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UNITED BUILDING GROUP, LLC 401(K) PLAN 401k Plan overview

Plan NameUNITED BUILDING GROUP, LLC 401(K) PLAN
Plan identification number 001

UNITED BUILDING GROUP, LLC 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • 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

UNITED BUILDING GROUP, LLC has sponsored the creation of one or more 401k plans.

Company Name:UNITED BUILDING GROUP, LLC
Employer identification number (EIN):611742729
NAIC Classification:238300

Additional information about UNITED BUILDING GROUP, LLC

Jurisdiction of Incorporation: Virginia Secretary of State
Incorporation Date: 2013-05-10
Company Identification Number: S454299
Legal Registered Office Address: 9204 VENTURE COURT

MANASSAS
United States of America (USA)
20111

More information about UNITED BUILDING GROUP, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UNITED BUILDING GROUP, LLC 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012021-01-01
0012020-01-01
0012019-01-01DAVID WRIGHT2020-10-13
0012018-01-01
0012017-01-01DAVID WRIGHT2018-09-21

Plan Statistics for UNITED BUILDING GROUP, LLC 401(K) PLAN

401k plan membership statisitcs for UNITED BUILDING GROUP, LLC 401(K) PLAN

Measure Date Value
2020: UNITED BUILDING GROUP, LLC 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01145
Total number of active participants reported on line 7a of the Form 55002020-01-0188
Number of retired or separated participants receiving benefits2020-01-011
Number of other retired or separated participants entitled to future benefits2020-01-0118
Total of all active and inactive participants2020-01-01107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01107
Number of participants with account balances2020-01-0154
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: UNITED BUILDING GROUP, LLC 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01154
Total number of active participants reported on line 7a of the Form 55002019-01-01111
Number of retired or separated participants receiving benefits2019-01-011
Number of other retired or separated participants entitled to future benefits2019-01-019
Total of all active and inactive participants2019-01-01121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01121
Number of participants with account balances2019-01-01121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-0153
2018: UNITED BUILDING GROUP, LLC 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01149
Total number of active participants reported on line 7a of the Form 55002018-01-01122
Number of retired or separated participants receiving benefits2018-01-011
Number of other retired or separated participants entitled to future benefits2018-01-017
Total of all active and inactive participants2018-01-01130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01130
Number of participants with account balances2018-01-0146
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010

Financial Data on UNITED BUILDING GROUP, LLC 401(K) PLAN

Measure Date Value
2020 : UNITED BUILDING GROUP, LLC 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$672,652
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$404,147
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$384,062
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$271,380
Value of total assets at end of year2020-12-31$2,867,847
Value of total assets at beginning of year2020-12-31$2,599,342
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$20,085
Total interest from all sources2020-12-31$68
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$159,710
Participant contributions at end of year2020-12-31$0
Participant contributions at beginning of year2020-12-31$2,112
Participant contributions at end of year2020-12-31$8,721
Participant contributions at beginning of year2020-12-31$0
Other income not declared elsewhere2020-12-31$5,807
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$268,505
Value of net assets at end of year (total assets less liabilities)2020-12-31$2,867,847
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$2,599,342
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Investment advisory and management fees2020-12-31$331
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$2,470,828
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$2,242,228
Interest on participant loans2020-12-31$68
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$383,317
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$355,002
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$395,397
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$111,670
Employer contributions (assets) at end of year2020-12-31$4,981
Employer contributions (assets) at beginning of year2020-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$384,062
Contract administrator fees2020-12-31$19,754
Did the plan have assets held for investment2020-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
2019 : UNITED BUILDING GROUP, LLC 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$236
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$236
Total income from all sources (including contributions)2019-12-31$680,905
Total income from all sources (including contributions)2019-12-31$680,905
Total loss/gain on sale of assets2019-12-31$0
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$145,873
Total of all expenses incurred2019-12-31$145,873
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$126,673
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$290,916
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$290,916
Value of total assets at end of year2019-12-31$2,599,342
Value of total assets at beginning of year2019-12-31$2,064,546
Value of total assets at beginning of year2019-12-31$2,064,546
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$19,200
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$19,200
Total interest from all sources2019-12-31$101
Total interest from all sources2019-12-31$101
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$165,639
Contributions received from participants2019-12-31$165,639
Participant contributions at end of year2019-12-31$2,112
Participant contributions at end of year2019-12-31$2,112
Participant contributions at end of year2019-12-31$0
Participant contributions at beginning of year2019-12-31$10,563
Participant contributions at beginning of year2019-12-31$10,563
Other income not declared elsewhere2019-12-31$3,690
Other income not declared elsewhere2019-12-31$3,690
Administrative expenses (other) incurred2019-12-31$525
Administrative expenses (other) incurred2019-12-31$525
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$535,032
Value of net income/loss2019-12-31$535,032
Value of net assets at end of year (total assets less liabilities)2019-12-31$2,599,342
Value of net assets at end of year (total assets less liabilities)2019-12-31$2,599,342
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$2,064,310
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$2,064,310
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$2,242,228
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$2,242,228
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$1,682,208
Interest on participant loans2019-12-31$101
Interest on participant loans2019-12-31$101
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$355,002
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$355,002
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$363,475
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$363,475
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$386,198
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$386,198
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$125,277
Contributions received in cash from employer2019-12-31$125,277
Employer contributions (assets) at end of year2019-12-31$0
Employer contributions (assets) at end of year2019-12-31$0
Employer contributions (assets) at beginning of year2019-12-31$8,300
Employer contributions (assets) at beginning of year2019-12-31$8,300
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$126,673
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$126,673
Contract administrator fees2019-12-31$18,675
Contract administrator fees2019-12-31$18,675
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$236
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$236
Did the plan have assets held for investment2019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31DAVIDSON, DOYLE & HILTON, LLP
Accountancy firm name2019-12-31DAVIDSON, DOYLE & HILTON, LLP
Accountancy firm EIN2019-12-31541953476
Accountancy firm EIN2019-12-31541953476
2018 : UNITED BUILDING GROUP, LLC 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$236
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$173,727
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$107,376
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$90,075
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$275,208
Value of total assets at end of year2018-12-31$2,064,546
Value of total assets at beginning of year2018-12-31$1,997,959
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$17,301
Total interest from all sources2018-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$153,699
Participant contributions at end of year2018-12-31$10,563
Other income not declared elsewhere2018-12-31$5,902
Administrative expenses (other) incurred2018-12-31$640
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$66,351
Value of net assets at end of year (total assets less liabilities)2018-12-31$2,064,310
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$1,997,959
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$1,682,208
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$1,674,946
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$363,475
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$323,013
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-107,383
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$121,509
Employer contributions (assets) at end of year2018-12-31$8,300
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$90,075
Contract administrator fees2018-12-31$16,661
Liabilities. Value of benefit claims payable at end of year2018-12-31$236
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31DAVIDSON, DOYLE & HILTON, LLP
Accountancy firm EIN2018-12-31541953476

Form 5500 Responses for UNITED BUILDING GROUP, LLC 401(K) PLAN

2020: UNITED BUILDING GROUP, LLC 401(K) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement - TrustYes
2019: UNITED BUILDING GROUP, LLC 401(K) PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement - TrustYes
2018: UNITED BUILDING GROUP, LLC 401(K) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number52380093
Policy instance 1
Insurance contract or identification number52380093
Number of Individuals Covered107
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,856
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $1,856
Insurance broker organization code?3
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number52380093
Policy instance 1
Insurance contract or identification number52380093
Number of Individuals Covered121
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $2,010
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $2,010
Insurance broker organization code?3
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number52380093
Policy instance 1
Insurance contract or identification number52380093
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $1,669
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $1,669
Insurance broker organization code?3

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