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403(B) THRIFT PLAN OF CROCKER ART MUSEUM 401k Plan overview

Plan Name403(B) THRIFT PLAN OF CROCKER ART MUSEUM
Plan identification number 001

403(B) THRIFT PLAN OF CROCKER ART MUSEUM Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • 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

CROCKER ART MUSEUM has sponsored the creation of one or more 401k plans.

Company Name:CROCKER ART MUSEUM
Employer identification number (EIN):942552486
NAIC Classification:712100
NAIC Description: Museums, Historical Sites, and Similar Institutions

Form 5500 Filing Information

Submission information for form 5500 for 401k plan 403(B) THRIFT PLAN OF CROCKER ART MUSEUM

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012021-07-01
0012020-07-01
0012019-07-01
0012018-07-01
0012017-07-01DAVID SEPAROVICH
0012017-07-01
0012016-07-01DAVID SEPAROVICH DAVID SEPAROVICH2018-04-09
0012015-07-01DAVID SEPAROVICH DAVID SEPAROVICH2017-03-24
0012014-07-01DAVID SEPAROVICH DAVID SEPAROVICH2016-02-24
0012013-07-01DAVID SEPAROVICH2015-04-10 DAVID SEPAROVICH2015-04-10
0012012-07-01DAVID SEPAROVICH2014-01-30 DAVID SEPAROVICH2014-01-30
0012011-07-01DAVID SEPAROVICH2013-01-29 DAVID SEPAROVICH2013-01-29
0012010-07-01DAVID SEPAROVICH2012-01-30 DAVID SEPAROVICH2012-01-30

Plan Statistics for 403(B) THRIFT PLAN OF CROCKER ART MUSEUM

401k plan membership statisitcs for 403(B) THRIFT PLAN OF CROCKER ART MUSEUM

Measure Date Value
2021: 403(B) THRIFT PLAN OF CROCKER ART MUSEUM 2021 401k membership
Total participants, beginning-of-year2021-07-0199
Total number of active participants reported on line 7a of the Form 55002021-07-0161
Number of retired or separated participants receiving benefits2021-07-010
Number of other retired or separated participants entitled to future benefits2021-07-0140
Total of all active and inactive participants2021-07-01101
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-07-010
Total participants2021-07-01101
Number of participants with account balances2021-07-0163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-07-010
2020: 403(B) THRIFT PLAN OF CROCKER ART MUSEUM 2020 401k membership
Total participants, beginning-of-year2020-07-01100
Total number of active participants reported on line 7a of the Form 55002020-07-0161
Number of retired or separated participants receiving benefits2020-07-010
Number of other retired or separated participants entitled to future benefits2020-07-0138
Total of all active and inactive participants2020-07-0199
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-07-010
Total participants2020-07-0199
Number of participants with account balances2020-07-0167
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-07-010
2019: 403(B) THRIFT PLAN OF CROCKER ART MUSEUM 2019 401k membership
Total participants, beginning-of-year2019-07-01116
Total number of active participants reported on line 7a of the Form 55002019-07-0171
Number of retired or separated participants receiving benefits2019-07-010
Number of other retired or separated participants entitled to future benefits2019-07-0129
Total of all active and inactive participants2019-07-01100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-07-010
Total participants2019-07-01100
Number of participants with account balances2019-07-0168
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-07-010
2018: 403(B) THRIFT PLAN OF CROCKER ART MUSEUM 2018 401k membership
Total participants, beginning-of-year2018-07-0194
Total number of active participants reported on line 7a of the Form 55002018-07-0187
Number of retired or separated participants receiving benefits2018-07-010
Number of other retired or separated participants entitled to future benefits2018-07-0129
Total of all active and inactive participants2018-07-01116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-07-010
Total participants2018-07-01116
Number of participants with account balances2018-07-0167
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-07-010
2017: 403(B) THRIFT PLAN OF CROCKER ART MUSEUM 2017 401k membership
Total participants, beginning-of-year2017-07-0196
Total number of active participants reported on line 7a of the Form 55002017-07-0169
Number of retired or separated participants receiving benefits2017-07-010
Number of other retired or separated participants entitled to future benefits2017-07-0125
Total of all active and inactive participants2017-07-0194
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-07-010
Total participants2017-07-0194
Number of participants with account balances2017-07-0165
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-07-010
2016: 403(B) THRIFT PLAN OF CROCKER ART MUSEUM 2016 401k membership
Total participants, beginning-of-year2016-07-01102
Total number of active participants reported on line 7a of the Form 55002016-07-0173
Number of retired or separated participants receiving benefits2016-07-010
Number of other retired or separated participants entitled to future benefits2016-07-0123
Total of all active and inactive participants2016-07-0196
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-07-010
Total participants2016-07-0196
Number of participants with account balances2016-07-0158
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-07-011
2015: 403(B) THRIFT PLAN OF CROCKER ART MUSEUM 2015 401k membership
Total participants, beginning-of-year2015-07-0193
Total number of active participants reported on line 7a of the Form 55002015-07-0177
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-0125
Total of all active and inactive participants2015-07-01102
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-07-010
Total participants2015-07-01102
Number of participants with account balances2015-07-0150
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-07-015
2014: 403(B) THRIFT PLAN OF CROCKER ART MUSEUM 2014 401k membership
Total participants, beginning-of-year2014-07-0153
Total number of active participants reported on line 7a of the Form 55002014-07-0175
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-0118
Total of all active and inactive participants2014-07-0193
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-07-010
Total participants2014-07-0193
Number of participants with account balances2014-07-0152
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-07-012

Financial Data on 403(B) THRIFT PLAN OF CROCKER ART MUSEUM

Measure Date Value
2022 : 403(B) THRIFT PLAN OF CROCKER ART MUSEUM 2022 401k financial data
Transfers to/from the plan2022-06-30$0
Total plan liabilities at end of year2022-06-30$0
Total plan liabilities at beginning of year2022-06-30$0
Total income from all sources2022-06-30$-780,453
Expenses. Total of all expenses incurred2022-06-30$105,373
Benefits paid (including direct rollovers)2022-06-30$104,802
Total plan assets at end of year2022-06-30$4,703,704
Total plan assets at beginning of year2022-06-30$5,589,530
Value of fidelity bond covering the plan2022-06-30$265,000
Total contributions received or receivable from participants2022-06-30$200,970
Expenses. Other expenses not covered elsewhere2022-06-30$0
Contributions received from other sources (not participants or employers)2022-06-30$4,385
Other income received2022-06-30$-1,064,930
Noncash contributions received2022-06-30$0
Net income (gross income less expenses)2022-06-30$-885,826
Net plan assets at end of year (total assets less liabilities)2022-06-30$4,703,704
Net plan assets at beginning of year (total assets less liabilities)2022-06-30$5,589,530
Total contributions received or receivable from employer(s)2022-06-30$79,122
Value of corrective distributions2022-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2022-06-30$571
2021 : 403(B) THRIFT PLAN OF CROCKER ART MUSEUM 2021 401k financial data
Transfers to/from the plan2021-06-30$0
Total plan liabilities at end of year2021-06-30$0
Total plan liabilities at beginning of year2021-06-30$0
Total income from all sources2021-06-30$1,772,642
Expenses. Total of all expenses incurred2021-06-30$226,467
Benefits paid (including direct rollovers)2021-06-30$225,627
Total plan assets at end of year2021-06-30$5,589,530
Total plan assets at beginning of year2021-06-30$4,043,355
Value of fidelity bond covering the plan2021-06-30$265,000
Total contributions received or receivable from participants2021-06-30$202,232
Expenses. Other expenses not covered elsewhere2021-06-30$840
Contributions received from other sources (not participants or employers)2021-06-30$0
Other income received2021-06-30$1,485,932
Net income (gross income less expenses)2021-06-30$1,546,175
Net plan assets at end of year (total assets less liabilities)2021-06-30$5,589,530
Net plan assets at beginning of year (total assets less liabilities)2021-06-30$4,043,355
Total contributions received or receivable from employer(s)2021-06-30$84,478
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-06-30$0
2020 : 403(B) THRIFT PLAN OF CROCKER ART MUSEUM 2020 401k financial data
Transfers to/from the plan2020-06-30$0
Total plan liabilities at end of year2020-06-30$0
Total plan liabilities at beginning of year2020-06-30$0
Total income from all sources2020-06-30$531,256
Expenses. Total of all expenses incurred2020-06-30$117,382
Benefits paid (including direct rollovers)2020-06-30$116,437
Total plan assets at end of year2020-06-30$4,043,355
Total plan assets at beginning of year2020-06-30$3,629,481
Value of fidelity bond covering the plan2020-06-30$265,000
Total contributions received or receivable from participants2020-06-30$226,274
Expenses. Other expenses not covered elsewhere2020-06-30$945
Contributions received from other sources (not participants or employers)2020-06-30$10,910
Other income received2020-06-30$197,304
Net income (gross income less expenses)2020-06-30$413,874
Net plan assets at end of year (total assets less liabilities)2020-06-30$4,043,355
Net plan assets at beginning of year (total assets less liabilities)2020-06-30$3,629,481
Total contributions received or receivable from employer(s)2020-06-30$96,768
2019 : 403(B) THRIFT PLAN OF CROCKER ART MUSEUM 2019 401k financial data
Transfers to/from the plan2019-06-30$0
Total plan liabilities at end of year2019-06-30$0
Total plan liabilities at beginning of year2019-06-30$0
Total income from all sources2019-06-30$494,881
Expenses. Total of all expenses incurred2019-06-30$148,387
Benefits paid (including direct rollovers)2019-06-30$147,399
Total plan assets at end of year2019-06-30$3,629,481
Total plan assets at beginning of year2019-06-30$3,282,987
Value of fidelity bond covering the plan2019-06-30$265,000
Total contributions received or receivable from participants2019-06-30$223,032
Expenses. Other expenses not covered elsewhere2019-06-30$988
Contributions received from other sources (not participants or employers)2019-06-30$0
Other income received2019-06-30$181,702
Net income (gross income less expenses)2019-06-30$346,494
Net plan assets at end of year (total assets less liabilities)2019-06-30$3,629,481
Net plan assets at beginning of year (total assets less liabilities)2019-06-30$3,282,987
Total contributions received or receivable from employer(s)2019-06-30$90,147
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-06-30$0
2018 : 403(B) THRIFT PLAN OF CROCKER ART MUSEUM 2018 401k financial data
Transfers to/from the plan2018-06-30$0
Total plan liabilities at end of year2018-06-30$0
Total plan liabilities at beginning of year2018-06-30$0
Total income from all sources2018-06-30$716,115
Expenses. Total of all expenses incurred2018-06-30$44,623
Benefits paid (including direct rollovers)2018-06-30$43,795
Total plan assets at end of year2018-06-30$3,282,987
Total plan assets at beginning of year2018-06-30$2,611,495
Value of fidelity bond covering the plan2018-06-30$265,000
Total contributions received or receivable from participants2018-06-30$179,966
Expenses. Other expenses not covered elsewhere2018-06-30$828
Contributions received from other sources (not participants or employers)2018-06-30$160,738
Other income received2018-06-30$294,475
Net income (gross income less expenses)2018-06-30$671,492
Net plan assets at end of year (total assets less liabilities)2018-06-30$3,282,987
Net plan assets at beginning of year (total assets less liabilities)2018-06-30$2,611,495
Total contributions received or receivable from employer(s)2018-06-30$80,936
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-06-30$0
2017 : 403(B) THRIFT PLAN OF CROCKER ART MUSEUM 2017 401k financial data
Transfers to/from the plan2017-06-30$0
Total plan liabilities at end of year2017-06-30$0
Total plan liabilities at beginning of year2017-06-30$0
Total income from all sources2017-06-30$566,875
Expenses. Total of all expenses incurred2017-06-30$140,889
Benefits paid (including direct rollovers)2017-06-30$140,161
Total plan assets at end of year2017-06-30$2,611,495
Total plan assets at beginning of year2017-06-30$2,185,509
Value of fidelity bond covering the plan2017-06-30$265,000
Total contributions received or receivable from participants2017-06-30$162,370
Expenses. Other expenses not covered elsewhere2017-06-30$728
Contributions received from other sources (not participants or employers)2017-06-30$3,776
Other income received2017-06-30$327,969
Net income (gross income less expenses)2017-06-30$425,986
Net plan assets at end of year (total assets less liabilities)2017-06-30$2,611,495
Net plan assets at beginning of year (total assets less liabilities)2017-06-30$2,185,509
Total contributions received or receivable from employer(s)2017-06-30$72,760
Value of certain deemed distributions of participant loans2017-06-30$0
2016 : 403(B) THRIFT PLAN OF CROCKER ART MUSEUM 2016 401k financial data
Transfers to/from the plan2016-06-30$0
Total plan liabilities at end of year2016-06-30$0
Total plan liabilities at beginning of year2016-06-30$0
Total income from all sources2016-06-30$179,321
Expenses. Total of all expenses incurred2016-06-30$214,424
Benefits paid (including direct rollovers)2016-06-30$213,717
Total plan assets at end of year2016-06-30$2,185,509
Total plan assets at beginning of year2016-06-30$2,220,612
Value of fidelity bond covering the plan2016-06-30$265,000
Total contributions received or receivable from participants2016-06-30$126,330
Expenses. Other expenses not covered elsewhere2016-06-30$707
Contributions received from other sources (not participants or employers)2016-06-30$36,366
Other income received2016-06-30$-37,537
Net income (gross income less expenses)2016-06-30$-35,103
Net plan assets at end of year (total assets less liabilities)2016-06-30$2,185,509
Net plan assets at beginning of year (total assets less liabilities)2016-06-30$2,220,612
Total contributions received or receivable from employer(s)2016-06-30$54,162
Value of certain deemed distributions of participant loans2016-06-30$0
2015 : 403(B) THRIFT PLAN OF CROCKER ART MUSEUM 2015 401k financial data
Total income from all sources2015-06-30$284,390
Expenses. Total of all expenses incurred2015-06-30$103,953
Benefits paid (including direct rollovers)2015-06-30$103,166
Total plan assets at end of year2015-06-30$2,220,612
Total plan assets at beginning of year2015-06-30$2,040,175
Value of fidelity bond covering the plan2015-06-30$265,000
Total contributions received or receivable from participants2015-06-30$146,235
Expenses. Other expenses not covered elsewhere2015-06-30$787
Contributions received from other sources (not participants or employers)2015-06-30$884
Other income received2015-06-30$70,581
Net income (gross income less expenses)2015-06-30$180,437
Net plan assets at end of year (total assets less liabilities)2015-06-30$2,220,612
Net plan assets at beginning of year (total assets less liabilities)2015-06-30$2,040,175
Total contributions received or receivable from employer(s)2015-06-30$66,690
Value of certain deemed distributions of participant loans2015-06-30$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-06-30$0

Form 5500 Responses for 403(B) THRIFT PLAN OF CROCKER ART MUSEUM

2021: 403(B) THRIFT PLAN OF CROCKER ART MUSEUM 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Submission has been amendedNo
2021-07-01This submission is the final filingNo
2021-07-01This return/report is a short plan year return/report (less than 12 months)No
2021-07-01Plan is a collectively bargained planNo
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – InsuranceYes
2020: 403(B) THRIFT PLAN OF CROCKER ART MUSEUM 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Submission has been amendedNo
2020-07-01This submission is the final filingNo
2020-07-01This return/report is a short plan year return/report (less than 12 months)No
2020-07-01Plan is a collectively bargained planNo
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – InsuranceYes
2019: 403(B) THRIFT PLAN OF CROCKER ART MUSEUM 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Submission has been amendedNo
2019-07-01This submission is the final filingNo
2019-07-01This return/report is a short plan year return/report (less than 12 months)No
2019-07-01Plan is a collectively bargained planNo
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – InsuranceYes
2018: 403(B) THRIFT PLAN OF CROCKER ART MUSEUM 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Submission has been amendedNo
2018-07-01This submission is the final filingNo
2018-07-01This return/report is a short plan year return/report (less than 12 months)No
2018-07-01Plan is a collectively bargained planNo
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – InsuranceYes
2017: 403(B) THRIFT PLAN OF CROCKER ART MUSEUM 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Submission has been amendedYes
2017-07-01This submission is the final filingNo
2017-07-01This return/report is a short plan year return/report (less than 12 months)No
2017-07-01Plan is a collectively bargained planNo
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – InsuranceYes
2016: 403(B) THRIFT PLAN OF CROCKER ART MUSEUM 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Submission has been amendedNo
2016-07-01This submission is the final filingNo
2016-07-01This return/report is a short plan year return/report (less than 12 months)No
2016-07-01Plan is a collectively bargained planNo
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – InsuranceYes
2015: 403(B) THRIFT PLAN OF CROCKER ART MUSEUM 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – InsuranceYes
2014: 403(B) THRIFT PLAN OF CROCKER ART MUSEUM 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number055138G
Policy instance 1
Insurance contract or identification number055138G
Number of Individuals Covered106
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $757
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 Administration1
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
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees757
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number055138G
Policy instance 1
Insurance contract or identification number055138G
Number of Individuals Covered99
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $509
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 Administration1
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
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees509
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number055138G
Policy instance 1
Insurance contract or identification number055138G
Number of Individuals Covered68
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $858
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 Administration1
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
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees858
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number055138G
Policy instance 1
Insurance contract or identification number055138G
Number of Individuals Covered67
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $899
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 Administration1
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
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees899
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number055138G
Policy instance 1
Insurance contract or identification number055138G
Number of Individuals Covered65
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $722
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 Administration1
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
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number055138G
Policy instance 1
Insurance contract or identification number055138G
Number of Individuals Covered50
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $114
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
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
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees114
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
Insurance broker nameSAN FRANCISCO REGIONAL OFFICE
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number055138G
Policy instance 1
Insurance contract or identification number055138G
Number of Individuals Covered52
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $330
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
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
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees330
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
Insurance broker nameSAN FRANCISCO REGIONAL OFFICE

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