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TEAK, INC. 401K PROFIT SHARING PLAN 401k Plan overview

Plan NameTEAK, INC. 401K PROFIT SHARING PLAN
Plan identification number 001

TEAK, INC. 401K PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • 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.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • 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

TEAK, INC. has sponsored the creation of one or more 401k plans.

Company Name:TEAK, INC.
Employer identification number (EIN):820448484
NAIC Classification:722513
NAIC Description:Limited-Service Restaurants

Additional information about TEAK, INC.

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 2077743

More information about TEAK, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TEAK, INC. 401K PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01BOB HUCKSTEP2023-09-22
0012021-01-01BOB HUCKSTEP2022-08-23
0012020-01-01BOB HUCKSTEP2021-08-30
0012019-01-01BOB HUCKSTEP2020-07-27
0012018-01-01BOB HUCKSTEP2019-08-29
0012017-01-01
0012016-01-01
0012015-01-01
0012014-01-01BOB HUCKSTEP
0012013-01-01BOB HUCKSTEP2014-10-13
0012012-01-01BOB HUCKSTEP2013-10-15
0012011-01-01BOB HUCKSTEP2012-09-26
0012010-01-01BOB HUCKSTEP2011-10-10

Plan Statistics for TEAK, INC. 401K PROFIT SHARING PLAN

401k plan membership statisitcs for TEAK, INC. 401K PROFIT SHARING PLAN

Measure Date Value
2022: TEAK, INC. 401K PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0178
Total number of active participants reported on line 7a of the Form 55002022-01-0152
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0110
Total of all active and inactive participants2022-01-0162
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-0162
Number of participants with account balances2022-01-0134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: TEAK, INC. 401K PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0178
Total number of active participants reported on line 7a of the Form 55002021-01-0144
Number of retired or separated participants receiving benefits2021-01-011
Number of other retired or separated participants entitled to future benefits2021-01-0116
Total of all active and inactive participants2021-01-0161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-0161
Number of participants with account balances2021-01-0139
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: TEAK, INC. 401K PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0179
Total number of active participants reported on line 7a of the Form 55002020-01-0149
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-019
Total of all active and inactive participants2020-01-0158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-0158
Number of participants with account balances2020-01-0138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: TEAK, INC. 401K PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0182
Total number of active participants reported on line 7a of the Form 55002019-01-0145
Number of retired or separated participants receiving benefits2019-01-011
Number of other retired or separated participants entitled to future benefits2019-01-0110
Total of all active and inactive participants2019-01-0156
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0156
Number of participants with account balances2019-01-0137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-013
2018: TEAK, INC. 401K PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0173
Total number of active participants reported on line 7a of the Form 55002018-01-0153
Number of retired or separated participants receiving benefits2018-01-011
Number of other retired or separated participants entitled to future benefits2018-01-0116
Total of all active and inactive participants2018-01-0170
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0170
Number of participants with account balances2018-01-0146
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-0110
2017: TEAK, INC. 401K PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0178
Total number of active participants reported on line 7a of the Form 55002017-01-0152
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0121
Total of all active and inactive participants2017-01-0173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0173
Number of participants with account balances2017-01-0164
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-0117
2016: TEAK, INC. 401K PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01112
Total number of active participants reported on line 7a of the Form 55002016-01-0165
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0113
Total of all active and inactive participants2016-01-0178
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0178
Number of participants with account balances2016-01-0171
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-0125
2015: TEAK, INC. 401K PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01103
Total number of active participants reported on line 7a of the Form 55002015-01-0172
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0140
Total of all active and inactive participants2015-01-01112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01112
Number of participants with account balances2015-01-01112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-0115
2014: TEAK, INC. 401K PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0190
Total number of active participants reported on line 7a of the Form 55002014-01-0163
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0140
Total of all active and inactive participants2014-01-01103
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01103
Number of participants with account balances2014-01-01103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-0116

Financial Data on TEAK, INC. 401K PROFIT SHARING PLAN

Measure Date Value
2022 : TEAK, INC. 401K PROFIT SHARING PLAN 2022 401k financial data
Total plan liabilities at end of year2022-12-31$0
Total plan liabilities at beginning of year2022-12-31$2,362
Total income from all sources2022-12-31$-570,751
Expenses. Total of all expenses incurred2022-12-31$135,667
Benefits paid (including direct rollovers)2022-12-31$124,223
Total plan assets at end of year2022-12-31$5,661,107
Total plan assets at beginning of year2022-12-31$6,369,887
Value of fidelity bond covering the plan2022-12-31$636,753
Total contributions received or receivable from participants2022-12-31$89,584
Other income received2022-12-31$-697,897
Net income (gross income less expenses)2022-12-31$-706,418
Net plan assets at end of year (total assets less liabilities)2022-12-31$5,661,107
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$6,367,525
Total contributions received or receivable from employer(s)2022-12-31$37,562
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$11,444
2021 : TEAK, INC. 401K PROFIT SHARING PLAN 2021 401k financial data
Total plan liabilities at end of year2021-12-31$2,362
Total plan liabilities at beginning of year2021-12-31$0
Total income from all sources2021-12-31$1,244,534
Expenses. Total of all expenses incurred2021-12-31$703,797
Benefits paid (including direct rollovers)2021-12-31$691,962
Total plan assets at end of year2021-12-31$6,369,887
Total plan assets at beginning of year2021-12-31$5,826,788
Value of fidelity bond covering the plan2021-12-31$500,000
Total contributions received or receivable from participants2021-12-31$115,353
Other income received2021-12-31$1,078,088
Net income (gross income less expenses)2021-12-31$540,737
Net plan assets at end of year (total assets less liabilities)2021-12-31$6,367,525
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$5,826,788
Total contributions received or receivable from employer(s)2021-12-31$51,093
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$11,835
2020 : TEAK, INC. 401K PROFIT SHARING PLAN 2020 401k financial data
Total income from all sources2020-12-31$865,417
Expenses. Total of all expenses incurred2020-12-31$31,652
Benefits paid (including direct rollovers)2020-12-31$25,534
Total plan assets at end of year2020-12-31$5,826,788
Total plan assets at beginning of year2020-12-31$4,993,023
Value of fidelity bond covering the plan2020-12-31$499,302
Total contributions received or receivable from participants2020-12-31$112,718
Contributions received from other sources (not participants or employers)2020-12-31$150,073
Other income received2020-12-31$554,777
Net income (gross income less expenses)2020-12-31$833,765
Net plan assets at end of year (total assets less liabilities)2020-12-31$5,826,788
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$4,993,023
Total contributions received or receivable from employer(s)2020-12-31$47,849
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$6,118
2019 : TEAK, INC. 401K PROFIT SHARING PLAN 2019 401k financial data
Total income from all sources2019-12-31$713,470
Expenses. Total of all expenses incurred2019-12-31$276,401
Benefits paid (including direct rollovers)2019-12-31$270,228
Total plan assets at end of year2019-12-31$4,993,023
Total plan assets at beginning of year2019-12-31$4,555,954
Value of fidelity bond covering the plan2019-12-31$350,000
Total contributions received or receivable from participants2019-12-31$103,910
Other income received2019-12-31$564,792
Net income (gross income less expenses)2019-12-31$437,069
Net plan assets at end of year (total assets less liabilities)2019-12-31$4,993,023
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$4,555,954
Total contributions received or receivable from employer(s)2019-12-31$44,768
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$6,173
2018 : TEAK, INC. 401K PROFIT SHARING PLAN 2018 401k financial data
Total plan liabilities at beginning of year2018-12-31$0
Total income from all sources2018-12-31$142,408
Expenses. Total of all expenses incurred2018-12-31$51,296
Benefits paid (including direct rollovers)2018-12-31$40,536
Total plan assets at end of year2018-12-31$4,555,954
Total plan assets at beginning of year2018-12-31$4,464,842
Value of fidelity bond covering the plan2018-12-31$350,000
Total contributions received or receivable from participants2018-12-31$102,376
Other income received2018-12-31$-1,758
Net income (gross income less expenses)2018-12-31$91,112
Net plan assets at end of year (total assets less liabilities)2018-12-31$4,555,954
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$4,464,842
Total contributions received or receivable from employer(s)2018-12-31$41,790
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$10,760
2017 : TEAK, INC. 401K PROFIT SHARING PLAN 2017 401k financial data
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$513,350
Expenses. Total of all expenses incurred2017-12-31$92,747
Benefits paid (including direct rollovers)2017-12-31$88,318
Total plan assets at end of year2017-12-31$4,464,842
Total plan assets at beginning of year2017-12-31$4,044,239
Value of fidelity bond covering the plan2017-12-31$350,000
Total contributions received or receivable from participants2017-12-31$98,440
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$371,733
Noncash contributions received2017-12-31$0
Net income (gross income less expenses)2017-12-31$420,603
Net plan assets at end of year (total assets less liabilities)2017-12-31$4,464,842
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$4,044,239
Total contributions received or receivable from employer(s)2017-12-31$43,177
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$4,429
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : TEAK, INC. 401K PROFIT SHARING PLAN 2016 401k financial data
Total plan liabilities at beginning of year2016-12-31$0
Total income from all sources2016-12-31$400,239
Expenses. Total of all expenses incurred2016-12-31$135,534
Benefits paid (including direct rollovers)2016-12-31$130,873
Total plan assets at end of year2016-12-31$4,044,239
Total plan assets at beginning of year2016-12-31$3,779,534
Value of fidelity bond covering the plan2016-12-31$350,000
Total contributions received or receivable from participants2016-12-31$99,288
Expenses. Other expenses not covered elsewhere2016-12-31$0
Contributions received from other sources (not participants or employers)2016-12-31$67,346
Other income received2016-12-31$91,120
Noncash contributions received2016-12-31$0
Net income (gross income less expenses)2016-12-31$264,705
Net plan assets at end of year (total assets less liabilities)2016-12-31$4,044,239
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$3,779,534
Total contributions received or receivable from employer(s)2016-12-31$142,485
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$4,661
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : TEAK, INC. 401K PROFIT SHARING PLAN 2015 401k financial data
Total plan liabilities at end of year2015-12-31$0
Total plan liabilities at beginning of year2015-12-31$593
Total income from all sources2015-12-31$299,927
Expenses. Total of all expenses incurred2015-12-31$163,268
Benefits paid (including direct rollovers)2015-12-31$159,768
Total plan assets at end of year2015-12-31$3,779,534
Total plan assets at beginning of year2015-12-31$3,643,468
Value of fidelity bond covering the plan2015-12-31$175,000
Total contributions received or receivable from participants2015-12-31$92,678
Other income received2015-12-31$38,650
Net income (gross income less expenses)2015-12-31$136,659
Net plan assets at end of year (total assets less liabilities)2015-12-31$3,779,534
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$3,642,875
Total contributions received or receivable from employer(s)2015-12-31$168,599
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$3,500
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : TEAK, INC. 401K PROFIT SHARING PLAN 2014 401k financial data
Total plan liabilities at end of year2014-12-31$593
Total plan liabilities at beginning of year2014-12-31$0
Total income from all sources2014-12-31$285,941
Expenses. Total of all expenses incurred2014-12-31$128,177
Benefits paid (including direct rollovers)2014-12-31$124,756
Total plan assets at end of year2014-12-31$3,643,468
Total plan assets at beginning of year2014-12-31$3,485,111
Value of fidelity bond covering the plan2014-12-31$175,000
Total contributions received or receivable from participants2014-12-31$84,839
Other income received2014-12-31$37,794
Net income (gross income less expenses)2014-12-31$157,764
Net plan assets at end of year (total assets less liabilities)2014-12-31$3,642,875
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$3,485,111
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-1022014-12-31$25
Total contributions received or receivable from employer(s)2014-12-31$163,308
Value of certain deemed distributions of participant loans2014-12-31$3,421
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0

Form 5500 Responses for TEAK, INC. 401K PROFIT SHARING PLAN

2022: TEAK, INC. 401K PROFIT SHARING PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: TEAK, INC. 401K PROFIT SHARING PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: TEAK, INC. 401K PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: TEAK, INC. 401K PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: TEAK, INC. 401K PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: TEAK, INC. 401K PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: TEAK, INC. 401K PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: TEAK, INC. 401K PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: TEAK, INC. 401K PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number511470-01
Policy instance 1
Insurance contract or identification number511470-01
Number of Individuals Covered1
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number511470-01
Policy instance 1
Insurance contract or identification number511470-01
Number of Individuals Covered1
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-712161
Policy instance 1
Insurance contract or identification numberGA-712161
Number of Individuals Covered42
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-712161
Policy instance 1
Insurance contract or identification numberGA-712161
Number of Individuals Covered39
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-712161
Policy instance 1
Insurance contract or identification numberGA-712161
Number of Individuals Covered64
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-7122161
Policy instance 1
Insurance contract or identification numberGA-7122161
Number of Individuals Covered90
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-7122161
Policy instance 1
Insurance contract or identification numberGA-7122161
Number of Individuals Covered88
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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