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AMERICAN SKYLIGHTS PROFIT SHARING AND 401(K) PLAN 401k Plan overview

Plan NameAMERICAN SKYLIGHTS PROFIT SHARING AND 401(K) PLAN
Plan identification number 001

AMERICAN SKYLIGHTS PROFIT SHARING AND 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

THE ANDI GROUP, INC. has sponsored the creation of one or more 401k plans.

Company Name:THE ANDI GROUP, INC.
Employer identification number (EIN):752457193
NAIC Classification:423990
NAIC Description:Other Miscellaneous Durable Goods Merchant Wholesalers

Additional information about THE ANDI GROUP, INC.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 1992-12-09
Company Identification Number: 0125278100
Legal Registered Office Address: 1218 E CORPORATE DR

ARLINGTON
United States of America (USA)
76006

More information about THE ANDI GROUP, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AMERICAN SKYLIGHTS PROFIT SHARING AND 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01
0012017-01-01FRANK TUCKER
0012016-01-01RYAN TUCKER
0012015-01-01FRANK TUCKER
0012014-01-01ELIZABETH POWELL2015-10-13
0012013-01-01
0012012-01-01ELIZABETH POWELL2013-10-14
0012011-01-01ELIZABETH POWELL2012-10-04
0012010-01-01ALEX ARELLANO2011-07-28

Plan Statistics for AMERICAN SKYLIGHTS PROFIT SHARING AND 401(K) PLAN

401k plan membership statisitcs for AMERICAN SKYLIGHTS PROFIT SHARING AND 401(K) PLAN

Measure Date Value
2022: AMERICAN SKYLIGHTS PROFIT SHARING AND 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0122
Total number of active participants reported on line 7a of the Form 55002022-01-0118
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-012
Total of all active and inactive participants2022-01-0120
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-0120
Number of participants with account balances2022-01-0111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: AMERICAN SKYLIGHTS PROFIT SHARING AND 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0121
Total number of active participants reported on line 7a of the Form 55002021-01-0119
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-013
Total of all active and inactive participants2021-01-0122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-0122
Number of participants with account balances2021-01-0112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: AMERICAN SKYLIGHTS PROFIT SHARING AND 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0122
Total number of active participants reported on line 7a of the Form 55002020-01-0117
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-014
Total of all active and inactive participants2020-01-0121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-0121
Number of participants with account balances2020-01-0112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: AMERICAN SKYLIGHTS PROFIT SHARING AND 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0122
Total number of active participants reported on line 7a of the Form 55002019-01-0118
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-014
Total of all active and inactive participants2019-01-0122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0122
Number of participants with account balances2019-01-0113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: AMERICAN SKYLIGHTS PROFIT SHARING AND 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0122
Total number of active participants reported on line 7a of the Form 55002018-01-0117
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-015
Total of all active and inactive participants2018-01-0122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0122
Number of participants with account balances2018-01-0114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: AMERICAN SKYLIGHTS PROFIT SHARING AND 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0120
Total number of active participants reported on line 7a of the Form 55002017-01-0118
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-014
Total of all active and inactive participants2017-01-0122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0122
Number of participants with account balances2017-01-0113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: AMERICAN SKYLIGHTS PROFIT SHARING AND 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0128
Total number of active participants reported on line 7a of the Form 55002016-01-0116
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-014
Total of all active and inactive participants2016-01-0120
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0120
Number of participants with account balances2016-01-0113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: AMERICAN SKYLIGHTS PROFIT SHARING AND 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0130
Total number of active participants reported on line 7a of the Form 55002015-01-0117
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0111
Total of all active and inactive participants2015-01-0128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0128
Number of participants with account balances2015-01-0120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010

Financial Data on AMERICAN SKYLIGHTS PROFIT SHARING AND 401(K) PLAN

Measure Date Value
2022 : AMERICAN SKYLIGHTS PROFIT SHARING AND 401(K) PLAN 2022 401k financial data
Transfers to/from the plan2022-12-31$0
Total plan liabilities at end of year2022-12-31$0
Total plan liabilities at beginning of year2022-12-31$0
Total income from all sources2022-12-31$-143,403
Expenses. Total of all expenses incurred2022-12-31$12,327
Benefits paid (including direct rollovers)2022-12-31$11,016
Total plan assets at end of year2022-12-31$1,719,495
Total plan assets at beginning of year2022-12-31$1,875,225
Value of fidelity bond covering the plan2022-12-31$165,000
Assets. Value of tangible personal property2022-12-31$0
Total contributions received or receivable from participants2022-12-31$64,327
Assets. Value of loans (other than to participants)2022-12-31$0
Expenses. Other expenses not covered elsewhere2022-12-31$0
Contributions received from other sources (not participants or employers)2022-12-31$0
Other income received2022-12-31$-229,506
Noncash contributions received2022-12-31$0
Net income (gross income less expenses)2022-12-31$-155,730
Net plan assets at end of year (total assets less liabilities)2022-12-31$1,719,495
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$1,875,225
Assets. Value of participant loans2022-12-31$0
Assets. Value of assets in partnership/joint-venture interests2022-12-31$0
Assets. Value of real-estate (other than employer real property)2022-12-31$0
Assets. Value of employer securities2022-12-31$0
Assets. Value of employer real property2022-12-31$0
Total contributions received or receivable from employer(s)2022-12-31$21,776
Value of certain deemed distributions of participant loans2022-12-31$1,223
Value of corrective distributions2022-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$88
2021 : AMERICAN SKYLIGHTS PROFIT SHARING AND 401(K) PLAN 2021 401k financial data
Transfers to/from the plan2021-12-31$0
Total plan liabilities at end of year2021-12-31$0
Total plan liabilities at beginning of year2021-12-31$0
Total income from all sources2021-12-31$144,463
Expenses. Total of all expenses incurred2021-12-31$13,870
Benefits paid (including direct rollovers)2021-12-31$13,845
Total plan assets at end of year2021-12-31$1,875,225
Total plan assets at beginning of year2021-12-31$1,744,632
Value of fidelity bond covering the plan2021-12-31$165,000
Assets. Value of tangible personal property2021-12-31$0
Total contributions received or receivable from participants2021-12-31$53,339
Assets. Value of loans (other than to participants)2021-12-31$0
Expenses. Other expenses not covered elsewhere2021-12-31$0
Contributions received from other sources (not participants or employers)2021-12-31$0
Other income received2021-12-31$72,348
Noncash contributions received2021-12-31$0
Net income (gross income less expenses)2021-12-31$130,593
Net plan assets at end of year (total assets less liabilities)2021-12-31$1,875,225
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$1,744,632
Assets. Value of participant loans2021-12-31$0
Assets. Value of assets in partnership/joint-venture interests2021-12-31$0
Assets. Value of real-estate (other than employer real property)2021-12-31$0
Assets. Value of employer securities2021-12-31$0
Assets. Value of employer real property2021-12-31$0
Total contributions received or receivable from employer(s)2021-12-31$18,776
Value of certain deemed distributions of participant loans2021-12-31$0
Value of corrective distributions2021-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$25
2020 : AMERICAN SKYLIGHTS PROFIT SHARING AND 401(K) PLAN 2020 401k financial data
Transfers to/from the plan2020-12-31$0
Total plan liabilities at end of year2020-12-31$0
Total plan liabilities at beginning of year2020-12-31$0
Total income from all sources2020-12-31$-325,814
Expenses. Total of all expenses incurred2020-12-31$762,600
Benefits paid (including direct rollovers)2020-12-31$762,575
Total plan assets at end of year2020-12-31$1,744,632
Total plan assets at beginning of year2020-12-31$2,833,046
Value of fidelity bond covering the plan2020-12-31$165,000
Assets. Value of tangible personal property2020-12-31$0
Total contributions received or receivable from participants2020-12-31$52,728
Assets. Value of loans (other than to participants)2020-12-31$0
Expenses. Other expenses not covered elsewhere2020-12-31$0
Contributions received from other sources (not participants or employers)2020-12-31$0
Other income received2020-12-31$-399,004
Noncash contributions received2020-12-31$0
Net income (gross income less expenses)2020-12-31$-1,088,414
Net plan assets at end of year (total assets less liabilities)2020-12-31$1,744,632
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$2,833,046
Assets. Value of participant loans2020-12-31$0
Assets. Value of assets in partnership/joint-venture interests2020-12-31$0
Assets. Value of real-estate (other than employer real property)2020-12-31$0
Assets. Value of employer securities2020-12-31$0
Assets. Value of employer real property2020-12-31$0
Total contributions received or receivable from employer(s)2020-12-31$20,462
Value of certain deemed distributions of participant loans2020-12-31$0
Value of corrective distributions2020-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$25
2019 : AMERICAN SKYLIGHTS PROFIT SHARING AND 401(K) PLAN 2019 401k financial data
Transfers to/from the plan2019-12-31$0
Total plan liabilities at end of year2019-12-31$0
Total plan liabilities at beginning of year2019-12-31$0
Total income from all sources2019-12-31$459,370
Expenses. Total of all expenses incurred2019-12-31$1,516
Benefits paid (including direct rollovers)2019-12-31$1,491
Total plan assets at end of year2019-12-31$2,833,046
Total plan assets at beginning of year2019-12-31$2,375,192
Value of fidelity bond covering the plan2019-12-31$165,000
Total contributions received or receivable from participants2019-12-31$53,509
Expenses. Other expenses not covered elsewhere2019-12-31$0
Contributions received from other sources (not participants or employers)2019-12-31$0
Other income received2019-12-31$386,548
Noncash contributions received2019-12-31$0
Net income (gross income less expenses)2019-12-31$457,854
Net plan assets at end of year (total assets less liabilities)2019-12-31$2,833,046
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$2,375,192
Assets. Value of participant loans2019-12-31$0
Total contributions received or receivable from employer(s)2019-12-31$19,313
Value of certain deemed distributions of participant loans2019-12-31$0
Value of corrective distributions2019-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$25
2018 : AMERICAN SKYLIGHTS PROFIT SHARING AND 401(K) PLAN 2018 401k financial data
Transfers to/from the plan2018-12-31$0
Total plan liabilities at end of year2018-12-31$0
Total plan liabilities at beginning of year2018-12-31$0
Total income from all sources2018-12-31$-52,826
Expenses. Total of all expenses incurred2018-12-31$678
Benefits paid (including direct rollovers)2018-12-31$653
Total plan assets at end of year2018-12-31$2,375,192
Total plan assets at beginning of year2018-12-31$2,428,696
Value of fidelity bond covering the plan2018-12-31$165,000
Total contributions received or receivable from participants2018-12-31$49,902
Expenses. Other expenses not covered elsewhere2018-12-31$0
Contributions received from other sources (not participants or employers)2018-12-31$0
Other income received2018-12-31$-121,288
Noncash contributions received2018-12-31$0
Net income (gross income less expenses)2018-12-31$-53,504
Net plan assets at end of year (total assets less liabilities)2018-12-31$2,375,192
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$2,428,696
Assets. Value of participant loans2018-12-31$907
Total contributions received or receivable from employer(s)2018-12-31$18,560
Value of certain deemed distributions of participant loans2018-12-31$0
Value of corrective distributions2018-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$25
2017 : AMERICAN SKYLIGHTS PROFIT SHARING AND 401(K) PLAN 2017 401k financial data
Transfers to/from the plan2017-12-31$0
Total plan liabilities at end of year2017-12-31$0
Total plan liabilities at beginning of year2017-12-31$0
Total income from all sources2017-12-31$448,784
Expenses. Total of all expenses incurred2017-12-31$7,217
Benefits paid (including direct rollovers)2017-12-31$7,192
Total plan assets at end of year2017-12-31$2,428,696
Total plan assets at beginning of year2017-12-31$1,987,129
Value of fidelity bond covering the plan2017-12-31$165,000
Assets. Value of tangible personal property2017-12-31$0
Total contributions received or receivable from participants2017-12-31$47,646
Assets. Value of loans (other than to participants)2017-12-31$0
Expenses. Other expenses not covered elsewhere2017-12-31$0
Contributions received from other sources (not participants or employers)2017-12-31$0
Other income received2017-12-31$382,340
Noncash contributions received2017-12-31$0
Net income (gross income less expenses)2017-12-31$441,567
Net plan assets at end of year (total assets less liabilities)2017-12-31$2,428,696
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$1,987,129
Assets. Value of participant loans2017-12-31$1,913
Assets. Value of assets in partnership/joint-venture interests2017-12-31$0
Assets. Value of real-estate (other than employer real property)2017-12-31$0
Assets. Value of employer securities2017-12-31$0
Assets. Value of employer real property2017-12-31$0
Total contributions received or receivable from employer(s)2017-12-31$18,798
Value of certain deemed distributions of participant loans2017-12-31$0
Value of corrective distributions2017-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$25
2016 : AMERICAN SKYLIGHTS PROFIT SHARING AND 401(K) PLAN 2016 401k financial data
Transfers to/from the plan2016-12-31$0
Total plan liabilities at end of year2016-12-31$0
Total plan liabilities at beginning of year2016-12-31$0
Total income from all sources2016-12-31$238,611
Expenses. Total of all expenses incurred2016-12-31$15,722
Benefits paid (including direct rollovers)2016-12-31$15,616
Total plan assets at end of year2016-12-31$1,987,129
Total plan assets at beginning of year2016-12-31$1,764,240
Value of fidelity bond covering the plan2016-12-31$165,000
Total contributions received or receivable from participants2016-12-31$47,168
Expenses. Other expenses not covered elsewhere2016-12-31$0
Contributions received from other sources (not participants or employers)2016-12-31$0
Other income received2016-12-31$173,867
Noncash contributions received2016-12-31$0
Net income (gross income less expenses)2016-12-31$222,889
Net plan assets at end of year (total assets less liabilities)2016-12-31$1,987,129
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$1,764,240
Assets. Value of participant loans2016-12-31$2,874
Total contributions received or receivable from employer(s)2016-12-31$17,576
Value of certain deemed distributions of participant loans2016-12-31$0
Value of corrective distributions2016-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$106
2015 : AMERICAN SKYLIGHTS PROFIT SHARING AND 401(K) PLAN 2015 401k financial data
Transfers to/from the plan2015-12-31$0
Total plan liabilities at end of year2015-12-31$0
Total plan liabilities at beginning of year2015-12-31$0
Total income from all sources2015-12-31$139,810
Expenses. Total of all expenses incurred2015-12-31$15,901
Benefits paid (including direct rollovers)2015-12-31$15,897
Total plan assets at end of year2015-12-31$1,764,240
Total plan assets at beginning of year2015-12-31$1,640,331
Value of fidelity bond covering the plan2015-12-31$165,000
Total contributions received or receivable from participants2015-12-31$46,164
Expenses. Other expenses not covered elsewhere2015-12-31$0
Contributions received from other sources (not participants or employers)2015-12-31$0
Other income received2015-12-31$93,646
Noncash contributions received2015-12-31$0
Net income (gross income less expenses)2015-12-31$123,909
Net plan assets at end of year (total assets less liabilities)2015-12-31$1,764,240
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$1,640,331
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-1022015-12-31$0
Total contributions received or receivable from employer(s)2015-12-31$0
Value of certain deemed distributions of participant loans2015-12-31$0
Value of corrective distributions2015-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$4

Form 5500 Responses for AMERICAN SKYLIGHTS PROFIT SHARING AND 401(K) PLAN

2022: AMERICAN SKYLIGHTS PROFIT SHARING AND 401(K) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01This submission is the final filingNo
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement - TrustYes
2021: AMERICAN SKYLIGHTS PROFIT SHARING AND 401(K) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01This submission is the final filingNo
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement - TrustYes
2020: AMERICAN SKYLIGHTS PROFIT SHARING AND 401(K) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01This submission is the final filingNo
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement - TrustYes
2019: AMERICAN SKYLIGHTS PROFIT SHARING AND 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 filingNo
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 – TrustYes
2019-01-01Plan benefit arrangement - TrustYes
2018: AMERICAN SKYLIGHTS PROFIT SHARING AND 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 – TrustYes
2018-01-01Plan benefit arrangement - TrustYes
2017: AMERICAN SKYLIGHTS PROFIT SHARING AND 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
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement - TrustYes
2016: AMERICAN SKYLIGHTS PROFIT SHARING AND 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 – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: AMERICAN SKYLIGHTS PROFIT SHARING AND 401(K) 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

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-029247
Policy instance 1
Insurance contract or identification numberGA-029247
Number of Individuals Covered0
Insurance policy start date2015-01-01
Insurance policy end date2015-11-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees0
Insurance broker name

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