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WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN 401k Plan overview

Plan NameWELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN
Plan identification number 005

WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS 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(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.
  • 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.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

WELLMONT HEALTH SYSTEM has sponsored the creation of one or more 401k plans.

Company Name:WELLMONT HEALTH SYSTEM
Employer identification number (EIN):621636465
NAIC Classification:622000
NAIC Description: Hospitals

Additional information about WELLMONT HEALTH SYSTEM

Jurisdiction of Incorporation: Virginia Secretary of State
Incorporation Date: 1996-06-14
Company Identification Number: F125749
Legal Registered Office Address: 131 EAST VALLEY STREET

ABINGDON
United States of America (USA)
24210

More information about WELLMONT HEALTH SYSTEM

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0052017-07-01
0052017-07-01
0052016-07-01HAMLIN J. WILSON HAMLIN J. WILSON2018-04-16
0052015-07-01HAMLIN J. WILSON HAMLIN J. WILSON2017-04-17
0052014-07-01HAMLIN J. WILSON
0052013-07-01HAMLIN J. WILSON
0052012-07-01HAMLIN J. WILSON
0052011-07-01HAMLIN J. WILSON
0052009-07-01HAMLIN J. WILSON

Plan Statistics for WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN

401k plan membership statisitcs for WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN

Measure Date Value
2017: WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-018,686
Total number of active participants reported on line 7a of the Form 55002017-07-010
Number of retired or separated participants receiving benefits2017-07-010
Number of other retired or separated participants entitled to future benefits2017-07-010
Total of all active and inactive participants2017-07-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-07-010
Total participants2017-07-010
Number of participants with account balances2017-07-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-07-01135
2016: WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-018,956
Total number of active participants reported on line 7a of the Form 55002016-07-017,324
Number of retired or separated participants receiving benefits2016-07-010
Number of other retired or separated participants entitled to future benefits2016-07-012,249
Total of all active and inactive participants2016-07-019,573
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-07-010
Total participants2016-07-019,573
Number of participants with account balances2016-07-016,645
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-07-01110
2015: WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-017,444
Total number of active participants reported on line 7a of the Form 55002015-07-014,993
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-012,488
Total of all active and inactive participants2015-07-017,481
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-07-010
Total participants2015-07-017,481
Number of participants with account balances2015-07-016,781
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-07-01107
2014: WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-017,485
Total number of active participants reported on line 7a of the Form 55002014-07-015,288
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-012,179
Total of all active and inactive participants2014-07-017,467
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-07-010
Total participants2014-07-017,467
Number of participants with account balances2014-07-016,643
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-07-01109
2013: WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-016,841
Total number of active participants reported on line 7a of the Form 55002013-07-015,136
Number of retired or separated participants receiving benefits2013-07-0164
Number of other retired or separated participants entitled to future benefits2013-07-011,692
Total of all active and inactive participants2013-07-016,892
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-07-010
Total participants2013-07-016,892
Number of participants with account balances2013-07-016,518
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-07-01254
2012: WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year2012-07-017,186
Total number of active participants reported on line 7a of the Form 55002012-07-015,163
Number of retired or separated participants receiving benefits2012-07-0179
Number of other retired or separated participants entitled to future benefits2012-07-011,837
Total of all active and inactive participants2012-07-017,079
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-07-010
Total participants2012-07-017,079
Number of participants with account balances2012-07-016,870
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-07-01127
2011: WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year2011-07-016,914
Total number of active participants reported on line 7a of the Form 55002011-07-015,247
Number of retired or separated participants receiving benefits2011-07-0158
Number of other retired or separated participants entitled to future benefits2011-07-011,911
Total of all active and inactive participants2011-07-017,216
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-07-010
Total participants2011-07-017,216
Number of participants with account balances2011-07-016,803
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-07-01117
2009: WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year2009-07-016,912
Total number of active participants reported on line 7a of the Form 55002009-07-015,656
Number of retired or separated participants receiving benefits2009-07-0178
Number of other retired or separated participants entitled to future benefits2009-07-011,516
Total of all active and inactive participants2009-07-017,250
Total participants2009-07-017,250
Number of participants with account balances2009-07-016,444
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-07-01115

Financial Data on WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN

Measure Date Value
2018 : WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-06-30$0
Total transfer of assets from this plan2018-06-30$170,488,906
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-06-30$0
Total income from all sources (including contributions)2018-06-30$23,890,152
Total loss/gain on sale of assets2018-06-30$0
Total of all expenses incurred2018-06-30$13,196,090
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-06-30$13,041,954
Expenses. Certain deemed distributions of participant loans2018-06-30$-4,918
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-06-30$11,055,769
Value of total assets at end of year2018-06-30$170,488,906
Value of total assets at beginning of year2018-06-30$159,794,844
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-06-30$159,054
Total interest from all sources2018-06-30$915,968
Total dividends received (eg from common stock, registered investment company shares)2018-06-30$4,952,022
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-06-30No
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2018-06-30$0
Total dividends received from registered investment company shares (eg mutual funds)2018-06-30$4,952,022
Was this plan covered by a fidelity bond2018-06-30Yes
Value of fidelity bond cover2018-06-30$10,000,000
If this is an individual account plan, was there a blackout period2018-06-30Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-06-30$0
Were there any nonexempt tranactions with any party-in-interest2018-06-30No
Participant contributions at end of year2018-06-30$28,956
Participant contributions at beginning of year2018-06-30$8,086
Income. Received or receivable in cash from other sources (including rollovers)2018-06-30$1,617,892
Administrative expenses (other) incurred2018-06-30$530
Total non interest bearing cash at end of year2018-06-30$133,612,414
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-06-30No
Value of net income/loss2018-06-30$10,694,062
Value of net assets at end of year (total assets less liabilities)2018-06-30$170,488,906
Value of net assets at beginning of year (total assets less liabilities)2018-06-30$159,794,844
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2018-06-30No
Were any leases to which the plan was party in default or uncollectible2018-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-06-30$21,100,561
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-06-30$118,184,385
Interest on participant loans2018-06-30$1,242
Interest earned on other investments2018-06-30$914,726
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-06-30$15,746,975
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-06-30$41,602,373
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-06-30$6,966,393
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-06-30No
Was there a failure to transmit to the plan any participant contributions2018-06-30No
Has the plan failed to provide any benefit when due under the plan2018-06-30No
Contributions received in cash from employer2018-06-30$9,437,877
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-06-30$13,041,954
Contract administrator fees2018-06-30$158,524
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-06-30Yes
Did the plan have assets held for investment2018-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-06-30Yes
Opinion of an independent qualified public accountant for this plan2018-06-30Disclaimer
Accountancy firm name2018-06-30PYA, P.C.
Accountancy firm EIN2018-06-30621517792
2017 : WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-06-30$0
Total income from all sources (including contributions)2017-06-30$24,279,100
Total loss/gain on sale of assets2017-06-30$0
Total of all expenses incurred2017-06-30$8,268,075
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-06-30$8,157,023
Expenses. Certain deemed distributions of participant loans2017-06-30$-4,184
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-06-30$8,025,695
Value of total assets at end of year2017-06-30$159,794,844
Value of total assets at beginning of year2017-06-30$143,783,819
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-06-30$115,236
Total interest from all sources2017-06-30$937,316
Total dividends received (eg from common stock, registered investment company shares)2017-06-30$3,447,005
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2017-06-30$3,447,005
Was this plan covered by a fidelity bond2017-06-30Yes
Value of fidelity bond cover2017-06-30$10,000,000
If this is an individual account plan, was there a blackout period2017-06-30No
Were there any nonexempt tranactions with any party-in-interest2017-06-30No
Participant contributions at end of year2017-06-30$8,086
Participant contributions at beginning of year2017-06-30$9,116
Income. Received or receivable in cash from other sources (including rollovers)2017-06-30$16,096
Administrative expenses (other) incurred2017-06-30$99
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-06-30No
Value of net income/loss2017-06-30$16,011,025
Value of net assets at end of year (total assets less liabilities)2017-06-30$159,794,844
Value of net assets at beginning of year (total assets less liabilities)2017-06-30$143,783,819
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2017-06-30No
Were any leases to which the plan was party in default or uncollectible2017-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-06-30$118,184,385
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-06-30$103,031,021
Interest on participant loans2017-06-30$209
Interest earned on other investments2017-06-30$937,107
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-06-30$41,602,373
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-06-30$40,743,682
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-06-30$11,869,084
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-06-30No
Was there a failure to transmit to the plan any participant contributions2017-06-30No
Has the plan failed to provide any benefit when due under the plan2017-06-30No
Contributions received in cash from employer2017-06-30$8,009,599
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-06-30$8,157,023
Contract administrator fees2017-06-30$115,137
Did the plan have assets held for investment2017-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-06-30Yes
Opinion of an independent qualified public accountant for this plan2017-06-30Disclaimer
Accountancy firm name2017-06-30ROEDEFER MOSS & CO., PLLC
Accountancy firm EIN2017-06-30621690032
2016 : WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-06-30$0
Expenses. Interest paid2016-06-30$-5,482
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022016-06-30$-5,482
Total income from all sources (including contributions)2016-06-30$8,213,497
Total loss/gain on sale of assets2016-06-30$0
Total of all expenses incurred2016-06-30$8,807,538
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-06-30$8,701,805
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-06-30$7,872,461
Value of total assets at end of year2016-06-30$143,783,819
Value of total assets at beginning of year2016-06-30$144,377,860
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-06-30$111,215
Total interest from all sources2016-06-30$1,017,696
Total dividends received (eg from common stock, registered investment company shares)2016-06-30$6,495,441
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2016-06-30$6,495,441
Was this plan covered by a fidelity bond2016-06-30Yes
Value of fidelity bond cover2016-06-30$10,000,000
If this is an individual account plan, was there a blackout period2016-06-30No
Were there any nonexempt tranactions with any party-in-interest2016-06-30No
Participant contributions at end of year2016-06-30$9,116
Participant contributions at beginning of year2016-06-30$11,099
Administrative expenses (other) incurred2016-06-30$113
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-06-30No
Value of net income/loss2016-06-30$-594,041
Value of net assets at end of year (total assets less liabilities)2016-06-30$143,783,819
Value of net assets at beginning of year (total assets less liabilities)2016-06-30$144,377,860
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2016-06-30No
Were any leases to which the plan was party in default or uncollectible2016-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-06-30$103,031,021
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-06-30$105,925,375
Interest on participant loans2016-06-30$248
Interest earned on other investments2016-06-30$1,017,448
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-06-30$40,743,682
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-06-30$38,441,386
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-06-30$-7,172,101
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-06-30No
Was there a failure to transmit to the plan any participant contributions2016-06-30No
Has the plan failed to provide any benefit when due under the plan2016-06-30No
Contributions received in cash from employer2016-06-30$7,872,461
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-06-30$8,701,805
Contract administrator fees2016-06-30$111,102
Did the plan have assets held for investment2016-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-06-30Yes
Opinion of an independent qualified public accountant for this plan2016-06-30Disclaimer
Accountancy firm name2016-06-30RODEFER MOSS & CO., PLLC
Accountancy firm EIN2016-06-30621690032
2015 : WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-06-30$0
Total income from all sources (including contributions)2015-06-30$4,623,677
Total loss/gain on sale of assets2015-06-30$0
Total of all expenses incurred2015-06-30$9,625,533
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-06-30$9,518,231
Expenses. Certain deemed distributions of participant loans2015-06-30$-578
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-06-30$-535,413
Value of total assets at end of year2015-06-30$144,377,860
Value of total assets at beginning of year2015-06-30$149,379,716
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-06-30$107,880
Total interest from all sources2015-06-30$1,000,149
Total dividends received (eg from common stock, registered investment company shares)2015-06-30$5,465,602
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2015-06-30$5,465,602
Was this plan covered by a fidelity bond2015-06-30Yes
Value of fidelity bond cover2015-06-30$10,000,000
If this is an individual account plan, was there a blackout period2015-06-30No
Were there any nonexempt tranactions with any party-in-interest2015-06-30No
Participant contributions at end of year2015-06-30$11,099
Participant contributions at beginning of year2015-06-30$12,971
Administrative expenses (other) incurred2015-06-30$876
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-06-30No
Value of net income/loss2015-06-30$-5,001,856
Value of net assets at end of year (total assets less liabilities)2015-06-30$144,377,860
Value of net assets at beginning of year (total assets less liabilities)2015-06-30$149,379,716
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2015-06-30No
Were any leases to which the plan was party in default or uncollectible2015-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-06-30$105,925,375
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-06-30$104,604,887
Interest on participant loans2015-06-30$285
Interest earned on other investments2015-06-30$999,864
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-06-30$38,441,386
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-06-30$38,800,722
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-06-30$-1,306,661
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-06-30No
Was there a failure to transmit to the plan any participant contributions2015-06-30No
Has the plan failed to provide any benefit when due under the plan2015-06-30No
Contributions received in cash from employer2015-06-30$-535,413
Employer contributions (assets) at beginning of year2015-06-30$5,961,136
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-06-30$9,518,231
Contract administrator fees2015-06-30$107,004
Did the plan have assets held for investment2015-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-06-30Yes
Opinion of an independent qualified public accountant for this plan2015-06-30Disclaimer
Accountancy firm name2015-06-30ROEDEFER MOSS & CO., PLLC
Accountancy firm EIN2015-06-30621690032
2014 : WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-06-30$0
Total income from all sources (including contributions)2014-06-30$26,708,895
Total loss/gain on sale of assets2014-06-30$0
Total of all expenses incurred2014-06-30$9,399,192
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-06-30$9,261,227
Expenses. Certain deemed distributions of participant loans2014-06-30$-1,743
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-06-30$8,987,802
Value of total assets at end of year2014-06-30$149,379,716
Value of total assets at beginning of year2014-06-30$132,070,013
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-06-30$139,708
Total interest from all sources2014-06-30$1,020,001
Total dividends received (eg from common stock, registered investment company shares)2014-06-30$2,920,480
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2014-06-30$2,920,480
Was this plan covered by a fidelity bond2014-06-30Yes
Value of fidelity bond cover2014-06-30$10,000,000
If this is an individual account plan, was there a blackout period2014-06-30No
Were there any nonexempt tranactions with any party-in-interest2014-06-30No
Participant contributions at end of year2014-06-30$12,971
Participant contributions at beginning of year2014-06-30$19,206
Income. Received or receivable in cash from other sources (including rollovers)2014-06-30$6,780
Administrative expenses (other) incurred2014-06-30$105
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-06-30No
Value of net income/loss2014-06-30$17,309,703
Value of net assets at end of year (total assets less liabilities)2014-06-30$149,379,716
Value of net assets at beginning of year (total assets less liabilities)2014-06-30$132,070,013
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2014-06-30No
Were any leases to which the plan was party in default or uncollectible2014-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-06-30$104,604,887
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-06-30$91,342,628
Interest on participant loans2014-06-30$438
Interest earned on other investments2014-06-30$1,019,563
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-06-30$38,800,722
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-06-30$38,000,416
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-06-30$13,780,612
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-06-30No
Was there a failure to transmit to the plan any participant contributions2014-06-30No
Has the plan failed to provide any benefit when due under the plan2014-06-30No
Contributions received in cash from employer2014-06-30$8,981,022
Employer contributions (assets) at end of year2014-06-30$5,961,136
Employer contributions (assets) at beginning of year2014-06-30$2,707,763
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-06-30$9,261,227
Contract administrator fees2014-06-30$139,603
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-06-30No
Did the plan have assets held for investment2014-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-06-30Yes
Opinion of an independent qualified public accountant for this plan2014-06-30Disclaimer
Accountancy firm name2014-06-30ROEDEFER MOSS & CO., PLLC
Accountancy firm EIN2014-06-30621690032
2013 : WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-06-30$0
Total income from all sources (including contributions)2013-06-30$23,945,233
Total loss/gain on sale of assets2013-06-30$0
Total of all expenses incurred2013-06-30$6,118,938
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-06-30$5,969,025
Expenses. Certain deemed distributions of participant loans2013-06-30$-2,326
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-06-30$11,277,307
Value of total assets at end of year2013-06-30$132,070,013
Value of total assets at beginning of year2013-06-30$114,243,718
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-06-30$152,239
Total interest from all sources2013-06-30$976,808
Total dividends received (eg from common stock, registered investment company shares)2013-06-30$1,863,694
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2013-06-30$1,863,694
Was this plan covered by a fidelity bond2013-06-30Yes
Value of fidelity bond cover2013-06-30$10,000,000
If this is an individual account plan, was there a blackout period2013-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-06-30$0
Were there any nonexempt tranactions with any party-in-interest2013-06-30No
Participant contributions at end of year2013-06-30$19,206
Participant contributions at beginning of year2013-06-30$10,420
Income. Received or receivable in cash from other sources (including rollovers)2013-06-30$6,788
Administrative expenses (other) incurred2013-06-30$439
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-06-30No
Value of net income/loss2013-06-30$17,826,295
Value of net assets at end of year (total assets less liabilities)2013-06-30$132,070,013
Value of net assets at beginning of year (total assets less liabilities)2013-06-30$114,243,718
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2013-06-30No
Were any leases to which the plan was party in default or uncollectible2013-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-06-30$91,342,628
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-06-30$76,924,646
Interest on participant loans2013-06-30$581
Interest earned on other investments2013-06-30$976,227
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-06-30$38,000,416
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-06-30$34,733,067
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-06-30$9,827,424
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-06-30No
Was there a failure to transmit to the plan any participant contributions2013-06-30No
Has the plan failed to provide any benefit when due under the plan2013-06-30No
Contributions received in cash from employer2013-06-30$11,270,519
Employer contributions (assets) at end of year2013-06-30$2,707,763
Employer contributions (assets) at beginning of year2013-06-30$2,575,585
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-06-30$5,969,025
Contract administrator fees2013-06-30$151,800
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-06-30No
Did the plan have assets held for investment2013-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-06-30Yes
Opinion of an independent qualified public accountant for this plan2013-06-30Disclaimer
Accountancy firm name2013-06-30RODEFER MOSS & CO., PLLC
Accountancy firm EIN2013-06-30621690032
2012 : WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN 2012 401k financial data
Total transfer of assets to this plan2012-06-30$387,983
Total income from all sources (including contributions)2012-06-30$10,321,686
Total of all expenses incurred2012-06-30$8,128,078
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-06-30$7,930,216
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-06-30$10,602,306
Value of total assets at end of year2012-06-30$114,243,718
Value of total assets at beginning of year2012-06-30$111,662,127
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-06-30$197,862
Total interest from all sources2012-06-30$350
Total dividends received (eg from common stock, registered investment company shares)2012-06-30$1,538,004
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2012-06-30$1,538,004
Was this plan covered by a fidelity bond2012-06-30Yes
Value of fidelity bond cover2012-06-30$1,000,000
If this is an individual account plan, was there a blackout period2012-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-06-30$0
Minimum employer required contribution for this plan year2012-06-30$0
Amount contributed by the employer to the plan for this plan year2012-06-30$0
Were there any nonexempt tranactions with any party-in-interest2012-06-30No
Participant contributions at end of year2012-06-30$10,420
Participant contributions at beginning of year2012-06-30$2,957
Income. Received or receivable in cash from other sources (including rollovers)2012-06-30$-16,429
Other income not declared elsewhere2012-06-30$886,054
Administrative expenses (other) incurred2012-06-30$197,862
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-06-30No
Value of net income/loss2012-06-30$2,193,608
Value of net assets at end of year (total assets less liabilities)2012-06-30$114,243,718
Value of net assets at beginning of year (total assets less liabilities)2012-06-30$111,662,127
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2012-06-30No
Were any leases to which the plan was party in default or uncollectible2012-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-06-30$76,924,646
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-06-30$76,416,373
Interest on participant loans2012-06-30$350
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-06-30$34,733,067
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-06-30$32,728,052
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-06-30$-2,705,028
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-06-30No
Was there a failure to transmit to the plan any participant contributions2012-06-30No
Has the plan failed to provide any benefit when due under the plan2012-06-30No
Contributions received in cash from employer2012-06-30$10,618,735
Employer contributions (assets) at end of year2012-06-30$2,575,585
Employer contributions (assets) at beginning of year2012-06-30$2,514,745
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-06-30$7,930,216
Did the plan have assets held for investment2012-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-06-30Yes
Opinion of an independent qualified public accountant for this plan2012-06-30Disclaimer
Accountancy firm name2012-06-30KPMG LLP
Accountancy firm EIN2012-06-30135565207
2011 : WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN 2011 401k financial data
Total transfer of assets to this plan2011-06-30$250,881
Total income from all sources (including contributions)2011-06-30$26,841,671
Total of all expenses incurred2011-06-30$8,641,150
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-06-30$8,467,565
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-06-30$10,482,317
Value of total assets at end of year2011-06-30$111,662,127
Value of total assets at beginning of year2011-06-30$93,210,725
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-06-30$173,585
Total interest from all sources2011-06-30$62
Total dividends received (eg from common stock, registered investment company shares)2011-06-30$1,337,511
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2011-06-30$1,337,511
Was this plan covered by a fidelity bond2011-06-30Yes
Value of fidelity bond cover2011-06-30$1,000,000
If this is an individual account plan, was there a blackout period2011-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-06-30$0
Were there any nonexempt tranactions with any party-in-interest2011-06-30No
Participant contributions at end of year2011-06-30$2,957
Participant contributions at beginning of year2011-06-30$15,478
Income. Received or receivable in cash from other sources (including rollovers)2011-06-30$159,718
Other income not declared elsewhere2011-06-30$1,359,052
Administrative expenses (other) incurred2011-06-30$173,585
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-06-30No
Value of net income/loss2011-06-30$18,200,521
Value of net assets at end of year (total assets less liabilities)2011-06-30$111,662,127
Value of net assets at beginning of year (total assets less liabilities)2011-06-30$93,210,725
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2011-06-30No
Were any leases to which the plan was party in default or uncollectible2011-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-06-30$76,416,373
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-06-30$58,443,597
Interest on participant loans2011-06-30$62
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-06-30$32,728,052
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-06-30$31,369,000
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-06-30$13,662,729
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-06-30No
Was there a failure to transmit to the plan any participant contributions2011-06-30No
Has the plan failed to provide any benefit when due under the plan2011-06-30No
Contributions received in cash from employer2011-06-30$10,322,599
Employer contributions (assets) at end of year2011-06-30$2,514,745
Employer contributions (assets) at beginning of year2011-06-30$3,382,650
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-06-30$8,467,565
Did the plan have assets held for investment2011-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-06-30Yes
Opinion of an independent qualified public accountant for this plan2011-06-30Disclaimer
Accountancy firm name2011-06-30KPMG LLP
Accountancy firm EIN2011-06-30135565207

Form 5500 Responses for WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN

2017: WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Submission has been amendedYes
2017-07-01This submission is the final filingYes
2017-07-01This return/report is a short plan year return/report (less than 12 months)No
2017-07-01Plan is a collectively bargained planNo
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan funding arrangement – TrustYes
2017-07-01Plan benefit arrangement – InsuranceYes
2017-07-01Plan benefit arrangement - TrustYes
2016: WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Submission has been amendedNo
2016-07-01This submission is the final filingNo
2016-07-01This return/report is a short plan year return/report (less than 12 months)No
2016-07-01Plan is a collectively bargained planNo
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan funding arrangement – TrustYes
2016-07-01Plan benefit arrangement – InsuranceYes
2016-07-01Plan benefit arrangement - TrustYes
2015: WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan funding arrangement – TrustYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-07-01Plan benefit arrangement - TrustYes
2014: WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan funding arrangement – TrustYes
2014-07-01Plan benefit arrangement – InsuranceYes
2014-07-01Plan benefit arrangement - TrustYes
2013: WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan funding arrangement – TrustYes
2013-07-01Plan benefit arrangement – InsuranceYes
2013-07-01Plan benefit arrangement - TrustYes
2012: WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan funding arrangement – TrustYes
2012-07-01Plan benefit arrangement – InsuranceYes
2012-07-01Plan benefit arrangement - TrustYes
2011: WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan funding arrangement – TrustYes
2011-07-01Plan benefit arrangement – InsuranceYes
2011-07-01Plan benefit arrangement - TrustYes
2009: WELLMONT HEALTH SYSTEM 401(A) RETIREMENT SAVINGS PLAN 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan funding arrangement – TrustYes
2009-07-01Plan benefit arrangement – InsuranceYes
2009-07-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number54494-014
Policy instance 5
Insurance contract or identification number54494-014
Number of Individuals Covered0
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $48
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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number54494
Policy instance 1
Insurance contract or identification number54494
Number of Individuals Covered17
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $45
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number54494
Policy instance 2
Insurance contract or identification number54494
Number of Individuals Covered0
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
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
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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number54494
Policy instance 3
Insurance contract or identification number54494
Number of Individuals Covered2085
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $4,003
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number54494
Policy instance 4
Insurance contract or identification number54494
Number of Individuals Covered0
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
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
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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number
Policy instance 5
Number of Individuals Covered33
Total amount of commissions paid to insurance brokerUSD $48
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number54494-011
Policy instance 1
Insurance contract or identification number54494-011
Number of Individuals Covered0
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $45
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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number54494-002
Policy instance 3
Insurance contract or identification number54494-002
Number of Individuals Covered0
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $4,003
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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number54494
Policy instance 4
Insurance contract or identification number54494
Number of Individuals Covered5911
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?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 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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number54494
Policy instance 3
Insurance contract or identification number54494
Number of Individuals Covered2506
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $3,575
Total amount of fees paid to insurance companyUSD $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 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 $3,117
Insurance broker organization code?3
Insurance broker nameROSE, MATTHEW J
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number54494
Policy instance 2
Insurance contract or identification number54494
Number of Individuals Covered18
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?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 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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number54494
Policy instance 1
Insurance contract or identification number54494
Number of Individuals Covered20
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $60
Total amount of fees paid to insurance companyUSD $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 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 $60
Insurance broker organization code?3
Insurance broker nameHASELTON, WILFRED C
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number54494
Policy instance 4
Insurance contract or identification number54494
Number of Individuals Covered19
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?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 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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number54494
Policy instance 3
Insurance contract or identification number54494
Number of Individuals Covered22
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $48
Total amount of fees paid to insurance companyUSD $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 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 $48
Insurance broker organization code?3
Insurance broker nameHASELTON, WILFRED C
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number54494
Policy instance 2
Insurance contract or identification number54494
Number of Individuals Covered5655
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?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 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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number54494
Policy instance 1
Insurance contract or identification number54494
Number of Individuals Covered2785
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $5,417
Total amount of fees paid to insurance companyUSD $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 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 $4,599
Insurance broker organization code?3
Insurance broker nameCROMER, JOSHUA
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number54494
Policy instance 4
Insurance contract or identification number54494
Number of Individuals Covered19
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?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 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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number54494
Policy instance 2
Insurance contract or identification number54494
Number of Individuals Covered5395
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?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 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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number54494
Policy instance 1
Insurance contract or identification number54494
Number of Individuals Covered3154
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $6,889
Total amount of fees paid to insurance companyUSD $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 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 $3,605
Insurance broker organization code?3
Insurance broker nameWILDER, KIMBERLY S
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number54494
Policy instance 3
Insurance contract or identification number54494
Number of Individuals Covered24
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $28
Total amount of fees paid to insurance companyUSD $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 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 $28
Insurance broker organization code?3
Insurance broker nameHASELTON, WILFRED C
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number54494
Policy instance 4
Insurance contract or identification number54494
Number of Individuals Covered19
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?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 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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number54494
Policy instance 2
Insurance contract or identification number54494
Number of Individuals Covered5369
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?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 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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number54494
Policy instance 3
Insurance contract or identification number54494
Number of Individuals Covered28
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?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 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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number54494
Policy instance 1
Insurance contract or identification number54494
Number of Individuals Covered3834
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $5,629
Total amount of fees paid to insurance companyUSD $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 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 $2,741
Insurance broker organization code?3
Insurance broker nameHAWKINS, CHARLES H
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number54494
Policy instance 3
Insurance contract or identification number54494
Number of Individuals Covered4787
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $110,507
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number54494
Policy instance 2
Insurance contract or identification number54494
Number of Individuals Covered18
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number54494
Policy instance 1
Insurance contract or identification number54494
Number of Individuals Covered31
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $83
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number54494
Policy instance 4
Insurance contract or identification number54494
Number of Individuals Covered2155
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number54494
Policy instance 2
Insurance contract or identification number54494
Number of Individuals Covered52
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number54494
Policy instance 1
Insurance contract or identification number54494
Number of Individuals Covered6064
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $103,549
Total amount of fees paid to insurance companyUSD $0
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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