TRI-STATE INSULATION COMPANY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan TRI-STATE INSULATION COMPANY 401(K) PLAN
| Measure | Date | Value |
|---|
| 2014: TRI-STATE INSULATION COMPANY 401(K) PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 34 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 39 |
| 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 | 3 |
| Total of all active and inactive participants | 2014-01-01 | 42 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-01-01 | 0 |
| Total participants | 2014-01-01 | 42 |
| Number of participants with account balances | 2014-01-01 | 20 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2014-01-01 | 2 |
| 2013: TRI-STATE INSULATION COMPANY 401(K) PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 32 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 31 |
| 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 | 4 |
| Total of all active and inactive participants | 2013-01-01 | 35 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-01-01 | 0 |
| Total participants | 2013-01-01 | 35 |
| Number of participants with account balances | 2013-01-01 | 20 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-01-01 | 3 |
| 2012: TRI-STATE INSULATION COMPANY 401(K) PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 31 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 24 |
| 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 | 4 |
| Total of all active and inactive participants | 2012-01-01 | 28 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-01-01 | 0 |
| Total participants | 2012-01-01 | 28 |
| Number of participants with account balances | 2012-01-01 | 17 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-01-01 | 1 |
| 2011: TRI-STATE INSULATION COMPANY 401(K) PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 23 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 18 |
| 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 | 5 |
| Total of all active and inactive participants | 2011-01-01 | 23 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-01-01 | 0 |
| Total participants | 2011-01-01 | 23 |
| Number of participants with account balances | 2011-01-01 | 19 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2011-01-01 | 0 |
| 2010: TRI-STATE INSULATION COMPANY 401(K) PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 25 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 17 |
| Number of retired or separated participants receiving benefits | 2010-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2010-01-01 | 2 |
| Total of all active and inactive participants | 2010-01-01 | 19 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2010-01-01 | 0 |
| Total participants | 2010-01-01 | 19 |
| Number of participants with account balances | 2010-01-01 | 19 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2010-01-01 | 0 |
| 2009: TRI-STATE INSULATION COMPANY 401(K) PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 31 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 21 |
| 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 | 6 |
| Total of all active and inactive participants | 2009-01-01 | 27 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-01-01 | 0 |
| Total participants | 2009-01-01 | 27 |
| Number of participants with account balances | 2009-01-01 | 23 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-01-01 | 0 |
| 2008: TRI-STATE INSULATION COMPANY 401(K) PLAN 2008 401k membership |
|---|
| Total participants, beginning-of-year | 2008-01-01 | 31 |
| Total number of active participants reported on line 7a of the Form 5500 | 2008-01-01 | 24 |
| Number of retired or separated participants receiving benefits | 2008-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2008-01-01 | 6 |
| Total of all active and inactive participants | 2008-01-01 | 30 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2008-01-01 | 0 |
| Total participants | 2008-01-01 | 30 |
| Number of participants with account balances | 2008-01-01 | 26 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2008-01-01 | 0 |
| Measure | Date | Value |
|---|
| 2014 : TRI-STATE INSULATION COMPANY 401(K) PLAN 2014 401k financial data |
|---|
| Transfers to/from the plan | 2014-12-31 | $170 |
| Total income from all sources | 2014-12-31 | $83,384 |
| Expenses. Total of all expenses incurred | 2014-12-31 | $302,377 |
| Benefits paid (including direct rollovers) | 2014-12-31 | $302,361 |
| Total plan assets at end of year | 2014-12-31 | $822,137 |
| Total plan assets at beginning of year | 2014-12-31 | $1,040,960 |
| Value of fidelity bond covering the plan | 2014-12-31 | $50,000 |
| Total contributions received or receivable from participants | 2014-12-31 | $42,446 |
| Expenses. Other expenses not covered elsewhere | 2014-12-31 | $16 |
| Contributions received from other sources (not participants or employers) | 2014-12-31 | $0 |
| Other income received | 2014-12-31 | $32,285 |
| Net income (gross income less expenses) | 2014-12-31 | $-218,993 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $822,137 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $1,040,960 |
| Assets. Value of participant loans | 2014-12-31 | $721 |
| Total contributions received or receivable from employer(s) | 2014-12-31 | $8,653 |
| Value of certain deemed distributions of participant loans | 2014-12-31 | $0 |
| Value of corrective distributions | 2014-12-31 | $0 |
| Funding deficiency by the employer to the plan for this plan year | 2014-12-31 | $0 |
| Minimum employer required contribution for this plan year | 2014-12-31 | $0 |
| Amount contributed by the employer to the plan for this plan year | 2014-12-31 | $0 |
| 2013 : TRI-STATE INSULATION COMPANY 401(K) PLAN 2013 401k financial data |
|---|
| Transfers to/from the plan | 2013-12-31 | $0 |
| Total income from all sources | 2013-12-31 | $213,884 |
| Expenses. Total of all expenses incurred | 2013-12-31 | $49,071 |
| Benefits paid (including direct rollovers) | 2013-12-31 | $49,055 |
| Total plan assets at end of year | 2013-12-31 | $1,040,960 |
| Total plan assets at beginning of year | 2013-12-31 | $876,147 |
| Value of fidelity bond covering the plan | 2013-12-31 | $50,000 |
| Total contributions received or receivable from participants | 2013-12-31 | $41,161 |
| Expenses. Other expenses not covered elsewhere | 2013-12-31 | $16 |
| Contributions received from other sources (not participants or employers) | 2013-12-31 | $0 |
| Other income received | 2013-12-31 | $167,547 |
| Net income (gross income less expenses) | 2013-12-31 | $164,813 |
| Net plan assets at end of year (total assets less liabilities) | 2013-12-31 | $1,040,960 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-12-31 | $876,147 |
| Assets. Value of participant loans | 2013-12-31 | $721 |
| Total contributions received or receivable from employer(s) | 2013-12-31 | $5,176 |
| Value of certain deemed distributions of participant loans | 2013-12-31 | $0 |
| Value of corrective distributions | 2013-12-31 | $0 |
| Funding deficiency by the employer to the plan for this plan year | 2013-12-31 | $0 |
| Minimum employer required contribution for this plan year | 2013-12-31 | $0 |
| Amount contributed by the employer to the plan for this plan year | 2013-12-31 | $0 |
| 2012 : TRI-STATE INSULATION COMPANY 401(K) PLAN 2012 401k financial data |
|---|
| Transfers to/from the plan | 2012-12-31 | $0 |
| Total income from all sources | 2012-12-31 | $132,194 |
| Expenses. Total of all expenses incurred | 2012-12-31 | $25,739 |
| Benefits paid (including direct rollovers) | 2012-12-31 | $25,723 |
| Total plan assets at end of year | 2012-12-31 | $876,147 |
| Total plan assets at beginning of year | 2012-12-31 | $769,692 |
| Value of fidelity bond covering the plan | 2012-12-31 | $50,000 |
| Total contributions received or receivable from participants | 2012-12-31 | $36,562 |
| Expenses. Other expenses not covered elsewhere | 2012-12-31 | $16 |
| Contributions received from other sources (not participants or employers) | 2012-12-31 | $0 |
| Other income received | 2012-12-31 | $91,347 |
| Net income (gross income less expenses) | 2012-12-31 | $106,455 |
| Net plan assets at end of year (total assets less liabilities) | 2012-12-31 | $876,147 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-12-31 | $769,692 |
| Assets. Value of participant loans | 2012-12-31 | $721 |
| Total contributions received or receivable from employer(s) | 2012-12-31 | $4,285 |
| Value of certain deemed distributions of participant loans | 2012-12-31 | $0 |
| Value of corrective distributions | 2012-12-31 | $0 |
| Funding deficiency by the employer to the plan for this plan year | 2012-12-31 | $0 |
| Minimum employer required contribution for this plan year | 2012-12-31 | $0 |
| Amount contributed by the employer to the plan for this plan year | 2012-12-31 | $0 |
| 2011 : TRI-STATE INSULATION COMPANY 401(K) PLAN 2011 401k financial data |
|---|
| Transfers to/from the plan | 2011-12-31 | $533 |
| Total income from all sources | 2011-12-31 | $14,725 |
| Expenses. Total of all expenses incurred | 2011-12-31 | $10,787 |
| Benefits paid (including direct rollovers) | 2011-12-31 | $10,771 |
| Total plan assets at end of year | 2011-12-31 | $769,692 |
| Total plan assets at beginning of year | 2011-12-31 | $765,221 |
| Value of fidelity bond covering the plan | 2011-12-31 | $50,000 |
| Total contributions received or receivable from participants | 2011-12-31 | $41,901 |
| Expenses. Other expenses not covered elsewhere | 2011-12-31 | $16 |
| Contributions received from other sources (not participants or employers) | 2011-12-31 | $0 |
| Other income received | 2011-12-31 | $-32,519 |
| Net income (gross income less expenses) | 2011-12-31 | $3,938 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-31 | $769,692 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-31 | $765,221 |
| Assets. Value of participant loans | 2011-12-31 | $721 |
| Total contributions received or receivable from employer(s) | 2011-12-31 | $5,343 |
| Value of certain deemed distributions of participant loans | 2011-12-31 | $0 |
| Value of corrective distributions | 2011-12-31 | $0 |
| Funding deficiency by the employer to the plan for this plan year | 2011-12-31 | $0 |
| Minimum employer required contribution for this plan year | 2011-12-31 | $0 |
| Amount contributed by the employer to the plan for this plan year | 2011-12-31 | $0 |
| 2010 : TRI-STATE INSULATION COMPANY 401(K) PLAN 2010 401k financial data |
|---|
| Transfers to/from the plan | 2010-12-31 | $0 |
| Total income from all sources | 2010-12-31 | $119,616 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $14,473 |
| Benefits paid (including direct rollovers) | 2010-12-31 | $14,249 |
| Total plan assets at end of year | 2010-12-31 | $765,221 |
| Total plan assets at beginning of year | 2010-12-31 | $660,078 |
| Value of fidelity bond covering the plan | 2010-12-31 | $50,000 |
| Total contributions received or receivable from participants | 2010-12-31 | $36,928 |
| Expenses. Other expenses not covered elsewhere | 2010-12-31 | $224 |
| Contributions received from other sources (not participants or employers) | 2010-12-31 | $0 |
| Other income received | 2010-12-31 | $76,794 |
| Net income (gross income less expenses) | 2010-12-31 | $105,143 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $765,221 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $660,078 |
| Assets. Value of participant loans | 2010-12-31 | $721 |
| Total contributions received or receivable from employer(s) | 2010-12-31 | $5,894 |
| Value of certain deemed distributions of participant loans | 2010-12-31 | $0 |
| Value of corrective distributions | 2010-12-31 | $0 |
| Funding deficiency by the employer to the plan for this plan year | 2010-12-31 | $0 |
| Minimum employer required contribution for this plan year | 2010-12-31 | $0 |
| Amount contributed by the employer to the plan for this plan year | 2010-12-31 | $0 |
| 2009 : TRI-STATE INSULATION COMPANY 401(K) PLAN 2009 401k financial data |
|---|
| Funding deficiency by the employer to the plan for this plan year | 2009-12-31 | $0 |
| Minimum employer required contribution for this plan year | 2009-12-31 | $0 |
| Amount contributed by the employer to the plan for this plan year | 2009-12-31 | $0 |
| 2008 : TRI-STATE INSULATION COMPANY 401(K) PLAN 2008 401k financial data |
|---|
| Total income from all sources | 2008-12-31 | $-138,806 |
| Expenses. Total of all expenses incurred | 2008-12-31 | $241,956 |
| Benefits paid (including direct rollovers) | 2008-12-31 | $231,804 |
| Total plan assets at end of year | 2008-12-31 | $509,731 |
| Total plan assets at beginning of year | 2008-12-31 | $890,493 |
| Value of fidelity bond covering the plan | 2008-12-31 | $50,000 |
| Total contributions received or receivable from participants | 2008-12-31 | $66,994 |
| Expenses. Other expenses not covered elsewhere | 2008-12-31 | $306 |
| Contributions received from other sources (not participants or employers) | 2008-12-31 | $0 |
| Other income received | 2008-12-31 | $-217,066 |
| Net income (gross income less expenses) | 2008-12-31 | $-380,762 |
| Net plan assets at end of year (total assets less liabilities) | 2008-12-31 | $509,731 |
| Net plan assets at beginning of year (total assets less liabilities) | 2008-12-31 | $890,493 |
| Assets. Value of participant loans | 2008-12-31 | $1,868 |
| Total contributions received or receivable from employer(s) | 2008-12-31 | $11,266 |
| Value of corrective distributions | 2008-12-31 | $9,846 |
| 2014: TRI-STATE INSULATION COMPANY 401(K) 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 |
| 2013: TRI-STATE INSULATION COMPANY 401(K) 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 |
| 2012: TRI-STATE INSULATION COMPANY 401(K) 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 |
| 2011: TRI-STATE INSULATION COMPANY 401(K) 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 |
| 2010: TRI-STATE INSULATION COMPANY 401(K) PLAN 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Submission has been amended | No |
| 2010-01-01 | This submission is the final filing | No |
| 2010-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-01-01 | Plan is a collectively bargained plan | No |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan funding arrangement – Trust | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: TRI-STATE INSULATION COMPANY 401(K) 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 |
| 2008: TRI-STATE INSULATION COMPANY 401(K) PLAN 2008 form 5500 responses |
|---|
| 2008-01-01 | Type of plan entity | Single employer plan |
| 2008-01-01 | Submission has been amended | No |
| 2008-01-01 | This submission is the final filing | No |
| 2008-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2008-01-01 | Plan is a collectively bargained plan | No |
| 2008-01-01 | Plan funding arrangement – Insurance | Yes |
| 2008-01-01 | Plan funding arrangement – Trust | Yes |
| 2008-01-01 | Plan benefit arrangement – Insurance | Yes |
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-800835 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-800835 | | Number of Individuals Covered | 20 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $1,941 | | 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? | Yes | | 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 $1,941 | | Insurance broker organization code? | 3 | | Insurance broker name | WOODBURY FIN SVCS INC |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-800835 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-800835 | | Number of Individuals Covered | 20 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $1,683 | | 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? | Yes | | 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 $1,683 | | Insurance broker organization code? | 3 | | Insurance broker name | WOODBURY FINANCIAL SVCS INC |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-800835 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-800835 | | Number of Individuals Covered | 24 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $1,615 | | 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? | Yes | | 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 $1,615 | | Insurance broker organization code? | 3 | | Insurance broker name | WOODBURY FINANCIAL SVCS INC |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-800835 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-800835 | | Number of Individuals Covered | 19 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $1,540 | | 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? | Yes | | 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 |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-800835 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-800835 | | Number of Individuals Covered | 19 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $1,330 | | 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? | Yes | | 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 $1,330 | | Insurance broker organization code? | 3 | | Insurance broker name | WOODBURY FINANCIAL SVCS INC |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-800835 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-800835 | | Number of Individuals Covered | 26 | | Insurance policy start date | 2008-01-01 | | Insurance policy end date | 2008-12-31 | | Total amount of commissions paid to insurance broker | USD $1,580 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,580 | | Insurance broker organization code? | 3 | | Insurance broker name | WOODBURY FINANCIAL SVCS INC. |
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