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TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN 401k Plan overview

Plan NameTUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN
Plan identification number 002

TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING 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.
  • Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

TUSCALOOSA EAR, NOSE, THROAT CENTER P.C. has sponsored the creation of one or more 401k plans.

Company Name:TUSCALOOSA EAR, NOSE, THROAT CENTER P.C.
Employer identification number (EIN):630726764
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022022-01-01
0022021-01-01
0022021-01-01DR. CARL STEPHENSON2024-02-06
0022020-01-01
0022019-01-01
0022018-01-01
0022017-01-01
0022016-01-01DR. CARL STEPHENSON
0022015-01-01CARLISLE STEPHENSON, III, MD
0022014-01-01DR. CARL STEPHENSON
0022014-01-01CARLISLE STEPHENSON, III, MD
0022013-01-01CARL STEPHENSON, III, MD
0022012-01-01CARL STEPHENSON III, MD
0022011-01-01CARL STEPHENSON III, MD
0022009-01-01CARL STEPHENSON III, MD

Plan Statistics for TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN

401k plan membership statisitcs for TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN

Measure Date Value
2017: TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0146
Total number of active participants reported on line 7a of the Form 55002017-01-0121
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0124
Total of all active and inactive participants2017-01-0145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0145
Number of participants with account balances2017-01-0145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-016
2016: TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0145
Total number of active participants reported on line 7a of the Form 55002016-01-0130
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0116
Total of all active and inactive participants2016-01-0146
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0146
Number of participants with account balances2016-01-0145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0148
Total number of active participants reported on line 7a of the Form 55002015-01-0125
Number of retired or separated participants receiving benefits2015-01-013
Number of other retired or separated participants entitled to future benefits2015-01-0118
Total of all active and inactive participants2015-01-0146
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0146
Number of participants with account balances2015-01-0146
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-015
2014: TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0134
Total number of active participants reported on line 7a of the Form 55002014-01-0130
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-0130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0130
Number of participants with account balances2014-01-0130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0151
Total number of active participants reported on line 7a of the Form 55002013-01-0136
Number of retired or separated participants receiving benefits2013-01-012
Number of other retired or separated participants entitled to future benefits2013-01-0112
Total of all active and inactive participants2013-01-0150
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0150
Number of participants with account balances2013-01-0143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-012
2012: TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0142
Total number of active participants reported on line 7a of the Form 55002012-01-0132
Number of other retired or separated participants entitled to future benefits2012-01-0113
Total of all active and inactive participants2012-01-0145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0145
Number of participants with account balances2012-01-0145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-013
2011: TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0146
Total number of active participants reported on line 7a of the Form 55002011-01-0130
Number of other retired or separated participants entitled to future benefits2011-01-0112
Total of all active and inactive participants2011-01-0142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0142
Number of participants with account balances2011-01-0142
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-011
2009: TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0147
Total number of active participants reported on line 7a of the Form 55002009-01-0131
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0114
Total of all active and inactive participants2009-01-0145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0145
Number of participants with account balances2009-01-0145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-012

Financial Data on TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN

Measure Date Value
2017 : TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources2017-12-31$1,463,711
Expenses. Total of all expenses incurred2017-12-31$94,255
Benefits paid (including direct rollovers)2017-12-31$67,805
Total plan assets at end of year2017-12-31$7,659,965
Total plan assets at beginning of year2017-12-31$6,290,509
Value of fidelity bond covering the plan2017-12-31$500,000
Assets. Value of tangible personal property2017-12-31$0
Total contributions received or receivable from participants2017-12-31$146,608
Other income received2017-12-31$1,063,272
Net income (gross income less expenses)2017-12-31$1,369,456
Net plan assets at end of year (total assets less liabilities)2017-12-31$7,659,965
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$6,290,509
Total contributions received or receivable from employer(s)2017-12-31$253,831
Value of corrective distributions2017-12-31$52
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$26,398
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources2016-12-31$620,173
Expenses. Total of all expenses incurred2016-12-31$1,234,996
Benefits paid (including direct rollovers)2016-12-31$1,213,784
Total plan assets at end of year2016-12-31$6,290,509
Total plan assets at beginning of year2016-12-31$6,905,332
Value of fidelity bond covering the plan2016-12-31$500,000
Assets. Value of tangible personal property2016-12-31$10,974
Total contributions received or receivable from participants2016-12-31$127,593
Other income received2016-12-31$266,002
Net income (gross income less expenses)2016-12-31$-614,823
Net plan assets at end of year (total assets less liabilities)2016-12-31$6,290,509
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$6,905,332
Total contributions received or receivable from employer(s)2016-12-31$226,578
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$21,212
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources2015-12-31$234,997
Expenses. Total of all expenses incurred2015-12-31$468,332
Benefits paid (including direct rollovers)2015-12-31$428,054
Total plan assets at end of year2015-12-31$6,905,332
Total plan assets at beginning of year2015-12-31$7,138,667
Value of fidelity bond covering the plan2015-12-31$500,000
Assets. Value of tangible personal property2015-12-31$35,594
Total contributions received or receivable from participants2015-12-31$124,200
Contributions received from other sources (not participants or employers)2015-12-31$20,000
Other income received2015-12-31$-135,610
Net income (gross income less expenses)2015-12-31$-233,335
Net plan assets at end of year (total assets less liabilities)2015-12-31$6,905,332
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$7,138,667
Total contributions received or receivable from employer(s)2015-12-31$226,407
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$40,278
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources2014-12-31$538,533
Expenses. Total of all expenses incurred2014-12-31$45,326
Benefits paid (including direct rollovers)2014-12-31$28,022
Total plan assets at end of year2014-12-31$7,450,987
Total plan assets at beginning of year2014-12-31$6,957,780
Value of fidelity bond covering the plan2014-12-31$500,000
Assets. Value of tangible personal property2014-12-31$2,236
Total contributions received or receivable from participants2014-12-31$124,321
Contributions received from other sources (not participants or employers)2014-12-31$4,900
Other income received2014-12-31$173,915
Net income (gross income less expenses)2014-12-31$493,207
Net plan assets at end of year (total assets less liabilities)2014-12-31$7,450,987
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$6,957,780
Total contributions received or receivable from employer(s)2014-12-31$235,397
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$17,304
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources2013-12-31$1,121,822
Expenses. Total of all expenses incurred2013-12-31$107,212
Benefits paid (including direct rollovers)2013-12-31$93,275
Total plan assets at end of year2013-12-31$6,957,780
Total plan assets at beginning of year2013-12-31$5,943,170
Value of fidelity bond covering the plan2013-12-31$500,000
Assets. Value of tangible personal property2013-12-31$24,061
Total contributions received or receivable from participants2013-12-31$127,018
Noncash contributions received2013-12-31$763,739
Net income (gross income less expenses)2013-12-31$1,014,610
Net plan assets at end of year (total assets less liabilities)2013-12-31$6,957,780
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$5,943,170
Assets. Value of assets in partnership/joint-venture interests2013-12-31$14,671
Total contributions received or receivable from employer(s)2013-12-31$231,065
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$13,937
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources2012-12-31$953,965
Expenses. Total of all expenses incurred2012-12-31$359,721
Benefits paid (including direct rollovers)2012-12-31$323,324
Total plan assets at end of year2012-12-31$5,943,170
Total plan assets at beginning of year2012-12-31$5,348,926
Value of fidelity bond covering the plan2012-12-31$500,000
Assets. Value of tangible personal property2012-12-31$37,165
Total contributions received or receivable from participants2012-12-31$119,469
Other income received2012-12-31$603,677
Net income (gross income less expenses)2012-12-31$594,244
Net plan assets at end of year (total assets less liabilities)2012-12-31$5,943,170
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$5,348,926
Assets. Value of assets in partnership/joint-venture interests2012-12-31$16,474
Total contributions received or receivable from employer(s)2012-12-31$230,819
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$36,397
2011 : TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources2011-12-31$-14,376
Expenses. Total of all expenses incurred2011-12-31$7,645,134
Benefits paid (including direct rollovers)2011-12-31$7,623,792
Total plan assets at end of year2011-12-31$5,350,927
Total plan assets at beginning of year2011-12-31$13,010,437
Value of fidelity bond covering the plan2011-12-31$500,000
Assets. Value of tangible personal property2011-12-31$40,055
Total contributions received or receivable from participants2011-12-31$127,198
Other income received2011-12-31$-361,638
Net income (gross income less expenses)2011-12-31$-7,659,510
Net plan assets at end of year (total assets less liabilities)2011-12-31$5,350,927
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$13,010,437
Assets. Value of assets in partnership/joint-venture interests2011-12-31$25,915
Total contributions received or receivable from employer(s)2011-12-31$220,064
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$21,342
2010 : TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN 2010 401k financial data
Total income from all sources2010-12-31$2,459,602
Expenses. Total of all expenses incurred2010-12-31$264,490
Benefits paid (including direct rollovers)2010-12-31$264,490
Total plan assets at end of year2010-12-31$13,010,437
Total plan assets at beginning of year2010-12-31$10,815,325
Value of fidelity bond covering the plan2010-12-31$500,000
Total contributions received or receivable from participants2010-12-31$120,976
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$2,118,610
Noncash contributions received2010-12-31$0
Net income (gross income less expenses)2010-12-31$2,195,112
Net plan assets at end of year (total assets less liabilities)2010-12-31$13,010,437
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$10,815,325
Total contributions received or receivable from employer(s)2010-12-31$220,016

Form 5500 Responses for TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN

2017: TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedYes
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement - TrustYes
2009: TUSCALOOSA EAR, NOSE, THROAT CENTER PC PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number814842
Policy instance 1
Insurance contract or identification number814842
Number of Individuals Covered34
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $3,538
Total amount of fees paid to insurance companyUSD $898
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,538
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSALES/MARKETING
Insurance broker organization code?3
Insurance broker namePLANTECH. LLP
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number814842
Policy instance 1
Insurance contract or identification number814842
Number of Individuals Covered31
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $3,056
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 Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,445
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSALES/MARKETING
Insurance broker organization code?3
Insurance broker namePLANTECH. LLP
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number814842
Policy instance 1
Insurance contract or identification number814842
Number of Individuals Covered32
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $2,965
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 Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,372
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSALES/MARKETING
Insurance broker organization code?3
Insurance broker nameMARTIN, MARTIN, RANDALL & ASSOCIATE
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number814842
Policy instance 1
Insurance contract or identification number814842
Number of Individuals Covered29
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,877
Total amount of fees paid to insurance companyUSD $784
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 Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,877
Amount paid for insurance broker fees315
Additional information about fees paid to insurance brokerSALES/MARKETING
Insurance broker organization code?3
Insurance broker nameMARTIN, MARTIN, RANDALL & ASSOCIATE
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number814842
Policy instance 1
Insurance contract or identification number814842
Number of Individuals Covered27
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,501
Total amount of fees paid to insurance companyUSD $595
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 Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $1,501
Amount paid for insurance broker fees220
Additional information about fees paid to insurance brokerCOMMISSION
Insurance broker organization code?3
Insurance broker nameMARTIN, MARTIN, RANDALL & ASSOCIATE

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