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401 (K) PROFIT SHARING PLAN & TRUST 401k Plan overview

Plan Name401 (K) PROFIT SHARING PLAN & TRUST
Plan identification number 001

401 (K) PROFIT SHARING PLAN & TRUST Benefits

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

401k Sponsoring company profile

THOMPSON PALMER & ASSOCIATES PC has sponsored the creation of one or more 401k plans.

Company Name:THOMPSON PALMER & ASSOCIATES PC
Employer identification number (EIN):830246322
NAIC Classification:541211
NAIC Description:Offices of Certified Public Accountants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan 401 (K) PROFIT SHARING PLAN & TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01RICHARD PALMER2023-10-16
0012021-01-01RICHARD PALMER2022-10-13 RICHARD PALMER2022-10-13
0012020-01-01
0012019-01-01
0012018-01-01
0012017-01-01RICHARD PALMER RICHARD PALMER2018-10-13
0012016-01-01RICHARD PALMER RICHARD PALMER2017-11-17
0012015-01-01RICHARD PALMER RICHARD PALMER2016-10-11
0012014-01-01RICHARD PALMER RICHARD PALMER2015-07-13
0012013-01-01RICHARD PALMER RICHARD PALMER2014-09-23
0012012-01-01RICHARD PALMER
0012011-01-01RICHARD PALMER
0012009-01-01RICHARD PALMER

Plan Statistics for 401 (K) PROFIT SHARING PLAN & TRUST

401k plan membership statisitcs for 401 (K) PROFIT SHARING PLAN & TRUST

Measure Date Value
2020: 401 (K) PROFIT SHARING PLAN & TRUST 2020 401k membership
Total participants, beginning-of-year2020-01-0112
Total number of active participants reported on line 7a of the Form 55002020-01-0110
Number of retired or separated participants receiving benefits2020-01-011
Total of all active and inactive participants2020-01-0111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-012
Total participants2020-01-0113
Number of participants with account balances2020-01-0113
2019: 401 (K) PROFIT SHARING PLAN & TRUST 2019 401k membership
Total participants, beginning-of-year2019-01-0111
Total number of active participants reported on line 7a of the Form 55002019-01-0110
Number of retired or separated participants receiving benefits2019-01-011
Total of all active and inactive participants2019-01-0111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-011
Total participants2019-01-0112
Number of participants with account balances2019-01-0112
2018: 401 (K) PROFIT SHARING PLAN & TRUST 2018 401k membership
Total participants, beginning-of-year2018-01-0113
Total number of active participants reported on line 7a of the Form 55002018-01-019
Number of retired or separated participants receiving benefits2018-01-012
Total of all active and inactive participants2018-01-0111
Total participants2018-01-0111
2017: 401 (K) PROFIT SHARING PLAN & TRUST 2017 401k membership
Total participants, beginning-of-year2017-01-0114
Total number of active participants reported on line 7a of the Form 55002017-01-0112
Number of other retired or separated participants entitled to future benefits2017-01-011
Total of all active and inactive participants2017-01-0113
Total participants2017-01-0113
2016: 401 (K) PROFIT SHARING PLAN & TRUST 2016 401k membership
Total participants, beginning-of-year2016-01-0113
Total number of active participants reported on line 7a of the Form 55002016-01-0113
Number of other retired or separated participants entitled to future benefits2016-01-011
Total of all active and inactive participants2016-01-0114
Total participants2016-01-0114
2015: 401 (K) PROFIT SHARING PLAN & TRUST 2015 401k membership
Total participants, beginning-of-year2015-01-0111
Total number of active participants reported on line 7a of the Form 55002015-01-0113
Number of other retired or separated participants entitled to future benefits2015-01-011
Total of all active and inactive participants2015-01-0114
Total participants2015-01-0114
2014: 401 (K) PROFIT SHARING PLAN & TRUST 2014 401k membership
Total participants, beginning-of-year2014-01-0112
Total number of active participants reported on line 7a of the Form 55002014-01-0111
Number of retired or separated participants receiving benefits2014-01-012
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-0113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-011
Total participants2014-01-0114
Number of participants with account balances2014-01-0112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: 401 (K) PROFIT SHARING PLAN & TRUST 2013 401k membership
Total participants, beginning-of-year2013-01-0111
Total number of active participants reported on line 7a of the Form 55002013-01-0110
Number of retired or separated participants receiving benefits2013-01-012
Total of all active and inactive participants2013-01-0112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0112
Number of participants with account balances2013-01-0112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: 401 (K) PROFIT SHARING PLAN & TRUST 2012 401k membership
Total participants, beginning-of-year2012-01-0111
Total number of active participants reported on line 7a of the Form 55002012-01-0111
Number of retired or separated participants receiving benefits2012-01-011
Total of all active and inactive participants2012-01-0112
Total participants2012-01-0112
Number of participants with account balances2012-01-0112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: 401 (K) PROFIT SHARING PLAN & TRUST 2011 401k membership
Total participants, beginning-of-year2011-01-0111
Total number of active participants reported on line 7a of the Form 55002011-01-0112
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-0112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0112
Number of participants with account balances2011-01-0111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: 401 (K) PROFIT SHARING PLAN & TRUST 2009 401k membership
Total participants, beginning-of-year2009-01-0110
Total number of active participants reported on line 7a of the Form 55002009-01-0111
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-0111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0111
Number of participants with account balances2009-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on 401 (K) PROFIT SHARING PLAN & TRUST

Measure Date Value
2020 : 401 (K) PROFIT SHARING PLAN & TRUST 2020 401k financial data
Total income from all sources2020-12-31$494,509
Expenses. Total of all expenses incurred2020-12-31$371,930
Benefits paid (including direct rollovers)2020-12-31$367,803
Total plan assets at end of year2020-12-31$2,916,792
Total plan assets at beginning of year2020-12-31$2,794,213
Total contributions received or receivable from participants2020-12-31$138,982
Other income received2020-12-31$317,956
Net income (gross income less expenses)2020-12-31$122,579
Net plan assets at end of year (total assets less liabilities)2020-12-31$2,916,792
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$2,794,213
Total contributions received or receivable from employer(s)2020-12-31$37,571
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$4,127
2019 : 401 (K) PROFIT SHARING PLAN & TRUST 2019 401k financial data
Total income from all sources2019-12-31$507,205
Expenses. Total of all expenses incurred2019-12-31$345,407
Benefits paid (including direct rollovers)2019-12-31$339,465
Total plan assets at end of year2019-12-31$2,794,213
Total plan assets at beginning of year2019-12-31$2,632,415
Total contributions received or receivable from participants2019-12-31$115,450
Other income received2019-12-31$357,562
Net income (gross income less expenses)2019-12-31$161,798
Net plan assets at end of year (total assets less liabilities)2019-12-31$2,794,213
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$2,632,415
Total contributions received or receivable from employer(s)2019-12-31$34,193
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$5,942
2018 : 401 (K) PROFIT SHARING PLAN & TRUST 2018 401k financial data
Total income from all sources2018-12-31$147,598
Expenses. Total of all expenses incurred2018-12-31$122,529
Benefits paid (including direct rollovers)2018-12-31$28,608
Total plan assets at end of year2018-12-31$2,632,415
Total plan assets at beginning of year2018-12-31$2,607,346
Total contributions received or receivable from participants2018-12-31$105,322
Expenses. Other expenses not covered elsewhere2018-12-31$84,853
Contributions received from other sources (not participants or employers)2018-12-31$8,522
Other income received2018-12-31$2,085
Net income (gross income less expenses)2018-12-31$25,069
Net plan assets at end of year (total assets less liabilities)2018-12-31$2,632,415
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$2,607,346
Total contributions received or receivable from employer(s)2018-12-31$31,669
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$9,068
2017 : 401 (K) PROFIT SHARING PLAN & TRUST 2017 401k financial data
Total income from all sources2017-12-31$386,850
Expenses. Total of all expenses incurred2017-12-31$29,031
Benefits paid (including direct rollovers)2017-12-31$20,940
Total plan assets at end of year2017-12-31$2,607,346
Total plan assets at beginning of year2017-12-31$2,249,527
Total contributions received or receivable from participants2017-12-31$99,521
Expenses. Other expenses not covered elsewhere2017-12-31$8,091
Other income received2017-12-31$255,626
Net income (gross income less expenses)2017-12-31$357,819
Net plan assets at end of year (total assets less liabilities)2017-12-31$2,607,346
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$2,249,527
Total contributions received or receivable from employer(s)2017-12-31$31,703
2016 : 401 (K) PROFIT SHARING PLAN & TRUST 2016 401k financial data
Total income from all sources2016-12-31$266,011
Expenses. Total of all expenses incurred2016-12-31$71,676
Benefits paid (including direct rollovers)2016-12-31$65,272
Total plan assets at end of year2016-12-31$2,249,527
Total plan assets at beginning of year2016-12-31$2,055,192
Total contributions received or receivable from participants2016-12-31$131,481
Expenses. Other expenses not covered elsewhere2016-12-31$6,404
Other income received2016-12-31$99,014
Net income (gross income less expenses)2016-12-31$194,335
Net plan assets at end of year (total assets less liabilities)2016-12-31$2,249,527
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$2,055,192
Total contributions received or receivable from employer(s)2016-12-31$35,516
2015 : 401 (K) PROFIT SHARING PLAN & TRUST 2015 401k financial data
Total income from all sources2015-12-31$113,817
Expenses. Total of all expenses incurred2015-12-31$47,442
Benefits paid (including direct rollovers)2015-12-31$38,157
Total plan assets at end of year2015-12-31$2,055,192
Total plan assets at beginning of year2015-12-31$1,988,817
Total contributions received or receivable from participants2015-12-31$134,571
Other income received2015-12-31$-52,743
Net income (gross income less expenses)2015-12-31$66,375
Net plan assets at end of year (total assets less liabilities)2015-12-31$2,055,192
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$1,988,817
Assets. Value of participant loans2015-12-31$9,674
Total contributions received or receivable from employer(s)2015-12-31$31,989
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$9,285
2014 : 401 (K) PROFIT SHARING PLAN & TRUST 2014 401k financial data
Total income from all sources2014-12-31$176,788
Expenses. Total of all expenses incurred2014-12-31$108,570
Benefits paid (including direct rollovers)2014-12-31$97,182
Total plan assets at end of year2014-12-31$1,988,817
Total plan assets at beginning of year2014-12-31$1,920,599
Total contributions received or receivable from participants2014-12-31$104,593
Other income received2014-12-31$48,722
Net income (gross income less expenses)2014-12-31$68,218
Net plan assets at end of year (total assets less liabilities)2014-12-31$1,988,817
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$1,920,599
Assets. Value of participant loans2014-12-31$16,605
Total contributions received or receivable from employer(s)2014-12-31$23,473
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$11,388
2013 : 401 (K) PROFIT SHARING PLAN & TRUST 2013 401k financial data
Total income from all sources2013-12-31$296,125
Expenses. Total of all expenses incurred2013-12-31$89,526
Benefits paid (including direct rollovers)2013-12-31$77,365
Total plan assets at end of year2013-12-31$1,920,599
Total plan assets at beginning of year2013-12-31$1,714,000
Total contributions received or receivable from participants2013-12-31$101,220
Expenses. Other expenses not covered elsewhere2013-12-31$223
Other income received2013-12-31$175,599
Net income (gross income less expenses)2013-12-31$206,599
Net plan assets at end of year (total assets less liabilities)2013-12-31$1,920,599
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$1,714,000
Assets. Value of participant loans2013-12-31$20,913
Total contributions received or receivable from employer(s)2013-12-31$19,306
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$11,938
2012 : 401 (K) PROFIT SHARING PLAN & TRUST 2012 401k financial data
Total income from all sources2012-12-31$211,461
Expenses. Total of all expenses incurred2012-12-31$9,540
Total plan assets at end of year2012-12-31$1,714,000
Total plan assets at beginning of year2012-12-31$1,512,078
Total contributions received or receivable from participants2012-12-31$95,534
Expenses. Other expenses not covered elsewhere2012-12-31$214
Other income received2012-12-31$96,022
Net income (gross income less expenses)2012-12-31$201,921
Net plan assets at end of year (total assets less liabilities)2012-12-31$1,714,000
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$1,512,078
Assets. Value of participant loans2012-12-31$7,624
Total contributions received or receivable from employer(s)2012-12-31$19,905
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$9,326
2011 : 401 (K) PROFIT SHARING PLAN & TRUST 2011 401k financial data
Total income from all sources2011-12-31$125,130
Expenses. Total of all expenses incurred2011-12-31$55,255
Total plan assets at end of year2011-12-31$1,512,078
Total plan assets at beginning of year2011-12-31$1,442,203
Total contributions received or receivable from participants2011-12-31$101,366
Expenses. Other expenses not covered elsewhere2011-12-31$50,799
Other income received2011-12-31$3,057
Net income (gross income less expenses)2011-12-31$69,875
Net plan assets at end of year (total assets less liabilities)2011-12-31$1,512,078
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$1,442,203
Assets. Value of participant loans2011-12-31$10,810
Total contributions received or receivable from employer(s)2011-12-31$20,707
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$4,456
2010 : 401 (K) PROFIT SHARING PLAN & TRUST 2010 401k financial data
Total income from all sources2010-12-31$117,347
Expenses. Total of all expenses incurred2010-12-31$27,948
Benefits paid (including direct rollovers)2010-12-31$13,581
Total plan assets at end of year2010-12-31$1,442,203
Total plan assets at beginning of year2010-12-31$1,029,630
Total contributions received or receivable from participants2010-12-31$96,184
Net income (gross income less expenses)2010-12-31$89,399
Net plan assets at end of year (total assets less liabilities)2010-12-31$1,442,203
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$1,029,630
Assets. Value of participant loans2010-12-31$17,538
Total contributions received or receivable from employer(s)2010-12-31$21,163
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$14,367

Form 5500 Responses for 401 (K) PROFIT SHARING PLAN & TRUST

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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number603047
Policy instance 3
Insurance contract or identification number603047
Number of Individuals Covered1
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )
Policy contract number70707861
Policy instance 2
Insurance contract or identification number70707861
Number of Individuals Covered3
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberGP69245
Policy instance 1
Insurance contract or identification numberGP69245
Number of Individuals Covered15
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $4,474
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Other information about contractGROUP VAR ANNUITY WITH GUAR FUND
Commission paid to Insurance BrokerUSD $4,474
ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )
Policy contract number70707861
Policy instance 2
Insurance contract or identification number70707861
Number of Individuals Covered3
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number603047
Policy instance 3
Insurance contract or identification number603047
Number of Individuals Covered1
Insurance policy start date2017-01-01
Insurance policy end date2019-12-31
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?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
NATIONWIDE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number020H08397397
Policy instance 4
Insurance contract or identification number020H08397397
Number of Individuals Covered2
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberGP69245
Policy instance 1
Insurance contract or identification numberGP69245
Number of Individuals Covered14
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $4,067
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Other information about contractGROUP VAR ANNUITY WITH GUAR FUND
Commission paid to Insurance BrokerUSD $4,067
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number020H08397397
Policy instance 4
Insurance contract or identification number020H08397397
Number of Individuals Covered2
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractGROUP VARIABLE ANNUITY CONTRACT WITH A GUARANTEED FUND
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number603047
Policy instance 3
Insurance contract or identification number603047
Number of Individuals Covered1
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?1
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )
Policy contract number70707861
Policy instance 2
Insurance contract or identification number70707861
Number of Individuals Covered3
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?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedGROUP VARIABLE ANNUITY CONTRACT WITH A GUARANTEED FUND
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
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberGP 69245
Policy instance 1
Insurance contract or identification numberGP 69245
Number of Individuals Covered15
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $3,775
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?Yes
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
Other information about contractGROUP VAR ANNUITY W/GUAR FUND
Commission paid to Insurance BrokerUSD $3,775
Insurance broker nameLINCOLN FINANCIAL ADVISORS
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number603047
Policy instance 1
Insurance contract or identification number603047
Number of Individuals Covered1
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberGP 59245
Policy instance 4
Insurance contract or identification numberGP 59245
Number of Individuals Covered14
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $2,776
Total amount of fees paid to insurance companyUSD $30
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractGROUP VAR ANNUITY W/GUAR FUND
Commission paid to Insurance BrokerUSD $2,776
Amount paid for insurance broker fees30
Additional information about fees paid to insurance brokerNON MONETARY COMPENSATION TO SALES REP
Insurance broker nameLINCOLN FINANCIAL ADVISORS
ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )
Policy contract number70707861
Policy instance 3
Insurance contract or identification number70707861
Number of Individuals Covered3
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?Yes
Are there contracts with allocated funds for types other than group deferred annuity or individual?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedGROUP VARIABLE ANNUITY CONTRACT WITH A GUARANTEED FUND
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
Other information about contractGROUP VARIABLE ANNUITY CONTRACT WITH A GUARANTEED FUND
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number020H08397397
Policy instance 2
Insurance contract or identification number020H08397397
Number of Individuals Covered2
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractGROUP VARIABLE ANNUITY CONTRACT WITH A GUARANTEED FUND
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number020H08397397
Policy instance 1
Insurance contract or identification number020H08397397
Number of Individuals Covered2
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractGROUP VARIABLE ANNUITY CONTRACT WITH A GUARANTEED FUND
ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )
Policy contract number70707861
Policy instance 2
Insurance contract or identification number70707861
Number of Individuals Covered3
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?Yes
Are there contracts with allocated funds for types other than group deferred annuity or individual?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractGROUP VARIABLE ANNUITY CONTRACT WITH A GUARANTEED FUND
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number603047
Policy instance 3
Insurance contract or identification number603047
Number of Individuals Covered1
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Are there contracts with allocated funds for individual policies?Yes
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number53511000000
Policy instance 1
Insurance contract or identification number53511000000
Number of Individuals Covered1
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $17
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractLIFE INSURANCE CONTRACT
Insurance broker nameADRIAN R ROBINSON
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number53511000000
Policy instance 2
Insurance contract or identification number53511000000
Number of Individuals Covered11
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractGROUP VARIABLE ANNUITY CONTRACT WITH A GUARANTEED FUND
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number53511000000
Policy instance 1
Insurance contract or identification number53511000000
Number of Individuals Covered1
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $17
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for types other than group deferred annuity or individual?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractLIFE INSURANCE CONTRACT
Insurance broker nameADRIAN R ROBISON
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number53511000000
Policy instance 2
Insurance contract or identification number53511000000
Number of Individuals Covered11
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Are there contracts with allocated funds for types other than group deferred annuity or individual?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractGROUP VARIABLE ANNUITY CONTRACT WITH A GUARANTEED FUND
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number53511000000
Policy instance 2
Insurance contract or identification number53511000000
Number of Individuals Covered11
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Are there contracts with allocated funds for types other than group deferred annuity or individual?Yes
Other information about contractGROUP VARIABLE ANNUITY CONTRACT WITH A GUARANTEED FUND
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number53511000000
Policy instance 1
Insurance contract or identification number53511000000
Number of Individuals Covered1
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $17
Are there contracts with allocated funds for types other than group deferred annuity or individual?Yes
Other information about contractLIFE INSURANCE CONTRACT
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number53511000000
Policy instance 2
Insurance contract or identification number53511000000
Number of Individuals Covered11
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Are there contracts with allocated funds for types other than group deferred annuity or individual?Yes
Other information about contractGROUP VARIABLE ANNUITY CONTRACT WITH A GUARANTEED FUND
Insurance broker nameLINCOLN FINANCIAL ADVISORS
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number53511000000
Policy instance 1
Insurance contract or identification number53511000000
Number of Individuals Covered1
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $17
Are there contracts with allocated funds for types other than group deferred annuity or individual?Yes
Other information about contractLIFE INSURANCE CONTRACT
Commission paid to Insurance BrokerUSD $17
Insurance broker nameADRIAN R ROBISON

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