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UMATILLA-MORROW HEAD START, INC. 403(B) PLAN TWO 401k Plan overview

Plan NameUMATILLA-MORROW HEAD START, INC. 403(B) PLAN TWO
Plan identification number 003

UMATILLA-MORROW HEAD START, INC. 403(B) PLAN TWO Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • 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 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
  • 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.

401k Sponsoring company profile

UMATILA-MORROW HEAD START, INC. has sponsored the creation of one or more 401k plans.

Company Name:UMATILA-MORROW HEAD START, INC.
Employer identification number (EIN):930937286
NAIC Classification:611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UMATILLA-MORROW HEAD START, INC. 403(B) PLAN TWO

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0032022-01-01
0032021-01-01
0032020-01-01
0032019-01-01
0032018-01-01
0032017-01-01AARON TREADWELL
0032016-01-01AARON TREADWELL
0032015-01-01AARON TREADWELL2016-09-15
0032014-01-01ERIC CARPENTER2015-09-30
0032013-01-01ERIC CARPENTER2014-10-07
0032012-01-01ERIC CARPENTER2013-08-16

Plan Statistics for UMATILLA-MORROW HEAD START, INC. 403(B) PLAN TWO

401k plan membership statisitcs for UMATILLA-MORROW HEAD START, INC. 403(B) PLAN TWO

Measure Date Value
2022: UMATILLA-MORROW HEAD START, INC. 403(B) PLAN TWO 2022 401k membership
Total participants, beginning-of-year2022-01-010
Total number of active participants reported on line 7a of the Form 55002022-01-010
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-010
Total participants2022-01-010
2021: UMATILLA-MORROW HEAD START, INC. 403(B) PLAN TWO 2021 401k membership
Total participants, beginning-of-year2021-01-01212
Total number of active participants reported on line 7a of the Form 55002021-01-0179
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0190
Total of all active and inactive participants2021-01-01169
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01169
Number of participants with account balances2021-01-01155
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-0120
2020: UMATILLA-MORROW HEAD START, INC. 403(B) PLAN TWO 2020 401k membership
Total participants, beginning-of-year2020-01-01182
Total number of active participants reported on line 7a of the Form 55002020-01-01143
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0169
Total of all active and inactive participants2020-01-01212
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01212
Number of participants with account balances2020-01-01175
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-0110
2019: UMATILLA-MORROW HEAD START, INC. 403(B) PLAN TWO 2019 401k membership
Total participants, beginning-of-year2019-01-01230
Total number of active participants reported on line 7a of the Form 55002019-01-01129
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0152
Total of all active and inactive participants2019-01-01181
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-011
Total participants2019-01-01182
Number of participants with account balances2019-01-01148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-0130
2018: UMATILLA-MORROW HEAD START, INC. 403(B) PLAN TWO 2018 401k membership
Total participants, beginning-of-year2018-01-01197
Total number of active participants reported on line 7a of the Form 55002018-01-01189
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0141
Total of all active and inactive participants2018-01-01230
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01230
Number of participants with account balances2018-01-01155
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-0116
2017: UMATILLA-MORROW HEAD START, INC. 403(B) PLAN TWO 2017 401k membership
Total participants, beginning-of-year2017-01-01161
Total number of active participants reported on line 7a of the Form 55002017-01-01161
Number of retired or separated participants receiving benefits2017-01-012
Number of other retired or separated participants entitled to future benefits2017-01-0134
Total of all active and inactive participants2017-01-01197
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01197
Number of participants with account balances2017-01-01130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-0110
2016: UMATILLA-MORROW HEAD START, INC. 403(B) PLAN TWO 2016 401k membership
Total participants, beginning-of-year2016-01-01124
Total number of active participants reported on line 7a of the Form 55002016-01-01135
Number of retired or separated participants receiving benefits2016-01-011
Number of other retired or separated participants entitled to future benefits2016-01-0125
Total of all active and inactive participants2016-01-01161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01161
Number of participants with account balances2016-01-01108
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010

Financial Data on UMATILLA-MORROW HEAD START, INC. 403(B) PLAN TWO

Measure Date Value
2022 : UMATILLA-MORROW HEAD START, INC. 403(B) PLAN TWO 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-01-01$0
Total transfer of assets from this plan2022-01-01$2,216,591
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-01$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-01$4,204
Total income from all sources (including contributions)2022-01-01$0
Total loss/gain on sale of assets2022-01-01$0
Total of all expenses incurred2022-01-01$0
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-01-01$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-01-01$0
Value of total assets at end of year2022-01-01$0
Value of total assets at beginning of year2022-01-01$2,220,795
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-01-01$0
Total interest from all sources2022-01-01$0
Total dividends received (eg from common stock, registered investment company shares)2022-01-01$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-01-01Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2022-01-01$0
Was this plan covered by a fidelity bond2022-01-01Yes
Value of fidelity bond cover2022-01-01$500,000
If this is an individual account plan, was there a blackout period2022-01-01No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2022-01-01$0
Were there any nonexempt tranactions with any party-in-interest2022-01-01No
Participant contributions at end of year2022-01-01$0
Participant contributions at beginning of year2022-01-01$3,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-01-01$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-01-01$4,204
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-01-01No
Value of net income/loss2022-01-01$0
Value of net assets at end of year (total assets less liabilities)2022-01-01$0
Value of net assets at beginning of year (total assets less liabilities)2022-01-01$2,216,591
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-01-01No
Were any loans by the plan or fixed income obligations due to the plan in default2022-01-01No
Were any leases to which the plan was party in default or uncollectible2022-01-01No
Value of interest in pooled separate accounts at end of year2022-01-01$0
Value of interest in pooled separate accounts at beginning of year2022-01-01$1,320,907
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-01-01$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-01-01$890,827
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-01-01No
Was there a failure to transmit to the plan any participant contributions2022-01-01No
Has the plan failed to provide any benefit when due under the plan2022-01-01No
Employer contributions (assets) at end of year2022-01-01$0
Employer contributions (assets) at beginning of year2022-01-01$6,061
Did the plan have assets held for investment2022-01-01No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-01-01No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-01-01Yes
Opinion of an independent qualified public accountant for this plan2022-01-01Unqualified
Accountancy firm name2022-01-01PETERSEN ADVISORS
Accountancy firm EIN2022-01-01261262413
2021 : UMATILLA-MORROW HEAD START, INC. 403(B) PLAN TWO 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total transfer of assets to this plan2021-12-31$68,247
Total transfer of assets from this plan2021-12-31$82,637
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$4,204
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$6,297
Total income from all sources (including contributions)2021-12-31$430,221
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$251,688
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$245,730
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$256,226
Value of total assets at end of year2021-12-31$2,220,795
Value of total assets at beginning of year2021-12-31$2,058,745
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$5,958
Total interest from all sources2021-12-31$6,341
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$85,810
Participant contributions at end of year2021-12-31$3,000
Participant contributions at beginning of year2021-12-31$16,656
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$4,204
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$6,297
Administrative expenses (other) incurred2021-12-31$5,958
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$178,533
Value of net assets at end of year (total assets less liabilities)2021-12-31$2,216,591
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$2,052,448
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in pooled separate accounts at end of year2021-12-31$1,320,907
Value of interest in pooled separate accounts at beginning of year2021-12-31$1,151,405
Interest earned on other investments2021-12-31$6,341
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$890,827
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$881,333
Net investment gain/loss from pooled separate accounts2021-12-31$167,654
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$170,416
Employer contributions (assets) at end of year2021-12-31$6,061
Employer contributions (assets) at beginning of year2021-12-31$9,351
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$245,730
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31PETERSEN ADVISORS
Accountancy firm EIN2021-12-31261262413
2020 : UMATILLA-MORROW HEAD START, INC. 403(B) PLAN TWO 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total transfer of assets from this plan2020-12-31$110,466
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$6,297
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$472,091
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$44,635
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$44,345
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$305,450
Value of total assets at end of year2020-12-31$2,058,745
Value of total assets at beginning of year2020-12-31$1,735,458
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$290
Total interest from all sources2020-12-31$6,554
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$81,003
Participant contributions at end of year2020-12-31$16,656
Participant contributions at beginning of year2020-12-31$37
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$3,732
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$6,297
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$0
Administrative expenses (other) incurred2020-12-31$290
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$427,456
Value of net assets at end of year (total assets less liabilities)2020-12-31$2,052,448
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$1,735,458
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$0
Value of interest in pooled separate accounts at end of year2020-12-31$1,151,405
Value of interest in pooled separate accounts at beginning of year2020-12-31$841,800
Interest earned on other investments2020-12-31$6,554
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$881,333
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$889,429
Net investment gain/loss from pooled separate accounts2020-12-31$160,087
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$220,715
Employer contributions (assets) at end of year2020-12-31$9,351
Employer contributions (assets) at beginning of year2020-12-31$4,192
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$44,345
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31PETERSEN ADVISORS
Accountancy firm EIN2020-12-31261262413
2019 : UMATILLA-MORROW HEAD START, INC. 403(B) PLAN TWO 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total transfer of assets to this plan2019-12-31$138,140
Total transfer of assets from this plan2019-12-31$211,527
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$3,239
Total income from all sources (including contributions)2019-12-31$418,141
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$384,520
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$378,975
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$251,092
Value of total assets at end of year2019-12-31$1,735,458
Value of total assets at beginning of year2019-12-31$1,778,463
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$5,545
Total interest from all sources2019-12-31$22,633
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$69,174
Participant contributions at end of year2019-12-31$37
Participant contributions at beginning of year2019-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$4,226
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$3,239
Administrative expenses (other) incurred2019-12-31$120
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$33,621
Value of net assets at end of year (total assets less liabilities)2019-12-31$1,735,458
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$1,775,224
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$10,387
Value of interest in pooled separate accounts at end of year2019-12-31$841,800
Value of interest in pooled separate accounts at beginning of year2019-12-31$747,256
Interest earned on other investments2019-12-31$22,633
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$889,429
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$1,020,820
Net investment gain/loss from pooled separate accounts2019-12-31$144,416
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31Yes
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$177,692
Employer contributions (assets) at end of year2019-12-31$4,192
Employer contributions (assets) at beginning of year2019-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$378,975
Contract administrator fees2019-12-31$5,425
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31PETERSEN ADVISORS
Accountancy firm EIN2019-12-31261262413
2018 : UMATILLA-MORROW HEAD START, INC. 403(B) PLAN TWO 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$3,239
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$314
Total income from all sources (including contributions)2018-12-31$215,702
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$205,981
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$200,340
Expenses. Certain deemed distributions of participant loans2018-12-31$534
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$253,826
Value of total assets at end of year2018-12-31$1,778,463
Value of total assets at beginning of year2018-12-31$1,765,817
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$5,107
Total interest from all sources2018-12-31$23,106
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$70,943
Participant contributions at end of year2018-12-31$0
Participant contributions at beginning of year2018-12-31$504
Participant contributions at end of year2018-12-31$0
Participant contributions at beginning of year2018-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$3,239
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$314
Administrative expenses (other) incurred2018-12-31$190
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$9,721
Value of net assets at end of year (total assets less liabilities)2018-12-31$1,775,224
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$1,765,503
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$10,387
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$10,758
Value of interest in pooled separate accounts at end of year2018-12-31$747,256
Value of interest in pooled separate accounts at beginning of year2018-12-31$710,573
Interest on participant loans2018-12-31$30
Interest earned on other investments2018-12-31$23,076
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$1,020,820
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$1,043,982
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-361
Net investment gain/loss from pooled separate accounts2018-12-31$-60,869
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$182,883
Employer contributions (assets) at end of year2018-12-31$0
Employer contributions (assets) at beginning of year2018-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$200,340
Contract administrator fees2018-12-31$4,917
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31PETERSEN ADVISORS
Accountancy firm EIN2018-12-31261262413
2017 : UMATILLA-MORROW HEAD START, INC. 403(B) PLAN TWO 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$314
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$345,191
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$68,272
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$62,253
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$221,935
Value of total assets at end of year2017-12-31$1,765,817
Value of total assets at beginning of year2017-12-31$1,488,584
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$6,019
Total interest from all sources2017-12-31$23,130
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$58,171
Participant contributions at end of year2017-12-31$504
Participant contributions at beginning of year2017-12-31$475
Participant contributions at end of year2017-12-31$0
Participant contributions at beginning of year2017-12-31$2,570
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$314
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$0
Administrative expenses (other) incurred2017-12-31$245
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$276,919
Value of net assets at end of year (total assets less liabilities)2017-12-31$1,765,503
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$1,488,584
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$10,758
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$9,136
Value of interest in pooled separate accounts at end of year2017-12-31$710,573
Value of interest in pooled separate accounts at beginning of year2017-12-31$497,073
Interest on participant loans2017-12-31$29
Interest earned on other investments2017-12-31$23,101
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$1,043,982
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$971,640
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$1,632
Net investment gain/loss from pooled separate accounts2017-12-31$98,494
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$163,764
Employer contributions (assets) at end of year2017-12-31$0
Employer contributions (assets) at beginning of year2017-12-31$7,690
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$62,253
Contract administrator fees2017-12-31$5,774
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31PETERSEN ADVISORS
Accountancy firm EIN2017-12-31261262413
2016 : UMATILLA-MORROW HEAD START, INC. 403(B) PLAN TWO 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total transfer of assets to this plan2016-12-31$1,005
Total transfer of assets from this plan2016-12-31$470
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$4,566
Total income from all sources (including contributions)2016-12-31$257,622
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$159,843
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$155,697
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$203,643
Value of total assets at end of year2016-12-31$1,488,584
Value of total assets at beginning of year2016-12-31$1,394,836
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$4,146
Total interest from all sources2016-12-31$22,666
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$57,071
Participant contributions at end of year2016-12-31$475
Participant contributions at beginning of year2016-12-31$454
Participant contributions at end of year2016-12-31$2,570
Participant contributions at beginning of year2016-12-31$3,102
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$4,895
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$4,566
Administrative expenses (other) incurred2016-12-31$245
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$97,779
Value of net assets at end of year (total assets less liabilities)2016-12-31$1,488,584
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$1,390,270
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$9,136
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$8,428
Value of interest in pooled separate accounts at end of year2016-12-31$497,073
Value of interest in pooled separate accounts at beginning of year2016-12-31$414,542
Interest on participant loans2016-12-31$21
Interest earned on other investments2016-12-31$22,645
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$971,640
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$962,168
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$718
Net investment gain/loss from pooled separate accounts2016-12-31$30,595
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$141,677
Employer contributions (assets) at end of year2016-12-31$7,690
Employer contributions (assets) at beginning of year2016-12-31$6,142
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$155,697
Contract administrator fees2016-12-31$3,901
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31PETERSEN ADVISORS
Accountancy firm EIN2016-12-31261262413

Form 5500 Responses for UMATILLA-MORROW HEAD START, INC. 403(B) PLAN TWO

2022: UMATILLA-MORROW HEAD START, INC. 403(B) PLAN TWO 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingYes
2022-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: UMATILLA-MORROW HEAD START, INC. 403(B) PLAN TWO 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: UMATILLA-MORROW HEAD START, INC. 403(B) PLAN TWO 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: UMATILLA-MORROW HEAD START, INC. 403(B) PLAN TWO 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: UMATILLA-MORROW HEAD START, INC. 403(B) PLAN TWO 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: UMATILLA-MORROW HEAD START, INC. 403(B) PLAN TWO 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: UMATILLA-MORROW HEAD START, INC. 403(B) PLAN TWO 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

WESTERN UNITED (National Association of Insurance Commissioners NAIC id number: 77925 )
Policy contract numberTSA
Policy instance 3
Insurance contract or identification numberTSA
Number of Individuals Covered0
Insurance policy start date2022-01-01
Insurance policy end date2022-01-01
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberC102422275
Policy instance 2
Insurance contract or identification numberC102422275
Number of Individuals Covered0
Insurance policy start date2022-01-01
Insurance policy end date2022-01-01
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractGROUP ANNUITIES
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG75611
Policy instance 1
Insurance contract or identification numberG75611
Number of Individuals Covered0
Insurance policy start date2022-01-01
Insurance policy end date2022-01-01
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WESTERN UNITED (National Association of Insurance Commissioners NAIC id number: 77925 )
Policy contract numberTSA
Policy instance 3
Insurance contract or identification numberTSA
Number of Individuals Covered8
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberC102422275
Policy instance 2
Insurance contract or identification numberC102422275
Number of Individuals Covered8
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $136
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractGROUP ANNUITIES
Commission paid to Insurance BrokerUSD $136
Insurance broker organization code?3
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG75611
Policy instance 1
Insurance contract or identification numberG75611
Number of Individuals Covered145
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $10,407
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,407
Insurance broker organization code?3
WESTERN UNITED (National Association of Insurance Commissioners NAIC id number: 77925 )
Policy contract numberTSA
Policy instance 3
Insurance contract or identification numberTSA
Number of Individuals Covered8
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberC102422275
Policy instance 2
Insurance contract or identification numberC102422275
Number of Individuals Covered8
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $172
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractGROUP ANNUITIES
Commission paid to Insurance BrokerUSD $172
Insurance broker organization code?3
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG75611
Policy instance 1
Insurance contract or identification numberG75611
Number of Individuals Covered150
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $6,815
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,815
Insurance broker organization code?3
WESTERN UNITED (National Association of Insurance Commissioners NAIC id number: 77925 )
Policy contract numberTSA
Policy instance 3
Insurance contract or identification numberTSA
Number of Individuals Covered9
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberC102422275
Policy instance 2
Insurance contract or identification numberC102422275
Number of Individuals Covered9
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $190
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractGROUP ANNUITIES
Commission paid to Insurance BrokerUSD $190
Insurance broker organization code?3
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG75611
Policy instance 1
Insurance contract or identification numberG75611
Number of Individuals Covered128
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $6,854
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,854
Insurance broker organization code?3
WESTERN UNITED (National Association of Insurance Commissioners NAIC id number: 77925 )
Policy contract numberTSA
Policy instance 3
Insurance contract or identification numberTSA
Number of Individuals Covered10
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberC102422275
Policy instance 2
Insurance contract or identification numberC102422275
Number of Individuals Covered12
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $202
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractGROUP ANNUITIES
Commission paid to Insurance BrokerUSD $202
Insurance broker organization code?3
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG75611
Policy instance 1
Insurance contract or identification numberG75611
Number of Individuals Covered140
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $6,769
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,769
Insurance broker organization code?3
WESTERN UNITED (National Association of Insurance Commissioners NAIC id number: 77925 )
Policy contract numberTSA
Policy instance 3
Insurance contract or identification numberTSA
Number of Individuals Covered10
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberC102422275
Policy instance 2
Insurance contract or identification numberC102422275
Number of Individuals Covered14
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $305
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractGROUP ANNUITIES
Commission paid to Insurance BrokerUSD $305
Insurance broker organization code?3
Insurance broker nameSIMMONS INSURANCE GROUP
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG75611
Policy instance 1
Insurance contract or identification numberG75611
Number of Individuals Covered125
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $5,854
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,854
Insurance broker organization code?3
Insurance broker nameSECURITIES AMERICA, INC.

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