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CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 401k Plan overview

Plan NameCARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN
Plan identification number 002

CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • 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

CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. has sponsored the creation of one or more 401k plans.

Company Name:CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC.
Employer identification number (EIN):952684977
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022019-07-01R. BRUCE MCFADDEN, M.D.2021-01-21
0022018-07-01R. BRUCE MCFADDEN, M.D.2020-01-31
0022017-07-01R. BRUCE MCFADDEN, M.D.2019-04-15
0022016-07-01
0022015-07-01
0022014-07-01
0022013-07-01
0022012-07-01R. BRUCE MCFADDEN, M.D.
0022011-07-01DR. R. BRUCE MCFADDEN DR. R. BRUCE MCFADDEN2013-01-29
0022009-07-01R. BRUCE MCFADDEN, M.D.

Plan Statistics for CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN

401k plan membership statisitcs for CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN

Measure Date Value
2019: CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-015
Total number of active participants reported on line 7a of the Form 55002019-07-010
Number of retired or separated participants receiving benefits2019-07-010
Number of other retired or separated participants entitled to future benefits2019-07-010
Total of all active and inactive participants2019-07-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-07-010
Total participants2019-07-010
Number of participants with account balances2019-07-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-07-010
2018: CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year2018-07-017
Total number of active participants reported on line 7a of the Form 55002018-07-012
Number of retired or separated participants receiving benefits2018-07-011
Number of other retired or separated participants entitled to future benefits2018-07-012
Total of all active and inactive participants2018-07-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-07-010
Total participants2018-07-015
Number of participants with account balances2018-07-015
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-07-010
2017: CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-017
Total number of active participants reported on line 7a of the Form 55002017-07-016
Number of retired or separated participants receiving benefits2017-07-010
Number of other retired or separated participants entitled to future benefits2017-07-011
Total of all active and inactive participants2017-07-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-07-010
Total participants2017-07-017
Number of participants with account balances2017-07-016
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-07-010
2016: CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-017
Total number of active participants reported on line 7a of the Form 55002016-07-016
Number of retired or separated participants receiving benefits2016-07-010
Number of other retired or separated participants entitled to future benefits2016-07-011
Total of all active and inactive participants2016-07-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-07-010
Total participants2016-07-017
Number of participants with account balances2016-07-016
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-07-010
2015: CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-016
Total number of active participants reported on line 7a of the Form 55002015-07-015
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-011
Total of all active and inactive participants2015-07-016
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-07-010
Total participants2015-07-016
Number of participants with account balances2015-07-016
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-07-010
2014: CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-016
Total number of active participants reported on line 7a of the Form 55002014-07-015
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-011
Total of all active and inactive participants2014-07-016
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-07-010
Total participants2014-07-016
Number of participants with account balances2014-07-016
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-07-010
2013: CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-016
Total number of active participants reported on line 7a of the Form 55002013-07-015
Number of retired or separated participants receiving benefits2013-07-010
Number of other retired or separated participants entitled to future benefits2013-07-011
Total of all active and inactive participants2013-07-016
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-07-010
Total participants2013-07-016
Number of participants with account balances2013-07-016
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-07-010
2012: CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-07-015
Total number of active participants reported on line 7a of the Form 55002012-07-016
Number of retired or separated participants receiving benefits2012-07-010
Number of other retired or separated participants entitled to future benefits2012-07-010
Total of all active and inactive participants2012-07-016
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-07-010
Total participants2012-07-016
Number of participants with account balances2012-07-016
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-07-010
2011: CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-07-016
Total number of active participants reported on line 7a of the Form 55002011-07-015
Number of retired or separated participants receiving benefits2011-07-010
Number of other retired or separated participants entitled to future benefits2011-07-012
Total of all active and inactive participants2011-07-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-07-010
Total participants2011-07-017
Number of participants with account balances2011-07-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-07-011
2009: CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-07-018
Total number of active participants reported on line 7a of the Form 55002009-07-015
Number of retired or separated participants receiving benefits2009-07-010
Number of other retired or separated participants entitled to future benefits2009-07-012
Total of all active and inactive participants2009-07-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-07-010
Total participants2009-07-017
Number of participants with account balances2009-07-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-07-011

Financial Data on CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN

Measure Date Value
2020 : CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 2020 401k financial data
Expenses. Total of all expenses incurred2020-04-30$1,948,603
Benefits paid (including direct rollovers)2020-04-30$1,948,413
Total plan assets at end of year2020-04-30$0
Total plan assets at beginning of year2020-04-30$1,948,603
Value of fidelity bond covering the plan2020-04-30$180,000
Net income (gross income less expenses)2020-04-30$-1,948,603
Net plan assets at end of year (total assets less liabilities)2020-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2020-04-30$1,948,603
Expenses. Administrative service providers (salaries,fees and commissions)2020-04-30$190
2019 : CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 2019 401k financial data
Transfers to/from the plan2019-06-30$0
Total income from all sources2019-06-30$244,455
Expenses. Total of all expenses incurred2019-06-30$191,543
Benefits paid (including direct rollovers)2019-06-30$191,416
Total plan assets at end of year2019-06-30$1,948,603
Total plan assets at beginning of year2019-06-30$1,895,691
Value of fidelity bond covering the plan2019-06-30$180,000
Total contributions received or receivable from participants2019-06-30$0
Expenses. Other expenses not covered elsewhere2019-06-30$127
Contributions received from other sources (not participants or employers)2019-06-30$0
Other income received2019-06-30$244,455
Noncash contributions received2019-06-30$0
Net income (gross income less expenses)2019-06-30$52,912
Net plan assets at end of year (total assets less liabilities)2019-06-30$1,948,603
Net plan assets at beginning of year (total assets less liabilities)2019-06-30$1,895,691
Assets. Value of participant loans2019-06-30$10,085
Assets. Value of assets in partnership/joint-venture interests2019-06-30$10,000
Total contributions received or receivable from employer(s)2019-06-30$0
Value of certain deemed distributions of participant loans2019-06-30$0
Value of corrective distributions2019-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2019-06-30$0
2017 : CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources2017-06-30$189,755
Expenses. Total of all expenses incurred2017-06-30$106,112
Benefits paid (including direct rollovers)2017-06-30$105,928
Total plan assets at end of year2017-06-30$1,688,832
Total plan assets at beginning of year2017-06-30$1,605,189
Value of fidelity bond covering the plan2017-06-30$180,000
Total contributions received or receivable from participants2017-06-30$0
Contributions received from other sources (not participants or employers)2017-06-30$0
Other income received2017-06-30$189,755
Net income (gross income less expenses)2017-06-30$83,643
Net plan assets at end of year (total assets less liabilities)2017-06-30$1,688,832
Net plan assets at beginning of year (total assets less liabilities)2017-06-30$1,605,189
Assets. Value of participant loans2017-06-30$23,385
Assets. Value of assets in partnership/joint-venture interests2017-06-30$20,000
Total contributions received or receivable from employer(s)2017-06-30$0
Value of certain deemed distributions of participant loans2017-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2017-06-30$184
2016 : CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources2016-06-30$207,320
Expenses. Total of all expenses incurred2016-06-30$86,641
Benefits paid (including direct rollovers)2016-06-30$86,598
Total plan assets at end of year2016-06-30$1,605,189
Total plan assets at beginning of year2016-06-30$1,484,510
Value of fidelity bond covering the plan2016-06-30$180,000
Total contributions received or receivable from participants2016-06-30$0
Contributions received from other sources (not participants or employers)2016-06-30$0
Other income received2016-06-30$135,866
Net income (gross income less expenses)2016-06-30$120,679
Net plan assets at end of year (total assets less liabilities)2016-06-30$1,605,189
Net plan assets at beginning of year (total assets less liabilities)2016-06-30$1,484,510
Assets. Value of participant loans2016-06-30$27,770
Assets. Value of assets in partnership/joint-venture interests2016-06-30$20,000
Total contributions received or receivable from employer(s)2016-06-30$71,454
Value of certain deemed distributions of participant loans2016-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2016-06-30$43
2015 : CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources2015-06-30$195,573
Expenses. Total of all expenses incurred2015-06-30$81,609
Benefits paid (including direct rollovers)2015-06-30$81,560
Total plan assets at end of year2015-06-30$1,484,510
Total plan assets at beginning of year2015-06-30$1,370,546
Value of fidelity bond covering the plan2015-06-30$130,000
Expenses. Other expenses not covered elsewhere2015-06-30$49
Other income received2015-06-30$123,343
Net income (gross income less expenses)2015-06-30$113,964
Net plan assets at end of year (total assets less liabilities)2015-06-30$1,484,510
Net plan assets at beginning of year (total assets less liabilities)2015-06-30$1,370,546
Assets. Value of participant loans2015-06-30$37,145
Assets. Value of assets in partnership/joint-venture interests2015-06-30$20,000
Total contributions received or receivable from employer(s)2015-06-30$72,230
2014 : CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources2014-06-30$237,432
Expenses. Total of all expenses incurred2014-06-30$11,080
Benefits paid (including direct rollovers)2014-06-30$11,000
Total plan assets at end of year2014-06-30$1,370,546
Total plan assets at beginning of year2014-06-30$1,144,194
Value of fidelity bond covering the plan2014-06-30$130,000
Expenses. Other expenses not covered elsewhere2014-06-30$80
Other income received2014-06-30$165,063
Net income (gross income less expenses)2014-06-30$226,352
Net plan assets at end of year (total assets less liabilities)2014-06-30$1,370,546
Net plan assets at beginning of year (total assets less liabilities)2014-06-30$1,144,194
Assets. Value of participant loans2014-06-30$35,320
Assets. Value of assets in partnership/joint-venture interests2014-06-30$20,000
Total contributions received or receivable from employer(s)2014-06-30$72,369
2013 : CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources2013-06-30$284,637
Expenses. Total of all expenses incurred2013-06-30$83,971
Benefits paid (including direct rollovers)2013-06-30$80,016
Total plan assets at end of year2013-06-30$1,144,194
Total plan assets at beginning of year2013-06-30$943,528
Value of fidelity bond covering the plan2013-06-30$130,000
Expenses. Other expenses not covered elsewhere2013-06-30$3,955
Other income received2013-06-30$221,774
Net income (gross income less expenses)2013-06-30$200,666
Net plan assets at end of year (total assets less liabilities)2013-06-30$1,144,194
Net plan assets at beginning of year (total assets less liabilities)2013-06-30$943,528
Assets. Value of participant loans2013-06-30$47,335
Assets. Value of assets in partnership/joint-venture interests2013-06-30$20,000
Total contributions received or receivable from employer(s)2013-06-30$62,863
2012 : CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources2012-06-30$11,892
Expenses. Total of all expenses incurred2012-06-30$34,674
Benefits paid (including direct rollovers)2012-06-30$34,033
Total plan assets at end of year2012-06-30$943,528
Total plan assets at beginning of year2012-06-30$966,310
Value of fidelity bond covering the plan2012-06-30$130,000
Expenses. Other expenses not covered elsewhere2012-06-30$641
Other income received2012-06-30$-20,478
Net income (gross income less expenses)2012-06-30$-22,782
Net plan assets at end of year (total assets less liabilities)2012-06-30$943,528
Net plan assets at beginning of year (total assets less liabilities)2012-06-30$966,310
Assets. Value of participant loans2012-06-30$58,567
Assets. Value of assets in partnership/joint-venture interests2012-06-30$20,000
Total contributions received or receivable from employer(s)2012-06-30$32,370
2011 : CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 2011 401k financial data
Total plan liabilities at beginning of year2011-06-30$0
Total income from all sources2011-06-30$219,516
Expenses. Total of all expenses incurred2011-06-30$43,295
Benefits paid (including direct rollovers)2011-06-30$42,475
Total plan assets at end of year2011-06-30$966,310
Total plan assets at beginning of year2011-06-30$790,089
Value of fidelity bond covering the plan2011-06-30$130,000
Other income received2011-06-30$156,792
Net income (gross income less expenses)2011-06-30$176,221
Net plan assets at end of year (total assets less liabilities)2011-06-30$966,310
Net plan assets at beginning of year (total assets less liabilities)2011-06-30$790,089
Assets. Value of participant loans2011-06-30$88,889
Assets. Value of assets in partnership/joint-venture interests2011-06-30$20,000
Total contributions received or receivable from employer(s)2011-06-30$62,724
Expenses. Administrative service providers (salaries,fees and commissions)2011-06-30$820

Form 5500 Responses for CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN

2019: CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01This submission is the final filingYes
2019-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan funding arrangement – TrustYes
2019-07-01Plan benefit arrangement – InsuranceYes
2019-07-01Plan benefit arrangement - TrustYes
2018: CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan funding arrangement – TrustYes
2018-07-01Plan benefit arrangement – InsuranceYes
2018-07-01Plan benefit arrangement - TrustYes
2017: CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan funding arrangement – TrustYes
2017-07-01Plan benefit arrangement – InsuranceYes
2017-07-01Plan benefit arrangement - TrustYes
2016: CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan funding arrangement – TrustYes
2016-07-01Plan benefit arrangement – InsuranceYes
2016-07-01Plan benefit arrangement - TrustYes
2015: CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan funding arrangement – TrustYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-07-01Plan benefit arrangement - TrustYes
2014: CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan funding arrangement – TrustYes
2014-07-01Plan benefit arrangement – InsuranceYes
2014-07-01Plan benefit arrangement - TrustYes
2013: CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan funding arrangement – TrustYes
2013-07-01Plan benefit arrangement – InsuranceYes
2013-07-01Plan benefit arrangement - TrustYes
2012: CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan funding arrangement – TrustYes
2012-07-01Plan benefit arrangement – InsuranceYes
2012-07-01Plan benefit arrangement - TrustYes
2011: CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan funding arrangement – TrustYes
2011-07-01Plan benefit arrangement – InsuranceYes
2011-07-01Plan benefit arrangement - TrustYes
2009: CARDIOVASCULAR PULMONARY MEDICAL GROUP, INC. PROFIT SHARING PLAN 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan funding arrangement – TrustYes
2009-07-01Plan benefit arrangement – InsuranceYes
2009-07-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

MONY LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 66370 )
Policy contract number11112455
Policy instance 1
Insurance contract or identification number11112455
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
MONY LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 66370 )
Policy contract number11112455
Policy instance 1
Insurance contract or identification number11112455
Number of Individuals Covered1
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MONY LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 66370 )
Policy contract number11112455
Policy instance 1
Insurance contract or identification number11112455
Number of Individuals Covered1
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MONY LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 66370 )
Policy contract number11112455
Policy instance 1
Insurance contract or identification number11112455
Number of Individuals Covered1
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Are there contracts with allocated funds for individual policies?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MONY LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 66370 )
Policy contract number11112455
Policy instance 1
Insurance contract or identification number11112455
Number of Individuals Covered1
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Are there contracts with allocated funds for individual policies?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MONY LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 66370 )
Policy contract number11112455
Policy instance 1
Insurance contract or identification number11112455
Number of Individuals Covered1
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MONY LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 66370 )
Policy contract number11112455
Policy instance 1
Insurance contract or identification number11112455
Number of Individuals Covered1
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MONY LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 66370 )
Policy contract number11112455
Policy instance 1
Insurance contract or identification number11112455
Number of Individuals Covered1
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MONY LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 66370 )
Policy contract number11112455
Policy instance 1
Insurance contract or identification number11112455
Number of Individuals Covered1
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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