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FORM 5500 DATA

Balch & Bingham LLP 401k Profit Sharing Plan

Overview

Plan Information

  • Plan Year01/01/2019 — 12/31/2019
  • Date of Plan12/23/1968
  • Net Assets as of 12/31/2019 $255,041,505
  • Plan Number1
  • 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) Participants365
  • Retired or separated participants receiving benefits13
  • Other retired or separated participants entitled to future benefits135
  • Subtotal513
  • Deceased participants whose beneficiaries are receiving or are entitled to receive benefits0
  • Total513
  • Total number of participants as of 01/01/2019522
  • Number of participants with account balances491
  • Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested18

Expenses

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

Sponsor Information

  • Address1901 6th Ave N Suite 1500
  • CityBirmingham
  • StateAL
  • Zip35203
  • Telephone(205) 251-8100
  • EIN63-0328165
  • Industry Code541110
  • Named AdministratorJames A. Bradford

Audit Information

  • Audit StatusAudited
  • AuditorPearce Bevill Leesburg & Moore Pc
  • Auditor EIN63-0813240
  • Audit Opinion Disclaimer
  • Audit TypeLimited Scope Audit

Benefits Provided Under the Plan

Code Benefit Description
2A Age/Service Weighted or New Comparability or Similar Plan Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New Comparability or Similar Plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the threshold or additional rate allowed under the permitted disparity rules of section 401(l)
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.
2R Brokerage Window Participant-directed brokerage accounts provided as an investment option under the plan.
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.
3B Self-Employed Plan Plan covering Self-Employed individuals.
3D Master plan A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

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 $2,000,000
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 $56,599,978
Contributions $9,097,046
Cash Contributions $9,097,046
Cash from Employers $5,718,949
Cash from Participants $3,271,960
Others (including rollovers) $106,137
Noncash Contributions $0
Total Earnings on Investments $42,076,960
Total Interest $50,774
Interest-Bearing Cash $0
U.S. Government Securities $0
Corporate Debt Instruments $0
Loans (other than to participants) $0
Participant Loans $50,774
Interest from Other Investments $0
Total Dividends $10,241,674
Preferred Stock $0
Common Stock $0
Rents $0
Net gain (loss) on sale of assets $782,891
Aggregate Proceeds $17,332,419
Aggregate Carrying Amount $16,549,528
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 $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 $31,001,621
Other Income $5,425,972
Expenses $25,977,533
Total Benefit Payments $25,597,036
Directly to participants or beneficiaries, including direct rollovers $25,573,982
To insurance carriers for the provision of benefits $23,054
Other Benefit Payment Fees $0
Corrective Distributions $13,939
Certain deemed distributions of participant loans $0
Interest expense $0
Total Administrative Expenses $366,558
Professional Fees $68,569
Contract Administrator Fees $175,420
Investment Advisory and management fees $117,583
Other Administrative Fees $4,986
Net Income $30,622,445
Transfers of Assets to this Plan $0
Transfers of Assets from this Plan $0

Asset and Liability Statement

12/31/2019 12/31/2018 Change YOY
Total Assets $255,041,505 $224,419,060 13.65%
Total noninterest-bearing cash $3,088,884 $3,678,891 -16.04%
Receivables $313,247 $308,328 1.60%
Employer Contributions $293,280 $277,794 5.57%
Participant Contributions $19,967 $30,534 -34.61%
Other Contributions $0 $0 0.0%
General Investments $362,651 $403,527 -10.13%
Interest-bearing cash $162,319 $207,228 -21.67%
U.S. Government Securities $200,332 $196,299 2.05%
Corporate Debt Instruments $563,302 $696,324 -19.10%
Preferred $0 $0 0.0%
All Other $563,302 $696,324 -19.10%
Corporate Stocks $9,294,248 $10,611,508 -12.41%
Preferred $0 $0 0.0%
Common $9,294,248 $10,611,508 -12.41%
Partnership/joint venture interests $0 $0 0.0%
Real estate (other than employer real property) $38,847 $37,670 3.12%
Loans (other than to participants) $0 $0 0.0%
Participants Loans $835,157 $959,702 -12.98%
Value of interest in common/collective trusts $17,685,276 $17,696,042 -0.06%
Value of interest in pooled separate accounts $0 $0 0.0%
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 $221,556,170 $188,367,388 17.62%
Value of funds held in insurance co. general account $0 $0 0.0%
Other Investments $1,303,723 $1,659,680 -21.45%
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 $255,041,505 $224,419,060 13.65%

Service Providers

Persons Receiving Only Eligible Indirect Compensation

  • Charles Schwab Investment Managemen

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
Massachusetts Mutual Life Ins. Co. Other services, Investment management fees paid indirectly by plan, Sub-transfer agency fees, Float revenue, Recordkeeping fees, Other insurance wrap fees, Soft dollars commissions, Securities brokerage commissions and fees, Other investment fees and expenses Contract Administrator $180,406 $34,843 $215,249
Welch Hornsby & Welch, Inc. Investment management Investment Advisor $0 $62,342 $62,342
Reliance Trust Company Trustee (bank, trust company, or similar financial institution) Service Provider $60,092 $0 $60,092
The Welch Group Securities brokerage commissions and fees Investment Service Provid $57,755 $0 $57,755
Welch Hornsby, Inc Investment advisory (plan) Investment Advisor $57,491 $0 $57,491
Hightower Advisors LLC Securities brokerage commissions and fees Investment Service Provid $31,533 $0 $31,533
Ogletree Deakins Nash Smoak Stewart Legal Legal $30,975 $0 $30,975
Pearce Bevill Leesburg Moore Accounting (including auditing) Auditor $29,294 $0 $29,294
Warren Averett Asset Mgmt LLC Securities brokerage commissions and fees Investment Service Provid $21,416 $0 $21,416
Hayek Kallen Investment Manage Securities brokerage commissions and fees Investment Service Provid $17,341 $0 $17,341
Navigate Wealth Management LLC Securities brokerage commissions and fees Investment Service Provid $14,228 $0 $14,228
Bridgeworth LLC Securities brokerage commissions and fees Investment Service Provid $10,147 $0 $10,147
Bhk Investment Advisors LLC Securities brokerage commissions and fees Investment Service Provid $6,587 $0 $6,587
Charles Schwab & Co., Inc. Shareholder servicing fees, Float revenue, Securities brokerage commissions and fees Investment Service Provid $3,885 $0 $3,885
American Beacon Investment management fees paid indirectly by plan Investment Provider $0 $0 $0
American Funds Investment management fees paid indirectly by plan Investment Provider $0 $0 $0
Blackrock Investment management fees paid indirectly by plan Investment Provider $0 $0 $0
Dodge & Cox Investment management fees paid indirectly by plan Investment Provider $0 $0 $0
Fidelity Investments Investment management fees paid indirectly by plan Investment Provider $0 $0 $0
Franklintempleton Investment management fees paid indirectly by plan Investment Provider $0 $0 $0
Harris Investment management fees paid indirectly by plan Investment Provider $0 $0 $0
Mfs Investment Management Investment management fees paid indirectly by plan Investment Provider $0 $0 $0
T. Rowe Price Investment management fees paid indirectly by plan Investment Provider $0 $0 $0
T. Rowe Price Investment management fees paid indirectly by plan Investment Provider $0 $0 $0
T. Rowe Price Investment management fees paid indirectly by plan Investment Provider $0 $0 $0
Vanguard Investment management fees paid indirectly by plan Investment Provider $0 $0 $0
Vanguard Investment management fees paid indirectly by plan Investment Provider $0 $0 $0
Wells Fargo Investment management fees paid indirectly by plan Investment Provider $0 $0 $0
Total $521,150 $97,185 $618,335

Indirect Compensation

Name Source of Indirect Compensation* Nature of Service Description of Indirect Compensation Indirect Compensation Paid by Plan
Massachusetts Mutual Life Ins. Co. Stable Val Wells Galliard Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
Massachusetts Mutual Life Ins. Co. Managed Conservative Portfolio Other insurance wrap fees Basis Points * Plan Assets $0
Massachusetts Mutual Life Ins. Co. Managed Growth Portfolio Other insurance wrap fees Basis Points * Plan Assets $0
Massachusetts Mutual Life Ins. Co. Massachusetts Mutual Life Ins. Co. Other services Plan Related Expenses $20,000
Massachusetts Mutual Life Ins. Co. Prem U.S. Govt Mny Mkt Fd Barings Other investment fees and expenses, Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
Massachusetts Mutual Life Ins. Co. Select Trpls Blue Chip Growth Fund Other investment fees and expenses, Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
Massachusetts Mutual Life Ins. Co. Fidelity Contrafund Sub-transfer agency fees Basis Points * Plan Assets $0
Massachusetts Mutual Life Ins. Co. Millennium Trust Company, LLC Other services Referral Fee $0
Massachusetts Mutual Life Ins. Co. Blackrock Hlth Sciences Opports Fd Sub-transfer agency fees Basis Points * Plan Assets $0
Massachusetts Mutual Life Ins. Co. T. Rowe Price Retirement 2005 Fund Sub-transfer agency fees Basis Points * Plan Assets $0
Massachusetts Mutual Life Ins. Co. T. Rowe Price Retirement 2010 Fund Sub-transfer agency fees Basis Points * Plan Assets $0
Massachusetts Mutual Life Ins. Co. T. Rowe Price Retirement 2015 Fund Sub-transfer agency fees Basis Points * Plan Assets $0
Massachusetts Mutual Life Ins. Co. T. Rowe Price Retirement 2020 Fund Sub-transfer agency fees Basis Points * Plan Assets $0
Massachusetts Mutual Life Ins. Co. T. Rowe Price Retirement 2025 Fund Sub-transfer agency fees Basis Points * Plan Assets $0
Massachusetts Mutual Life Ins. Co. T. Rowe Price Retirement 2030 Fund Sub-transfer agency fees Basis Points * Plan Assets $0
Massachusetts Mutual Life Ins. Co. T. Rowe Price Retirement 2035 Fund Sub-transfer agency fees Basis Points * Plan Assets $0
Massachusetts Mutual Life Ins. Co. T. Rowe Price Retirement 2040 Fund Sub-transfer agency fees Basis Points * Plan Assets $0
Massachusetts Mutual Life Ins. Co. T. Rowe Price Retirement 2045 Fund Sub-transfer agency fees Basis Points * Plan Assets $0
Massachusetts Mutual Life Ins. Co. T. Rowe Price Retirement 2050 Fund Sub-transfer agency fees Basis Points * Plan Assets $0
Massachusetts Mutual Life Ins. Co. T. Rowe Price Retirement 2055 Fund Sub-transfer agency fees Basis Points * Plan Assets $0
Massachusetts Mutual Life Ins. Co. T. Rowe Price Retirement 2060 Fund Sub-transfer agency fees Basis Points * Plan Assets $0
Massachusetts Mutual Life Ins. Co. T. Rowe Price Retirement Bal Fund Sub-transfer agency fees Basis Points * Plan Assets $0
Massachusetts Mutual Life Ins. Co. Oakmark Equity & Income Fund Sub-transfer agency fees Basis Points * Plan Assets $0
Massachusetts Mutual Life Ins. Co. Charles Schwab & Co, Inc. Securities brokerage commissions and fees Plan Related Expenses $14,843
Massachusetts Mutual Life Ins. Co. Dodge and Cox Income Fund Sub-transfer agency fees Basis Points * Plan Assets $0
Welch Hornsby & Welch, Inc. Massachusetts Mutual Life Ins. Co. Investment management Plan Related Expenses $62,342
Charles Schwab & Co., Inc. Buffalo Shareholder servicing fees Basis Points * Plan Assets $0
Charles Schwab & Co., Inc. Doubleline Shareholder servicing fees Basis Points * Plan Assets $0
Charles Schwab & Co., Inc. Eaton Vance Shareholder servicing fees Basis Points * Plan Assets $0
Charles Schwab & Co., Inc. MFS Shareholder servicing fees Basis Points * Plan Assets $0
Charles Schwab & Co., Inc. Blackrock Shareholder servicing fees Basis Points * Plan Assets $0
Charles Schwab & Co., Inc. Allianz Funds Shareholder servicing fees Basis Points * Plan Assets $0
Charles Schwab & Co., Inc. Jpmorgan Shareholder servicing fees Basis Points * Plan Assets $0
Charles Schwab & Co., Inc. Baron Capital Group Shareholder servicing fees Basis Points * Plan Assets $0
Charles Schwab & Co., Inc. Alliancebernstein Shareholder servicing fees Basis Points * Plan Assets $0
Charles Schwab & Co., Inc. DWS Shareholder servicing fees Basis Points * Plan Assets $0
Charles Schwab & Co., Inc. Hartford Mutual Funds Shareholder servicing fees Basis Points * Plan Assets $0
Charles Schwab & Co., Inc. Lord Abbett Shareholder servicing fees Basis Points * Plan Assets $0
Charles Schwab & Co., Inc. Pgim Funds Prudential Shareholder servicing fees Basis Points * Plan Assets $0
Charles Schwab & Co., Inc. Putnam Shareholder servicing fees Basis Points * Plan Assets $0
Charles Schwab & Co., Inc. Artisan Shareholder servicing fees Basis Points * Plan Assets $0
Charles Schwab & Co., Inc. T. Rowe Price Shareholder servicing fees Basis Points * Plan Assets $0
Charles Schwab & Co., Inc. Sterling Capital Funds Shareholder servicing fees Basis Points * Plan Assets $0
Charles Schwab & Co., Inc. Invesco Shareholder servicing fees Basis Points * Plan Assets $0
Charles Schwab & Co., Inc. Osterweis Shareholder servicing fees Basis Points * Plan Assets $0
Charles Schwab & Co., Inc. Schwab Funds Shareholder servicing fees Basis Points * Plan Assets $0
Charles Schwab & Co., Inc. Vulcan Value Partners Shareholder servicing fees Basis Points * Plan Assets $0
American Beacon American Beacon Large Cap Value Fnd Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
American Beacon American Beacon Small Cap Val Fd Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
American Funds Amer Funds Europacific Growth Fund Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
Blackrock Blackrock Hlth Sciences Opports Fd Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
Dodge & Cox Dodge and Cox Income Fund Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
Fidelity Investments Fidelity Contrafund Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
Franklintempleton Franklin Small Cap Growth Fund Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
Harris Oakmark Equity & Income Fund Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
Mfs Investment Management Mfs Mid Cap Value Fund Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
T. Rowe Price T. Rowe Price Global Technology Fd Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
T. Rowe Price T. Rowe Price Retirement 2005 Fund Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
T. Rowe Price T. Rowe Price Retirement 2010 Fund Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
T. Rowe Price T. Rowe Price Retirement 2015 Fund Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
T. Rowe Price T. Rowe Price Retirement 2020 Fund Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
T. Rowe Price T. Rowe Price Retirement 2025 Fund Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
T. Rowe Price T. Rowe Price Retirement 2030 Fund Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
T. Rowe Price T. Rowe Price Retirement 2035 Fund Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
T. Rowe Price T. Rowe Price Retirement 2040 Fund Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
T. Rowe Price T. Rowe Price Retirement 2045 Fund Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
T. Rowe Price T. Rowe Price Retirement 2050 Fund Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
T. Rowe Price T. Rowe Price Retirement 2055 Fund Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
T. Rowe Price T. Rowe Price Retirement 2060 Fund Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
T. Rowe Price T. Rowe Price Retirement Bal Fund Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
T. Rowe Price T. Rowe Price Mid-Cap Growth Fund Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
Vanguard Vanguard Extended Market Index Fund Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
Vanguard Vanguard Energy Fund Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
Vanguard Vanguard Institutional Index Fund Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
Vanguard Vanguard Total Bond Mrkt Index Fund Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
Vanguard Vanguard Total Intl Stock Index Fd Investment management fees paid indirectly by plan Basis Points * Plan Assets $0
Wells Fargo Wells Fargo Core Bond Fund Investment management fees paid indirectly by plan Basis Points * Plan Assets $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
Wells Fargo Stable Value Massachusetts Mutual Life Insurance Company DFE: Common/Collective Trust $17,685,276
Total $17,685,276

Insurance Information

Insurance Information

Insurance Carrier Summary Persons Covered
Northwestern Mutual 5
EIN 39-0509570
Industry Code 67091
Contract Number 12637
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 $17
Persons Receiving Commissions and Fees
Agent/Broker Organization Code Commissions Paid Fees Paid Purpose of Fees Paid
Ken Azar 1849 Data Dr Hoover, AL 35244 Insurance Agent or Broker $0 $17 PERSISTENCY FEES AND OTHER COMPENSATION
Allocated Funds
Type of Contract Individual Policies
Basis of premium rates See Attached
Premiums paid to carrier $6,304
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
The Lincoln National Life Insurance Company 2
EIN 35-0472300
Industry Code 65676
Contract Number P02512
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 $100
Persons Receiving Commissions and Fees
Agent/Broker Organization Code Commissions Paid Fees Paid Purpose of Fees Paid
Mike Priestley 3500 Blue Lake Dr Birmingham, AL 35243 Insurance Agent or Broker $50 $0
House Account 2 Metroplex Dr. Brimingham, AL 35209 Insurance Agent or Broker $50 $0
Allocated Funds
Type of Contract Individual Policies
Basis of premium rates Those Approved By Various State Insurance Departments
Premiums paid to carrier $5,000
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
Metropolitan Life Insurance Company 2
EIN 13-5581829
Industry Code 65978
Contract Number 087563
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 Individual Policies
Basis of premium rates Available Upon Request
Premiums paid to carrier $1,163
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
The Guardian Life Insurance Company 1
EIN 13-5123390
Industry Code 64246
Contract Number 3764585
Contract Year 07/01/2018 — 07/01/2019
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 Individual Policies
Basis of premium rates See Attached
Premiums paid to carrier $1,296
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
Protective Life Insurance Company 1
EIN 63-0169720
Industry Code 68136
Contract Number B00116414
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 $52
Persons Receiving Commissions and Fees
Agent/Broker Organization Code Commissions Paid Fees Paid Purpose of Fees Paid
Henry Coker 3480 Eastern Blvd, Compass Bank Montgomery, AL 36116 Insurance Agent or Broker $52 $0
Allocated Funds
Type of Contract Individual Policies
Basis of premium rates Policies Comply With State/Fed Regs
Premiums paid to carrier $2,000
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
Protective Life Insurance Company 1
EIN 63-0169720
Industry Code 68136
Contract Number B00267692
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 $29
Persons Receiving Commissions and Fees
Agent/Broker Organization Code Commissions Paid Fees Paid Purpose of Fees Paid
Manly P Lee Po Box 530826 Birmingham, AL 35253 Insurance Agent or Broker $29 $0
Allocated Funds
Type of Contract Individual Policies
Basis of premium rates Policies Comply With State/Fed Regs
Premiums paid to carrier $1,550
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
Protective Life Insurance Company 1
EIN 63-0169720
Industry Code 68136
Contract Number B00309181
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 $157
Persons Receiving Commissions and Fees
Agent/Broker Organization Code Commissions Paid Fees Paid Purpose of Fees Paid
FPIG 2501 20th Place South Birmingham, AL 35223 Insurance Agent or Broker $121 $0
Joie K Black 2795 Acton Place Birmingham, AL 35243 Insurance Agent or Broker $36 $0
Allocated Funds
Type of Contract Individual Policies
Basis of premium rates Policies Comply With State/Fed Regs
Premiums paid to carrier $5,425
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
Protective Life Insurance Company 1
EIN 63-0169720
Industry Code 68136
Contract Number PL0429514
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 $46
Persons Receiving Commissions and Fees
Agent/Broker Organization Code Commissions Paid Fees Paid Purpose of Fees Paid
Manly P Lee Po Box 530826 Birmingham, AL 35253 Insurance Agent or Broker $46 $0
Allocated Funds
Type of Contract Individual Policies
Basis of premium rates Policies Comply With State/Fed Regs
Premiums paid to carrier $2,318
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