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WATTS HEALTHCARE CORPORATION EXECUTIVE RETIREMENT PROGRAM 401k Plan overview

Plan NameWATTS HEALTHCARE CORPORATION EXECUTIVE RETIREMENT PROGRAM
Plan identification number 002

WATTS HEALTHCARE CORPORATION EXECUTIVE RETIREMENT PROGRAM Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Money purchase (other than target benefit)
  • 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.
  • 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

WATTS HEALTHCARE CORPORATION has sponsored the creation of one or more 401k plans.

Company Name:WATTS HEALTHCARE CORPORATION
Employer identification number (EIN):753046480
NAIC Classification:621498
NAIC Description:All Other Outpatient Care Centers

Additional information about WATTS HEALTHCARE CORPORATION

Jurisdiction of Incorporation: California Department of State
Incorporation Date:
Company Identification Number: C2374894

More information about WATTS HEALTHCARE CORPORATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WATTS HEALTHCARE CORPORATION EXECUTIVE RETIREMENT PROGRAM

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022022-01-01HARA YOHANNES2023-10-12
0022021-01-01HARA YOHANNES2022-10-17 HARA YOHANNES2022-10-17
0022020-01-01STARLA BALDWIN2021-07-27 STARLA BALDWIN2021-07-27
0022019-01-01STARLA BALDWIN2020-06-25
0022019-01-01STARLA BALDWIN2020-09-28 STARLA BALDWIN2020-09-28
0022018-01-01STARLA BALDWIN2019-10-28 STARLA MABIN2019-10-28
0022017-01-01STARLA BALDWIN2018-10-18 STARLA BALDWIN2018-10-18
0022016-01-01STARLA BALDWIN2017-05-02 STARLA BALDWIN2017-05-02
0022015-01-01STARLA MABIN-BALDWIN STARLA MABIN-BALDWIN2016-10-18
0022014-01-01STARLA MABIN-BALDWIN STARLA MABIN-BALDWIN2015-10-14
0022013-01-01MONICA COWARD MONICA COWARD2014-10-14
0022012-01-01MONICA COWARD MONICA COWARD2013-10-11
0022011-01-01WILLIAM L. BUFFINGTON
0022009-01-01WILLIAM L. BUFFINGTON WILLIAM L. BUFFINGTON2010-10-07

Plan Statistics for WATTS HEALTHCARE CORPORATION EXECUTIVE RETIREMENT PROGRAM

401k plan membership statisitcs for WATTS HEALTHCARE CORPORATION EXECUTIVE RETIREMENT PROGRAM

Measure Date Value
2015: WATTS HEALTHCARE CORPORATION EXECUTIVE RETIREMENT PROGRAM 2015 401k membership
Total participants, beginning-of-year2015-01-0129
Total number of active participants reported on line 7a of the Form 55002015-01-0130
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-012
Total of all active and inactive participants2015-01-0132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0132
Number of participants with account balances2015-01-0132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: WATTS HEALTHCARE CORPORATION EXECUTIVE RETIREMENT PROGRAM 2014 401k membership
Total participants, beginning-of-year2014-01-0128
Total number of active participants reported on line 7a of the Form 55002014-01-0127
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-012
Total of all active and inactive participants2014-01-0129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0129
Number of participants with account balances2014-01-0129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: WATTS HEALTHCARE CORPORATION EXECUTIVE RETIREMENT PROGRAM 2013 401k membership
Total participants, beginning-of-year2013-01-0128
Total number of active participants reported on line 7a of the Form 55002013-01-0126
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-012
Total of all active and inactive participants2013-01-0128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0128
Number of participants with account balances2013-01-0128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: WATTS HEALTHCARE CORPORATION EXECUTIVE RETIREMENT PROGRAM 2012 401k membership
Total participants, beginning-of-year2012-01-0130
Total number of active participants reported on line 7a of the Form 55002012-01-0124
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-014
Total of all active and inactive participants2012-01-0128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0128
Number of participants with account balances2012-01-0128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: WATTS HEALTHCARE CORPORATION EXECUTIVE RETIREMENT PROGRAM 2011 401k membership
Total participants, beginning-of-year2011-01-0131
Total number of active participants reported on line 7a of the Form 55002011-01-0127
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-013
Total of all active and inactive participants2011-01-0130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0130
Number of participants with account balances2011-01-0130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: WATTS HEALTHCARE CORPORATION EXECUTIVE RETIREMENT PROGRAM 2009 401k membership
Total participants, beginning-of-year2009-01-0126
Total number of active participants reported on line 7a of the Form 55002009-01-0129
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-012
Total of all active and inactive participants2009-01-0131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0131
Number of participants with account balances2009-01-0131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on WATTS HEALTHCARE CORPORATION EXECUTIVE RETIREMENT PROGRAM

Measure Date Value
2015 : WATTS HEALTHCARE CORPORATION EXECUTIVE RETIREMENT PROGRAM 2015 401k financial data
Total income from all sources2015-12-31$304,890
Expenses. Total of all expenses incurred2015-12-31$40
Total plan assets at end of year2015-12-31$3,964,310
Total plan assets at beginning of year2015-12-31$3,659,460
Value of fidelity bond covering the plan2015-12-31$100,000
Other income received2015-12-31$119,830
Net income (gross income less expenses)2015-12-31$304,850
Net plan assets at end of year (total assets less liabilities)2015-12-31$3,964,310
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$3,659,460
Total contributions received or receivable from employer(s)2015-12-31$185,060
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$40
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : WATTS HEALTHCARE CORPORATION EXECUTIVE RETIREMENT PROGRAM 2014 401k financial data
Total income from all sources2014-12-31$406,987
Expenses. Total of all expenses incurred2014-12-31$-1,638
Benefits paid (including direct rollovers)2014-12-31$-1,678
Total plan assets at end of year2014-12-31$3,659,460
Total plan assets at beginning of year2014-12-31$3,250,835
Value of fidelity bond covering the plan2014-12-31$100,000
Other income received2014-12-31$229,981
Net income (gross income less expenses)2014-12-31$408,625
Net plan assets at end of year (total assets less liabilities)2014-12-31$3,659,460
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$3,250,835
Total contributions received or receivable from employer(s)2014-12-31$177,006
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$40
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : WATTS HEALTHCARE CORPORATION EXECUTIVE RETIREMENT PROGRAM 2013 401k financial data
Total income from all sources2013-12-31$652,903
Expenses. Total of all expenses incurred2013-12-31$97,169
Benefits paid (including direct rollovers)2013-12-31$96,739
Total plan assets at end of year2013-12-31$3,250,835
Total plan assets at beginning of year2013-12-31$2,695,101
Value of fidelity bond covering the plan2013-12-31$100,000
Contributions received from other sources (not participants or employers)2013-12-31$1,308
Other income received2013-12-31$433,743
Net income (gross income less expenses)2013-12-31$555,734
Net plan assets at end of year (total assets less liabilities)2013-12-31$3,250,835
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$2,695,101
Total contributions received or receivable from employer(s)2013-12-31$217,852
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$430
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : WATTS HEALTHCARE CORPORATION EXECUTIVE RETIREMENT PROGRAM 2012 401k financial data
Total income from all sources2012-12-31$437,526
Expenses. Total of all expenses incurred2012-12-31$181,293
Benefits paid (including direct rollovers)2012-12-31$181,133
Total plan assets at end of year2012-12-31$2,695,101
Total plan assets at beginning of year2012-12-31$2,438,868
Value of fidelity bond covering the plan2012-12-31$100,000
Other income received2012-12-31$193,383
Net income (gross income less expenses)2012-12-31$256,233
Net plan assets at end of year (total assets less liabilities)2012-12-31$2,695,101
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$2,438,868
Total contributions received or receivable from employer(s)2012-12-31$244,143
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$160
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : WATTS HEALTHCARE CORPORATION EXECUTIVE RETIREMENT PROGRAM 2011 401k financial data
Total income from all sources2011-12-31$269,641
Expenses. Total of all expenses incurred2011-12-31$2,865
Benefits paid (including direct rollovers)2011-12-31$2,700
Total plan assets at end of year2011-12-31$2,438,868
Total plan assets at beginning of year2011-12-31$2,172,092
Value of fidelity bond covering the plan2011-12-31$100,000
Other income received2011-12-31$22,308
Net income (gross income less expenses)2011-12-31$266,776
Net plan assets at end of year (total assets less liabilities)2011-12-31$2,438,868
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$2,172,092
Total contributions received or receivable from employer(s)2011-12-31$247,333
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$165
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : WATTS HEALTHCARE CORPORATION EXECUTIVE RETIREMENT PROGRAM 2010 401k financial data
Total income from all sources2010-12-31$435,917
Expenses. Total of all expenses incurred2010-12-31$311
Total plan assets at end of year2010-12-31$2,172,092
Total plan assets at beginning of year2010-12-31$1,736,486
Value of fidelity bond covering the plan2010-12-31$100,000
Other income received2010-12-31$211,770
Net income (gross income less expenses)2010-12-31$435,606
Net plan assets at end of year (total assets less liabilities)2010-12-31$2,172,092
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$1,736,486
Total contributions received or receivable from employer(s)2010-12-31$224,147
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$311
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
2009 : WATTS HEALTHCARE CORPORATION EXECUTIVE RETIREMENT PROGRAM 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for WATTS HEALTHCARE CORPORATION EXECUTIVE RETIREMENT PROGRAM

2015: WATTS HEALTHCARE CORPORATION EXECUTIVE RETIREMENT PROGRAM 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: WATTS HEALTHCARE CORPORATION EXECUTIVE RETIREMENT PROGRAM 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: WATTS HEALTHCARE CORPORATION EXECUTIVE RETIREMENT PROGRAM 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: WATTS HEALTHCARE CORPORATION EXECUTIVE RETIREMENT PROGRAM 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: WATTS HEALTHCARE CORPORATION EXECUTIVE RETIREMENT PROGRAM 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: WATTS HEALTHCARE CORPORATION EXECUTIVE RETIREMENT PROGRAM 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number39107-001
Policy instance 1
Insurance contract or identification number39107-001
Number of Individuals Covered32
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number39107-001
Policy instance 1
Insurance contract or identification number39107-001
Number of Individuals Covered29
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
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?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number39107-001
Policy instance 1
Insurance contract or identification number39107-001
Number of Individuals Covered28
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
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?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number39107-001
Policy instance 1
Insurance contract or identification number39107-001
Number of Individuals Covered28
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
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?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number39107-001
Policy instance 1
Insurance contract or identification number39107-001
Number of Individuals Covered30
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
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?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number39107-001
Policy instance 1
Insurance contract or identification number39107-001
Number of Individuals Covered31
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
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?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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