Back to top
FORM 5500 DATA

Rehabilitation Institute of Chicago d/b/a Shirley Ryan AbilityLab 403(b) Retirement Plan

Overview

Plan Information

  • Plan Year01/01/2018 — 12/31/2018
  • Date of Plan01/01/2000
  • Net Assets as of 12/31/2018 $38,240,377
  • Plan Number2
  • Plan Type Single Employer
  • Is the plan collectively bargained? No
  • Did the plan file for an extension of time or the DFVC Program?Yes
  • Plan Funding ArrangementInsurance Trust
  • Plan Benefit ArrangementInsurance Trust

Participant Information as of 12/31/2018

  • Active (Eligible) Participants647
  • Retired or separated participants receiving benefits2
  • Other retired or separated participants entitled to future benefits130
  • Subtotal779
  • Deceased participants whose beneficiaries are receiving or are entitled to receive benefits1
  • Total780
  • Total number of participants as of 01/01/2018776
  • Number of participants with account balances551
  • Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested0

Expenses

  • Total Benefit Payments$0
  • Corrective Distributions$0
  • Administrative Service Providers$0
  • Other Expenses$0
  • Total Expenses$0
  • Total Transfers$0

Sponsor Information

  • Address355 E. Erie Street
  • CityChicago
  • StateIL
  • Zip60611
  • Telephone(312) 238-1000
  • EIN36-2256036
  • Industry Code622000
  • Named AdministratorNancy Paridy
  • Named Plan SponsorJonathan Tingstad

Audit Information

  • Audit StatusAudited
  • AuditorCrowe LLP
  • Auditor EIN35-0921680
  • Audit Opinion Disclaimer
  • Audit TypeLimited Scope Audit

Benefits Provided Under the Plan

Code Benefit Description
2F ERISA section 404(c) Plan This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
2G 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.
2L Code section 403(b)(1) arrangement A 403(b) plan, also known as a tax-sheltered annuity (TSA) plan, is a retirement plan for certain employees of public schools, employees of certain tax-exempt organizations, and certain ministers.

Questions and Answers

Question Answer Amount
During the plan year did the employer fail to transmit to the plan any participant contributions within the time period described in 29 CFT 2510.3-102? Yes $108,417
Were any loans by the plan or fixed income obligations due the plan in default as of the close of plan year or classified during the year as uncollectible? Disregard participant loans secured by participant's account balance. No
Were any leases to which the plan was a party in default or classified during the year as uncollectible? No
Were there any nonexempt transactions with any party-in-interest? No
Was this plan covered by a fidelity bond? Yes $500,000
Did the plan have a loss, whether or not reimbursed by the plan's fidelity bond, that was caused by fraud or dishonesty? No
Did the plan hold any assets whose current value was neither readily determinable on an established market nor set by an independent third party appraiser? No
Did the plan receive any noncash contributions whose value was neither readily determinable on an established market nor set by an independent third party appraiser? No
Did the plan have assets held for investment? Yes
Were any plan transactions or series of transactions in excess of 5% of the current value of plan assets? No
Were all the plan assets either distributed to participants or beneficiaries, transferred to another plan, or brought under the control of the PBGC? No
Has the plan failed to provide any benefit when due under the plan? No
If this is an individual account plan, was there a blackout period? Yes
If there was a blackout period, have you either provided the required notice or one of the exceptions to providing the notice applied under 29 CFR 2520.101-3? Yes

Financials

Income and Expense Statement

Income $687,827
Contributions $2,308,733
Cash Contributions $2,308,733
Cash from Employers $0
Cash from Participants $1,848,812
Others (including rollovers) $459,921
Noncash Contributions $0
Total Earnings on Investments $-832,214
Total Interest $150,649
Interest-Bearing Cash $1,130
U.S. Government Securities $0
Corporate Debt Instruments $0
Loans (other than to participants) $0
Participant Loans $0
Interest from Other Investments $149,519
Total Dividends $745,911
Preferred Stock $0
Common Stock $0
Rents $0
Net gain (loss) on sale of assets $0
Aggregate Proceeds $0
Aggregate Carrying Amount $0
Total Unrealized Appreciation (depreciation) of assets $0
Real Estate $0
Other $0
Net investment gain (loss) from common/collective trusts $0
Net investment gain (loss) from pooled separate accounts $-370,856
Net investment gain (loss) from master trust investment accounts $0
Net investment gain (loss) from 103-12 investment entities $0
Net investment gain (loss) from registered investment companies $-1,357,918
Other Income $-788,692
Expenses $4,809,305
Total Benefit Payments $4,800,095
Directly to participants or beneficiaries, including direct rollovers $4,800,095
To insurance carriers for the provision of benefits $0
Other Benefit Payment Fees $0
Corrective Distributions $0
Certain deemed distributions of participant loans $0
Interest expense $0
Total Administrative Expenses $9,210
Professional Fees $0
Contract Administrator Fees $0
Investment Advisory and management fees $0
Other Administrative Fees $9,210
Net Income $-4,121,478
Transfers of Assets to this Plan $0
Transfers of Assets from this Plan $0

Asset and Liability Statement

12/31/2018 12/31/2017 Change YOY
Total Assets $38,240,377 $42,361,855 -9.73%
Total noninterest-bearing cash $127 $125 1.60%
Receivables $46,132 $0 0.0%
Employer Contributions $0 $0 0.0%
Participant Contributions $46,132 $0 0.0%
Other Contributions $0 $0 0.0%
General Investments $879,933 $182,439 382.32%
Interest-bearing cash $879,933 $182,439 382.32%
U.S. Government Securities $0 $0 0.0%
Corporate Debt Instruments $0 $0 0.0%
Preferred $0 $0 0.0%
All Other $0 $0 0.0%
Corporate Stocks $0 $0 0.0%
Preferred $0 $0 0.0%
Common $0 $0 0.0%
Partnership/joint venture interests $0 $0 0.0%
Real estate (other than employer real property) $0 $0 0.0%
Loans (other than to participants) $0 $0 0.0%
Participants Loans $0 $0 0.0%
Value of interest in common/collective trusts $0 $0 0.0%
Value of interest in pooled separate accounts $7,672,852 $6,322,230 21.36%
Value of interest in master trust investment accounts $0 $0 0.0%
Value of interest in 103-12 investment entities $0 $0 0.0%
Value of interest in registered investment companies $15,716,866 $20,088,539 -21.76%
Value of funds held in insurance co. general account $4,311,395 $5,171,147 -16.63%
Other Investments $9,613,072 $10,597,375 -9.29%
Employer-related Investments $0 $0 0.0%
Employer Securities $0 $0 0.0%
Employer Real Property $0 $0 0.0%
Buildings and other property used in plan operation $0 $0 0.0%
Total Liabilities $0 $0 0.0%
Benefit Claims Payable (1) $0 $0 0.0%
Operating Payables (1) $0 $0 0.0%
Acquisition Indebtedness (1) $0 $0 0.0%
Other liabilities (1) $0 $0 0.0%
Net Assets $38,240,377 $42,361,855 -9.73%

Service Providers

Persons Receiving Only Eligible Indirect Compensation

  • TIAA

Other Service Providers Receiving Direct or Indirect Compensation

Name Nature of Service Relationship to Plan Sponsor Direct Compensation Paid by Plan Indirect Compensation Paid by Plan Total Compensation
American United Life Insurance Co Recordkeeping and information management (computing, tabulating, data processing, etc.), Direct payment from the plan, Recordkeeping fees, Investment management fees paid indirectly by plan, Shareholder servicing fees, Sub-transfer agency fees, Distribution (12b-1) fees, Insurance mortality and expense charge, Other insurance wrap fees, Participant communication NONE $1,305 $19,333 $20,638
Principal Life Insurance Company Recordkeeping and information management (computing, tabulating, data processing, etc.), Direct payment from the plan NONE $4,405 $0 $4,405
Transamerica Retirement Solutions Claims processing, Recordkeeping and information management (computing, tabulating, data processing, etc.), Investment management, Participant loan processing, Participant communication, Direct payment from the plan, Sales loads (front end and deferred), Shareholder servicing fees, Finders' fees/placement fees, Float revenue, Distribution (12b-1) fees, Recordkeeping fees, Account maintenance fees NONE $2,555 $0 $2,555
The Prudential Ins Co of America Claims processing, Recordkeeping and information management (computing, tabulating, data processing, etc.), Investment management, Participant loan processing, Participant communication, Direct payment from the plan, Sales loads (front end and deferred), Shareholder servicing fees, Distribution (12b-1) fees, Recordkeeping fees, Account maintenance fees NONE $945 $0 $945
Total $9,210 $19,333 $28,543

Indirect Compensation

Name Source of Indirect Compensation* Nature of Service Description of Indirect Compensation Indirect Compensation Paid by Plan
American United Life Insurance Co American United Life Insurance Co Insurance mortality and expense charge, Other insurance wrap fees Asset Charge $19,333
American United Life Insurance Co Amercent Heritage Inv Distribution (12b-1) fees, Sub-transfer agency fees, Shareholder servicing fees, Investment management fees paid indirectly by plan .35 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Allianzgi Nfj Dividend Val Adm Distribution (12b-1) fees, Sub-transfer agency fees, Shareholder servicing fees, Investment management fees paid indirectly by plan .35 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Victory Sycam Establish Val A Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .50 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Amercent Midcap Val Inv Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .35 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Amercent Large Comp Val A Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .60 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Amercent Strat Alloc Agrsv Inv Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .35 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Amercent Alloccon Inv Distribution (12b-1) fees, Shareholder servicing fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan .35 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Amercent Strat Alloc Mod Inv Distribution (12b-1) fees, Shareholder servicing fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan .35 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Amerfds Europac Grth R4 Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .35 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Amerfds Fdamental Invs R4 Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .35 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Amerfds Grth Fd of America R4 Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .35 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Amerfds New World R4 Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .35 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Amerfds Washington Mutual R4 Distribution (12b-1) fees, Shareholder servicing fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan .35 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Columbia Midcap Indx A Distribution (12b-1) fees, Shareholder servicing fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan .25 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Columbia Smcap Indx A Distribution (12b-1) fees, Shareholder servicing fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan .25 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Fidelity Adv Lev Comp Stock A Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .50 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Franklin Smcap Val A Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .40 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Goldmansachs Smcapval Inst Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .10 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Invesco Smcap Grth A Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .50 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Jan Hen Balanced Port S Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .25 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Oppenheimer Main St Mid Cap Y Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .25 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Oak Ridge Smcap Grth I Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .25 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Pax Global Env Mkts Indv Inv Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .35 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Pimco Total Return Adm Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .25 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Pioneer Fdamental Grth Y Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .35 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Prudential High-Yield Z Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .25 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co State St S&P 500 Indx Cl F Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .15 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Thornburg Ltd-Term Inc R5 Distribution (12b-1) fees, Sub-transfer agency fees, Shareholder servicing fees, Investment management fees paid indirectly by plan .20 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Tiaa-Cref Lifecyce Idx 2010 R Distribution (12b-1) fees, Sub-transfer agency fees, Shareholder servicing fees, Investment management fees paid indirectly by plan .25 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Tiaa-Cref Lifecyce Idx 2015 R Distribution (12b-1) fees, Sub-transfer agency fees, Shareholder servicing fees, Investment management fees paid indirectly by plan .25 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Tiaa-Cref Lifecycle Idx 2020 R Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .25 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Tiaa-Cref Lifecycle Idx 2025 R Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .25 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Tiaa-Cref Lifecycle Idx 2030 R Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .25 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Tiaa-Cref Lifecycle Id 2035 R Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .25 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Tiaa-Cref Lifecycle Id 2040 R Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .25 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Tiaa-Cref Lifecycle Id 2045 R Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .25 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Tiaa-Cref Lifecycle Id 2050 R Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .25 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Tiaa-Cref Lifecycle Id 2055 R Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .25 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Tiaa-Cref Bond Indx R Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .25 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Tiaa-Cref Emerg Mkts Eq Indx R Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .25 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Tiaa-Cref Lgcapgrth Indx R Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .25 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Tiaa-Cref Lgcap Val Indx R Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .25 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Tiaa-Cref Lifecycle Indx Inc R Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .25 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Tiaa-Cref Social Choice Eqty R Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .25 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Pioneer Sel Mid Cap Grth Vct I Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .25 % Annual Percentage Calculated and Paid Daily $0
American United Life Insurance Co Tiaa-Cref Lifecycle Id 2060 R Distribution (12b-1) fees, Sub-transfer agency fees, Investment management fees paid indirectly by plan, Shareholder servicing fees .25 % Annual Percentage Calculated and Paid Daily $0
*As outlined by the Form 5500 Instructions for service providers with indirect compensation.

Service Providers Who Fail or Refuse to Provide Information

There are no service providers who failed or refused to provide information.

Termination Information on Accountants and Enrolled Actuaries

There is no termination information for this plan.

Investments

Investments

Name of Investment Investment Manager Type of Investment Dollar Value
Tiaa Real Estate Tiaa-Cref DFE: Pooled Separate Account $1,332,613
Pru Stock Index Prudential Retirement Ins DFE: Pooled Separate Account $753,760
Tflic Large Value Transamerica Financial Life Ins Co DFE: Pooled Separate Account $527,127
Tflic Large Core Transamerica Financial Life Ins Co DFE: Pooled Separate Account $458,536
Tr Price Equity Income Prudential Retirement Ins DFE: Pooled Separate Account $353,976
Medley Money Market Prudential Retirement Ins DFE: Pooled Separate Account $314,782
Stock Index Account Prudential Retirement Ins DFE: Pooled Separate Account $313,265
Asset Alloc - Intermed/Long Horiz Transamerica Financial Life Ins Co DFE: Pooled Separate Account $306,245
Pru Conservative Balanced Prudential Retirement Ins DFE: Pooled Separate Account $290,291
Pru Flexible Managed Prudential Retirement Ins DFE: Pooled Separate Account $246,995
Tflic Small Core Transamerica Financial Life Ins Co DFE: Pooled Separate Account $242,386
Tflic Intl. Equity Transamerica Financial Life Ins Co DFE: Pooled Separate Account $228,899
Conservative Balanced Prudential Retirement Ins DFE: Pooled Separate Account $228,055
Asset Alloc - Intermed Horiz Transamerica Financial Life Ins Co DFE: Pooled Separate Account $220,110
Pru Value Portfolio Prudential Retirement Ins DFE: Pooled Separate Account $205,103
Pru Govt Income Prudential Retirement Ins DFE: Pooled Separate Account $196,992
Government Fixed Fund Transamerica Financial Life Ins Co DFE: Pooled Separate Account $178,040
Equity Account Prudential Retirement Ins DFE: Pooled Separate Account $150,499
Pru Diversified Bond Prudential Retirement Ins DFE: Pooled Separate Account $143,723
Pru Jennison Prudential Retirement Ins DFE: Pooled Separate Account $141,006
T Rowe Price Intnl Prudential Retirement Ins DFE: Pooled Separate Account $115,362
Jans Aspn Srs Ovrsea 100 Prudential Retirement Ins DFE: Pooled Separate Account $114,329
Pru Global Prudential Retirement Ins DFE: Pooled Separate Account $91,008
Flexible Managed Account Prudential Retirement Ins DFE: Pooled Separate Account $89,133
Capital Growth Account Prudential Retirement Ins DFE: Pooled Separate Account $80,364
Pru High Yield Bond Prudential Retirement Ins DFE: Pooled Separate Account $78,663
Diversified Bond Account Prudential Retirement Ins DFE: Pooled Separate Account $51,528
Global Account Prudential Retirement Ins DFE: Pooled Separate Account $38,259
Mfs Emerging Growth Prudential Retirement Ins DFE: Pooled Separate Account $35,617
Pru Equity Prudential Retirement Ins DFE: Pooled Separate Account $33,336
Mfs Research Prudential Retirement Ins DFE: Pooled Separate Account $31,546
Government Income Account Prudential Retirement Ins DFE: Pooled Separate Account $30,765
Money Market Account Prudential Retirement Ins DFE: Pooled Separate Account $19,695
Tflic High Quality Bond Transamerica Financial Life Ins Co DFE: Pooled Separate Account $18,602
Asset Alloc - Short Horiz Transamerica Financial Life Ins Co DFE: Pooled Separate Account $10,183
Inv VI Core Equity Fd 10 Prudential Retirement Ins DFE: Pooled Separate Account $2,059
Total $7,672,852

Insurance Information

Insurance Information

Insurance Carrier Summary Persons Covered
Tiaa-Cref 106
EIN 13-1624203
Industry Code 69345
Contract Number 334121
Contract Year 01/01/2018 — 12/31/2018
Value in General Account at Year End $2,633,053
Value in Separate Accounts at Year End $9,299,916
Insurance Fees and Commissions $0
Persons Receiving Commissions and Fees There are no brokers listed for this plan.
Allocated Funds
Type of Contract Unspecified
Basis of premium rates
Premiums paid to carrier $0
Premiums due but unpaid at the end of the year $0
If the carrier, service, or other organization incurred any specific costs in connection with the acquisition or retention of the contract or policy, enter amount $0
Specify the nature of the costs
Unallocated Funds
Type of Contract Guaranteed Investment
Balance at the end of the previous year $2,794,518
Additions $363,766
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $83,783
Transferred from separate account $279,983
Other $0
Total of Balance and Additions $3,158,284
Deductions $525,231
Disbursed from fund to pay benefits or purchase annuities during the year $364,282
Administration charge made by carrier $0
Transferred to Separate Account $279
Other $160,670
Balance at the end of the current year $2,633,053
Transamerica Financial Life Insurance Company 85
EIN 36-6071399
Industry Code 70688
Contract Number FA065593
Contract Year 01/01/2018 — 12/31/2018
Value in General Account at Year End $1,366,167
Value in Separate Accounts at Year End $3,835,895
Insurance Fees and Commissions $4,643
Persons Receiving Commissions and Fees
Agent/Broker Organization Code Commissions Paid Fees Paid Purpose of Fees Paid
Cetera Advisor Network LLC 200 North Sepulveda Ave El Segundo, CA 90245 Insurance Agent or Broker $4,643 $0
Allocated Funds
Type of Contract Unspecified
Basis of premium rates
Premiums paid to carrier $0
Premiums due but unpaid at the end of the year $0
If the carrier, service, or other organization incurred any specific costs in connection with the acquisition or retention of the contract or policy, enter amount $0
Specify the nature of the costs
Unallocated Funds
Type of Contract Guaranteed Investment
Balance at the end of the previous year $1,406,920
Additions $47,680
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $47,332
Transferred from separate account $348
Other $0
Total of Balance and Additions $1,454,600
Deductions $88,433
Disbursed from fund to pay benefits or purchase annuities during the year $87,446
Administration charge made by carrier $605
Transferred to Separate Account $382
Other $0
Balance at the end of the current year $1,366,167
The Prudential Insurance Company of America 31
EIN 22-1211670
Industry Code 68241
Contract Number 350531
Contract Year 01/01/2018 — 12/31/2018
Value in General Account at Year End $158,744
Value in Separate Accounts at Year End $3,148,549
Insurance Fees and Commissions $0
Persons Receiving Commissions and Fees There are no brokers listed for this plan.
Allocated Funds
Type of Contract Unspecified
Basis of premium rates
Premiums paid to carrier $0
Premiums due but unpaid at the end of the year $0
If the carrier, service, or other organization incurred any specific costs in connection with the acquisition or retention of the contract or policy, enter amount $0
Specify the nature of the costs
Unallocated Funds
Type of Contract Guaranteed Investment
Balance at the end of the previous year $71,216
Additions $87,603
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $2,605
Transferred from separate account $84,998
Other $0
Total of Balance and Additions $158,819
Deductions $75
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $75
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $158,744
The Prudential Insurance Company of America 24
EIN 22-1211670
Industry Code 68241
Contract Number 005506
Contract Year 01/01/2018 — 12/31/2018
Value in General Account at Year End $153,431
Value in Separate Accounts at Year End $1,001,564
Insurance Fees and Commissions $0
Persons Receiving Commissions and Fees There are no brokers listed for this plan.
Allocated Funds
Type of Contract Unspecified
Basis of premium rates
Premiums paid to carrier $0
Premiums due but unpaid at the end of the year $0
If the carrier, service, or other organization incurred any specific costs in connection with the acquisition or retention of the contract or policy, enter amount $0
Specify the nature of the costs
Unallocated Funds
Type of Contract Guaranteed Investment
Balance at the end of the previous year $149,133
Additions $4,474
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $4,474
Transferred from separate account $0
Other $0
Total of Balance and Additions $153,607
Deductions $176
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $176
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $153,431
American United Life Insurance Company 0
EIN 35-0145825
Industry Code 60895
Contract Number G76383
Contract Year 01/01/2018 — 12/31/2018
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
Insurance Fees and Commissions $37,387
Persons Receiving Commissions and Fees
Agent/Broker Organization Code Commissions Paid Fees Paid Purpose of Fees Paid
Northwestern Mutual Investment 611 East Wisconsin Ave Milwaukee, WI 53202 Insurance Agent or Broker $37,387 $0
Allocated Funds
Type of Contract Unspecified
Basis of premium rates
Premiums paid to carrier $0
Premiums due but unpaid at the end of the year $0
If the carrier, service, or other organization incurred any specific costs in connection with the acquisition or retention of the contract or policy, enter amount $0
Specify the nature of the costs
Unallocated Funds
Type of Contract GROUP ANNUITY CONTRACT
Balance at the end of the previous year $749,360
Additions $274,943
Contributions Deposited during the year $52,943
Dividends and credits $0
Interest credited during the year $6,552
Transferred from separate account $215,448
Other $0
Total of Balance and Additions $1,024,303
Deductions $1,024,303
Disbursed from fund to pay benefits or purchase annuities during the year $9,593
Administration charge made by carrier $115
Transferred to Separate Account $160,023
Other $854,572
Balance at the end of the current year $0