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AMERICAN AGENCIES CO., INC. 1165 (E) PROFIT SHARING PLAN 401k Plan overview

Plan NameAMERICAN AGENCIES CO., INC. 1165 (E) PROFIT SHARING PLAN
Plan identification number 002

AMERICAN AGENCIES CO., INC. 1165 (E) 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.
  • 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.
  • Plan not intended to be qualified - A plan not intended to be qualified under Code sections 401, 403, or 408.

401k Sponsoring company profile

AMERICAN AGENCIES CO., INC. has sponsored the creation of one or more 401k plans.

Company Name:AMERICAN AGENCIES CO., INC.
Employer identification number (EIN):660405406
NAIC Classification:423300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AMERICAN AGENCIES CO., INC. 1165 (E) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022016-01-01JOSE R. HERNANDEZ GIERBOLINI JOSE R. HERNANDEZ GIERBOLINI2017-06-28
0022016-01-01 JOSE R. HERNANDEZ GIERBOLINI2019-12-11
0022016-01-01 JOSE R. HERNANDEZ GIERBOLINI2018-10-15
0022015-01-01JOSE R. HERNANDEZ GIERBOLINI JOSE R. HERNANDEZ GIERBOLINI2016-06-01
0022014-01-01JOSE R. HERNANDEZ GIERBOLINI JOSE R. HERNANDEZ GIERBOLINI2015-05-27
0022013-01-01JOSE R. HERNANDEZ GIERBOLINI JOSE R. HERNANDEZ GIERBOLINI2014-06-10
0022012-01-01JOSE R. HERNANDEZ GIERBOLINI JOSE R. HERNANDEZ GIERBOLINI2013-07-08
0022011-01-01JOSE R. HERNANDEZ GIERBOLINI JOSE R. HERNANDEZ GIERBOLINI2012-10-08

Plan Statistics for AMERICAN AGENCIES CO., INC. 1165 (E) PROFIT SHARING PLAN

401k plan membership statisitcs for AMERICAN AGENCIES CO., INC. 1165 (E) PROFIT SHARING PLAN

Measure Date Value
2016: AMERICAN AGENCIES CO., INC. 1165 (E) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0120
Total number of active participants reported on line 7a of the Form 55002016-01-0117
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-0117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0117
Number of participants with account balances2016-01-0115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: AMERICAN AGENCIES CO., INC. 1165 (E) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0129
Total number of active participants reported on line 7a of the Form 55002015-01-0120
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-0120
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0120
Number of participants with account balances2015-01-0119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: AMERICAN AGENCIES CO., INC. 1165 (E) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0127
Total number of active participants reported on line 7a of the Form 55002014-01-0129
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 participants2014-01-0129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0129
Number of participants with account balances2014-01-0126
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: AMERICAN AGENCIES CO., INC. 1165 (E) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0128
Total number of active participants reported on line 7a of the Form 55002013-01-0127
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-0127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0127
Number of participants with account balances2013-01-0127
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: AMERICAN AGENCIES CO., INC. 1165 (E) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0132
Total number of active participants reported on line 7a of the Form 55002012-01-0128
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-0128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0128
Number of participants with account balances2012-01-0128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: AMERICAN AGENCIES CO., INC. 1165 (E) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0137
Total number of active participants reported on line 7a of the Form 55002011-01-0132
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-0132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0132
Number of participants with account balances2011-01-0132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010

Financial Data on AMERICAN AGENCIES CO., INC. 1165 (E) PROFIT SHARING PLAN

Measure Date Value
2016 : AMERICAN AGENCIES CO., INC. 1165 (E) PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources2016-12-31$41,774
Expenses. Total of all expenses incurred2016-12-31$48,892
Benefits paid (including direct rollovers)2016-12-31$46,978
Total plan assets at end of year2016-12-31$319,511
Total plan assets at beginning of year2016-12-31$326,629
Total contributions received or receivable from participants2016-12-31$21,664
Expenses. Other expenses not covered elsewhere2016-12-31$1,914
Other income received2016-12-31$20,110
Net income (gross income less expenses)2016-12-31$-7,118
Net plan assets at end of year (total assets less liabilities)2016-12-31$319,511
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$326,629
Assets. Value of participant loans2016-12-31$22,699
2015 : AMERICAN AGENCIES CO., INC. 1165 (E) PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources2015-12-31$49,811
Expenses. Total of all expenses incurred2015-12-31$77,819
Benefits paid (including direct rollovers)2015-12-31$75,778
Total plan assets at end of year2015-12-31$326,629
Total plan assets at beginning of year2015-12-31$354,637
Total contributions received or receivable from participants2015-12-31$34,713
Expenses. Other expenses not covered elsewhere2015-12-31$2,041
Contributions received from other sources (not participants or employers)2015-12-31$20,283
Other income received2015-12-31$-5,185
Net income (gross income less expenses)2015-12-31$-28,008
Net plan assets at end of year (total assets less liabilities)2015-12-31$326,629
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$354,637
Assets. Value of participant loans2015-12-31$30,170
Total contributions received or receivable from employer(s)2015-12-31$0
2014 : AMERICAN AGENCIES CO., INC. 1165 (E) PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources2014-12-31$47,796
Expenses. Total of all expenses incurred2014-12-31$5,634
Benefits paid (including direct rollovers)2014-12-31$1,875
Total plan assets at end of year2014-12-31$354,786
Total plan assets at beginning of year2014-12-31$312,624
Total contributions received or receivable from participants2014-12-31$36,129
Expenses. Other expenses not covered elsewhere2014-12-31$3,759
Other income received2014-12-31$11,667
Net income (gross income less expenses)2014-12-31$42,162
Net plan assets at end of year (total assets less liabilities)2014-12-31$354,786
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$312,624
Assets. Value of participant loans2014-12-31$32,762
2013 : AMERICAN AGENCIES CO., INC. 1165 (E) PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources2013-12-31$64,012
Expenses. Total of all expenses incurred2013-12-31$37,577
Benefits paid (including direct rollovers)2013-12-31$33,220
Total plan assets at end of year2013-12-31$312,624
Total plan assets at beginning of year2013-12-31$286,189
Total contributions received or receivable from participants2013-12-31$28,563
Expenses. Other expenses not covered elsewhere2013-12-31$4,357
Other income received2013-12-31$35,449
Net income (gross income less expenses)2013-12-31$26,435
Net plan assets at end of year (total assets less liabilities)2013-12-31$312,624
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$286,189
Assets. Value of participant loans2013-12-31$34,680
2012 : AMERICAN AGENCIES CO., INC. 1165 (E) PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources2012-12-31$53,630
Expenses. Total of all expenses incurred2012-12-31$25,289
Benefits paid (including direct rollovers)2012-12-31$20,992
Total plan assets at end of year2012-12-31$286,189
Total plan assets at beginning of year2012-12-31$257,848
Total contributions received or receivable from participants2012-12-31$32,486
Expenses. Other expenses not covered elsewhere2012-12-31$4,297
Other income received2012-12-31$21,144
Net income (gross income less expenses)2012-12-31$28,341
Net plan assets at end of year (total assets less liabilities)2012-12-31$286,189
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$257,848
Assets. Value of participant loans2012-12-31$31,919
Total contributions received or receivable from employer(s)2012-12-31$0
2011 : AMERICAN AGENCIES CO., INC. 1165 (E) PROFIT SHARING PLAN 2011 401k financial data
Total plan liabilities at beginning of year2011-12-31$0
Total income from all sources2011-12-31$31,072
Expenses. Total of all expenses incurred2011-12-31$21,721
Benefits paid (including direct rollovers)2011-12-31$16,950
Total plan assets at end of year2011-12-31$257,848
Total plan assets at beginning of year2011-12-31$248,497
Total contributions received or receivable from participants2011-12-31$36,472
Expenses. Other expenses not covered elsewhere2011-12-31$3,753
Other income received2011-12-31$-5,400
Net income (gross income less expenses)2011-12-31$9,351
Net plan assets at end of year (total assets less liabilities)2011-12-31$257,848
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$248,497
Assets. Value of participant loans2011-12-31$17,529
Total contributions received or receivable from employer(s)2011-12-31$0
Value of certain deemed distributions of participant loans2011-12-31$1,018
2010 : AMERICAN AGENCIES CO., INC. 1165 (E) PROFIT SHARING PLAN 2010 401k financial data
Transfers to/from the plan2010-12-31$0
Total plan liabilities at end of year2010-12-31$0
Total plan liabilities at beginning of year2010-12-31$0
Total income from all sources2010-12-31$79,007
Expenses. Total of all expenses incurred2010-12-31$42,184
Benefits paid (including direct rollovers)2010-12-31$38,801
Total plan assets at end of year2010-12-31$232,362
Total plan assets at beginning of year2010-12-31$195,539
Total contributions received or receivable from participants2010-12-31$49,062
Expenses. Other expenses not covered elsewhere2010-12-31$3,383
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$22,383
Noncash contributions received2010-12-31$0
Net income (gross income less expenses)2010-12-31$36,823
Net plan assets at end of year (total assets less liabilities)2010-12-31$232,362
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$195,539
Assets. Value of participant loans2010-12-31$16,135
Total contributions received or receivable from employer(s)2010-12-31$7,562
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$0

Form 5500 Responses for AMERICAN AGENCIES CO., INC. 1165 (E) PROFIT SHARING PLAN

2016: AMERICAN AGENCIES CO., INC. 1165 (E) 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: AMERICAN AGENCIES CO., INC. 1165 (E) 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: AMERICAN AGENCIES CO., INC. 1165 (E) PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
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: AMERICAN AGENCIES CO., INC. 1165 (E) 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: AMERICAN AGENCIES CO., INC. 1165 (E) 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: AMERICAN AGENCIES CO., INC. 1165 (E) PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedYes
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 – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number114918
Policy instance 1
Insurance contract or identification number114918
Number of Individuals Covered20
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $809
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $107
Insurance broker organization code?3
Insurance broker nameGUILLERMO LAVERGNE
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number9991555-000
Policy instance 1
Insurance contract or identification number9991555-000
Insurance policy start date2014-01-01
Insurance policy end date2014-07-14
Total amount of commissions paid to insurance brokerUSD $354
Total amount of fees paid to insurance companyUSD $107
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?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 $354
Insurance broker organization code?3
Amount paid for insurance broker fees107
Additional information about fees paid to insurance brokerTPA
Insurance broker nameA & A EMPLOYEE BENEFITS CONSULTING
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number114918
Policy instance 2
Insurance contract or identification number114918
Number of Individuals Covered27
Insurance policy start date2014-07-14
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,629
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 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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $1,629
Insurance broker organization code?3
Insurance broker nameFULCRO INSURANCE, INC
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number9991555-000
Policy instance 1
Insurance contract or identification number9991555-000
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $635
Total amount of fees paid to insurance companyUSD $125
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?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 $635
Insurance broker organization code?3
Amount paid for insurance broker fees125
Additional information about fees paid to insurance brokerTPA
Insurance broker nameA & A EMPLOYEE BENEFITS CONSULTING
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number9991555-000
Policy instance 1
Insurance contract or identification number9991555-000
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $622
Total amount of fees paid to insurance companyUSD $124
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?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 $622
Insurance broker organization code?3
Amount paid for insurance broker fees124
Additional information about fees paid to insurance brokerTPA
Insurance broker nameA & A EMPLOYEE BENEFITS CONSULTING
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number9991555-000
Policy instance 1
Insurance contract or identification number9991555-000
Number of Individuals Covered32
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $595
Total amount of fees paid to insurance companyUSD $117
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?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
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number9991555-000
Policy instance 1
Insurance contract or identification number9991555-000
Number of Individuals Covered41
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $521
Total amount of fees paid to insurance companyUSD $101
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?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
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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