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BACKMAN TITLE COMPANY OF UTAH 401(K) PLAN 401k Plan overview

Plan NameBACKMAN TITLE COMPANY OF UTAH 401(K) PLAN
Plan identification number 001

BACKMAN TITLE COMPANY OF UTAH 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
  • Life insurance

401k Sponsoring company profile

BACKMAN TITLE COMPANY OF UTAH has sponsored the creation of one or more 401k plans.

Company Name:BACKMAN TITLE COMPANY OF UTAH
Employer identification number (EIN):870461613
NAIC Classification:561300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BACKMAN TITLE COMPANY OF UTAH 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01SYDNEY DEMING2023-07-27 SYDNEY DEMING2023-07-27
0012021-01-01BRETT SIMPSON2022-05-20 BRETT SIMPSON2022-05-20
0012020-01-01BRETT SIMPSON2021-05-05 BRETT SIMPSON2021-05-05
0012019-01-01BRETT SIMPSON2020-09-24 BRETT SIMPSON2020-09-24
0012018-01-01BRETT SIMPSON2019-07-25 BRETT SIMPSON2019-07-25
0012017-01-01BRETT SIMPSON2018-08-23 BRETT SIMPSON2018-08-23
0012016-01-01BRETT SIMPSON2017-09-19 BRETT SIMPSON2017-09-19
0012015-01-01BRETT SIMPSON2016-09-14 BRETT SIMPSON2016-09-14
0012014-01-01BRETT SIMPSON2015-07-27 BRETT SIMPSON2015-07-27
0012013-01-01BRETT SIMPSON2014-10-01 BRETT SIMPSON2014-10-01
0012012-01-01BRETT SIMPSON BRETT SIMPSON2013-10-11
0012011-01-01BRETT SIMPSON BRETT SIMPSON2012-10-15
0012009-01-01BRETT E. SIMPSON, CFO, MIS BRETT E. SIMPSON, CFO, MIS2010-10-13

Plan Statistics for BACKMAN TITLE COMPANY OF UTAH 401(K) PLAN

401k plan membership statisitcs for BACKMAN TITLE COMPANY OF UTAH 401(K) PLAN

Measure Date Value
2012: BACKMAN TITLE COMPANY OF UTAH 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01105
Total number of active participants reported on line 7a of the Form 55002012-01-0187
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-017
Total of all active and inactive participants2012-01-0194
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0194
Number of participants with account balances2012-01-0177
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-013
2011: BACKMAN TITLE COMPANY OF UTAH 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01122
Total number of active participants reported on line 7a of the Form 55002011-01-0186
Number of retired or separated participants receiving benefits2011-01-014
Number of other retired or separated participants entitled to future benefits2011-01-0112
Total of all active and inactive participants2011-01-01102
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01102
Number of participants with account balances2011-01-0184
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-016
2009: BACKMAN TITLE COMPANY OF UTAH 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01137
Total number of active participants reported on line 7a of the Form 55002009-01-01121
Number of retired or separated participants receiving benefits2009-01-012
Number of other retired or separated participants entitled to future benefits2009-01-019
Total of all active and inactive participants2009-01-01132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01132
Number of participants with account balances2009-01-0193
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-012

Financial Data on BACKMAN TITLE COMPANY OF UTAH 401(K) PLAN

Measure Date Value
2012 : BACKMAN TITLE COMPANY OF UTAH 401(K) PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total transfer of assets to this plan2012-12-31$0
Total transfer of assets from this plan2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total income from all sources (including contributions)2012-12-31$403,181
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$191,203
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$189,460
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$139,188
Value of total assets at end of year2012-12-31$3,060,352
Value of total assets at beginning of year2012-12-31$2,848,374
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$1,743
Total interest from all sources2012-12-31$4,936
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$500,000
If this is an individual account plan, was there a blackout period2012-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$120,894
Participant contributions at end of year2012-12-31$102,365
Participant contributions at beginning of year2012-12-31$71,437
Participant contributions at end of year2012-12-31$9,223
Participant contributions at beginning of year2012-12-31$5,392
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$1,114
Other income not declared elsewhere2012-12-31$1,076
Administrative expenses (other) incurred2012-12-31$1,743
Total non interest bearing cash at end of year2012-12-31$0
Total non interest bearing cash at beginning of year2012-12-31$2,022
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$211,978
Value of net assets at end of year (total assets less liabilities)2012-12-31$3,060,352
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$2,848,374
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$18,160
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$2,765,235
Value of interest in pooled separate accounts at end of year2012-12-31$79,944
Interest on participant loans2012-12-31$4,936
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$2,850,660
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$2,213
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$2,491
Net investment gain/loss from pooled separate accounts2012-12-31$255,490
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$18,294
Employer contributions (assets) at beginning of year2012-12-31$961
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$189,460
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-12-31Yes
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31STAYNER, BATES & JENSEN, P.C.
Accountancy firm EIN2012-12-31870495153
2011 : BACKMAN TITLE COMPANY OF UTAH 401(K) PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total income from all sources (including contributions)2011-12-31$169,468
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$433,425
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$433,425
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$154,662
Value of total assets at end of year2011-12-31$2,848,374
Value of total assets at beginning of year2011-12-31$3,112,331
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$0
Total interest from all sources2011-12-31$3,681
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$500,000
If this is an individual account plan, was there a blackout period2011-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$130,668
Participant contributions at end of year2011-12-31$71,437
Participant contributions at beginning of year2011-12-31$99,475
Participant contributions at end of year2011-12-31$5,392
Participant contributions at beginning of year2011-12-31$14,251
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$1,114
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$2,914
Total non interest bearing cash at end of year2011-12-31$2,022
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-263,957
Value of net assets at end of year (total assets less liabilities)2011-12-31$2,848,374
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$3,112,331
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$2,765,235
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$2,991,302
Interest on participant loans2011-12-31$3,681
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$2,213
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$1,643
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$11,125
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$23,994
Employer contributions (assets) at end of year2011-12-31$961
Employer contributions (assets) at beginning of year2011-12-31$2,746
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$433,425
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31STAYNER, BATES & JENSEN, P.C.
Accountancy firm EIN2011-12-31870495153
2010 : BACKMAN TITLE COMPANY OF UTAH 401(K) PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total income from all sources (including contributions)2010-12-31$520,120
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$133,410
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$133,410
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$226,221
Value of total assets at end of year2010-12-31$3,112,331
Value of total assets at beginning of year2010-12-31$2,725,621
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$0
Total interest from all sources2010-12-31$3,450
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$500,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$190,886
Participant contributions at end of year2010-12-31$99,475
Participant contributions at beginning of year2010-12-31$39,517
Participant contributions at end of year2010-12-31$14,251
Participant contributions at beginning of year2010-12-31$17,929
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2010-12-31$58
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$2,914
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$1,500
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$386,710
Value of net assets at end of year (total assets less liabilities)2010-12-31$3,112,331
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$2,725,621
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$2,991,302
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$108,434
Value of interest in pooled separate accounts at beginning of year2010-12-31$2,538,059
Interest on participant loans2010-12-31$3,450
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$1,643
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$11,585
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$290,449
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$35,335
Employer contributions (assets) at end of year2010-12-31$2,746
Employer contributions (assets) at beginning of year2010-12-31$8,597
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$133,352
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31STAYNER, BATES & JENSEN, P.C.
Accountancy firm EIN2010-12-31870495153

Form 5500 Responses for BACKMAN TITLE COMPANY OF UTAH 401(K) PLAN

2012: BACKMAN TITLE COMPANY OF UTAH 401(K) PLAN 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: BACKMAN TITLE COMPANY OF UTAH 401(K) PLAN 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: BACKMAN TITLE COMPANY OF UTAH 401(K) PLAN 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

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number196-00163
Policy instance 1
Insurance contract or identification number196-00163
Number of Individuals Covered0
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $19,623
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $16,478
Insurance broker organization code?4
Insurance broker nameRAYMOND JAMES FINANCIAL SERVICES
JACKSON NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79944 )
Policy contract number0031951080
Policy instance 3
Insurance contract or identification number0031951080
Number of Individuals Covered12
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?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
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number007708832
Policy instance 2
Insurance contract or identification number007708832
Number of Individuals Covered2
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?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
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number334799-01
Policy instance 4
Insurance contract or identification number334799-01
Number of Individuals Covered71
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number196-00163
Policy instance 1
Insurance contract or identification number196-00163
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $16,270
Total amount of fees paid to insurance companyUSD $4,067
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number7708832
Policy instance 2
Insurance contract or identification number7708832
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?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
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number196-00163
Policy instance 3
Insurance contract or identification number196-00163
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $15,865
Total amount of fees paid to insurance companyUSD $3,966
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No

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