GLENDALE FAMILY CLINIC, PC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GLENDALE FAMILY CLINIC, PC PROFIT SHARING PLAN & TRUST AGREEMENT
401k plan membership statisitcs for GLENDALE FAMILY CLINIC, PC PROFIT SHARING PLAN & TRUST AGREEMENT
| Measure | Date | Value |
|---|
| 2017: GLENDALE FAMILY CLINIC, PC PROFIT SHARING PLAN & TRUST AGREEMENT 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 16 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 8 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 7 |
| Total of all active and inactive participants | 2017-01-01 | 16 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2017-01-01 | 0 |
| Total participants | 2017-01-01 | 16 |
| Number of participants with account balances | 2017-01-01 | 16 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2017-01-01 | 0 |
| 2016: GLENDALE FAMILY CLINIC, PC PROFIT SHARING PLAN & TRUST AGREEMENT 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 16 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 9 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 6 |
| Total of all active and inactive participants | 2016-01-01 | 16 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2016-01-01 | 0 |
| Total participants | 2016-01-01 | 16 |
| Number of participants with account balances | 2016-01-01 | 16 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2016-01-01 | 0 |
| 2015: GLENDALE FAMILY CLINIC, PC PROFIT SHARING PLAN & TRUST AGREEMENT 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 14 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 8 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 6 |
| Total of all active and inactive participants | 2015-01-01 | 15 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2015-01-01 | 0 |
| Total participants | 2015-01-01 | 15 |
| Number of participants with account balances | 2015-01-01 | 15 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2015-01-01 | 0 |
| 2014: GLENDALE FAMILY CLINIC, PC PROFIT SHARING PLAN & TRUST AGREEMENT 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 14 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 7 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 6 |
| Total of all active and inactive participants | 2014-01-01 | 14 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-01-01 | 0 |
| Total participants | 2014-01-01 | 14 |
| Number of participants with account balances | 2014-01-01 | 14 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2014-01-01 | 1 |
| 2013: GLENDALE FAMILY CLINIC, PC PROFIT SHARING PLAN & TRUST AGREEMENT 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 13 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 7 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 6 |
| Total of all active and inactive participants | 2013-01-01 | 14 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-01-01 | 0 |
| Total participants | 2013-01-01 | 14 |
| Number of participants with account balances | 2013-01-01 | 14 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-01-01 | 0 |
| 2012: GLENDALE FAMILY CLINIC, PC PROFIT SHARING PLAN & TRUST AGREEMENT 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 13 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 7 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 5 |
| Total of all active and inactive participants | 2012-01-01 | 13 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-01-01 | 0 |
| Total participants | 2012-01-01 | 13 |
| Number of participants with account balances | 2012-01-01 | 13 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-01-01 | 1 |
| 2011: GLENDALE FAMILY CLINIC, PC PROFIT SHARING PLAN & TRUST AGREEMENT 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 13 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 6 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 4 |
| Total of all active and inactive participants | 2011-01-01 | 11 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-01-01 | 0 |
| Total participants | 2011-01-01 | 11 |
| Number of participants with account balances | 2011-01-01 | 11 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2011-01-01 | 0 |
| Measure | Date | Value |
|---|
| 2017 : GLENDALE FAMILY CLINIC, PC PROFIT SHARING PLAN & TRUST AGREEMENT 2017 401k financial data |
|---|
| Transfers to/from the plan | 2017-12-31 | $0 |
| Total plan liabilities at end of year | 2017-12-31 | $0 |
| Total plan liabilities at beginning of year | 2017-12-31 | $0 |
| Total income from all sources | 2017-12-31 | $-625 |
| Expenses. Total of all expenses incurred | 2017-12-31 | $190 |
| Benefits paid (including direct rollovers) | 2017-12-31 | $0 |
| Total plan assets at end of year | 2017-12-31 | $776,534 |
| Total plan assets at beginning of year | 2017-12-31 | $777,349 |
| Value of fidelity bond covering the plan | 2017-12-31 | $205,000 |
| Total contributions received or receivable from participants | 2017-12-31 | $0 |
| Expenses. Other expenses not covered elsewhere | 2017-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2017-12-31 | $0 |
| Other income received | 2017-12-31 | $-16,745 |
| Noncash contributions received | 2017-12-31 | $0 |
| Net income (gross income less expenses) | 2017-12-31 | $-815 |
| Net plan assets at end of year (total assets less liabilities) | 2017-12-31 | $776,534 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-12-31 | $777,349 |
| Total contributions received or receivable from employer(s) | 2017-12-31 | $16,120 |
| Value of certain deemed distributions of participant loans | 2017-12-31 | $0 |
| Value of corrective distributions | 2017-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-12-31 | $190 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2017-12-31 | $0 |
| 2016 : GLENDALE FAMILY CLINIC, PC PROFIT SHARING PLAN & TRUST AGREEMENT 2016 401k financial data |
|---|
| Total plan liabilities at end of year | 2016-12-31 | $0 |
| Total plan liabilities at beginning of year | 2016-12-31 | $1,337 |
| Total income from all sources | 2016-12-31 | $-20,763 |
| Expenses. Total of all expenses incurred | 2016-12-31 | $0 |
| Benefits paid (including direct rollovers) | 2016-12-31 | $0 |
| Total plan assets at end of year | 2016-12-31 | $777,349 |
| Total plan assets at beginning of year | 2016-12-31 | $799,449 |
| Value of fidelity bond covering the plan | 2016-12-31 | $205,000 |
| Total contributions received or receivable from participants | 2016-12-31 | $0 |
| Expenses. Other expenses not covered elsewhere | 2016-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2016-12-31 | $0 |
| Other income received | 2016-12-31 | $-37,033 |
| Noncash contributions received | 2016-12-31 | $0 |
| Net income (gross income less expenses) | 2016-12-31 | $-20,763 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-31 | $777,349 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-31 | $798,112 |
| Total contributions received or receivable from employer(s) | 2016-12-31 | $16,270 |
| Value of certain deemed distributions of participant loans | 2016-12-31 | $0 |
| Value of corrective distributions | 2016-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-12-31 | $0 |
| 2015 : GLENDALE FAMILY CLINIC, PC PROFIT SHARING PLAN & TRUST AGREEMENT 2015 401k financial data |
|---|
| Total plan liabilities at end of year | 2015-12-31 | $1,337 |
| Total plan liabilities at beginning of year | 2015-12-31 | $1,337 |
| Total income from all sources | 2015-12-31 | $71,580 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $0 |
| Benefits paid (including direct rollovers) | 2015-12-31 | $0 |
| Total plan assets at end of year | 2015-12-31 | $799,449 |
| Total plan assets at beginning of year | 2015-12-31 | $727,869 |
| Value of fidelity bond covering the plan | 2015-12-31 | $205,000 |
| Total contributions received or receivable from participants | 2015-12-31 | $0 |
| Expenses. Other expenses not covered elsewhere | 2015-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2015-12-31 | $0 |
| Other income received | 2015-12-31 | $42,317 |
| Noncash contributions received | 2015-12-31 | $0 |
| Net income (gross income less expenses) | 2015-12-31 | $71,580 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $798,112 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $726,532 |
| Total contributions received or receivable from employer(s) | 2015-12-31 | $29,263 |
| Value of certain deemed distributions of participant loans | 2015-12-31 | $0 |
| Value of corrective distributions | 2015-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-12-31 | $0 |
| 2014 : GLENDALE FAMILY CLINIC, PC PROFIT SHARING PLAN & TRUST AGREEMENT 2014 401k financial data |
|---|
| Total plan liabilities at end of year | 2014-12-31 | $1,337 |
| Total plan liabilities at beginning of year | 2014-12-31 | $1,337 |
| Total income from all sources | 2014-12-31 | $53,074 |
| Expenses. Total of all expenses incurred | 2014-12-31 | $4,307 |
| Benefits paid (including direct rollovers) | 2014-12-31 | $4,307 |
| Total plan assets at end of year | 2014-12-31 | $727,869 |
| Total plan assets at beginning of year | 2014-12-31 | $679,102 |
| Value of fidelity bond covering the plan | 2014-12-31 | $205,000 |
| Total contributions received or receivable from participants | 2014-12-31 | $0 |
| Expenses. Other expenses not covered elsewhere | 2014-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2014-12-31 | $0 |
| Other income received | 2014-12-31 | $38,140 |
| Noncash contributions received | 2014-12-31 | $0 |
| Net income (gross income less expenses) | 2014-12-31 | $48,767 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $726,532 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $677,765 |
| Assets. Value of assets in partnership/joint-venture interests | 2014-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2014-12-31 | $14,934 |
| Value of certain deemed distributions of participant loans | 2014-12-31 | $0 |
| Value of corrective distributions | 2014-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2014-12-31 | $0 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2014-12-31 | $0 |
| 2013 : GLENDALE FAMILY CLINIC, PC PROFIT SHARING PLAN & TRUST AGREEMENT 2013 401k financial data |
|---|
| Total plan liabilities at end of year | 2013-12-31 | $1,337 |
| Total plan liabilities at beginning of year | 2013-12-31 | $1,337 |
| Total income from all sources | 2013-12-31 | $71,416 |
| Expenses. Total of all expenses incurred | 2013-12-31 | $0 |
| Benefits paid (including direct rollovers) | 2013-12-31 | $0 |
| Total plan assets at end of year | 2013-12-31 | $679,102 |
| Total plan assets at beginning of year | 2013-12-31 | $607,686 |
| Value of fidelity bond covering the plan | 2013-12-31 | $180,000 |
| Total contributions received or receivable from participants | 2013-12-31 | $0 |
| Expenses. Other expenses not covered elsewhere | 2013-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2013-12-31 | $0 |
| Other income received | 2013-12-31 | $47,552 |
| Noncash contributions received | 2013-12-31 | $0 |
| Net income (gross income less expenses) | 2013-12-31 | $71,416 |
| Net plan assets at end of year (total assets less liabilities) | 2013-12-31 | $677,765 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-12-31 | $606,349 |
| Assets. Value of assets in partnership/joint-venture interests | 2013-12-31 | $202,850 |
| Total contributions received or receivable from employer(s) | 2013-12-31 | $23,864 |
| Value of certain deemed distributions of participant loans | 2013-12-31 | $0 |
| Value of corrective distributions | 2013-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2013-12-31 | $0 |
| 2012 : GLENDALE FAMILY CLINIC, PC PROFIT SHARING PLAN & TRUST AGREEMENT 2012 401k financial data |
|---|
| Total plan liabilities at end of year | 2012-12-31 | $1,337 |
| Total plan liabilities at beginning of year | 2012-12-31 | $1,337 |
| Total income from all sources | 2012-12-31 | $81,791 |
| Expenses. Total of all expenses incurred | 2012-12-31 | $0 |
| Total plan assets at end of year | 2012-12-31 | $607,686 |
| Total plan assets at beginning of year | 2012-12-31 | $525,895 |
| Value of fidelity bond covering the plan | 2012-12-31 | $180,000 |
| Other income received | 2012-12-31 | $58,809 |
| Net income (gross income less expenses) | 2012-12-31 | $81,791 |
| Net plan assets at end of year (total assets less liabilities) | 2012-12-31 | $606,349 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-12-31 | $524,558 |
| Assets. Value of assets in partnership/joint-venture interests | 2012-12-31 | $202,850 |
| Total contributions received or receivable from employer(s) | 2012-12-31 | $22,982 |
| 2011 : GLENDALE FAMILY CLINIC, PC PROFIT SHARING PLAN & TRUST AGREEMENT 2011 401k financial data |
|---|
| Total plan liabilities at end of year | 2011-12-31 | $1,337 |
| Total plan liabilities at beginning of year | 2011-12-31 | $1,337 |
| Total income from all sources | 2011-12-31 | $83,663 |
| Expenses. Total of all expenses incurred | 2011-12-31 | $981 |
| Total plan assets at end of year | 2011-12-31 | $525,895 |
| Total plan assets at beginning of year | 2011-12-31 | $443,213 |
| Value of fidelity bond covering the plan | 2011-12-31 | $180,000 |
| Other income received | 2011-12-31 | $60,602 |
| Net income (gross income less expenses) | 2011-12-31 | $82,682 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-31 | $524,558 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-31 | $441,876 |
| Assets. Value of assets in partnership/joint-venture interests | 2011-12-31 | $178,850 |
| Total contributions received or receivable from employer(s) | 2011-12-31 | $23,061 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2011-12-31 | $981 |
| 2010 : GLENDALE FAMILY CLINIC, PC PROFIT SHARING PLAN & TRUST AGREEMENT 2010 401k financial data |
|---|
| Total plan liabilities at end of year | 2010-12-31 | $1,337 |
| Total plan liabilities at beginning of year | 2010-12-31 | $1,337 |
| Total income from all sources | 2010-12-31 | $-16,798 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $19,327 |
| Benefits paid (including direct rollovers) | 2010-12-31 | $18,435 |
| Total plan assets at end of year | 2010-12-31 | $443,213 |
| Total plan assets at beginning of year | 2010-12-31 | $479,338 |
| Value of fidelity bond covering the plan | 2010-12-31 | $65,000 |
| Other income received | 2010-12-31 | $-38,854 |
| Net income (gross income less expenses) | 2010-12-31 | $-36,125 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $441,876 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $478,001 |
| Total contributions received or receivable from employer(s) | 2010-12-31 | $22,056 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2010-12-31 | $892 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2010-12-31 | $0 |
| 2017: GLENDALE FAMILY CLINIC, PC PROFIT SHARING PLAN & TRUST AGREEMENT 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | No |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – Trust | Yes |
| 2017-01-01 | Plan benefit arrangement - Trust | Yes |
| 2016: GLENDALE FAMILY CLINIC, PC PROFIT SHARING PLAN & TRUST AGREEMENT 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – Trust | Yes |
| 2016-01-01 | Plan benefit arrangement - Trust | Yes |
| 2015: GLENDALE FAMILY CLINIC, PC PROFIT SHARING PLAN & TRUST AGREEMENT 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – Trust | Yes |
| 2015-01-01 | Plan benefit arrangement - Trust | Yes |
| 2014: GLENDALE FAMILY CLINIC, PC PROFIT SHARING PLAN & TRUST AGREEMENT 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Submission has been amended | No |
| 2014-01-01 | This submission is the final filing | No |
| 2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-01-01 | Plan is a collectively bargained plan | No |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – Trust | Yes |
| 2014-01-01 | Plan benefit arrangement - Trust | Yes |
| 2013: GLENDALE FAMILY CLINIC, PC PROFIT SHARING PLAN & TRUST AGREEMENT 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Submission has been amended | No |
| 2013-01-01 | This submission is the final filing | No |
| 2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-01-01 | Plan is a collectively bargained plan | No |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – Trust | Yes |
| 2013-01-01 | Plan benefit arrangement - Trust | Yes |
| 2012: GLENDALE FAMILY CLINIC, PC PROFIT SHARING PLAN & TRUST AGREEMENT 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Submission has been amended | No |
| 2012-01-01 | This submission is the final filing | No |
| 2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-01-01 | Plan is a collectively bargained plan | No |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – Trust | Yes |
| 2012-01-01 | Plan benefit arrangement - Trust | Yes |
| 2011: GLENDALE FAMILY CLINIC, PC PROFIT SHARING PLAN & TRUST AGREEMENT 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Submission has been amended | No |
| 2011-01-01 | This submission is the final filing | No |
| 2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-01-01 | Plan is a collectively bargained plan | No |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan funding arrangement – Trust | Yes |
| 2011-01-01 | Plan benefit arrangement - Trust | Yes |
| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | 01-5995518 |
| Policy instance | 1 |
| Insurance contract or identification number | 01-5995518 | | Number of Individuals Covered | 16 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | 01-5995518 |
| Policy instance | 1 |
| Insurance contract or identification number | 01-5995518 | | Number of Individuals Covered | 14 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | 01-5995518 |
| Policy instance | 1 |
| Insurance contract or identification number | 01-5995518 | | Number of Individuals Covered | 14 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | 01-5995518 |
| Policy instance | 1 |
| Insurance contract or identification number | 01-5995518 | | Number of Individuals Covered | 14 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | 01-5995518 |
| Policy instance | 1 |
| Insurance contract or identification number | 01-5995518 | | Number of Individuals Covered | 13 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | 01-5995518 |
| Policy instance | 1 |
| Insurance contract or identification number | 01-5995518 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | 01-5995518 |
| Policy instance | 1 |
| Insurance contract or identification number | 01-5995518 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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