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U. S. RISK LLC 401(K) PLAN 401k Plan overview

Plan NameU. S. RISK LLC 401(K) PLAN
Plan identification number 003

U. S. RISK LLC 401(K) 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.
  • 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

U.S. RISK LLC has sponsored the creation of one or more 401k plans.

Company Name:U.S. RISK LLC
Employer identification number (EIN):752436502
NAIC Classification:524210
NAIC Description:Insurance Agencies and Brokerages

Form 5500 Filing Information

Submission information for form 5500 for 401k plan U. S. RISK LLC 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0032019-01-01
0032018-01-01
0032017-01-01BROOKE BIRDSONG BROOKE BIRDSONG2018-09-05
0032016-01-01JON CARLEY

Plan Statistics for U. S. RISK LLC 401(K) PLAN

401k plan membership statisitcs for U. S. RISK LLC 401(K) PLAN

Measure Date Value
2019: U. S. RISK LLC 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01385
Total number of active participants reported on line 7a of the Form 55002019-01-010
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-010
Number of participants with account balances2019-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: U. S. RISK LLC 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01372
Total number of active participants reported on line 7a of the Form 55002018-01-01267
Number of retired or separated participants receiving benefits2018-01-0139
Number of other retired or separated participants entitled to future benefits2018-01-0177
Total of all active and inactive participants2018-01-01383
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-011
Total participants2018-01-01384
Number of participants with account balances2018-01-01319
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-0115
2017: U. S. RISK LLC 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01318
Total number of active participants reported on line 7a of the Form 55002017-01-01270
Number of retired or separated participants receiving benefits2017-01-0138
Number of other retired or separated participants entitled to future benefits2017-01-0163
Total of all active and inactive participants2017-01-01371
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-011
Total participants2017-01-01372
Number of participants with account balances2017-01-01280
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-0118
2016: U. S. RISK LLC 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01288
Total number of active participants reported on line 7a of the Form 55002016-01-01212
Number of retired or separated participants receiving benefits2016-01-017
Number of other retired or separated participants entitled to future benefits2016-01-0162
Total of all active and inactive participants2016-01-01281
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01281
Number of participants with account balances2016-01-01215
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-0119

Financial Data on U. S. RISK LLC 401(K) PLAN

Measure Date Value
2019 : U. S. RISK LLC 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$4,150,382
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$21,543,744
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$21,221,727
Expenses. Certain deemed distributions of participant loans2019-12-31$283,009
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$1,238,276
Value of total assets at end of year2019-12-31$0
Value of total assets at beginning of year2019-12-31$17,393,362
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$39,008
Total interest from all sources2019-12-31$13,173
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2019-12-31$0
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$881,198
Participant contributions at beginning of year2019-12-31$232,659
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$39,228
Administrative expenses (other) incurred2019-12-31$39,008
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$-17,393,362
Value of net assets at end of year (total assets less liabilities)2019-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$17,393,362
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$15,633,766
Interest on participant loans2019-12-31$10,318
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$177,513
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$177,513
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$2,855
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$1,349,424
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$2,898,933
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$317,850
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$21,221,727
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31CROWE, LLP
Accountancy firm EIN2019-12-31350921680
2018 : U. S. RISK LLC 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total transfer of assets to this plan2018-12-31$2,041,198
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$853,585
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$3,494,249
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$3,473,228
Expenses. Certain deemed distributions of participant loans2018-12-31$0
Value of total corrective distributions2018-12-31$7,542
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$1,863,723
Value of total assets at end of year2018-12-31$17,393,362
Value of total assets at beginning of year2018-12-31$17,992,828
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$13,479
Total interest from all sources2018-12-31$10,378
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$1,309,596
Participant contributions at end of year2018-12-31$232,659
Participant contributions at beginning of year2018-12-31$155,538
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$31,785
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-2,640,664
Value of net assets at end of year (total assets less liabilities)2018-12-31$17,393,362
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$17,992,828
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$15,633,766
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$16,263,347
Interest on participant loans2018-12-31$10,378
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$177,513
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$318,490
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$318,490
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$1,349,424
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$1,255,453
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-1,020,516
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31Yes
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$522,342
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$3,473,228
Contract administrator fees2018-12-31$13,479
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31CROWE LLP
Accountancy firm EIN2018-12-31350921680
2017 : U. S. RISK LLC 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$5,094,601
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$2,524,389
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$2,519,152
Expenses. Certain deemed distributions of participant loans2017-12-31$968
Value of total corrective distributions2017-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$2,510,273
Value of total assets at end of year2017-12-31$17,992,828
Value of total assets at beginning of year2017-12-31$15,422,616
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$4,269
Total interest from all sources2017-12-31$6,807
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$1,227,573
Participant contributions at end of year2017-12-31$155,538
Participant contributions at beginning of year2017-12-31$93,587
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$882,223
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$2,570,212
Value of net assets at end of year (total assets less liabilities)2017-12-31$17,992,828
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$15,422,616
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$16,263,347
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$13,623,628
Interest on participant loans2017-12-31$5,753
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$318,490
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$435,770
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$435,770
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$1,054
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$1,255,453
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$1,268,815
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$2,577,521
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31Yes
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$400,477
Employer contributions (assets) at beginning of year2017-12-31$816
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$2,519,152
Contract administrator fees2017-12-31$4,269
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31CROWE LLP
Accountancy firm EIN2017-12-31350921680
2016 : U. S. RISK LLC 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total income from all sources (including contributions)2016-12-31$2,411,678
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$1,374,980
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$1,297,673
Expenses. Certain deemed distributions of participant loans2016-12-31$65,147
Value of total corrective distributions2016-12-31$8,454
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$1,504,140
Value of total assets at end of year2016-12-31$15,422,616
Value of total assets at beginning of year2016-12-31$14,385,918
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$3,706
Total interest from all sources2016-12-31$5,032
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Administrative expenses professional fees incurred2016-12-31$3,706
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$1,155,500
Participant contributions at end of year2016-12-31$93,587
Participant contributions at beginning of year2016-12-31$160,167
Participant contributions at beginning of year2016-12-31$33,253
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$8,254
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$1,036,698
Value of net assets at end of year (total assets less liabilities)2016-12-31$15,422,616
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$14,385,918
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$13,623,628
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$12,517,520
Interest on participant loans2016-12-31$5,032
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$435,770
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$504,432
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$504,432
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$1,268,815
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$1,158,345
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$902,506
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31Yes
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$340,386
Employer contributions (assets) at end of year2016-12-31$816
Employer contributions (assets) at beginning of year2016-12-31$12,201
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$1,297,673
Contract administrator fees2016-12-31$0
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31CROWE HORWATH LLP
Accountancy firm EIN2016-12-31350921680

Form 5500 Responses for U. S. RISK LLC 401(K) PLAN

2019: U. S. RISK LLC 401(K) PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingYes
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: U. S. RISK LLC 401(K) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: U. S. RISK LLC 401(K) 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: U. S. RISK LLC 401(K) 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

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-44-D534
Policy instance 1
Insurance contract or identification numberGAP-44-D534
Number of Individuals Covered0
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?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?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
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees0
Insurance broker organization code?6
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-44-D534
Policy instance 1
Insurance contract or identification numberGAP-44-D534
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $3,739
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit 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
Commission paid to Insurance BrokerUSD $3,739
Insurance broker organization code?6
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-44-D534
Policy instance 1
Insurance contract or identification numberGAP-44-D534
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $3,732
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit 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
Commission paid to Insurance BrokerUSD $3,732
Amount paid for insurance broker fees0
Insurance broker organization code?6
Insurance broker nameMORGAN STANLEY SMITH BARNEY LL

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