020-05-31$105,508
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-05-31$73,270
Expenses. Certain deemed distributions of participant loans2020-05-31$4,020
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-05-31$517,877
Value of total assets at end of year2020-05-31$3,537,928
Value of total assets at beginning of year2020-05-31$2,985,053
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-05-31$28,218
Total interest from all sources2020-05-31$13,195
Total dividends received (eg from common stock, registered investment company shares)2020-05-31$74,398
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-05-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-05-31$74,398
Was this plan covered by a fidelity bond2020-05-31Yes
Value of fidelity bond cover2020-05-31$310,000
If this is an individual account plan, was there a blackout period2020-05-31Yes
Were there any nonexempt tranactions with any party-in-interest2020-05-31No
Contributions received from participants2020-05-31$307,192
Participant contributions at end of year2020-05-31$58,721
Participant contributions at beginning of year2020-05-31$55,517
Other income not declared elsewhere2020-05-31$0
Administrative expenses (other) incurred2020-05-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-05-31No
Value of net income/loss2020-05-31$552,875
Value of net assets at end of year (total assets less liabilities)2020-05-31$3,537,928
Value of net assets at beginning of year (total assets less liabilities)2020-05-31$2,985,053
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-05-31No
Were any leases to which the plan was party in default or uncollectible2020-05-31No
Investment advisory and management fees2020-05-31$9,784
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-05-31$3,186,357
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-05-31$2,519,568
Interest on participant loans2020-05-31$2,850
Interest earned on other investments2020-05-31$10,345
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-05-31$292,850
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-05-31$409,968
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-05-31$52,913
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-05-31No
Was there a failure to transmit to the plan any participant contributions2020-05-31No
Has the plan failed to provide any benefit when due under the plan2020-05-31No
Contributions received in cash from employer2020-05-31$210,685
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-05-31$73,270
Contract administrator fees2020-05-31$18,434
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-05-31Yes
Did the plan have assets held for investment2020-05-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-05-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-05-31Yes
Opinion of an independent qualified public accountant for this plan2020-05-31Disclaimer
Accountancy firm name2020-05-31JONES AND KOLB, CPAS
Accountancy firm EIN2020-05-31581763570
2019 : GEORGIA HIGHLANDS MEDICAL SERVICES, INC 403(B) RETIREMENT PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-05-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-05-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-05-31$0
Total income from all sources (including contributions)2019-05-31$488,952
Total loss/gain on sale of assets2019-05-31$0
Total of all expenses incurred2019-05-31$296,461
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-05-31$270,947
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-05-31$473,150
Value of total assets at end of year2019-05-31$2,985,053
Value of total assets at beginning of year2019-05-31$2,792,562
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-05-31$25,514
Total interest from all sources2019-05-31$11,815
Total dividends received (eg from common stock, registered investment company shares)2019-05-31$109,354
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-05-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-05-31$109,354
Was this plan covered by a fidelity bond2019-05-31Yes
Value of fidelity bond cover2019-05-31$310,000
If this is an individual account plan, was there a blackout period2019-05-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-05-31$0
Were there any nonexempt tranactions with any party-in-interest2019-05-31No
Contributions received from participants2019-05-31$286,295
Participant contributions at end of year2019-05-31$55,517
Participant contributions at beginning of year2019-05-31$69,948
Income. Received or receivable in cash from other sources (including rollovers)2019-05-31$19,165
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-05-31No
Value of net income/loss2019-05-31$192,491
Value of net assets at end of year (total assets less liabilities)2019-05-31$2,985,053
Value of net assets at beginning of year (total assets less liabilities)2019-05-31$2,792,562
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-05-31No
Were any leases to which the plan was party in default or uncollectible2019-05-31No
Investment advisory and management fees2019-05-31$11,089
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-05-31$2,519,568
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-05-31$2,339,631
Interest on participant loans2019-05-31$2,546
Interest earned on other investments2019-05-31$9,269
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-05-31$409,968
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-05-31$382,983
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-05-31$-105,367
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-05-31No
Was there a failure to transmit to the plan any participant contributions2019-05-31No
Has the plan failed to provide any benefit when due under the plan2019-05-31No
Contributions received in cash from employer2019-05-31$167,690
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-05-31$270,947
Contract administrator fees2019-05-31$14,425
Did the plan have assets held for investment2019-05-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-05-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-05-31Yes
Opinion of an independent qualified public accountant for this plan2019-05-31Disclaimer
Accountancy firm name2019-05-31JONES AND KOLB
Accountancy firm EIN2019-05-31581763570

Form 5500 Responses for GEORGIA HIGHLANDS MEDICAL SERVICES, INC 403(B) RETIREMENT PLAN

2022: GEORGIA HIGHLANDS MEDICAL SERVICES, INC 403(B) RETIREMENT PLAN 2022 form 5500 responses
2022-06-01Type of plan entitySingle employer plan
2022-06-01Submission has been amendedNo
2022-06-01This submission is the final filingNo
2022-06-01This return/report is a short plan year return/report (less than 12 months)No
2022-06-01Plan is a collectively bargained planNo
2022-06-01Plan funding arrangement – InsuranceYes
2022-06-01Plan funding arrangement – TrustYes
2022-06-01Plan benefit arrangement – InsuranceYes
2022-06-01Plan benefit arrangement - TrustYes
2021: GEORGIA HIGHLANDS MEDICAL SERVICES, INC 403(B) RETIREMENT PLAN 2021 form 5500 responses
2021-06-01Type of plan entitySingle employer plan
2021-06-01Submission has been amendedNo
2021-06-01This submission is the final filingNo
2021-06-01This return/report is a short plan year return/report (less than 12 months)No
2021-06-01Plan is a collectively bargained planNo
2021-06-01Plan funding arrangement – InsuranceYes
2021-06-01Plan funding arrangement – TrustYes
2021-06-01Plan benefit arrangement – InsuranceYes
2021-06-01Plan benefit arrangement - TrustYes
2020: GEORGIA HIGHLANDS MEDICAL SERVICES, INC 403(B) RETIREMENT PLAN 2020 form 5500 responses
2020-06-01Type of plan entitySingle employer plan
2020-06-01Submission has been amendedNo
2020-06-01This submission is the final filingNo
2020-06-01This return/report is a short plan year return/report (less than 12 months)No
2020-06-01Plan is a collectively bargained planNo
2020-06-01Plan funding arrangement – InsuranceYes
2020-06-01Plan funding arrangement – TrustYes
2020-06-01Plan benefit arrangement – InsuranceYes
2020-06-01Plan benefit arrangement - TrustYes
2019: GEORGIA HIGHLANDS MEDICAL SERVICES, INC 403(B) RETIREMENT PLAN 2019 form 5500 responses
2019-06-01Type of plan entitySingle employer plan
2019-06-01Submission has been amendedNo
2019-06-01This submission is the final filingNo
2019-06-01This return/report is a short plan year return/report (less than 12 months)No
2019-06-01Plan is a collectively bargained planNo
2019-06-01Plan funding arrangement – InsuranceYes
2019-06-01Plan funding arrangement – TrustYes
2019-06-01Plan benefit arrangement – InsuranceYes
2019-06-01Plan benefit arrangement - TrustYes
2018: GEORGIA HIGHLANDS MEDICAL SERVICES, INC 403(B) RETIREMENT PLAN 2018 form 5500 responses
2018-06-01Type of plan entitySingle employer plan
2018-06-01Submission has been amendedNo
2018-06-01This submission is the final filingNo
2018-06-01This return/report is a short plan year return/report (less than 12 months)No
2018-06-01Plan is a collectively bargained planNo
2018-06-01Plan funding arrangement – InsuranceYes
2018-06-01Plan funding arrangement – TrustYes
2018-06-01Plan benefit arrangement – InsuranceYes
2018-06-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number68216
Policy instance 3
Insurance contract or identification number68216
Number of Individuals Covered8
Insurance policy start date2022-06-01
Insurance policy end date2023-05-31
Total amount of commissions paid to insurance brokerUSD $154
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $154
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberCR28728
Policy instance 2
Insurance contract or identification numberCR28728
Number of Individuals Covered8
Insurance policy start date2022-06-01
Insurance policy end date2023-05-31
Total amount of commissions paid to insurance brokerUSD $1,274
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,274
Insurance broker organization code?4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number893322007
Policy instance 1
Insurance contract or identification number893322007
Number of Individuals Covered11
Insurance policy start date2022-06-01
Insurance policy end date2023-05-31
Total amount of commissions paid to insurance brokerUSD $393
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $393
Insurance broker organization code?4
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number68216
Policy instance 3
Insurance contract or identification number68216
Number of Individuals Covered8
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $183
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $172
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberCR28728
Policy instance 2
Insurance contract or identification numberCR28728
Number of Individuals Covered8
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $1,161
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,161
Insurance broker organization code?4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number893322007
Policy instance 1
Insurance contract or identification number893322007
Number of Individuals Covered13
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $809
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $809
Insurance broker organization code?4
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number68216
Policy instance 3
Insurance contract or identification number68216
Number of Individuals Covered9
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $154
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $144
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberCR28728
Policy instance 2
Insurance contract or identification numberCR28728
Number of Individuals Covered8
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $1,261
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,261
Insurance broker organization code?4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number893322007
Policy instance 1
Insurance contract or identification number893322007
Number of Individuals Covered12
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $722
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $722
Insurance broker organization code?4
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number68216
Policy instance 3
Insurance contract or identification number68216
Number of Individuals Covered9
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $134
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $122
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberCR28728
Policy instance 2
Insurance contract or identification numberCR28728
Number of Individuals Covered9
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $1,155
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,155
Insurance broker organization code?4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number893322007
Policy instance 1
Insurance contract or identification number893322007
Number of Individuals Covered12
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $457
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $274
Insurance broker organization code?4
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number68216
Policy instance 3
Insurance contract or identification number68216
Number of Individuals Covered9
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $146
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $132
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberCR28728
Policy instance 2
Insurance contract or identification numberCR28728
Number of Individuals Covered9
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $1,111
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,111
Insurance broker organization code?4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number893322007
Policy instance 1
Insurance contract or identification number893322007
Number of Individuals Covered74
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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