FBN INC. - LONGHORN CASINO has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan FBN, INC. , DBA LONGHORN CASINO SAVINGS AND RETIREMENT PLAN
401k plan membership statisitcs for FBN, INC. , DBA LONGHORN CASINO SAVINGS AND RETIREMENT PLAN
| Measure | Date | Value |
|---|
| 2014: FBN, INC. , DBA LONGHORN CASINO SAVINGS AND RETIREMENT PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 72 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 43 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 27 |
| Total of all active and inactive participants | 2014-01-01 | 70 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-01-01 | 0 |
| Total participants | 2014-01-01 | 70 |
| Number of participants with account balances | 2014-01-01 | 62 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2014-01-01 | 1 |
| 2013: FBN, INC. , DBA LONGHORN CASINO SAVINGS AND RETIREMENT PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 75 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 45 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 26 |
| Total of all active and inactive participants | 2013-01-01 | 71 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-01-01 | 0 |
| Total participants | 2013-01-01 | 71 |
| Number of participants with account balances | 2013-01-01 | 65 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-01-01 | 5 |
| 2012: FBN, INC. , DBA LONGHORN CASINO SAVINGS AND RETIREMENT PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 80 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 51 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 25 |
| Total of all active and inactive participants | 2012-01-01 | 76 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-01-01 | 1 |
| Total participants | 2012-01-01 | 77 |
| Number of participants with account balances | 2012-01-01 | 52 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-01-01 | 9 |
| 2011: FBN, INC. , DBA LONGHORN CASINO SAVINGS AND RETIREMENT PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 84 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 56 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 23 |
| Total of all active and inactive participants | 2011-01-01 | 79 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-01-01 | 0 |
| Total participants | 2011-01-01 | 79 |
| Number of participants with account balances | 2011-01-01 | 79 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2011-01-01 | 0 |
| 2009: FBN, INC. , DBA LONGHORN CASINO SAVINGS AND RETIREMENT PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 97 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 64 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 34 |
| Total of all active and inactive participants | 2009-01-01 | 98 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-01-01 | 0 |
| Total participants | 2009-01-01 | 98 |
| Number of participants with account balances | 2009-01-01 | 98 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-01-01 | 2 |
| Measure | Date | Value |
|---|
| 2014 : FBN, INC. , DBA LONGHORN CASINO SAVINGS AND RETIREMENT PLAN 2014 401k financial data |
|---|
| Transfers to/from the plan | 2014-12-31 | $0 |
| Total income from all sources | 2014-12-31 | $195,292 |
| Expenses. Total of all expenses incurred | 2014-12-31 | $65,828 |
| Benefits paid (including direct rollovers) | 2014-12-31 | $65,252 |
| Total plan assets at end of year | 2014-12-31 | $1,926,114 |
| Total plan assets at beginning of year | 2014-12-31 | $1,796,650 |
| Value of fidelity bond covering the plan | 2014-12-31 | $10,000 |
| Total contributions received or receivable from participants | 2014-12-31 | $81,285 |
| Expenses. Other expenses not covered elsewhere | 2014-12-31 | $576 |
| Contributions received from other sources (not participants or employers) | 2014-12-31 | $0 |
| Other income received | 2014-12-31 | $114,007 |
| Net income (gross income less expenses) | 2014-12-31 | $129,464 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $1,926,114 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $1,796,650 |
| Assets. Value of participant loans | 2014-12-31 | $152,063 |
| Total contributions received or receivable from employer(s) | 2014-12-31 | $0 |
| Value of certain deemed distributions of participant loans | 2014-12-31 | $0 |
| Value of corrective distributions | 2014-12-31 | $0 |
| Funding deficiency by the employer to the plan for this plan year | 2014-12-31 | $0 |
| Minimum employer required contribution for this plan year | 2014-12-31 | $0 |
| Amount contributed by the employer to the plan for this plan year | 2014-12-31 | $0 |
| 2013 : FBN, INC. , DBA LONGHORN CASINO SAVINGS AND RETIREMENT PLAN 2013 401k financial data |
|---|
| Transfers to/from the plan | 2013-12-31 | $0 |
| Total income from all sources | 2013-12-31 | $378,933 |
| Expenses. Total of all expenses incurred | 2013-12-31 | $186,394 |
| Benefits paid (including direct rollovers) | 2013-12-31 | $185,798 |
| Total plan assets at end of year | 2013-12-31 | $1,796,650 |
| Total plan assets at beginning of year | 2013-12-31 | $1,604,111 |
| Value of fidelity bond covering the plan | 2013-12-31 | $10,000 |
| Total contributions received or receivable from participants | 2013-12-31 | $78,518 |
| Expenses. Other expenses not covered elsewhere | 2013-12-31 | $596 |
| Contributions received from other sources (not participants or employers) | 2013-12-31 | $0 |
| Other income received | 2013-12-31 | $300,415 |
| Net income (gross income less expenses) | 2013-12-31 | $192,539 |
| Net plan assets at end of year (total assets less liabilities) | 2013-12-31 | $1,796,650 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-12-31 | $1,604,111 |
| Assets. Value of participant loans | 2013-12-31 | $159,675 |
| Total contributions received or receivable from employer(s) | 2013-12-31 | $0 |
| Value of certain deemed distributions of participant loans | 2013-12-31 | $0 |
| Value of corrective distributions | 2013-12-31 | $0 |
| Funding deficiency by the employer to the plan for this plan year | 2013-12-31 | $0 |
| Minimum employer required contribution for this plan year | 2013-12-31 | $0 |
| Amount contributed by the employer to the plan for this plan year | 2013-12-31 | $0 |
| 2012 : FBN, INC. , DBA LONGHORN CASINO SAVINGS AND RETIREMENT PLAN 2012 401k financial data |
|---|
| Transfers to/from the plan | 2012-12-31 | $0 |
| Total income from all sources | 2012-12-31 | $256,293 |
| Expenses. Total of all expenses incurred | 2012-12-31 | $405,800 |
| Benefits paid (including direct rollovers) | 2012-12-31 | $405,066 |
| Total plan assets at end of year | 2012-12-31 | $1,604,111 |
| Total plan assets at beginning of year | 2012-12-31 | $1,753,618 |
| Value of fidelity bond covering the plan | 2012-12-31 | $10,000 |
| Total contributions received or receivable from participants | 2012-12-31 | $84,636 |
| Expenses. Other expenses not covered elsewhere | 2012-12-31 | $734 |
| Contributions received from other sources (not participants or employers) | 2012-12-31 | $0 |
| Other income received | 2012-12-31 | $171,657 |
| Net income (gross income less expenses) | 2012-12-31 | $-149,507 |
| Net plan assets at end of year (total assets less liabilities) | 2012-12-31 | $1,604,111 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-12-31 | $1,753,618 |
| Assets. Value of participant loans | 2012-12-31 | $170,889 |
| Total contributions received or receivable from employer(s) | 2012-12-31 | $0 |
| Value of certain deemed distributions of participant loans | 2012-12-31 | $0 |
| Value of corrective distributions | 2012-12-31 | $0 |
| Funding deficiency by the employer to the plan for this plan year | 2012-12-31 | $0 |
| Minimum employer required contribution for this plan year | 2012-12-31 | $0 |
| Amount contributed by the employer to the plan for this plan year | 2012-12-31 | $0 |
| 2011 : FBN, INC. , DBA LONGHORN CASINO SAVINGS AND RETIREMENT PLAN 2011 401k financial data |
|---|
| Transfers to/from the plan | 2011-12-31 | $0 |
| Total income from all sources | 2011-12-31 | $77,801 |
| Expenses. Total of all expenses incurred | 2011-12-31 | $203,387 |
| Benefits paid (including direct rollovers) | 2011-12-31 | $202,609 |
| Total plan assets at end of year | 2011-12-31 | $1,753,618 |
| Total plan assets at beginning of year | 2011-12-31 | $1,879,204 |
| Total contributions received or receivable from participants | 2011-12-31 | $123,240 |
| Expenses. Other expenses not covered elsewhere | 2011-12-31 | $778 |
| Contributions received from other sources (not participants or employers) | 2011-12-31 | $30,110 |
| Other income received | 2011-12-31 | $-84,249 |
| Net income (gross income less expenses) | 2011-12-31 | $-125,586 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-31 | $1,753,618 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-31 | $1,879,204 |
| Assets. Value of participant loans | 2011-12-31 | $105,789 |
| Total contributions received or receivable from employer(s) | 2011-12-31 | $8,700 |
| Value of certain deemed distributions of participant loans | 2011-12-31 | $0 |
| Value of corrective distributions | 2011-12-31 | $0 |
| Funding deficiency by the employer to the plan for this plan year | 2011-12-31 | $0 |
| Minimum employer required contribution for this plan year | 2011-12-31 | $0 |
| Amount contributed by the employer to the plan for this plan year | 2011-12-31 | $0 |
| 2010 : FBN, INC. , DBA LONGHORN CASINO SAVINGS AND RETIREMENT PLAN 2010 401k financial data |
|---|
| Transfers to/from the plan | 2010-12-31 | $0 |
| Total income from all sources | 2010-12-31 | $350,710 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $18,217 |
| Benefits paid (including direct rollovers) | 2010-12-31 | $17,405 |
| Total plan assets at end of year | 2010-12-31 | $1,879,204 |
| Total plan assets at beginning of year | 2010-12-31 | $1,546,711 |
| Total contributions received or receivable from participants | 2010-12-31 | $140,718 |
| Expenses. Other expenses not covered elsewhere | 2010-12-31 | $812 |
| Contributions received from other sources (not participants or employers) | 2010-12-31 | $0 |
| Other income received | 2010-12-31 | $195,464 |
| Net income (gross income less expenses) | 2010-12-31 | $332,493 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $1,879,204 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $1,546,711 |
| Assets. Value of participant loans | 2010-12-31 | $141,194 |
| Total contributions received or receivable from employer(s) | 2010-12-31 | $14,528 |
| Value of certain deemed distributions of participant loans | 2010-12-31 | $0 |
| Value of corrective distributions | 2010-12-31 | $0 |
| Funding deficiency by the employer to the plan for this plan year | 2010-12-31 | $0 |
| Minimum employer required contribution for this plan year | 2010-12-31 | $0 |
| Amount contributed by the employer to the plan for this plan year | 2010-12-31 | $0 |
| 2009 : FBN, INC. , DBA LONGHORN CASINO SAVINGS AND RETIREMENT PLAN 2009 401k financial data |
|---|
| Funding deficiency by the employer to the plan for this plan year | 2009-12-31 | $0 |
| Minimum employer required contribution for this plan year | 2009-12-31 | $0 |
| Amount contributed by the employer to the plan for this plan year | 2009-12-31 | $0 |
| 2014: FBN, INC. , DBA LONGHORN CASINO SAVINGS AND RETIREMENT PLAN 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 – Insurance | Yes |
| 2013: FBN, INC. , DBA LONGHORN CASINO SAVINGS AND RETIREMENT PLAN 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 – Insurance | Yes |
| 2012: FBN, INC. , DBA LONGHORN CASINO SAVINGS AND RETIREMENT PLAN 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 – Insurance | Yes |
| 2011: FBN, INC. , DBA LONGHORN CASINO SAVINGS AND RETIREMENT PLAN 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 – Insurance | Yes |
| 2009: FBN, INC. , DBA LONGHORN CASINO SAVINGS AND RETIREMENT PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Submission has been amended | No |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan funding arrangement – Trust | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-803518 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-803518 | | Number of Individuals Covered | 62 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $1,584 | | Total amount of fees paid to insurance company | USD $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 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? | Yes | | 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 | | Commission paid to Insurance Broker | USD $1,584 | | Insurance broker organization code? | 3 | | Insurance broker name | PLANMEMBER SECURITIES CORPORATION |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-803518 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-803518 | | Number of Individuals Covered | 65 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $1,454 | | Total amount of fees paid to insurance company | USD $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 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? | Yes | | 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 | | Commission paid to Insurance Broker | USD $1,454 | | Insurance broker organization code? | 3 | | Insurance broker name | PLANMEMBER SECURITIES CORP |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-803518 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-803518 | | Number of Individuals Covered | 52 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $1,651 | | Total amount of fees paid to insurance company | USD $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 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? | Yes | | 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 | | Commission paid to Insurance Broker | USD $1,260 | | Insurance broker organization code? | 3 | | Insurance broker name | PLANMEMBER SECURITIES CORP |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-803518 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-803518 | | Number of Individuals Covered | 79 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $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 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? | Yes | | 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 |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | GA-803518 |
| Policy instance | 1 |
| Insurance contract or identification number | GA-803518 | | Number of Individuals Covered | 78 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $1,445 | | Total amount of fees paid to insurance company | USD $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 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? | Yes | | 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 | | Commission paid to Insurance Broker | USD $1,445 | | Insurance broker organization code? | 3 | | Insurance broker name | CHICAGO INVESTMENT GROUP |
|
