HOME AND GARDEN PARTY DBA CELEBRATING HOME has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan THE POTTERY GROUP EMPLOYEE BENEFIT PLAN
| Measure | Date | Value |
|---|
| 2014: THE POTTERY GROUP EMPLOYEE BENEFIT PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-09-01 | 190 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-09-01 | 157 |
| Number of retired or separated participants receiving benefits | 2014-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-09-01 | 0 |
| Total of all active and inactive participants | 2014-09-01 | 157 |
| 2011: THE POTTERY GROUP EMPLOYEE BENEFIT PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-09-01 | 208 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-09-01 | 0 |
| Number of retired or separated participants receiving benefits | 2011-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-09-01 | 0 |
| Total of all active and inactive participants | 2011-09-01 | 0 |
| 2009: THE POTTERY GROUP EMPLOYEE BENEFIT PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-09-01 | 197 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-09-01 | 197 |
| Total of all active and inactive participants | 2009-09-01 | 197 |
| Total participants | 2009-09-01 | 197 |
| 2008: THE POTTERY GROUP EMPLOYEE BENEFIT PLAN 2008 401k membership |
|---|
| Total participants, beginning-of-year | 2008-09-01 | 167 |
| Total number of active participants reported on line 7a of the Form 5500 | 2008-09-01 | 167 |
| Number of retired or separated participants receiving benefits | 2008-09-01 | 0 |
| Total of all active and inactive participants | 2008-09-01 | 167 |
| Total participants | 2008-09-01 | 167 |
| 2007: THE POTTERY GROUP EMPLOYEE BENEFIT PLAN 2007 401k membership |
|---|
| Total participants, beginning-of-year | 2007-09-01 | 191 |
| Total number of active participants reported on line 7a of the Form 5500 | 2007-09-01 | 191 |
| Number of retired or separated participants receiving benefits | 2007-09-01 | 0 |
| Total of all active and inactive participants | 2007-09-01 | 191 |
| Total participants | 2007-09-01 | 191 |
| 2006: THE POTTERY GROUP EMPLOYEE BENEFIT PLAN 2006 401k membership |
|---|
| Total participants, beginning-of-year | 2006-09-01 | 204 |
| Total number of active participants reported on line 7a of the Form 5500 | 2006-09-01 | 204 |
| Number of retired or separated participants receiving benefits | 2006-09-01 | 0 |
| Total of all active and inactive participants | 2006-09-01 | 204 |
| Total participants | 2006-09-01 | 204 |
| 2005: THE POTTERY GROUP EMPLOYEE BENEFIT PLAN 2005 401k membership |
|---|
| Total participants, beginning-of-year | 2005-09-01 | 205 |
| Total number of active participants reported on line 7a of the Form 5500 | 2005-09-01 | 205 |
| Number of retired or separated participants receiving benefits | 2005-09-01 | 0 |
| Total of all active and inactive participants | 2005-09-01 | 205 |
| Total participants | 2005-09-01 | 205 |
| 2004: THE POTTERY GROUP EMPLOYEE BENEFIT PLAN 2004 401k membership |
|---|
| Total participants, beginning-of-year | 2004-09-01 | 249 |
| Total number of active participants reported on line 7a of the Form 5500 | 2004-09-01 | 249 |
| Number of retired or separated participants receiving benefits | 2004-09-01 | 0 |
| Total of all active and inactive participants | 2004-09-01 | 249 |
| Total participants | 2004-09-01 | 249 |
| 2003: THE POTTERY GROUP EMPLOYEE BENEFIT PLAN 2003 401k membership |
|---|
| Total participants, beginning-of-year | 2003-09-01 | 248 |
| Total number of active participants reported on line 7a of the Form 5500 | 2003-09-01 | 248 |
| Number of retired or separated participants receiving benefits | 2003-09-01 | 0 |
| Total of all active and inactive participants | 2003-09-01 | 248 |
| Total participants | 2003-09-01 | 248 |
| 2002: THE POTTERY GROUP EMPLOYEE BENEFIT PLAN 2002 401k membership |
|---|
| Total participants, beginning-of-year | 2002-09-01 | 226 |
| Total number of active participants reported on line 7a of the Form 5500 | 2002-09-01 | 226 |
| Number of retired or separated participants receiving benefits | 2002-09-01 | 0 |
| Total of all active and inactive participants | 2002-09-01 | 226 |
| Total participants | 2002-09-01 | 226 |
| 2001: THE POTTERY GROUP EMPLOYEE BENEFIT PLAN 2001 401k membership |
|---|
| Total participants, beginning-of-year | 2001-09-01 | 198 |
| Total number of active participants reported on line 7a of the Form 5500 | 2001-09-01 | 198 |
| Number of retired or separated participants receiving benefits | 2001-09-01 | 0 |
| Total of all active and inactive participants | 2001-09-01 | 198 |
| Total participants | 2001-09-01 | 198 |
| 2014: THE POTTERY GROUP EMPLOYEE BENEFIT PLAN 2014 form 5500 responses |
|---|
| 2014-09-01 | Type of plan entity | Single employer plan |
| 2014-09-01 | Submission has been amended | No |
| 2014-09-01 | This submission is the final filing | No |
| 2014-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-09-01 | Plan is a collectively bargained plan | No |
| 2014-09-01 | Plan funding arrangement – Insurance | Yes |
| 2014-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: THE POTTERY GROUP EMPLOYEE BENEFIT PLAN 2011 form 5500 responses |
|---|
| 2011-09-01 | Type of plan entity | Single employer plan |
| 2011-09-01 | Submission has been amended | No |
| 2011-09-01 | This submission is the final filing | Yes |
| 2011-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-09-01 | Plan is a collectively bargained plan | No |
| 2011-09-01 | Plan funding arrangement – Insurance | Yes |
| 2011-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: THE POTTERY GROUP EMPLOYEE BENEFIT PLAN 2009 form 5500 responses |
|---|
| 2009-09-01 | Type of plan entity | Single employer plan |
| 2009-09-01 | Submission has been amended | No |
| 2009-09-01 | This submission is the final filing | No |
| 2009-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-09-01 | Plan is a collectively bargained plan | No |
| 2009-09-01 | Plan funding arrangement – Insurance | Yes |
| 2009-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2008: THE POTTERY GROUP EMPLOYEE BENEFIT PLAN 2008 form 5500 responses |
|---|
| 2008-09-01 | Type of plan entity | Single employer plan |
| 2008-09-01 | Submission has been amended | No |
| 2008-09-01 | This submission is the final filing | No |
| 2008-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2008-09-01 | Plan is a collectively bargained plan | No |
| 2008-09-01 | Plan funding arrangement – Insurance | Yes |
| 2008-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2008-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2008-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2007: THE POTTERY GROUP EMPLOYEE BENEFIT PLAN 2007 form 5500 responses |
|---|
| 2007-09-01 | Type of plan entity | Single employer plan |
| 2007-09-01 | Submission has been amended | No |
| 2007-09-01 | This submission is the final filing | No |
| 2007-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2007-09-01 | Plan is a collectively bargained plan | No |
| 2007-09-01 | Plan funding arrangement – Insurance | Yes |
| 2007-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2007-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2007-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2006: THE POTTERY GROUP EMPLOYEE BENEFIT PLAN 2006 form 5500 responses |
|---|
| 2006-09-01 | Type of plan entity | Single employer plan |
| 2006-09-01 | Submission has been amended | No |
| 2006-09-01 | This submission is the final filing | No |
| 2006-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2006-09-01 | Plan is a collectively bargained plan | No |
| 2006-09-01 | Plan funding arrangement – Insurance | Yes |
| 2006-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2006-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2006-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2005: THE POTTERY GROUP EMPLOYEE BENEFIT PLAN 2005 form 5500 responses |
|---|
| 2005-09-01 | Type of plan entity | Single employer plan |
| 2005-09-01 | Submission has been amended | No |
| 2005-09-01 | This submission is the final filing | No |
| 2005-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2005-09-01 | Plan is a collectively bargained plan | No |
| 2005-09-01 | Plan funding arrangement – Insurance | Yes |
| 2005-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2005-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2005-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2004: THE POTTERY GROUP EMPLOYEE BENEFIT PLAN 2004 form 5500 responses |
|---|
| 2004-09-01 | Type of plan entity | Single employer plan |
| 2004-09-01 | Submission has been amended | No |
| 2004-09-01 | This submission is the final filing | No |
| 2004-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2004-09-01 | Plan is a collectively bargained plan | No |
| 2004-09-01 | Plan funding arrangement – Insurance | Yes |
| 2004-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2004-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2004-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2003: THE POTTERY GROUP EMPLOYEE BENEFIT PLAN 2003 form 5500 responses |
|---|
| 2003-09-01 | Type of plan entity | Single employer plan |
| 2003-09-01 | Submission has been amended | No |
| 2003-09-01 | This submission is the final filing | No |
| 2003-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2003-09-01 | Plan is a collectively bargained plan | No |
| 2003-09-01 | Plan funding arrangement – Insurance | Yes |
| 2003-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2003-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2003-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2002: THE POTTERY GROUP EMPLOYEE BENEFIT PLAN 2002 form 5500 responses |
|---|
| 2002-09-01 | Type of plan entity | Single employer plan |
| 2002-09-01 | Submission has been amended | No |
| 2002-09-01 | This submission is the final filing | No |
| 2002-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2002-09-01 | Plan is a collectively bargained plan | No |
| 2002-09-01 | Plan funding arrangement – Insurance | Yes |
| 2002-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2002-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2002-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2001: THE POTTERY GROUP EMPLOYEE BENEFIT PLAN 2001 form 5500 responses |
|---|
| 2001-09-01 | Type of plan entity | Single employer plan |
| 2001-09-01 | First time form 5500 has been submitted | Yes |
| 2001-09-01 | Submission has been amended | No |
| 2001-09-01 | This submission is the final filing | No |
| 2001-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2001-09-01 | Plan is a collectively bargained plan | No |
| 2001-09-01 | Plan funding arrangement – Insurance | Yes |
| 2001-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2001-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2001-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | 540315 |
| Policy instance | 1 |
| Insurance contract or identification number | 540315 | | Number of Individuals Covered | 77 | | Insurance policy start date | 2014-09-01 | | Insurance policy end date | 2015-08-31 | | Total amount of commissions paid to insurance broker | USD $1,660 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $11,063 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,660 | | Insurance broker organization code? | 3 | | Insurance broker name | RINA TIKIA |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0837954 |
| Policy instance | 2 |
| Insurance contract or identification number | 0837954 | | Number of Individuals Covered | 238 | | Insurance policy start date | 2014-09-01 | | Insurance policy end date | 2015-08-31 | | Total amount of commissions paid to insurance broker | USD $13,021 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $70,915 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,766 | | Insurance broker organization code? | 3 | | Insurance broker name | ROGERS BENEFIT GROUP INC |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 237318 |
| Policy instance | 3 |
| Insurance contract or identification number | 237318 | | Number of Individuals Covered | 157 | | Insurance policy start date | 2014-09-01 | | Insurance policy end date | 2015-08-31 | | Total amount of commissions paid to insurance broker | USD $16,619 | | Total amount of fees paid to insurance company | USD $1,503 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | AD&D, SUPPLEMENTAL LIFE, DEPENDENT LIFE, SUPPLEMENTAL AD&D, DEPENDENT AD&D | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $63,885 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,619 | | Amount paid for insurance broker fees | 1503 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 | | Insurance broker name | TIKIA CONSULTING GROUP INC |
|
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | 405272 0010 |
| Policy instance | 4 |
| Insurance contract or identification number | 405272 0010 | | Number of Individuals Covered | 155 | | Insurance policy start date | 2014-09-01 | | Insurance policy end date | 2015-08-31 | | Total amount of commissions paid to insurance broker | USD $54,645 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $273,222 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $35,857 | | Insurance broker organization code? | 3 | | Insurance broker name | RINA TIKIA C/O TIKIA CONSULTING GRO |
|
| EMC NATIONAL LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 62928 ) |
| Policy contract number | GL0872 |
| Policy instance | 4 |
| Insurance contract or identification number | GL0872 | | Number of Individuals Covered | 243 | | Insurance policy start date | 2011-09-01 | | Insurance policy end date | 2012-08-31 | | Total amount of commissions paid to insurance broker | USD $3,526 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $15,090 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 87167 |
| Policy instance | 3 |
| Insurance contract or identification number | 87167 | | Number of Individuals Covered | 242 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-08-31 | | Total amount of commissions paid to insurance broker | USD $1,713 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $11,418 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 87167 |
| Policy instance | 2 |
| Insurance contract or identification number | 87167 | | Number of Individuals Covered | 258 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $2,616 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $17,440 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | LAT-G0564 |
| Policy instance | 1 |
| Insurance contract or identification number | LAT-G0564 | | Number of Individuals Covered | 193 | | Insurance policy start date | 2011-09-01 | | Insurance policy end date | 2012-08-31 | | Total amount of commissions paid to insurance broker | USD $11,280 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $198,444 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMC NATIONAL LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 62928 ) |
| Policy contract number | GL0872 |
| Policy instance | 1 |
| Insurance contract or identification number | GL0872 | | Number of Individuals Covered | 265 | | Insurance policy start date | 2010-09-01 | | Insurance policy end date | 2011-08-31 | | Total amount of commissions paid to insurance broker | USD $3,461 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $15,313 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | LAT-G0564 |
| Policy instance | 2 |
| Insurance contract or identification number | LAT-G0564 | | Number of Individuals Covered | 185 | | Insurance policy start date | 2010-09-01 | | Insurance policy end date | 2011-08-31 | | Total amount of commissions paid to insurance broker | USD $11,400 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $184,794 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 87167 |
| Policy instance | 3 |
| Insurance contract or identification number | 87167 | | Number of Individuals Covered | 268 | | Insurance policy start date | 2010-09-01 | | Insurance policy end date | 2011-08-31 | | Total amount of commissions paid to insurance broker | USD $2,542 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,949 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MERITAIN HEALTH (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | GR1476 |
| Policy instance | 3 |
| Insurance contract or identification number | GR1476 | | Number of Individuals Covered | 178 | | Insurance policy start date | 2008-09-01 | | Insurance policy end date | 2009-08-31 | | Total amount of commissions paid to insurance broker | USD $10,620 | | Welfare Benefit Premiums Paid to Carrier | USD $157,524 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,620 | | Insurance broker organization code? | 3 | | Insurance broker name | COBBS ALLEN & HALL AGENCY |
|
| EMC NATIONAL LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 62928 ) |
| Policy contract number | GL0872 |
| Policy instance | 2 |
| Insurance contract or identification number | GL0872 | | Number of Individuals Covered | 227 | | Insurance policy start date | 2008-09-01 | | Insurance policy end date | 2009-08-31 | | Total amount of commissions paid to insurance broker | USD $2,141 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $9,705 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $597 | | Insurance broker organization code? | 3 | | Insurance broker name | DIANNA ROBERTS |
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| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 87167 |
| Policy instance | 1 |
| Insurance contract or identification number | 87167 | | Number of Individuals Covered | 234 | | Insurance policy start date | 2008-09-01 | | Insurance policy end date | 2009-08-31 | | Total amount of commissions paid to insurance broker | USD $2,841 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,112 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,841 | | Insurance broker organization code? | 3 | | Insurance broker name | COBBS ALLEN & HALL, INC. |
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| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 87167 |
| Policy instance | 3 |
| Insurance contract or identification number | 87167 | | Number of Individuals Covered | 243 | | Insurance policy start date | 2007-09-01 | | Insurance policy end date | 2008-08-31 | | Total amount of commissions paid to insurance broker | USD $2,667 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,848 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,216 | | Insurance broker organization code? | 3 | | Insurance broker name | HUB INTERNATIONAL MIDWEST LIMITED |
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| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 186 | | Insurance policy start date | 2007-09-01 | | Insurance policy end date | 2008-08-31 | | Total amount of commissions paid to insurance broker | USD $9,840 | | Welfare Benefit Premiums Paid to Carrier | USD $190,212 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,840 | | Insurance broker organization code? | 3 | | Insurance broker name | COBBS ALLEN & HALL AGENCY |
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| EMC NATIONAL LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 62928 ) |
| Policy contract number | GL0872 |
| Policy instance | 1 |
| Insurance contract or identification number | GL0872 | | Number of Individuals Covered | 238 | | Insurance policy start date | 2007-09-01 | | Insurance policy end date | 2008-08-31 | | Total amount of commissions paid to insurance broker | USD $1,902 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $9,808 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $585 | | Insurance broker organization code? | 3 | | Insurance broker name | DIANNA ROBERTS |
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| EMC NATIONAL LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 62928 ) |
| Policy contract number | GL0872 |
| Policy instance | 2 |
| Insurance contract or identification number | GL0872 | | Number of Individuals Covered | 274 | | Insurance policy start date | 2006-09-01 | | Insurance policy end date | 2007-08-31 | | Total amount of commissions paid to insurance broker | USD $1,847 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $9,656 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $566 | | Insurance broker organization code? | 3 | | Insurance broker name | DIANNA ROBERTS |
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| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 ) |
| Policy contract number | |
| Policy instance | 1 |
| Number of Individuals Covered | 186 | | Insurance policy start date | 2006-09-01 | | Insurance policy end date | 2007-08-31 | | Total amount of commissions paid to insurance broker | USD $11,640 | | Welfare Benefit Premiums Paid to Carrier | USD $152,693 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,640 | | Insurance broker organization code? | 3 | | Insurance broker name | COBBS ALLEN & HALL AGENCY |
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| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 ) |
| Policy contract number | |
| Policy instance | 1 |
| Number of Individuals Covered | 190 | | Insurance policy start date | 2005-09-01 | | Insurance policy end date | 2006-08-31 | | Total amount of commissions paid to insurance broker | USD $12,797 | | Welfare Benefit Premiums Paid to Carrier | USD $127,638 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,797 | | Insurance broker organization code? | 3 | | Insurance broker name | COBBS ALLEN & HALL AGENCY |
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| EMC NATIONAL LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 62928 ) |
| Policy contract number | GL0872 |
| Policy instance | 2 |
| Insurance contract or identification number | GL0872 | | Number of Individuals Covered | 226 | | Insurance policy start date | 2005-09-01 | | Insurance policy end date | 2006-08-31 | | Total amount of commissions paid to insurance broker | USD $7,581 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $12,910 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,233 | | Insurance broker organization code? | 3 | | Insurance broker name | DIANNA ROBERTS |
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| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | GRH710396 |
| Policy instance | 1 |
| Insurance contract or identification number | GRH710396 | | Number of Individuals Covered | 202 | | Insurance policy start date | 2004-09-01 | | Insurance policy end date | 2005-08-31 | | Total amount of commissions paid to insurance broker | USD $17,291 | | Welfare Benefit Premiums Paid to Carrier | USD $169,928 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $17,291 | | Insurance broker organization code? | 3 | | Insurance broker name | COBBS ALLEN & HALL AGENCY |
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| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | GRH710396 |
| Policy instance | 1 |
| Insurance contract or identification number | GRH710396 | | Number of Individuals Covered | 248 | | Insurance policy start date | 2003-09-01 | | Insurance policy end date | 2004-08-31 | | Total amount of commissions paid to insurance broker | USD $20,463 | | Welfare Benefit Premiums Paid to Carrier | USD $204,635 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20,463 | | Insurance broker organization code? | 3 | | Insurance broker name | COBBS ALLEN & HALL AGENCY |
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| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | GRH710396 |
| Policy instance | 1 |
| Insurance contract or identification number | GRH710396 | | Number of Individuals Covered | 203 | | Insurance policy start date | 2002-09-01 | | Insurance policy end date | 2003-08-31 | | Total amount of commissions paid to insurance broker | USD $21,240 | | Welfare Benefit Premiums Paid to Carrier | USD $212,403 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $21,240 | | Insurance broker organization code? | 3 | | Insurance broker name | HIBERNIA INSURANCE AGENCY |
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| PRODUCERS EXCHANGE BENEFIT SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | |
| Policy instance | 1 |
| Number of Individuals Covered | 164 | | Insurance policy start date | 2001-09-01 | | Insurance policy end date | 2002-08-31 | | Total amount of commissions paid to insurance broker | USD $12,173 | | Welfare Benefit Premiums Paid to Carrier | USD $130,755 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,173 | | Insurance broker organization code? | 3 | | Insurance broker name | HIBERNIA INSURANCE AGENCY |
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