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CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 401k Plan overview

Plan NameCARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003)
Plan identification number 028

CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • 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.
  • 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.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Plan covering Self-Employed individuals.
  • 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.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).
  • Life insurance

401k Sponsoring company profile

CARLSMITH BALL LLP, A LLLP LLP has sponsored the creation of one or more 401k plans.

Company Name:CARLSMITH BALL LLP, A LLLP LLP
Employer identification number (EIN):990035220
NAIC Classification:541110
NAIC Description:Offices of Lawyers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003)

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0282022-07-01JOHN C. KHIL2024-03-19
0282021-07-01JOHN C. KHIL2023-03-28
0282020-07-01
0282019-07-01
0282018-07-01
0282017-07-01
0282016-07-01JOHN C. KHIL
0282015-07-01JOHN C. KHIL JOHN C. KHIL2017-04-11
0282014-07-01JOHN C. KHIL JOHN C. KHIL2016-04-14
0282013-07-01JOHN C. KHIL
0282012-07-01JON SHIGEMITSU, RET. PLAN COMMITTEE JON SHIGEMITSU, RET. PLAN COMMITTEE2014-04-15
0282011-07-01JON SHIGEMITSU, RET. PLAN COMMITTEE JON SHIGEMITSU, RET. PLAN COMMITTEE2013-04-09
0282010-07-01JON SHIGEMITSU, RET. PLAN COMMITTEE
0282009-07-01JON SHIGEMITSU, RET. PLAN COMMITTEE

Plan Statistics for CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003)

401k plan membership statisitcs for CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003)

Measure Date Value
2020: CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 2020 401k membership
Total participants, beginning-of-year2020-07-0145
Total number of active participants reported on line 7a of the Form 55002020-07-0127
Number of retired or separated participants receiving benefits2020-07-011
Number of other retired or separated participants entitled to future benefits2020-07-0115
Total of all active and inactive participants2020-07-0143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-07-010
Total participants2020-07-0143
Number of participants with account balances2020-07-0143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-07-010
2019: CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 2019 401k membership
Total participants, beginning-of-year2019-07-0150
Total number of active participants reported on line 7a of the Form 55002019-07-0129
Number of retired or separated participants receiving benefits2019-07-010
Number of other retired or separated participants entitled to future benefits2019-07-0117
Total of all active and inactive participants2019-07-0146
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-07-010
Total participants2019-07-0146
Number of participants with account balances2019-07-0146
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-07-010
2018: CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 2018 401k membership
Total participants, beginning-of-year2018-07-0151
Total number of active participants reported on line 7a of the Form 55002018-07-0133
Number of retired or separated participants receiving benefits2018-07-010
Number of other retired or separated participants entitled to future benefits2018-07-0115
Total of all active and inactive participants2018-07-0148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-07-010
Total participants2018-07-0148
Number of participants with account balances2018-07-0148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-07-011
2017: CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 2017 401k membership
Total participants, beginning-of-year2017-07-0155
Total number of active participants reported on line 7a of the Form 55002017-07-0136
Number of retired or separated participants receiving benefits2017-07-010
Number of other retired or separated participants entitled to future benefits2017-07-0114
Total of all active and inactive participants2017-07-0150
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-07-011
Total participants2017-07-0151
Number of participants with account balances2017-07-0148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-07-010
2016: CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 2016 401k membership
Total participants, beginning-of-year2016-07-0155
Total number of active participants reported on line 7a of the Form 55002016-07-0137
Number of retired or separated participants receiving benefits2016-07-0112
Number of other retired or separated participants entitled to future benefits2016-07-010
Total of all active and inactive participants2016-07-0149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-07-010
Total participants2016-07-0149
Number of participants with account balances2016-07-0149
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-07-010
2015: CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 2015 401k membership
Total participants, beginning-of-year2015-07-0161
Total number of active participants reported on line 7a of the Form 55002015-07-0142
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-0112
Total of all active and inactive participants2015-07-0154
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-07-010
Total participants2015-07-0154
Number of participants with account balances2015-07-0153
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-07-010
2014: CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 2014 401k membership
Total participants, beginning-of-year2014-07-0164
Total number of active participants reported on line 7a of the Form 55002014-07-0148
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-0112
Total of all active and inactive participants2014-07-0160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-07-010
Total participants2014-07-0160
Number of participants with account balances2014-07-0160
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-07-010
2013: CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 2013 401k membership
Total participants, beginning-of-year2013-07-0166
Total number of active participants reported on line 7a of the Form 55002013-07-0147
Number of other retired or separated participants entitled to future benefits2013-07-0113
Total of all active and inactive participants2013-07-0160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-07-010
Total participants2013-07-0160
Number of participants with account balances2013-07-0159
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-07-010
2012: CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 2012 401k membership
Total participants, beginning-of-year2012-07-0168
Total number of active participants reported on line 7a of the Form 55002012-07-0147
Number of retired or separated participants receiving benefits2012-07-011
Number of other retired or separated participants entitled to future benefits2012-07-0115
Total of all active and inactive participants2012-07-0163
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-07-011
Total participants2012-07-0164
Number of participants with account balances2012-07-0163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-07-010
2011: CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 2011 401k membership
Total participants, beginning-of-year2011-07-0171
Total number of active participants reported on line 7a of the Form 55002011-07-0151
Number of retired or separated participants receiving benefits2011-07-010
Number of other retired or separated participants entitled to future benefits2011-07-0117
Total of all active and inactive participants2011-07-0168
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-07-010
Total participants2011-07-0168
Number of participants with account balances2011-07-0168
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-07-011
2010: CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 2010 401k membership
Total participants, beginning-of-year2010-07-0168
Total number of active participants reported on line 7a of the Form 55002010-07-0151
Number of retired or separated participants receiving benefits2010-07-010
Number of other retired or separated participants entitled to future benefits2010-07-0114
Total of all active and inactive participants2010-07-0165
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-07-010
Total participants2010-07-0165
Number of participants with account balances2010-07-0164
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-07-011
2009: CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 2009 401k membership
Total participants, beginning-of-year2009-07-0175
Total number of active participants reported on line 7a of the Form 55002009-07-0159
Number of retired or separated participants receiving benefits2009-07-010
Number of other retired or separated participants entitled to future benefits2009-07-0111
Total of all active and inactive participants2009-07-0170
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-07-010
Total participants2009-07-0170
Number of participants with account balances2009-07-0167
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-07-010

Financial Data on CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003)

Measure Date Value
2021 : CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 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$9,404,529
Expenses. Total of all expenses incurred2021-06-30$3,196,849
Benefits paid (including direct rollovers)2021-06-30$3,104,887
Total plan assets at end of year2021-06-30$43,149,534
Total plan assets at beginning of year2021-06-30$36,941,854
Value of fidelity bond covering the plan2021-06-30$500,000
Total contributions received or receivable from participants2021-06-30$352,068
Expenses. Other expenses not covered elsewhere2021-06-30$5,587
Contributions received from other sources (not participants or employers)2021-06-30$0
Other income received2021-06-30$8,521,603
Noncash contributions received2021-06-30$0
Net income (gross income less expenses)2021-06-30$6,207,680
Net plan assets at end of year (total assets less liabilities)2021-06-30$43,149,534
Net plan assets at beginning of year (total assets less liabilities)2021-06-30$36,941,854
Assets. Value of participant loans2021-06-30$152,172
Total contributions received or receivable from employer(s)2021-06-30$530,858
Value of certain deemed distributions of participant loans2021-06-30$0
Value of corrective distributions2021-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2021-06-30$86,375
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-06-30$0
2020 : CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 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$1,514,344
Expenses. Total of all expenses incurred2020-06-30$4,230,741
Benefits paid (including direct rollovers)2020-06-30$4,145,101
Total plan assets at end of year2020-06-30$36,941,854
Total plan assets at beginning of year2020-06-30$39,658,251
Value of fidelity bond covering the plan2020-06-30$500,000
Total contributions received or receivable from participants2020-06-30$351,751
Expenses. Other expenses not covered elsewhere2020-06-30$5,453
Contributions received from other sources (not participants or employers)2020-06-30$46,363
Other income received2020-06-30$999,174
Noncash contributions received2020-06-30$0
Net income (gross income less expenses)2020-06-30$-2,716,397
Net plan assets at end of year (total assets less liabilities)2020-06-30$36,941,854
Net plan assets at beginning of year (total assets less liabilities)2020-06-30$39,658,251
Assets. Value of participant loans2020-06-30$131,435
Total contributions received or receivable from employer(s)2020-06-30$117,056
Value of certain deemed distributions of participant loans2020-06-30$0
Value of corrective distributions2020-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2020-06-30$80,187
2019 : CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 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$3,324,747
Expenses. Total of all expenses incurred2019-06-30$3,251,212
Benefits paid (including direct rollovers)2019-06-30$3,156,404
Total plan assets at end of year2019-06-30$39,658,251
Total plan assets at beginning of year2019-06-30$39,584,716
Value of fidelity bond covering the plan2019-06-30$500,000
Total contributions received or receivable from participants2019-06-30$336,701
Expenses. Other expenses not covered elsewhere2019-06-30$5,448
Contributions received from other sources (not participants or employers)2019-06-30$0
Other income received2019-06-30$1,971,638
Noncash contributions received2019-06-30$0
Net income (gross income less expenses)2019-06-30$73,535
Net plan assets at end of year (total assets less liabilities)2019-06-30$39,658,251
Net plan assets at beginning of year (total assets less liabilities)2019-06-30$39,584,716
Assets. Value of participant loans2019-06-30$92,616
Total contributions received or receivable from employer(s)2019-06-30$1,016,408
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$89,360
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-06-30$0
2018 : CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 2018 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-06-30$0
2017 : CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 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$5,006,241
Expenses. Total of all expenses incurred2017-06-30$3,575,750
Benefits paid (including direct rollovers)2017-06-30$3,468,195
Total plan assets at end of year2017-06-30$36,034,734
Total plan assets at beginning of year2017-06-30$34,604,243
Value of fidelity bond covering the plan2017-06-30$500,000
Total contributions received or receivable from participants2017-06-30$380,343
Expenses. Other expenses not covered elsewhere2017-06-30$5,834
Contributions received from other sources (not participants or employers)2017-06-30$0
Other income received2017-06-30$3,653,693
Noncash contributions received2017-06-30$0
Net income (gross income less expenses)2017-06-30$1,430,491
Net plan assets at end of year (total assets less liabilities)2017-06-30$36,034,734
Net plan assets at beginning of year (total assets less liabilities)2017-06-30$34,604,243
Assets. Value of participant loans2017-06-30$108,846
Total contributions received or receivable from employer(s)2017-06-30$972,205
Value of certain deemed distributions of participant loans2017-06-30$0
Value of corrective distributions2017-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2017-06-30$101,721
2016 : CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 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$1,660,952
Expenses. Total of all expenses incurred2016-06-30$1,512,381
Benefits paid (including direct rollovers)2016-06-30$1,402,896
Total plan assets at end of year2016-06-30$34,604,243
Total plan assets at beginning of year2016-06-30$34,455,672
Value of fidelity bond covering the plan2016-06-30$500,000
Total contributions received or receivable from participants2016-06-30$431,562
Expenses. Other expenses not covered elsewhere2016-06-30$6,074
Contributions received from other sources (not participants or employers)2016-06-30$0
Other income received2016-06-30$219,416
Noncash contributions received2016-06-30$0
Net income (gross income less expenses)2016-06-30$148,571
Net plan assets at end of year (total assets less liabilities)2016-06-30$34,604,243
Net plan assets at beginning of year (total assets less liabilities)2016-06-30$34,455,672
Assets. Value of participant loans2016-06-30$165,084
Assets. Value of assets in partnership/joint-venture interests2016-06-30$0
Assets. Value of real-estate (other than employer real property)2016-06-30$0
Assets. Value of employer securities2016-06-30$0
Assets. Value of employer real property2016-06-30$0
Total contributions received or receivable from employer(s)2016-06-30$1,009,974
Value of certain deemed distributions of participant loans2016-06-30$0
Value of corrective distributions2016-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2016-06-30$103,411
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-06-30$0
2015 : CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 2015 401k financial data
Transfers to/from the plan2015-06-30$1,230,649
Total plan liabilities at end of year2015-06-30$0
Total plan liabilities at beginning of year2015-06-30$0
Total income from all sources2015-06-30$1,994,155
Expenses. Total of all expenses incurred2015-06-30$6,094,706
Benefits paid (including direct rollovers)2015-06-30$5,947,087
Total plan assets at end of year2015-06-30$34,455,672
Total plan assets at beginning of year2015-06-30$37,325,574
Value of fidelity bond covering the plan2015-06-30$500,000
Total contributions received or receivable from participants2015-06-30$424,173
Expenses. Other expenses not covered elsewhere2015-06-30$6,069
Contributions received from other sources (not participants or employers)2015-06-30$0
Other income received2015-06-30$573,812
Noncash contributions received2015-06-30$0
Net income (gross income less expenses)2015-06-30$-4,100,551
Net plan assets at end of year (total assets less liabilities)2015-06-30$34,455,672
Net plan assets at beginning of year (total assets less liabilities)2015-06-30$37,325,574
Assets. Value of participant loans2015-06-30$282,166
Total contributions received or receivable from employer(s)2015-06-30$996,170
Value of certain deemed distributions of participant loans2015-06-30$0
Value of corrective distributions2015-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2015-06-30$141,550
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-06-30$0
2014 : CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 2014 401k financial data
Transfers to/from the plan2014-06-30$0
Total plan liabilities at end of year2014-06-30$0
Total plan liabilities at beginning of year2014-06-30$0
Total income from all sources2014-06-30$6,224,750
Expenses. Total of all expenses incurred2014-06-30$3,543,023
Benefits paid (including direct rollovers)2014-06-30$3,385,317
Total plan assets at end of year2014-06-30$37,325,574
Total plan assets at beginning of year2014-06-30$34,643,847
Value of fidelity bond covering the plan2014-06-30$500,000
Total contributions received or receivable from participants2014-06-30$380,930
Expenses. Other expenses not covered elsewhere2014-06-30$5,499
Contributions received from other sources (not participants or employers)2014-06-30$0
Other income received2014-06-30$4,735,713
Noncash contributions received2014-06-30$0
Net income (gross income less expenses)2014-06-30$2,681,727
Net plan assets at end of year (total assets less liabilities)2014-06-30$37,325,574
Net plan assets at beginning of year (total assets less liabilities)2014-06-30$34,643,847
Assets. Value of participant loans2014-06-30$143,268
Total contributions received or receivable from employer(s)2014-06-30$1,108,107
Value of certain deemed distributions of participant loans2014-06-30$0
Value of corrective distributions2014-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2014-06-30$152,207
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-06-30$0
2013 : CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 2013 401k financial data
Transfers to/from the plan2013-06-30$18,571
Total plan liabilities at end of year2013-06-30$0
Total plan liabilities at beginning of year2013-06-30$0
Total income from all sources2013-06-30$4,762,655
Expenses. Total of all expenses incurred2013-06-30$4,869,200
Benefits paid (including direct rollovers)2013-06-30$4,702,693
Total plan assets at end of year2013-06-30$34,643,847
Total plan assets at beginning of year2013-06-30$34,731,821
Value of fidelity bond covering the plan2013-06-30$500,000
Total contributions received or receivable from participants2013-06-30$415,551
Expenses. Other expenses not covered elsewhere2013-06-30$9,057
Contributions received from other sources (not participants or employers)2013-06-30$0
Other income received2013-06-30$3,172,342
Noncash contributions received2013-06-30$0
Net income (gross income less expenses)2013-06-30$-106,545
Net plan assets at end of year (total assets less liabilities)2013-06-30$34,643,847
Net plan assets at beginning of year (total assets less liabilities)2013-06-30$34,731,821
Assets. Value of participant loans2013-06-30$144,660
Assets. Value of assets in partnership/joint-venture interests2013-06-30$39,351
Total contributions received or receivable from employer(s)2013-06-30$1,174,762
Value of certain deemed distributions of participant loans2013-06-30$0
Value of corrective distributions2013-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2013-06-30$157,450
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-06-30$0
2012 : CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 2012 401k financial data
Transfers to/from the plan2012-06-30$0
Total plan liabilities at end of year2012-06-30$0
Total plan liabilities at beginning of year2012-06-30$0
Total income from all sources2012-06-30$2,471,324
Expenses. Total of all expenses incurred2012-06-30$1,016,188
Benefits paid (including direct rollovers)2012-06-30$818,484
Total plan assets at end of year2012-06-30$34,731,821
Total plan assets at beginning of year2012-06-30$33,276,685
Value of fidelity bond covering the plan2012-06-30$500,000
Total contributions received or receivable from participants2012-06-30$424,080
Expenses. Other expenses not covered elsewhere2012-06-30$7,326
Contributions received from other sources (not participants or employers)2012-06-30$0
Other income received2012-06-30$1,057,107
Noncash contributions received2012-06-30$0
Net income (gross income less expenses)2012-06-30$1,455,136
Net plan assets at end of year (total assets less liabilities)2012-06-30$34,731,821
Net plan assets at beginning of year (total assets less liabilities)2012-06-30$33,276,685
Assets. Value of participant loans2012-06-30$161,005
Assets. Value of assets in partnership/joint-venture interests2012-06-30$38,223
Total contributions received or receivable from employer(s)2012-06-30$990,137
Value of certain deemed distributions of participant loans2012-06-30$0
Value of corrective distributions2012-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2012-06-30$190,378
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-06-30$0
2011 : CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 2011 401k financial data
Transfers to/from the plan2011-06-30$0
Total plan liabilities at end of year2011-06-30$0
Total plan liabilities at beginning of year2011-06-30$0
Total income from all sources2011-06-30$6,433,511
Expenses. Total of all expenses incurred2011-06-30$605,875
Benefits paid (including direct rollovers)2011-06-30$418,760
Total plan assets at end of year2011-06-30$33,276,685
Total plan assets at beginning of year2011-06-30$27,449,049
Value of fidelity bond covering the plan2011-06-30$500,000
Total contributions received or receivable from participants2011-06-30$435,055
Expenses. Other expenses not covered elsewhere2011-06-30$10,732
Contributions received from other sources (not participants or employers)2011-06-30$0
Other income received2011-06-30$4,545,902
Noncash contributions received2011-06-30$0
Net income (gross income less expenses)2011-06-30$5,827,636
Net plan assets at end of year (total assets less liabilities)2011-06-30$33,276,685
Net plan assets at beginning of year (total assets less liabilities)2011-06-30$27,449,049
Assets. Value of participant loans2011-06-30$225,958
Assets. Value of assets in partnership/joint-venture interests2011-06-30$45,885
Total contributions received or receivable from employer(s)2011-06-30$1,452,554
Value of certain deemed distributions of participant loans2011-06-30$0
Value of corrective distributions2011-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2011-06-30$176,383
2010 : CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-06-30$0

Form 5500 Responses for CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003)

2020: CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – TrustYes
2020-07-01Plan benefit arrangement – InsuranceYes
2020-07-01Plan benefit arrangement - TrustYes
2019: CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
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: CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 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: CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 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: CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 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: CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 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 funding arrangement – TrustYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-07-01Plan benefit arrangement - TrustYes
2014: CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 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 funding arrangement – TrustYes
2014-07-01Plan benefit arrangement – InsuranceYes
2014-07-01Plan benefit arrangement - TrustYes
2013: CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
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: CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
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: CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 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
2010: CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 2010 form 5500 responses
2010-07-01Type of plan entitySingle employer plan
2010-07-01Submission has been amendedNo
2010-07-01This submission is the final filingNo
2010-07-01This return/report is a short plan year return/report (less than 12 months)No
2010-07-01Plan is a collectively bargained planNo
2010-07-01Plan funding arrangement – InsuranceYes
2010-07-01Plan funding arrangement – TrustYes
2010-07-01Plan benefit arrangement – InsuranceYes
2010-07-01Plan benefit arrangement - TrustYes
2009: CARLSMITH BALL LLP 401(K) PROFIT SHARING PLAN (003) 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

HARTFORD LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71153 )
Policy contract numberU01954291
Policy instance 2
Insurance contract or identification numberU01954291
Number of Individuals Covered1
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $106
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,278
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number892740087
Policy instance 1
Insurance contract or identification number892740087
Number of Individuals Covered19
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number892740087
Policy instance 1
Insurance contract or identification number892740087
Number of Individuals Covered39
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 $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71153 )
Policy contract numberU01954291
Policy instance 2
Insurance contract or identification numberU01954291
Number of Individuals Covered1
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $106
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,278
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $106
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number892740087
Policy instance 1
Insurance contract or identification number892740087
Number of Individuals Covered41
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Are there contracts with allocated funds for types other than group deferred annuity or individual?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractGIC
HARTFORD LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71153 )
Policy contract numberU01954291
Policy instance 2
Insurance contract or identification numberU01954291
Number of Individuals Covered1
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $106
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,278
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $106
Insurance broker organization code?3
HARTFORD LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71153 )
Policy contract numberU01954291
Policy instance 2
Insurance contract or identification numberU01954291
Number of Individuals Covered1
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $106
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,278
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number892740087
Policy instance 1
Insurance contract or identification number892740087
Number of Individuals Covered40
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 $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number892740087
Policy instance 1
Insurance contract or identification number892740087
Number of Individuals Covered44
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 $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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71153 )
Policy contract number102U01954291
Policy instance 2
Insurance contract or identification number102U01954291
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $106
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 BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $5,278
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $106
Insurance broker organization code?3
Insurance broker nameJODI LAM
HARTFORD LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71153 )
Policy contract number102U01954291
Policy instance 2
Insurance contract or identification number102U01954291
Number of Individuals Covered1
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $105
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 BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $5,278
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $105
Insurance broker organization code?3
Insurance broker nameJODI LAM
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number892740087
Policy instance 1
Insurance contract or identification number892740087
Number of Individuals Covered50
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 $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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE & ANNUITY (National Association of Insurance Commissioners NAIC id number: 71153 )
Policy contract number102U01954291
Policy instance 2
Insurance contract or identification number102U01954291
Number of Individuals Covered1
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $106
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 BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $5,278
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $106
Insurance broker organization code?3
Insurance broker nameJODI LAM
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number892740087
Policy instance 1
Insurance contract or identification number892740087
Number of Individuals Covered47
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?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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number892740087
Policy instance 1
Insurance contract or identification number892740087
Number of Individuals Covered50
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
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE & ANNUITY (National Association of Insurance Commissioners NAIC id number: 71153 )
Policy contract number102U01954291
Policy instance 2
Insurance contract or identification number102U01954291
Number of Individuals Covered1
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $106
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 BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $5,278
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $106
Insurance broker organization code?3
Insurance broker nameJODI LAM
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number892740087
Policy instance 2
Insurance contract or identification number892740087
Number of Individuals Covered16
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
HARTFORD LIFE & ANNUITY (National Association of Insurance Commissioners NAIC id number: 71153 )
Policy contract number102U01954291
Policy instance 1
Insurance contract or identification number102U01954291
Number of Individuals Covered1
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $106
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 BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $5,278
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract numberSC2250180D
Policy instance 2
Insurance contract or identification numberSC2250180D
Number of Individuals Covered1
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $12
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 BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $680
HARTFORD LIFE & ANNUITY (National Association of Insurance Commissioners NAIC id number: 71153 )
Policy contract numberU01954291
Policy instance 1
Insurance contract or identification numberU01954291
Number of Individuals Covered1
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $9,774
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 BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $34,278
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number892726-0087
Policy instance 3
Insurance contract or identification number892726-0087
Number of Individuals Covered16
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No

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