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MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN 401k Plan overview

Plan NameMACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN
Plan identification number 001

MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • 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

MACT HEALTH BOARD INCORPORATED has sponsored the creation of one or more 401k plans.

Company Name:MACT HEALTH BOARD INCORPORATED
Employer identification number (EIN):941668995
NAIC Classification:621498
NAIC Description:All Other Outpatient Care Centers

Additional information about MACT HEALTH BOARD INCORPORATED

Jurisdiction of Incorporation: California Department of State
Incorporation Date:
Company Identification Number: C0961903

More information about MACT HEALTH BOARD INCORPORATED

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01
0012017-01-01MARIELA CONTRERAS2018-07-26 MARIELA CONTRERAS2018-07-26
0012016-01-01MARIELA CONTRERAS2017-07-03 MARIELA CONTRERAS2017-07-03
0012015-01-01MARIELA CONTRERAS2016-07-25
0012014-01-01MARIELA CONTRERAS2015-10-09 MARIELA CONTRERAS2015-10-09
0012013-01-01RICHARD CHAFFEY2014-09-09
0012012-01-01RICHARD CHAFFEY2013-08-20
0012011-01-01RICHARD CHAFFEY
0012010-01-01BEATRICE VELO
0012009-01-01BEATRICE VELO
0012009-01-01VELO BEATRICE
0012009-01-01BEATRICE VELO

Plan Statistics for MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN

401k plan membership statisitcs for MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN

Measure Date Value
2022: MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01201
Total number of active participants reported on line 7a of the Form 55002022-01-01161
Number of retired or separated participants receiving benefits2022-01-015
Number of other retired or separated participants entitled to future benefits2022-01-0168
Total of all active and inactive participants2022-01-01234
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01234
Number of participants with account balances2022-01-01232
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-011
2021: MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01185
Total number of active participants reported on line 7a of the Form 55002021-01-01144
Number of retired or separated participants receiving benefits2021-01-013
Number of other retired or separated participants entitled to future benefits2021-01-0152
Total of all active and inactive participants2021-01-01199
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01199
Number of participants with account balances2021-01-01195
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01164
Total number of active participants reported on line 7a of the Form 55002020-01-01134
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0156
Total of all active and inactive participants2020-01-01190
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01190
Number of participants with account balances2020-01-01182
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01134
Total number of active participants reported on line 7a of the Form 55002019-01-01113
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0133
Total of all active and inactive participants2019-01-01146
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01146
Number of participants with account balances2019-01-01146
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01129
Total number of active participants reported on line 7a of the Form 55002018-01-01101
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0140
Total of all active and inactive participants2018-01-01141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01141
Number of participants with account balances2018-01-01134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2011: MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01101
Total number of active participants reported on line 7a of the Form 55002011-01-0188
Total of all active and inactive participants2011-01-0188
Total participants2011-01-0188
2010: MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01126
Total number of active participants reported on line 7a of the Form 55002010-01-0154
Number of retired or separated participants receiving benefits2010-01-012
Number of other retired or separated participants entitled to future benefits2010-01-0145
Total of all active and inactive participants2010-01-01101
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-01101
Number of participants with account balances2010-01-01101
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01160
Total number of active participants reported on line 7a of the Form 55002009-01-0194
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0132
Total of all active and inactive participants2009-01-01126
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01126
Number of participants with account balances2009-01-01126
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN

Measure Date Value
2022 : MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$266,132
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$346,241
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$296,465
Expenses. Certain deemed distributions of participant loans2022-12-31$14,354
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$1,210,477
Value of total assets at end of year2022-12-31$6,001,349
Value of total assets at beginning of year2022-12-31$6,081,458
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$35,422
Total interest from all sources2022-12-31$6,521
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$654,627
Participant contributions at end of year2022-12-31$104,929
Participant contributions at beginning of year2022-12-31$67,930
Participant contributions at end of year2022-12-31$21
Participant contributions at beginning of year2022-12-31$17,236
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$85,070
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-80,109
Value of net assets at end of year (total assets less liabilities)2022-12-31$6,001,349
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$6,081,458
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in pooled separate accounts at end of year2022-12-31$5,763,651
Value of interest in pooled separate accounts at beginning of year2022-12-31$5,800,608
Interest on participant loans2022-12-31$6,521
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$114,784
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$195,684
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-950,866
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$470,780
Employer contributions (assets) at end of year2022-12-31$17,964
Employer contributions (assets) at beginning of year2022-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$296,465
Contract administrator fees2022-12-31$35,422
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31MANN, URRUTIA, NELSON CPAS
Accountancy firm EIN2022-12-31200276349
2021 : MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN 2021 401k financial data
Total income from all sources (including contributions)2021-12-31$1,525,055
Total of all expenses incurred2021-12-31$419,369
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$380,435
Expenses. Certain deemed distributions of participant loans2021-12-31$1,094
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$914,177
Value of total assets at end of year2021-12-31$6,081,458
Value of total assets at beginning of year2021-12-31$4,975,772
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$37,840
Total interest from all sources2021-12-31$7,016
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
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$536,058
Participant contributions at end of year2021-12-31$67,930
Participant contributions at beginning of year2021-12-31$87,016
Participant contributions at end of year2021-12-31$17,236
Participant contributions at beginning of year2021-12-31$-86
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$1,105,686
Value of net assets at end of year (total assets less liabilities)2021-12-31$6,081,458
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$4,975,772
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$5,800,608
Value of interest in pooled separate accounts at beginning of year2021-12-31$4,761,100
Interest on participant loans2021-12-31$5,386
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$1,630
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$195,684
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$127,742
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$603,862
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$378,119
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$380,435
Contract administrator fees2021-12-31$37,840
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 name2021-12-31MANN, URRUTIA, NELSON CPAS
Accountancy firm EIN2021-12-31200276349
2020 : MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN 2020 401k financial data
Total income from all sources (including contributions)2020-12-31$1,423,969
Total of all expenses incurred2020-12-31$131,803
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$106,091
Expenses. Certain deemed distributions of participant loans2020-12-31$225
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$860,791
Value of total assets at end of year2020-12-31$4,975,772
Value of total assets at beginning of year2020-12-31$3,683,606
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$25,487
Total interest from all sources2020-12-31$8,031
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$300,000
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$519,808
Participant contributions at end of year2020-12-31$87,016
Participant contributions at beginning of year2020-12-31$98,755
Participant contributions at end of year2020-12-31$-86
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2020-12-31$189
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$1,292,166
Value of net assets at end of year (total assets less liabilities)2020-12-31$4,975,772
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$3,683,606
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 pooled separate accounts at end of year2020-12-31$4,761,100
Value of interest in pooled separate accounts at beginning of year2020-12-31$3,584,851
Interest on participant loans2020-12-31$7,124
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$907
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$127,742
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$555,147
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$340,983
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$105,902
Contract administrator fees2020-12-31$25,487
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 plan2020-12-31Unqualified
Accountancy firm name2020-12-31MANN, URRUTIA, NELSON CPAS
Accountancy firm EIN2020-12-31200276349
2019 : MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
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$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$1,163,042
Total income from all sources (including contributions)2019-12-31$1,163,042
Total loss/gain on sale of assets2019-12-31$0
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$368,784
Total of all expenses incurred2019-12-31$368,784
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$366,332
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$366,332
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$736,978
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$736,978
Value of total assets at end of year2019-12-31$3,683,606
Value of total assets at end of year2019-12-31$3,683,606
Value of total assets at beginning of year2019-12-31$2,889,348
Value of total assets at beginning of year2019-12-31$2,889,348
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$2,452
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$2,452
Total interest from all sources2019-12-31$3,923
Total interest from all sources2019-12-31$3,923
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
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
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
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$300,000
Value of fidelity bond cover2019-12-31$300,000
If this is an individual account plan, was there a blackout period2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$415,585
Contributions received from participants2019-12-31$415,585
Participant contributions at end of year2019-12-31$98,755
Participant contributions at end of year2019-12-31$98,755
Participant contributions at beginning of year2019-12-31$3,920
Participant contributions at beginning of year2019-12-31$3,920
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$21,332
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$21,332
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
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$794,258
Value of net income/loss2019-12-31$794,258
Value of net assets at end of year (total assets less liabilities)2019-12-31$3,683,606
Value of net assets at end of year (total assets less liabilities)2019-12-31$3,683,606
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$2,889,348
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$2,889,348
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
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 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
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Investment advisory and management fees2019-12-31$2,452
Investment advisory and management fees2019-12-31$2,452
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$3,584,851
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$3,584,851
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$2,885,428
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$2,885,428
Interest on participant loans2019-12-31$3,923
Interest on participant loans2019-12-31$3,923
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$422,141
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$422,141
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
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
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
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$300,061
Contributions received in cash from employer2019-12-31$300,061
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$366,332
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$366,332
Did the plan have assets held for investment2019-12-31Yes
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
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
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
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
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31MANN, URRUTIA, NELSON CPAS
Accountancy firm name2019-12-31MANN, URRUTIA, NELSON CPAS
Accountancy firm EIN2019-12-31200276349
Accountancy firm EIN2019-12-31200276349
2018 : MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN 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$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$418,485
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$344,948
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$330,616
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$613,899
Value of total assets at end of year2018-12-31$2,889,348
Value of total assets at beginning of year2018-12-31$2,815,811
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$14,332
Total interest from all sources2018-12-31$391
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
Administrative expenses professional fees incurred2018-12-31$14,332
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$300,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$355,981
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$0
Assets. Loans (other than to participants) at end of year2018-12-31$3,920
Assets. Loans (other than to participants) at beginning of year2018-12-31$11,164
Administrative expenses (other) incurred2018-12-31$0
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$73,537
Value of net assets at end of year (total assets less liabilities)2018-12-31$2,889,348
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$2,815,811
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$2,885,428
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$2,804,647
Interest on participant loans2018-12-31$391
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-195,805
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 contributions2018-12-31Yes
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$257,918
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$330,616
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 name2018-12-31MANN, URRUTIA, NELSON CPAS
Accountancy firm EIN2018-12-31200276349
2011 : MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN 2011 401k financial data
Total income from all sources (including contributions)2011-12-31$209,682
Total of all expenses incurred2011-12-31$226,073
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$223,878
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$220,136
Value of total assets at end of year2011-12-31$1,281,487
Value of total assets at beginning of year2011-12-31$1,297,878
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$2,195
Total interest from all sources2011-12-31$4,544
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$300
If this is an individual account plan, was there a blackout period2011-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$123,476
Participant contributions at end of year2011-12-31$6,941
Participant contributions at beginning of year2011-12-31$6,680
Participant contributions at end of year2011-12-31$8,656
Participant contributions at beginning of year2011-12-31$5,700
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$1,300
Administrative expenses (other) incurred2011-12-31$2,195
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-16,391
Value of net assets at end of year (total assets less liabilities)2011-12-31$1,281,487
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$1,297,878
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in pooled separate accounts at end of year2011-12-31$1,136,120
Value of interest in pooled separate accounts at beginning of year2011-12-31$1,141,152
Interest on participant loans2011-12-31$477
Interest earned on other investments2011-12-31$4,067
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$125,473
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$141,220
Net investment gain/loss from pooled separate accounts2011-12-31$-14,998
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$95,360
Employer contributions (assets) at end of year2011-12-31$4,297
Employer contributions (assets) at beginning of year2011-12-31$3,126
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$223,878
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-12-31No
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31MANN, URRUTIA NELSON CPA
Accountancy firm EIN2011-12-31200276349
2010 : MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN 2010 401k financial data
Unrealized appreciation/depreciation of real estate assets2010-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$0
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Expenses. Interest paid2010-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022010-12-31$0
Total income from all sources (including contributions)2010-12-31$293,951
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$230,035
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$228,421
Expenses. Certain deemed distributions of participant loans2010-12-31$0
Value of total corrective distributions2010-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$174,099
Value of total assets at end of year2010-12-31$1,297,878
Value of total assets at beginning of year2010-12-31$1,233,962
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$1,614
Total interest from all sources2010-12-31$5,764
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2010-12-31$0
Assets. Real estate other than employer real property at end of year2010-12-31$0
Assets. Real estate other than employer real property at beginning of year2010-12-31$0
Administrative expenses professional fees incurred2010-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2010-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2010-12-31$0
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$176
If this is an individual account plan, was there a blackout period2010-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$90,707
Participant contributions at end of year2010-12-31$6,680
Participant contributions at beginning of year2010-12-31$22,437
Participant contributions at end of year2010-12-31$5,700
Participant contributions at beginning of year2010-12-31$0
Assets. Other investments not covered elsewhere at end of year2010-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2010-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2010-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$0
Assets. Loans (other than to participants) at end of year2010-12-31$0
Assets. Loans (other than to participants) at beginning of year2010-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2010-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$0
Other income not declared elsewhere2010-12-31$0
Administrative expenses (other) incurred2010-12-31$170
Liabilities. Value of operating payables at end of year2010-12-31$0
Liabilities. Value of operating payables at beginning of year2010-12-31$0
Total non interest bearing cash at end of year2010-12-31$0
Total non interest bearing cash at beginning of year2010-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Income. Non cash contributions2010-12-31$0
Value of net income/loss2010-12-31$63,916
Value of net assets at end of year (total assets less liabilities)2010-12-31$1,297,878
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$1,233,962
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Assets. partnership/joint venture interests at end of year2010-12-31$0
Assets. partnership/joint venture interests at beginning of year2010-12-31$0
Investment advisory and management fees2010-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$0
Value of interest in pooled separate accounts at end of year2010-12-31$1,141,152
Value of interest in pooled separate accounts at beginning of year2010-12-31$1,061,282
Interest on participant loans2010-12-31$1,326
Income. Interest from loans (other than to participants)2010-12-31$0
Interest earned on other investments2010-12-31$4,438
Income. Interest from US Government securities2010-12-31$0
Income. Interest from corporate debt instruments2010-12-31$0
Value of interest in master investment trust accounts at end of year2010-12-31$0
Value of interest in master investment trust accounts at beginning of year2010-12-31$0
Value of interest in common/collective trusts at end of year2010-12-31$0
Value of interest in common/collective trusts at beginning of year2010-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2010-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2010-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$141,220
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$150,243
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$0
Asset value of US Government securities at end of year2010-12-31$0
Asset value of US Government securities at beginning of year2010-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$0
Net investment gain/loss from pooled separate accounts2010-12-31$114,088
Net investment gain or loss from common/collective trusts2010-12-31$0
Net gain/loss from 103.12 investment entities2010-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Assets. Invements in employer securities at end of year2010-12-31$0
Assets. Invements in employer securities at beginning of year2010-12-31$0
Assets. Value of employer real property at end of year2010-12-31$0
Assets. Value of employer real property at beginning of year2010-12-31$0
Contributions received in cash from employer2010-12-31$83,392
Employer contributions (assets) at end of year2010-12-31$3,126
Employer contributions (assets) at beginning of year2010-12-31$0
Income. Dividends from preferred stock2010-12-31$0
Income. Dividends from common stock2010-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$228,421
Asset. Corporate debt instrument preferred debt at end of year2010-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2010-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2010-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2010-12-31$0
Contract administrator fees2010-12-31$1,444
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31No
Assets. Corporate common stocks other than exployer securities at end of year2010-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2010-12-31$0
Liabilities. Value of benefit claims payable at end of year2010-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2010-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2010-12-31$0
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Aggregate proceeds on sale of assets2010-12-31$0
Aggregate carrying amount (costs) on sale of assets2010-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2010-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2010-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31MANN URRUTIA NELSON CPA
Accountancy firm EIN2010-12-31200276349
2009 : MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN

2022: MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN 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 filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
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: MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
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: MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
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: MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN 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 benefit arrangement – InsuranceYes
2018: MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN 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 benefit arrangement – InsuranceYes
2011: MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01First time form 5500 has been submittedYes
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01First time form 5500 has been submittedYes
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: MACT HEALTH BOARD, INC. TAX DEFERRED ANNUITY PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01First time form 5500 has been submittedYes
2009-01-01Submission has been amendedYes
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number664T97
Policy instance 1
Insurance contract or identification number664T97
Number of Individuals Covered231
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $373
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees373
Additional information about fees paid to insurance brokerCOMMISSIONS
Insurance broker organization code?3
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number664T97
Policy instance 1
Insurance contract or identification number664T97
Number of Individuals Covered190
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $404
Commission paid to Insurance BrokerUSD $404
Insurance broker organization code?3
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number664T97
Policy instance 1
Insurance contract or identification number664T97
Number of Individuals Covered182
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $8,829
Total amount of fees paid to insurance companyUSD $4,597
Commission paid to Insurance BrokerUSD $8,829
Insurance broker organization code?3
Amount paid for insurance broker fees4597
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number664T97
Policy instance 1
Insurance contract or identification number664T97
Number of Individuals Covered147
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $34,337
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $34,337
Insurance broker organization code?3
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number004652
Policy instance 1
Insurance contract or identification number004652
Number of Individuals Covered88
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of fees paid to insurance companyUSD $2,267
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number004652
Policy instance 1
Insurance contract or identification number004652
Number of Individuals Covered101
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $435
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1235
Additional information about fees paid to insurance brokerSERVICE TO INSURER OR PLAN
Insurance broker nameHD VEST INSURANCE AGENCY LLC

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