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PATRIOT BANK 401K PLAN 401k Plan overview

Plan NamePATRIOT BANK 401K PLAN
Plan identification number 001

PATRIOT BANK 401K PLAN Benefits

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

PATRIOT BANK has sponsored the creation of one or more 401k plans.

Company Name:PATRIOT BANK
Employer identification number (EIN):750341605
NAIC Classification:522110
NAIC Description:Commercial Banking

Additional information about PATRIOT BANK

Jurisdiction of Incorporation: Florida Department of State Division of Corporations
Incorporation Date: 2004-07-20
Company Identification Number: P04000107450
Legal Registered Office Address: 1815 LITTLE RD.

TRINITY

34655

More information about PATRIOT BANK

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PATRIOT BANK 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012016-01-01
0012015-01-01
0012014-01-01DIANNE KIRSCH
0012013-01-01DIANNE KIRSCH
0012012-01-01DIANNE KIRSCH
0012011-01-01DIANNE KIRSCH
0012009-01-01JANE POE

Plan Statistics for PATRIOT BANK 401K PLAN

401k plan membership statisitcs for PATRIOT BANK 401K PLAN

Measure Date Value
2016: PATRIOT BANK 401K PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01122
Total number of active participants reported on line 7a of the Form 55002016-01-010
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 participants2016-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-010
Number of participants with account balances2016-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: PATRIOT BANK 401K PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01340
Total number of active participants reported on line 7a of the Form 55002015-01-010
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-01122
Total of all active and inactive participants2015-01-01122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01122
Number of participants with account balances2015-01-01122
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-014
2014: PATRIOT BANK 401K PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01315
Total number of active participants reported on line 7a of the Form 55002014-01-01169
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-01171
Total of all active and inactive participants2014-01-01340
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01340
Number of participants with account balances2014-01-01327
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-0131
2013: PATRIOT BANK 401K PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01302
Total number of active participants reported on line 7a of the Form 55002013-01-01231
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0194
Total of all active and inactive participants2013-01-01325
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01325
Number of participants with account balances2013-01-01301
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-0140
2012: PATRIOT BANK 401K PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01231
Total number of active participants reported on line 7a of the Form 55002012-01-01243
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0157
Total of all active and inactive participants2012-01-01300
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01300
Number of participants with account balances2012-01-01259
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: PATRIOT BANK 401K PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01216
Total number of active participants reported on line 7a of the Form 55002011-01-01201
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-0130
Total of all active and inactive participants2011-01-01231
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01231
Number of participants with account balances2011-01-01183
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: PATRIOT BANK 401K PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01182
Total number of active participants reported on line 7a of the Form 55002009-01-01195
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0128
Total of all active and inactive participants2009-01-01223
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01223
Number of participants with account balances2009-01-01163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on PATRIOT BANK 401K PLAN

Measure Date Value
2016 : PATRIOT BANK 401K PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-05-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-05-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-05-31$0
Total income from all sources (including contributions)2016-05-31$-37,380
Total loss/gain on sale of assets2016-05-31$0
Total of all expenses incurred2016-05-31$1,518,559
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-05-31$1,511,097
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-05-31$0
Value of total assets at end of year2016-05-31$0
Value of total assets at beginning of year2016-05-31$1,555,939
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-05-31$7,462
Total interest from all sources2016-05-31$42
Total dividends received (eg from common stock, registered investment company shares)2016-05-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-05-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2016-05-31$0
Was this plan covered by a fidelity bond2016-05-31Yes
Value of fidelity bond cover2016-05-31$5,000,000
If this is an individual account plan, was there a blackout period2016-05-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-05-31$0
Were there any nonexempt tranactions with any party-in-interest2016-05-31No
Participant contributions at end of year2016-05-31$0
Participant contributions at beginning of year2016-05-31$6,425
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-05-31No
Value of net income/loss2016-05-31$-1,555,939
Value of net assets at end of year (total assets less liabilities)2016-05-31$0
Value of net assets at beginning of year (total assets less liabilities)2016-05-31$1,555,939
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-05-31No
Were any leases to which the plan was party in default or uncollectible2016-05-31No
Investment advisory and management fees2016-05-31$7,462
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-05-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-05-31$1,109,113
Interest on participant loans2016-05-31$42
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-05-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-05-31$141,513
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-05-31$-37,422
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-05-31No
Was there a failure to transmit to the plan any participant contributions2016-05-31No
Has the plan failed to provide any benefit when due under the plan2016-05-31No
Assets. Invements in employer securities at end of year2016-05-31$0
Assets. Invements in employer securities at beginning of year2016-05-31$298,888
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-05-31$1,511,097
Did the plan have assets held for investment2016-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-05-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-05-31Yes
Opinion of an independent qualified public accountant for this plan2016-05-31Disclaimer
Accountancy firm name2016-05-31BRIGGS & VESELKA
Accountancy firm EIN2016-05-31741769118
2015 : PATRIOT BANK 401K PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$839,830
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$5,844,945
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$5,798,890
Value of total corrective distributions2015-12-31$25,387
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$1,011,601
Value of total assets at end of year2015-12-31$1,555,939
Value of total assets at beginning of year2015-12-31$6,561,054
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$20,668
Total interest from all sources2015-12-31$3,246
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2015-12-31$0
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$5,000,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$724,276
Participant contributions at end of year2015-12-31$6,425
Participant contributions at beginning of year2015-12-31$90,512
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$144,427
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-5,005,115
Value of net assets at end of year (total assets less liabilities)2015-12-31$1,555,939
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$6,561,054
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Investment advisory and management fees2015-12-31$20,668
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$1,109,113
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$4,850,563
Interest on participant loans2015-12-31$3,246
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$141,513
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$1,062,155
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-175,017
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Assets. Invements in employer securities at end of year2015-12-31$298,888
Assets. Invements in employer securities at beginning of year2015-12-31$392,558
Contributions received in cash from employer2015-12-31$142,898
Employer contributions (assets) at end of year2015-12-31$0
Employer contributions (assets) at beginning of year2015-12-31$165,266
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$5,798,890
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31BRIGGS & VESELKA CO.
Accountancy firm EIN2015-12-31741769118
2014 : PATRIOT BANK 401K PLAN 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2014-12-31$32,512
Total unrealized appreciation/depreciation of assets2014-12-31$32,512
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$11,764
Total income from all sources (including contributions)2014-12-31$1,751,590
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$1,361,342
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$1,354,527
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$1,447,752
Value of total assets at end of year2014-12-31$6,561,054
Value of total assets at beginning of year2014-12-31$6,182,570
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$6,815
Total interest from all sources2014-12-31$2,426
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$382,398
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2014-12-31$382,398
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$10,000,000
If this is an individual account plan, was there a blackout period2014-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$979,835
Participant contributions at end of year2014-12-31$90,512
Participant contributions at beginning of year2014-12-31$83,009
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$302,519
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-12-31$11,764
Other income not declared elsewhere2014-12-31$285
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$390,248
Value of net assets at end of year (total assets less liabilities)2014-12-31$6,561,054
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$6,170,806
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Investment advisory and management fees2014-12-31$6,815
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$4,850,563
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$4,586,829
Interest on participant loans2014-12-31$2,426
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$1,062,155
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$923,170
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$-113,783
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Assets. Invements in employer securities at end of year2014-12-31$392,558
Assets. Invements in employer securities at beginning of year2014-12-31$338,550
Contributions received in cash from employer2014-12-31$165,398
Employer contributions (assets) at end of year2014-12-31$165,266
Employer contributions (assets) at beginning of year2014-12-31$251,012
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$1,354,527
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31HARPER & PEARSON COMPANY, P.C.
Accountancy firm EIN2014-12-31741695589
2013 : PATRIOT BANK 401K PLAN 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2013-12-31$25,168
Total unrealized appreciation/depreciation of assets2013-12-31$25,168
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$11,764
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$16,234
Total income from all sources (including contributions)2013-12-31$2,327,667
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$781,781
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$775,255
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$1,515,174
Value of total assets at end of year2013-12-31$6,182,570
Value of total assets at beginning of year2013-12-31$4,641,154
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$6,526
Total interest from all sources2013-12-31$2,641
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$196,811
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$196,811
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$5,000,000
If this is an individual account plan, was there a blackout period2013-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$1,215,547
Participant contributions at end of year2013-12-31$83,009
Participant contributions at beginning of year2013-12-31$77,635
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$48,615
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-12-31$11,764
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$16,234
Other income not declared elsewhere2013-12-31$4,469
Total non interest bearing cash at end of year2013-12-31$0
Total non interest bearing cash at beginning of year2013-12-31$200
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$1,545,886
Value of net assets at end of year (total assets less liabilities)2013-12-31$6,170,806
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$4,624,920
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Investment advisory and management fees2013-12-31$6,526
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$4,586,829
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$2,951,781
Interest on participant loans2013-12-31$2,641
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$923,170
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$983,930
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Assets. Invements in employer securities at end of year2013-12-31$338,550
Assets. Invements in employer securities at beginning of year2013-12-31$305,000
Contributions received in cash from employer2013-12-31$251,012
Employer contributions (assets) at end of year2013-12-31$251,012
Employer contributions (assets) at beginning of year2013-12-31$322,608
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$775,255
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31HARPER & PEARSON COMPANY, P.C.
Accountancy firm EIN2013-12-31741695589
2012 : PATRIOT BANK 401K PLAN 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2012-12-31$15,250
Total unrealized appreciation/depreciation of assets2012-12-31$15,250
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$16,234
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$17,858
Total income from all sources (including contributions)2012-12-31$1,837,260
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$424,032
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$421,251
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$1,479,548
Value of total assets at end of year2012-12-31$4,641,154
Value of total assets at beginning of year2012-12-31$3,229,550
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$2,781
Total interest from all sources2012-12-31$1,773
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$94,823
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2012-12-31$94,823
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$5,000,000
If this is an individual account plan, was there a blackout period2012-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$1,095,681
Participant contributions at end of year2012-12-31$77,635
Participant contributions at beginning of year2012-12-31$33,382
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$61,259
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-12-31$16,234
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$17,858
Other income not declared elsewhere2012-12-31$1,623
Total non interest bearing cash at end of year2012-12-31$200
Total non interest bearing cash at beginning of year2012-12-31$196
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$1,413,228
Value of net assets at end of year (total assets less liabilities)2012-12-31$4,624,920
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$3,211,692
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Investment advisory and management fees2012-12-31$2,781
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$2,951,781
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$2,229,969
Interest on participant loans2012-12-31$1,773
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$983,930
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$676,253
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Assets. Invements in employer securities at end of year2012-12-31$305,000
Assets. Invements in employer securities at beginning of year2012-12-31$289,750
Contributions received in cash from employer2012-12-31$322,608
Employer contributions (assets) at end of year2012-12-31$322,608
Employer contributions (assets) at beginning of year2012-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$421,251
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31HARPER & PEARSON COMPANY, P.C.
Accountancy firm EIN2012-12-31741695589
2011 : PATRIOT BANK 401K PLAN 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2011-12-31$-45,750
Total unrealized appreciation/depreciation of assets2011-12-31$-45,750
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$17,858
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total income from all sources (including contributions)2011-12-31$800,274
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$656,799
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$640,793
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$891,641
Value of total assets at end of year2011-12-31$3,229,550
Value of total assets at beginning of year2011-12-31$3,068,217
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$16,006
Total interest from all sources2011-12-31$6,161
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$25,638
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$25,638
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$5,000,000
If this is an individual account plan, was there a blackout period2011-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$891,563
Participant contributions at end of year2011-12-31$33,382
Participant contributions at beginning of year2011-12-31$14,288
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$78
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-12-31$17,858
Other income not declared elsewhere2011-12-31$-28,396
Total non interest bearing cash at end of year2011-12-31$196
Total non interest bearing cash at beginning of year2011-12-31$59
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$143,475
Value of net assets at end of year (total assets less liabilities)2011-12-31$3,211,692
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$3,068,217
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$2,229,969
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$2,488,051
Interest on participant loans2011-12-31$599
Interest earned on other investments2011-12-31$5,562
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$676,253
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$230,319
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$-49,020
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Assets. Invements in employer securities at end of year2011-12-31$289,750
Assets. Invements in employer securities at beginning of year2011-12-31$335,500
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$640,793
Contract administrator fees2011-12-31$16,006
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-12-31Yes
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31HARPER & PEARSON COMPANY, P.C.
Accountancy firm EIN2011-12-31741695589
2010 : PATRIOT BANK 401K PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total income from all sources (including contributions)2010-12-31$1,172,314
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$416,063
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$398,687
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$859,946
Value of total assets at end of year2010-12-31$3,068,217
Value of total assets at beginning of year2010-12-31$2,311,966
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$17,376
Total interest from all sources2010-12-31$478
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$3,000,000
If this is an individual account plan, was there a blackout period2010-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$784,174
Participant contributions at end of year2010-12-31$14,288
Participant contributions at beginning of year2010-12-31$7,517
Participant contributions at end of year2010-12-31$0
Participant contributions at beginning of year2010-12-31$2,008
Assets. Other investments not covered elsewhere at end of year2010-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2010-12-31$2,371
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$75,772
Other income not declared elsewhere2010-12-31$20,440
Total non interest bearing cash at end of year2010-12-31$59
Total non interest bearing cash at beginning of year2010-12-31$59
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$756,251
Value of net assets at end of year (total assets less liabilities)2010-12-31$3,068,217
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$2,311,966
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$2,488,051
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$1,764,059
Interest on participant loans2010-12-31$478
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$230,319
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$209,602
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$291,450
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Assets. Invements in employer securities at end of year2010-12-31$335,500
Assets. Invements in employer securities at beginning of year2010-12-31$326,350
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$398,687
Contract administrator fees2010-12-31$17,376
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31HARPER & PEARSON COMPANY, P.C.
Accountancy firm EIN2010-12-31741695589
2009 : PATRIOT BANK 401K PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for PATRIOT BANK 401K PLAN

2016: PATRIOT BANK 401K 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 filingYes
2016-01-01This return/report is a short plan year return/report (less than 12 months)Yes
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: PATRIOT BANK 401K 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: PATRIOT BANK 401K 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: PATRIOT BANK 401K 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: PATRIOT BANK 401K 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: PATRIOT BANK 401K 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 – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: PATRIOT BANK 401K 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 – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
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 numberGA-827115
Policy instance 1
Insurance contract or identification numberGA-827115
Number of Individuals Covered0
Insurance policy start date2016-01-01
Insurance policy end date2016-05-02
Total amount of commissions paid to insurance brokerUSD $3,468
Total amount of fees paid to insurance companyUSD $578
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?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,468
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameMALCOLM THOMPSON & ASSOCIATES
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number827115
Policy instance 1
Insurance contract or identification number827115
Number of Individuals Covered122
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $17,850
Total amount of fees paid to insurance companyUSD $5,361
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?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,850
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameMERRILL LYNCH PIERCE FENNER SMITH
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number827115
Policy instance 1
Insurance contract or identification number827115
Number of Individuals Covered327
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $16,604
Total amount of fees paid to insurance companyUSD $4,994
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?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,604
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameMERRILL LYNCH PIERCE FENNER SMITH
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number827115
Policy instance 1
Insurance contract or identification number827115
Number of Individuals Covered301
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $13,661
Total amount of fees paid to insurance companyUSD $4,096
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?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,661
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameMERRILL LYNCH PIERCE FENNER SMITH
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number827115
Policy instance 1
Insurance contract or identification number827115
Number of Individuals Covered259
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $6,499
Total amount of fees paid to insurance companyUSD $2,839
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?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,499
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameMERRILL LYNCH PIERCE FENNER SMITH
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number55756
Policy instance 1
Insurance contract or identification number55756
Number of Individuals Covered0
Insurance policy start date2011-01-01
Insurance policy end date2011-10-03
Total amount of commissions paid to insurance brokerUSD $11,085
Total amount of fees paid to insurance companyUSD $2,869
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
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number827115
Policy instance 2
Insurance contract or identification number827115
Number of Individuals Covered183
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $20,873
Total amount of fees paid to insurance companyUSD $8,000
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?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number55756
Policy instance 1
Insurance contract or identification number55756
Number of Individuals Covered157
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $10,975
Total amount of fees paid to insurance companyUSD $3,547
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

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