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Overview

Plan Information

  • Plan Year01/01/2019 — 12/31/2019
  • Date of Plan04/01/1958
  • Net Assets as of 12/31/2019 $5,663,803,937
  • 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 12/31/2019

  • Active (Eligible) Participants12,212
  • Retired or separated participants receiving benefits271
  • Other retired or separated participants entitled to future benefits7,838
  • Subtotal20,321
  • Deceased participants whose beneficiaries are receiving or are entitled to receive benefits24
  • Total20,345
  • Total number of participants as of 01/01/201920,270
  • Number of participants with account balances19,930
  • Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested181

Expenses

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

Sponsor Information

  • AddressPo Box 15437
  • CityWilmington
  • StateDE
  • Zip19850-5437
  • Telephone(302) 886-3000
  • EIN23-2967016
  • Industry Code325410
  • Named AdministratorDarija Grgic
  • Named Plan SponsorKevin Durning

Plan Administrator Information

  • Administrator NameAstrazeneca Administration Committee
  • Address1800 Concord Pike
  • CityWilmington
  • StateDE
  • Zip19850-5437
  • Telephone(302) 886-3000
  • Administrator EIN23-2967016

Audit Information

  • Audit StatusAudited
  • AuditorPricewaterhousecoopers LLP
  • Auditor EIN13-4008324
  • Audit OpinionUnqualified
  • Audit Type Full Audit

Benefits Provided Under the Plan

Code Benefit Description
2E Profit-sharing A defined contribution plan that allows employer discretionary contributions. These plans often contain a 401(k) feature.
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.
2J 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.
2K Code section 401(m) arrangement Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contributions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
2T Participant-directed Account Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
3F Leased Employees Plan sponsor(s) received services of leased employees, as defined in Code section 414(n), during the plan year.
3H Controlled Group Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

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? No
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 $5,000,000
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? No
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? No

Financials

Income and Expense Statement

Income $1,401,066,645
Contributions $368,105,663
Cash Contributions $368,105,663
Cash from Employers $166,644,858
Cash from Participants $170,182,070
Others (including rollovers) $31,278,735
Noncash Contributions $0
Total Earnings on Investments $1,032,960,982
Total Interest $12,092,158
Interest-Bearing Cash $3,367,893
U.S. Government Securities $0
Corporate Debt Instruments $0
Loans (other than to participants) $0
Participant Loans $1,632,720
Interest from Other Investments $7,091,545
Total Dividends $56,566,786
Preferred Stock $0
Common Stock $4,544,221
Rents $0
Net gain (loss) on sale of assets $1,295,364
Aggregate Proceeds $10,467,040
Aggregate Carrying Amount $9,171,676
Total Unrealized Appreciation (depreciation) of assets $36,554,104
Real Estate $0
Other $36,554,104
Net investment gain (loss) from common/collective trusts $762,101,249
Net investment gain (loss) from pooled separate accounts $0
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 $164,351,321
Other Income $0
Expenses $420,279,196
Total Benefit Payments $418,983,388
Directly to participants or beneficiaries, including direct rollovers $418,983,388
To insurance carriers for the provision of benefits $0
Other Benefit Payment Fees $0
Corrective Distributions $105,719
Certain deemed distributions of participant loans $42,110
Interest expense $0
Total Administrative Expenses $1,147,979
Professional Fees $0
Contract Administrator Fees $0
Investment Advisory and management fees $0
Other Administrative Fees $1,147,979
Net Income $980,787,449
Transfers of Assets to this Plan $0
Transfers of Assets from this Plan $15,092

Asset and Liability Statement

12/31/2019 12/31/2018 Change YOY
Total Assets $5,663,803,937 $4,658,945,561 21.57%
Total noninterest-bearing cash $0 $0 0.0%
Receivables $12,400,295 $13,435,175 -7.70%
Employer Contributions $8,225,115 $7,306,887 12.57%
Participant Contributions $4,175,180 $6,128,288 -31.87%
Other Contributions $0 $0 0.0%
General Investments $152,986,740 $145,378,860 5.23%
Interest-bearing cash $152,986,740 $145,378,860 5.23%
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 $38,330,513 $38,103,006 0.60%
Value of interest in common/collective trusts $4,003,869,067 $3,156,652,563 26.84%
Value of interest in pooled separate accounts $72,135,839 $45,806,825 57.48%
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 $1,003,383,848 $879,034,913 14.15%
Value of funds held in insurance co. general account $227,282,354 $254,256,226 -10.61%
Other Investments $0 $0 0.0%
Employer-related Investments $153,415,281 $126,277,993 21.49%
Employer Securities $153,415,281 $126,277,993 21.49%
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 $5,663,803,937 $4,658,945,561 21.57%

Service Providers

Persons Receiving Only Eligible Indirect Compensation

  • Fid Inv Inst Ops Co
  • Blackrock Inst Tr. Co N.A.
  • Dimensional Fund Advisors Lp
  • Mass Mutual Life Ins Co.
  • Mutual of America Life Ins Co

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
Fid Inv Inst Ops Co Recordkeeping fees, Account maintenance fees, Direct payment from the plan Recordkeeper $1,147,979 $0 $1,147,979
Total $1,147,979 $0 $1,147,979

Indirect Compensation

There are no service providers with indirect compensation listed for this plan.

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
Vanguard Inst Index Cit Vanguard Fiduciary Trust Co DFE: Common/Collective Trust $923,067,700
Vanguard Target 2035 Vanguard Fiduciary Trust Co DFE: Common/Collective Trust $471,834,465
Vanguard Target 2030 Vanguard Fiduciary Trust Co DFE: Common/Collective Trust $429,040,622
Vanguard Target 2040 Vanguard Fiduciary Trust Co DFE: Common/Collective Trust $364,191,253
Vanguard Target 2025 Vanguard Fiduciary Trust Co DFE: Common/Collective Trust $331,457,264
Vftc Inst Extend Mkt Index Tr Vanguard Fiduciary Trust Co DFE: Common/Collective Trust $299,233,941
Vanguard Target 2045 Vanguard Fiduciary Trust Co DFE: Common/Collective Trust $231,595,029
Vanguard Tot Bd Mkt Idx Vanguard Fiduciary Trust Co DFE: Common/Collective Trust $179,689,588
Vanguard Target 2020 Vanguard Fiduciary Trust Co DFE: Common/Collective Trust $166,316,675
Vanguard Total Int Stk Mkt Idx Tr Vanguard Fiduciary Trust Co DFE: Common/Collective Trust $161,644,202
Champlain Mid Cap Cit Sei Trust Company DFE: Common/Collective Trust $145,380,222
Vanguard Target 2050 Vanguard Fiduciary Trust Co DFE: Common/Collective Trust $113,003,211
Group Annuity Contract Ga29046 New York Life DFE: Pooled Separate Account $47,731,121
Blackrock Total Return Bond Fund T Blackrock Institutional Trust Co DFE: Common/Collective Trust $47,273,540
Vanguard Target 2015 Vanguard Fiduciary Trust Co DFE: Common/Collective Trust $42,658,075
Vanguard Target Inc Vanguard Fiduciary Trust Co DFE: Common/Collective Trust $38,245,241
Vanguard Target 2055 Vanguard Fiduciary Trust Co DFE: Common/Collective Trust $37,180,606
Group Annuity Contract Ga 37437 Metropolitan Life Insurance Company (Inc) DFE: Pooled Separate Account $25,172,327
Vanguard Target 2060 Vanguard Fiduciary Trust Co DFE: Common/Collective Trust $17,942,502
Vanguard Target 2065 Vanguard Fiduciary Trust Co DFE: Common/Collective Trust $4,114,930
Fiduciary Cap Preservation Plus Fnd Alerus Financial DFE: Common/Collective Trust $0
Total $4,076,772,514

Insurance Information

Insurance Information

Insurance Carrier Summary Persons Covered
Jackson National Life Ins 0
EIN 38-1659835
Industry Code 65056
Contract Number G-1591-2
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $1,302,440
Additions $7,221
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $7,221
Transferred from separate account $0
Other $0
Total of Balance and Additions $1,309,661
Deductions $1,309,661
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $1,309,661
Balance at the end of the current year $0
Jackson National Life Ins 0
EIN 38-1659835
Industry Code 65056
Contract Number G-1591-3
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $1,839,940
Additions $29,645
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $29,645
Transferred from separate account $0
Other $0
Total of Balance and Additions $1,869,585
Deductions $1,869,585
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $1,869,585
Balance at the end of the current year $0
Jackson National Life Ins 0
EIN 38-1659835
Industry Code 65056
Contract Number G-1591-4
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $4,321,351
Additions $104,576
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $104,576
Transferred from separate account $0
Other $0
Total of Balance and Additions $4,425,927
Deductions $1,475,309
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $1,475,309
Balance at the end of the current year $2,950,618
Jackson National Life Ins 0
EIN 38-1659835
Industry Code 65056
Contract Number G-1591-5
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $1,627,754
Additions $38,415
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $38,415
Transferred from separate account $0
Other $0
Total of Balance and Additions $1,666,169
Deductions $0
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $1,666,169
Jackson National Life Ins 0
EIN 38-1659835
Industry Code 65056
Contract Number G-1591-6
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $6,788,611
Additions $186,687
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $186,687
Transferred from separate account $0
Other $0
Total of Balance and Additions $6,975,298
Deductions $0
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $6,975,298
Jackson National Life Ins 0
EIN 38-1659835
Industry Code 65056
Contract Number G-1591-7
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $2,516,663
Additions $53,605
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $53,605
Transferred from separate account $0
Other $0
Total of Balance and Additions $2,570,268
Deductions $0
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $2,570,268
Jackson National Life Ins 0
EIN 38-1659835
Industry Code 65056
Contract Number G-1591-8
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $4,030,962
Additions $120,526
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $120,526
Transferred from separate account $0
Other $0
Total of Balance and Additions $4,151,488
Deductions $0
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $4,151,488
Jackson National Life Ins 0
EIN 38-1659835
Industry Code 65056
Contract Number G-1591-9
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $2,058,926
Additions $60,326
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $60,326
Transferred from separate account $0
Other $0
Total of Balance and Additions $2,119,252
Deductions $0
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $2,119,252
Mass Mutual Life Insurance Co. 0
EIN 04-1590850
Industry Code 65935
Contract Number GIC35161
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $6,166,375
Additions $169,575
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $169,575
Transferred from separate account $0
Other $0
Total of Balance and Additions $6,335,950
Deductions $0
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $6,335,950
Metlife 0
EIN 13-5581829
Industry Code 65978
Contract Number GAC32930
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $2,097,453
Additions $11,595
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $11,595
Transferred from separate account $0
Other $0
Total of Balance and Additions $2,109,048
Deductions $2,109,048
Disbursed from fund to pay benefits or purchase annuities during the year $2,109,048
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $0
Metlife 0
EIN 13-5581829
Industry Code 65978
Contract Number GAC32964
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $4,493,023
Additions $77,574
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $77,574
Transferred from separate account $0
Other $0
Total of Balance and Additions $4,570,597
Deductions $4,570,597
Disbursed from fund to pay benefits or purchase annuities during the year $4,570,597
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $0
Metlife 0
EIN 13-5581829
Industry Code 65978
Contract Number GAC35227
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $4,798,589
Additions $124,169
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $124,169
Transferred from separate account $0
Other $0
Total of Balance and Additions $4,922,758
Deductions $1,639,202
Disbursed from fund to pay benefits or purchase annuities during the year $1,639,202
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $3,283,556
Metlife 0
EIN 13-5581829
Industry Code 65978
Contract Number GAC 35321
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $4,174,688
Additions $113,551
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $113,551
Transferred from separate account $0
Other $0
Total of Balance and Additions $4,288,239
Deductions $0
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $4,288,239
Metlife 0
EIN 13-5581829
Industry Code 65978
Contract Number GAC 35524
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $6,137,573
Additions $138,095
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $138,095
Transferred from separate account $0
Other $0
Total of Balance and Additions $6,275,668
Deductions $0
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $6,275,668
Minnesota Life 0
EIN 41-0417830
Industry Code 66168
Contract Number A112275
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 INTEREST
Balance at the end of the previous year $7,064,576
Additions $256,443
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $256,443
Transferred from separate account $0
Other $0
Total of Balance and Additions $7,321,019
Deductions $0
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $7,321,019
Mutual of America 0
EIN 13-1614399
Industry Code 88668
Contract Number 027-010-A
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $4,581,166
Additions $58,808
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $58,808
Transferred from separate account $0
Other $0
Total of Balance and Additions $4,639,974
Deductions $4,639,974
Disbursed from fund to pay benefits or purchase annuities during the year $4,633,474
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $6,500
Balance at the end of the current year $0
New York Life Ins 0
EIN 13-5582869
Industry Code 66915
Contract Number GA31152011
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $4,140,836
Additions $32,516
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $32,516
Transferred from separate account $0
Other $0
Total of Balance and Additions $4,173,352
Deductions $4,173,352
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $4,601
Transferred to Separate Account $0
Other $4,168,751
Balance at the end of the current year $0
New York Life Ins 0
EIN 13-5582869
Industry Code 66915
Contract Number GA31152012
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $6,081,169
Additions $110,126
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $110,126
Transferred from separate account $0
Other $0
Total of Balance and Additions $6,191,295
Deductions $6,191,295
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $13,410
Transferred to Separate Account $0
Other $6,177,885
Balance at the end of the current year $0
New York Life Ins 0
EIN 13-5582869
Industry Code 66915
Contract Number GA31152013
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $3,716,072
Additions $69,055
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $69,055
Transferred from separate account $0
Other $0
Total of Balance and Additions $3,785,127
Deductions $3,785,127
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $9,536
Transferred to Separate Account $0
Other $3,775,591
Balance at the end of the current year $0
New York Life Ins 0
EIN 13-5582869
Industry Code 66915
Contract Number GA31152014
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $2,419,357
Additions $63,647
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $63,647
Transferred from separate account $0
Other $0
Total of Balance and Additions $2,483,004
Deductions $831,681
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $9,546
Transferred to Separate Account $0
Other $822,135
Balance at the end of the current year $1,651,323
New York Life Ins 0
EIN 13-5582869
Industry Code 66915
Contract Number GA31152015
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $1,287,818
Additions $37,006
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $37,006
Transferred from separate account $0
Other $0
Total of Balance and Additions $1,324,824
Deductions $6,356
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $6,356
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $1,318,468
New York Life Ins 0
EIN 13-5582869
Industry Code 66915
Contract Number GA31152016
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $7,998,011
Additions $215,953
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $215,953
Transferred from separate account $0
Other $0
Total of Balance and Additions $8,213,964
Deductions $27,595
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $27,595
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $8,186,369
New York Life Ins 0
EIN 13-5582869
Industry Code 66915
Contract Number GA31152017
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $1,578,634
Additions $39,012
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $39,012
Transferred from separate account $0
Other $0
Total of Balance and Additions $1,617,646
Deductions $7,014
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $7,014
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $1,610,632
New York Life Ins 0
EIN 13-5582869
Industry Code 66915
Contract Number GA29046
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $47,731,121
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 Unspecified
Balance at the end of the previous year $0
Additions $0
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $0
Transferred from separate account $0
Other $0
Total of Balance and Additions $0
Deductions $0
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $0
Ohio National Fin Serv 0
EIN 31-0397080
Industry Code 67172
Contract Number GP5550
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $1,348,101
Additions $23,225
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $23,225
Transferred from separate account $0
Other $0
Total of Balance and Additions $1,371,326
Deductions $1,371,326
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $1,371,326
Balance at the end of the current year $0
Ohio National Fin Serv 0
EIN 31-0397080
Industry Code 67172
Contract Number GP5557
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $2,195,595
Additions $17,553
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $19,595
Transferred from separate account $0
Other $-2,042
Total of Balance and Additions $2,213,148
Deductions $2,213,148
Disbursed from fund to pay benefits or purchase annuities during the year $1,103,572
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $1,109,576
Balance at the end of the current year $0
Ohio National Fin Serv 0
EIN 31-0397080
Industry Code 67172
Contract Number GP5579
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $2,362,377
Additions $61,894
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $61,894
Transferred from separate account $0
Other $0
Total of Balance and Additions $2,424,271
Deductions $0
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $2,424,271
Ohio National Fin Serv 0
EIN 31-0397080
Industry Code 67172
Contract Number GP5590
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $5,698,174
Additions $141,664
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $141,664
Transferred from separate account $0
Other $0
Total of Balance and Additions $5,839,838
Deductions $0
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $5,839,838
Principal Life 0
EIN 42-0127290
Industry Code 61271
Contract Number 4-43217
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 INTEREST CONTRACT
Balance at the end of the previous year $14,002,832
Additions $318,844
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $318,844
Transferred from separate account $0
Other $0
Total of Balance and Additions $14,321,676
Deductions $1,774,815
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $1,774,815
Balance at the end of the current year $12,546,861
Protective Life Ins Co 0
EIN 63-0169720
Industry Code 68136
Contract Number GA 2118
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $1,957,200
Additions $44,202
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $44,202
Transferred from separate account $0
Other $0
Total of Balance and Additions $2,001,402
Deductions $0
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $2,001,402
Protective Life Ins Co 0
EIN 63-0169720
Industry Code 68136
Contract Number GA 2137
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $2,073,377
Additions $50,105
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $50,105
Transferred from separate account $0
Other $0
Total of Balance and Additions $2,123,482
Deductions $0
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $2,123,482
Prudential 0
EIN 22-1211670
Industry Code 68241
Contract Number 62006
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 GROUP ANNUITY CONTRACT
Balance at the end of the previous year $21,467,195
Additions $3,494,335
Contributions Deposited during the year $3,000,000
Dividends and credits $0
Interest credited during the year $494,335
Transferred from separate account $0
Other $0
Total of Balance and Additions $24,961,530
Deductions $1,111,727
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $1,111,727
Balance at the end of the current year $23,849,803
The Prudential Ins Co of America 0
EIN 22-1211670
Industry Code 68241
Contract Number 062206001
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $65,181,744
Additions $1,622,862
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $1,622,862
Transferred from separate account $0
Other $0
Total of Balance and Additions $66,804,606
Deductions $0
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $66,804,606
United of Omaha 0
EIN 47-0322111
Industry Code 69868
Contract Number SDGA 14469-5
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $3,686,653
Additions $117,196
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $90,323
Transferred from separate account $0
Other $26,873
Total of Balance and Additions $3,803,849
Deductions $0
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $3,803,849
United of Omaha 0
EIN 47-0322111
Industry Code 69868
Contract Number SDGA20243
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 GROUP ANNUITY CONTRACT
Balance at the end of the previous year $11,948,208
Additions $468,289
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $310,889
Transferred from separate account $0
Other $157,400
Total of Balance and Additions $12,416,497
Deductions $3,293,681
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $3,293,681
Balance at the end of the current year $9,122,816
Protective Life Ins Co 0
EIN 63-0169720
Industry Code 68136
Contract Number GA-2124
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $7,344,952
Additions $122,077
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $122,077
Transferred from separate account $0
Other $0
Total of Balance and Additions $7,467,029
Deductions $1,853,256
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $1,853,256
Balance at the end of the current year $5,613,773
Mass Mutual Life Insurance Co. 0
EIN 04-1590850
Industry Code 65935
Contract Number GIC 35162
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $5,119,637
Additions $163,828
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $163,828
Transferred from separate account $0
Other $0
Total of Balance and Additions $5,283,465
Deductions $0
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $5,283,465
Mass Mutual Life Insurance Co. 0
EIN 04-1590850
Industry Code 65935
Contract Number GIC 35165
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $8,446,371
Additions $294,778
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $294,778
Transferred from separate account $0
Other $0
Total of Balance and Additions $8,741,149
Deductions $0
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $8,741,149
Minnesota Life Insurance Company 0
EIN 41-0417830
Industry Code 66168
Contract Number A113948
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 INTEREST
Balance at the end of the previous year $10,000,000
Additions $359,000
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $359,000
Transferred from separate account $0
Other $0
Total of Balance and Additions $10,359,000
Deductions $0
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $10,359,000
Metlife 0
EIN 13-5581829
Industry Code 65978
Contract Number GAC-37510
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
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 $8,000,000
Additions $50,291
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $50,291
Transferred from separate account $0
Other $0
Total of Balance and Additions $8,050,291
Deductions $0
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $8,050,291
Metlife 0
EIN 13-5581829
Industry Code 65978
Contract Number GAC-37437
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $0
Value in Separate Accounts at Year End $25,172,327
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 $25,000,000
Additions $172,327
Contributions Deposited during the year $172,327
Dividends and credits $0
Interest credited during the year $0
Transferred from separate account $0
Other $0
Total of Balance and Additions $25,172,327
Deductions $0
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $0
Balance at the end of the current year $25,172,327