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NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan NameNEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN
Plan identification number 001

NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • 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 contribtions 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.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).
  • Life insurance

401k Sponsoring company profile

NEWPORT CENTER MEDICAL GROUP has sponsored the creation of one or more 401k plans.

Company Name:NEWPORT CENTER MEDICAL GROUP
Employer identification number (EIN):330521967
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012023-01-01WILLIAM P. FUKUDA, MD2024-08-12
0012022-01-01WILLIAM FUKUDA2023-10-06
0012021-01-01WILLIAM P. FUKUDA, MD2022-10-17
0012020-01-01WILLIAM P. FUKUDA, MD2021-04-22
0012019-01-01BRADLEY KAYS, MD2020-05-05
0012018-01-01
0012017-01-01
0012016-01-01
0012015-01-01
0012014-01-01BRADLEY KAYS, MD
0012013-01-01RONALD M TILSEN, MD
0012012-01-01RONALD M TILSEN, MD
0012011-01-01RONALD M TILSEN, MD
0012010-01-01RONALD M TILSEN, MD
0012009-01-01RONALD M TILSEN, MD

Plan Statistics for NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN

Measure Date Value
2023: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-0132
Total number of active participants reported on line 7a of the Form 55002023-01-0118
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-0112
Total of all active and inactive participants2023-01-0130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2023-01-010
Total participants2023-01-0130
Number of participants with account balances2023-01-0130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2023-01-010
2022: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0131
Total number of active participants reported on line 7a of the Form 55002022-01-0119
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0113
Total of all active and inactive participants2022-01-0132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-0132
Number of participants with account balances2022-01-0131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-015
2021: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0135
Total number of active participants reported on line 7a of the Form 55002021-01-0120
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0110
Total of all active and inactive participants2021-01-0130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-0130
Number of participants with account balances2021-01-0130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0135
Total number of active participants reported on line 7a of the Form 55002020-01-0123
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0111
Total of all active and inactive participants2020-01-0134
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-0134
Number of participants with account balances2020-01-0134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-011
2019: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0136
Total number of active participants reported on line 7a of the Form 55002019-01-0124
Number of retired or separated participants receiving benefits2019-01-011
Number of other retired or separated participants entitled to future benefits2019-01-0110
Total of all active and inactive participants2019-01-0135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0135
Number of participants with account balances2019-01-0135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-012
2018: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0137
Total number of active participants reported on line 7a of the Form 55002018-01-0126
Number of retired or separated participants receiving benefits2018-01-011
Number of other retired or separated participants entitled to future benefits2018-01-019
Total of all active and inactive participants2018-01-0136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0136
Number of participants with account balances2018-01-0136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-011
2017: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0134
Total number of active participants reported on line 7a of the Form 55002017-01-0124
Number of retired or separated participants receiving benefits2017-01-011
Number of other retired or separated participants entitled to future benefits2017-01-0112
Total of all active and inactive participants2017-01-0137
Total participants2017-01-0137
Number of participants with account balances2017-01-0137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-013
2016: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0134
Total number of active participants reported on line 7a of the Form 55002016-01-0124
Number of retired or separated participants receiving benefits2016-01-011
Number of other retired or separated participants entitled to future benefits2016-01-019
Total of all active and inactive participants2016-01-0134
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0134
Number of participants with account balances2016-01-0134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-012
2015: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0137
Total number of active participants reported on line 7a of the Form 55002015-01-0126
Number of retired or separated participants receiving benefits2015-01-011
Number of other retired or separated participants entitled to future benefits2015-01-017
Total of all active and inactive participants2015-01-0134
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0134
Number of participants with account balances2015-01-0132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-013
2014: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0138
Total number of active participants reported on line 7a of the Form 55002014-01-0127
Number of retired or separated participants receiving benefits2014-01-011
Number of other retired or separated participants entitled to future benefits2014-01-019
Total of all active and inactive participants2014-01-0137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0137
Number of participants with account balances2014-01-0136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-013
2013: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0137
Total number of active participants reported on line 7a of the Form 55002013-01-0132
Number of retired or separated participants receiving benefits2013-01-011
Number of other retired or separated participants entitled to future benefits2013-01-015
Total of all active and inactive participants2013-01-0138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0138
Number of participants with account balances2013-01-0135
2012: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0141
Total number of active participants reported on line 7a of the Form 55002012-01-0130
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-017
Total of all active and inactive participants2012-01-0137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0137
Number of participants with account balances2012-01-0136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-013
2011: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0138
Total number of active participants reported on line 7a of the Form 55002011-01-0134
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-017
Total of all active and inactive participants2011-01-0141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0141
Number of participants with account balances2011-01-0135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-012
2010: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0140
Total number of active participants reported on line 7a of the Form 55002010-01-0131
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-017
Total of all active and inactive participants2010-01-0138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0138
Number of participants with account balances2010-01-0135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-014
2009: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0144
Total number of active participants reported on line 7a of the Form 55002009-01-0134
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-016
Total of all active and inactive participants2009-01-0140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0140
Number of participants with account balances2009-01-0138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-011

Financial Data on NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN

Measure Date Value
2023 : NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2023 401k financial data
Total plan liabilities at end of year2023-12-31$0
Total plan liabilities at beginning of year2023-12-31$6,000
Total income from all sources2023-12-31$1,125,744
Expenses. Total of all expenses incurred2023-12-31$143,223
Benefits paid (including direct rollovers)2023-12-31$111,877
Total plan assets at end of year2023-12-31$7,122,425
Total plan assets at beginning of year2023-12-31$6,145,904
Value of fidelity bond covering the plan2023-12-31$500,000
Total contributions received or receivable from participants2023-12-31$94,895
Other income received2023-12-31$923,525
Net income (gross income less expenses)2023-12-31$982,521
Net plan assets at end of year (total assets less liabilities)2023-12-31$7,122,425
Net plan assets at beginning of year (total assets less liabilities)2023-12-31$6,139,904
Assets. Value of participant loans2023-12-31$61,199
Assets. Value of assets in partnership/joint-venture interests2023-12-31$387,636
Total contributions received or receivable from employer(s)2023-12-31$107,324
Expenses. Administrative service providers (salaries,fees and commissions)2023-12-31$31,346
2022 : NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2022 401k financial data
Total plan liabilities at end of year2022-12-31$6,000
Total plan liabilities at beginning of year2022-12-31$6,000
Total income from all sources2022-12-31$-765,897
Expenses. Total of all expenses incurred2022-12-31$13,651
Benefits paid (including direct rollovers)2022-12-31$2,266
Total plan assets at end of year2022-12-31$6,145,904
Total plan assets at beginning of year2022-12-31$6,925,452
Value of fidelity bond covering the plan2022-12-31$500,000
Total contributions received or receivable from participants2022-12-31$88,695
Assets. Value of loans (other than to participants)2022-12-31$83,173
Other income received2022-12-31$-963,865
Net income (gross income less expenses)2022-12-31$-779,548
Net plan assets at end of year (total assets less liabilities)2022-12-31$6,139,904
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$6,919,452
Assets. Value of participant loans2022-12-31$68,134
Assets. Value of assets in partnership/joint-venture interests2022-12-31$428,251
Total contributions received or receivable from employer(s)2022-12-31$109,273
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$11,385
2021 : NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2021 401k financial data
Total plan liabilities at end of year2021-12-31$6,000
Total plan liabilities at beginning of year2021-12-31$0
Total income from all sources2021-12-31$1,313,397
Expenses. Total of all expenses incurred2021-12-31$2,535,761
Benefits paid (including direct rollovers)2021-12-31$2,502,068
Total plan assets at end of year2021-12-31$6,925,452
Total plan assets at beginning of year2021-12-31$8,141,816
Value of fidelity bond covering the plan2021-12-31$500,000
Total contributions received or receivable from participants2021-12-31$74,255
Assets. Value of loans (other than to participants)2021-12-31$69,844
Contributions received from other sources (not participants or employers)2021-12-31$5,020
Other income received2021-12-31$1,127,955
Net income (gross income less expenses)2021-12-31$-1,222,364
Net plan assets at end of year (total assets less liabilities)2021-12-31$6,919,452
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$8,141,816
Assets. Value of participant loans2021-12-31$90,957
Assets. Value of assets in partnership/joint-venture interests2021-12-31$232,497
Total contributions received or receivable from employer(s)2021-12-31$106,167
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$33,693
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
2020 : NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2020 401k financial data
Total plan liabilities at end of year2020-12-31$0
Total plan liabilities at beginning of year2020-12-31$0
Total income from all sources2020-12-31$1,467,326
Expenses. Total of all expenses incurred2020-12-31$684,046
Benefits paid (including direct rollovers)2020-12-31$654,732
Total plan assets at end of year2020-12-31$8,141,816
Total plan assets at beginning of year2020-12-31$7,358,536
Value of fidelity bond covering the plan2020-12-31$500,000
Total contributions received or receivable from participants2020-12-31$103,376
Assets. Value of loans (other than to participants)2020-12-31$69,844
Expenses. Other expenses not covered elsewhere2020-12-31$19
Other income received2020-12-31$1,208,219
Net income (gross income less expenses)2020-12-31$783,280
Net plan assets at end of year (total assets less liabilities)2020-12-31$8,141,816
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$7,358,536
Assets. Value of participant loans2020-12-31$32,344
Assets. Value of assets in partnership/joint-venture interests2020-12-31$346,057
Total contributions received or receivable from employer(s)2020-12-31$155,731
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$29,295
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
2019 : NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2019 401k financial data
Total plan liabilities at end of year2019-12-31$0
Total plan liabilities at beginning of year2019-12-31$0
Total income from all sources2019-12-31$1,567,717
Expenses. Total of all expenses incurred2019-12-31$341,257
Benefits paid (including direct rollovers)2019-12-31$315,744
Total plan assets at end of year2019-12-31$7,358,536
Total plan assets at beginning of year2019-12-31$6,132,076
Value of fidelity bond covering the plan2019-12-31$500,000
Total contributions received or receivable from participants2019-12-31$120,131
Assets. Value of loans (other than to participants)2019-12-31$69,844
Other income received2019-12-31$1,309,172
Net income (gross income less expenses)2019-12-31$1,226,460
Net plan assets at end of year (total assets less liabilities)2019-12-31$7,358,536
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$6,132,076
Assets. Value of participant loans2019-12-31$51,980
Assets. Value of assets in partnership/joint-venture interests2019-12-31$349,173
Total contributions received or receivable from employer(s)2019-12-31$138,414
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$25,513
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
2018 : NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2018 401k financial data
Total plan liabilities at end of year2018-12-31$0
Total plan liabilities at beginning of year2018-12-31$0
Total income from all sources2018-12-31$-166,884
Expenses. Total of all expenses incurred2018-12-31$125,401
Benefits paid (including direct rollovers)2018-12-31$95,960
Total plan assets at end of year2018-12-31$6,132,076
Total plan assets at beginning of year2018-12-31$6,424,361
Value of fidelity bond covering the plan2018-12-31$500,000
Total contributions received or receivable from participants2018-12-31$103,327
Assets. Value of loans (other than to participants)2018-12-31$69,844
Other income received2018-12-31$-416,790
Net income (gross income less expenses)2018-12-31$-292,285
Net plan assets at end of year (total assets less liabilities)2018-12-31$6,132,076
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$6,424,361
Assets. Value of participant loans2018-12-31$52,096
Assets. Value of assets in partnership/joint-venture interests2018-12-31$410,976
Total contributions received or receivable from employer(s)2018-12-31$146,579
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$29,441
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
2017 : NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2017 401k financial data
Total plan liabilities at end of year2017-12-31$0
Total plan liabilities at beginning of year2017-12-31$0
Total income from all sources2017-12-31$1,112,515
Expenses. Total of all expenses incurred2017-12-31$291,213
Benefits paid (including direct rollovers)2017-12-31$262,167
Total plan assets at end of year2017-12-31$6,424,361
Total plan assets at beginning of year2017-12-31$5,603,059
Value of fidelity bond covering the plan2017-12-31$500,000
Total contributions received or receivable from participants2017-12-31$101,586
Assets. Value of loans (other than to participants)2017-12-31$69,844
Other income received2017-12-31$886,056
Net income (gross income less expenses)2017-12-31$821,302
Net plan assets at end of year (total assets less liabilities)2017-12-31$6,424,361
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$5,603,059
Assets. Value of participant loans2017-12-31$68,603
Assets. Value of assets in partnership/joint-venture interests2017-12-31$330,730
Total contributions received or receivable from employer(s)2017-12-31$124,873
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$29,046
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2016 401k financial data
Total plan liabilities at end of year2016-12-31$0
Total plan liabilities at beginning of year2016-12-31$0
Total income from all sources2016-12-31$595,116
Expenses. Total of all expenses incurred2016-12-31$161,388
Benefits paid (including direct rollovers)2016-12-31$135,451
Total plan assets at end of year2016-12-31$5,603,059
Total plan assets at beginning of year2016-12-31$5,169,331
Value of fidelity bond covering the plan2016-12-31$500,000
Total contributions received or receivable from participants2016-12-31$108,026
Assets. Value of loans (other than to participants)2016-12-31$169,844
Other income received2016-12-31$370,196
Net income (gross income less expenses)2016-12-31$433,728
Net plan assets at end of year (total assets less liabilities)2016-12-31$5,603,059
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$5,169,331
Assets. Value of participant loans2016-12-31$55,104
Assets. Value of assets in partnership/joint-venture interests2016-12-31$80,730
Total contributions received or receivable from employer(s)2016-12-31$116,894
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$25,937
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total plan liabilities at end of year2015-12-31$0
Total plan liabilities at beginning of year2015-12-31$0
Total income from all sources2015-12-31$224,785
Expenses. Total of all expenses incurred2015-12-31$1,730,350
Benefits paid (including direct rollovers)2015-12-31$1,679,046
Total plan assets at end of year2015-12-31$5,169,331
Total plan assets at beginning of year2015-12-31$6,674,896
Value of fidelity bond covering the plan2015-12-31$500,000
Total contributions received or receivable from participants2015-12-31$139,067
Assets. Value of loans (other than to participants)2015-12-31$169,844
Expenses. Other expenses not covered elsewhere2015-12-31$854
Contributions received from other sources (not participants or employers)2015-12-31$6,798
Other income received2015-12-31$-61,189
Net income (gross income less expenses)2015-12-31$-1,505,565
Net plan assets at end of year (total assets less liabilities)2015-12-31$5,169,331
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$6,674,896
Assets. Value of participant loans2015-12-31$18,434
Total contributions received or receivable from employer(s)2015-12-31$140,109
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$50,450
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2014 401k financial data
Total plan liabilities at end of year2014-12-31$0
Total plan liabilities at beginning of year2014-12-31$0
Total income from all sources2014-12-31$647,213
Expenses. Total of all expenses incurred2014-12-31$152,666
Benefits paid (including direct rollovers)2014-12-31$103,360
Total plan assets at end of year2014-12-31$6,674,896
Total plan assets at beginning of year2014-12-31$6,180,349
Value of fidelity bond covering the plan2014-12-31$500,000
Total contributions received or receivable from participants2014-12-31$144,335
Assets. Value of loans (other than to participants)2014-12-31$69,844
Expenses. Other expenses not covered elsewhere2014-12-31$1,293
Other income received2014-12-31$335,075
Net income (gross income less expenses)2014-12-31$494,547
Net plan assets at end of year (total assets less liabilities)2014-12-31$6,674,896
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$6,180,349
Assets. Value of participant loans2014-12-31$46,272
Total contributions received or receivable from employer(s)2014-12-31$167,803
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$48,013
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2013 401k financial data
Total plan liabilities at end of year2013-12-31$0
Total plan liabilities at beginning of year2013-12-31$0
Total income from all sources2013-12-31$1,188,241
Expenses. Total of all expenses incurred2013-12-31$829,207
Benefits paid (including direct rollovers)2013-12-31$780,782
Total plan assets at end of year2013-12-31$6,180,349
Total plan assets at beginning of year2013-12-31$5,821,315
Value of fidelity bond covering the plan2013-12-31$500,000
Total contributions received or receivable from participants2013-12-31$114,346
Assets. Value of loans (other than to participants)2013-12-31$69,844
Expenses. Other expenses not covered elsewhere2013-12-31$579
Other income received2013-12-31$913,655
Net income (gross income less expenses)2013-12-31$359,034
Net plan assets at end of year (total assets less liabilities)2013-12-31$6,180,349
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$5,821,315
Assets. Value of participant loans2013-12-31$36,032
Total contributions received or receivable from employer(s)2013-12-31$160,240
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$47,846
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2012 401k financial data
Total plan liabilities at end of year2012-12-31$0
Total plan liabilities at beginning of year2012-12-31$0
Total income from all sources2012-12-31$722,824
Expenses. Total of all expenses incurred2012-12-31$659,058
Benefits paid (including direct rollovers)2012-12-31$626,733
Total plan assets at end of year2012-12-31$5,821,315
Total plan assets at beginning of year2012-12-31$5,757,549
Value of fidelity bond covering the plan2012-12-31$500,000
Total contributions received or receivable from participants2012-12-31$112,023
Assets. Value of loans (other than to participants)2012-12-31$139,688
Other income received2012-12-31$460,717
Net income (gross income less expenses)2012-12-31$63,766
Net plan assets at end of year (total assets less liabilities)2012-12-31$5,821,315
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$5,757,549
Assets. Value of participant loans2012-12-31$13,378
Total contributions received or receivable from employer(s)2012-12-31$150,084
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$32,325
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2011 401k financial data
Total plan liabilities at end of year2011-12-31$0
Total plan liabilities at beginning of year2011-12-31$0
Total income from all sources2011-12-31$132,171
Expenses. Total of all expenses incurred2011-12-31$336,501
Benefits paid (including direct rollovers)2011-12-31$307,836
Total plan assets at end of year2011-12-31$5,757,549
Total plan assets at beginning of year2011-12-31$5,961,879
Value of fidelity bond covering the plan2011-12-31$500,000
Total contributions received or receivable from participants2011-12-31$116,875
Assets. Value of loans (other than to participants)2011-12-31$200,000
Expenses. Other expenses not covered elsewhere2011-12-31$603
Contributions received from other sources (not participants or employers)2011-12-31$8,458
Other income received2011-12-31$-181,669
Net income (gross income less expenses)2011-12-31$-204,330
Net plan assets at end of year (total assets less liabilities)2011-12-31$5,757,549
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$5,961,879
Assets. Value of participant loans2011-12-31$30,310
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-1022011-12-31$47,332
Total contributions received or receivable from employer(s)2011-12-31$188,507
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$28,062
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2010 401k financial data
Total plan liabilities at end of year2010-12-31$0
Total plan liabilities at beginning of year2010-12-31$0
Total income from all sources2010-12-31$741,471
Expenses. Total of all expenses incurred2010-12-31$116,379
Benefits paid (including direct rollovers)2010-12-31$86,650
Total plan assets at end of year2010-12-31$5,961,879
Total plan assets at beginning of year2010-12-31$5,336,787
Value of fidelity bond covering the plan2010-12-31$500,000
Total contributions received or receivable from participants2010-12-31$137,292
Assets. Value of loans (other than to participants)2010-12-31$200,000
Other income received2010-12-31$426,137
Net income (gross income less expenses)2010-12-31$625,092
Net plan assets at end of year (total assets less liabilities)2010-12-31$5,961,879
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$5,336,787
Assets. Value of participant loans2010-12-31$85,254
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-1022010-12-31$138,999
Total contributions received or receivable from employer(s)2010-12-31$178,042
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$29,729
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0

Form 5500 Responses for NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN

2023: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement - TrustYes
2022: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: NEWPORT CENTER MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number12579
Policy instance 1
Insurance contract or identification number12579
Number of Individuals Covered30
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $9,744
Total amount of fees paid to insurance companyUSD $2,551
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedGROUP ANNUITY CONTRACT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number12579
Policy instance 1
Insurance contract or identification number12579
Number of Individuals Covered28
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $9,196
Total amount of fees paid to insurance companyUSD $1,941
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedGROUP ANNUITY CONTRACT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,196
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerBROKER COMMISSION
Insurance broker organization code?3
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number12579
Policy instance 1
Insurance contract or identification number12579
Number of Individuals Covered36
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $11,718
Total amount of fees paid to insurance companyUSD $4,021
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedGROUP ANNUITY CONTRACT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,718
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerBROKER COMMISSION
Insurance broker organization code?3
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number12579
Policy instance 1
Insurance contract or identification number12579
Number of Individuals Covered36
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $9,983
Total amount of fees paid to insurance companyUSD $2,198
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedGROUP ANNUITY CONTRACT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,983
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerBROKER COMMISSION
Insurance broker organization code?3
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number12579
Policy instance 1
Insurance contract or identification number12579
Number of Individuals Covered36
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $9,195
Total amount of fees paid to insurance companyUSD $2,341
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedGROUP ANNUITY CONTRACT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,195
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerBROKER COMMISSION
Insurance broker organization code?3
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number2623580W
Policy instance 2
Insurance contract or identification number2623580W
Number of Individuals Covered1
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number12579
Policy instance 1
Insurance contract or identification number12579
Number of Individuals Covered35
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $8,674
Total amount of fees paid to insurance companyUSD $2,558
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedGROUP ANNUITY CONTRACT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,674
Insurance broker organization code?3
Amount paid for insurance broker fees1736
Additional information about fees paid to insurance brokerTPA FEES
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number2623580W
Policy instance 2
Insurance contract or identification number2623580W
Number of Individuals Covered1
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number2623580W
Policy instance 2
Insurance contract or identification number2623580W
Number of Individuals Covered1
Insurance policy start date2016-10-01
Insurance policy end date2017-09-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number12579
Policy instance 1
Insurance contract or identification number12579
Number of Individuals Covered38
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $7,739
Total amount of fees paid to insurance companyUSD $2,040
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedGROUP ANNUITY CONTRACT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,739
Insurance broker organization code?3
Amount paid for insurance broker fees1548
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker nameMORGAN STANLEY & CO. INC.
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number2623580W
Policy instance 2
Insurance contract or identification number2623580W
Number of Individuals Covered1
Insurance policy start date2015-10-01
Insurance policy end date2016-09-30
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number12579
Policy instance 1
Insurance contract or identification number12579
Number of Individuals Covered37
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
Total amount of commissions paid to insurance brokerUSD $6,312
Total amount of fees paid to insurance companyUSD $1,892
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedGROUP ANNUITY CONTRACT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,312
Insurance broker organization code?3
Amount paid for insurance broker fees1158
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker nameMORGAN STANLEY & CO. INC.
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number12579
Policy instance 1
Insurance contract or identification number12579
Number of Individuals Covered34
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $12,531
Total amount of fees paid to insurance companyUSD $808
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedGROUP ANNUITY CONTRACT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,531
Insurance broker organization code?3
Amount paid for insurance broker fees700
Additional information about fees paid to insurance brokerDISTRIBUTION AND LOAN PROCESSING FEES
Insurance broker nameMORGAN STANLEY & CO. INC.
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number2623580W
Policy instance 2
Insurance contract or identification number2623580W
Number of Individuals Covered1
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number12579
Policy instance 1
Insurance contract or identification number12579
Number of Individuals Covered38
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $12,223
Total amount of fees paid to insurance companyUSD $508
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedGROUP ANNUITY CONTRACT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,223
Insurance broker organization code?3
Amount paid for insurance broker fees400
Additional information about fees paid to insurance brokerDISTRIBUTION AND LOAN PROCESSING FEES
Insurance broker nameMORGAN STANLEY & CO. INC.
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number2623580W
Policy instance 2
Insurance contract or identification number2623580W
Number of Individuals Covered1
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number12579
Policy instance 1
Insurance contract or identification number12579
Number of Individuals Covered38
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $9,883
Total amount of fees paid to insurance companyUSD $610
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedGROUP ANNUITY CONTRACT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,883
Insurance broker organization code?3
Amount paid for insurance broker fees500
Additional information about fees paid to insurance brokerDISTRIBUTION AND LOAN PROCESSING FEES
Insurance broker nameMORGAN STANLEY & CO. INC.
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number2623580W
Policy instance 2
Insurance contract or identification number2623580W
Number of Individuals Covered1
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number2623580W
Policy instance 2
Insurance contract or identification number2623580W
Number of Individuals Covered1
Insurance policy start date2011-10-01
Insurance policy end date2012-09-30
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $175,126
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number12579
Policy instance 1
Insurance contract or identification number12579
Number of Individuals Covered38
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $8,637
Total amount of fees paid to insurance companyUSD $613
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedGROUP ANNUITY CONTRACT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,637
Insurance broker organization code?3
Amount paid for insurance broker fees113
Additional information about fees paid to insurance brokerMISCELLANEOUS ACCOUNT FEES
Insurance broker nameCREATIVE RETIREMENT SOLUTIONS
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number1578035
Policy instance 2
Insurance contract or identification number1578035
Number of Individuals Covered1
Insurance policy start date2010-10-01
Insurance policy end date2011-10-01
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number12579
Policy instance 1
Insurance contract or identification number12579
Number of Individuals Covered38
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $9,441
Total amount of fees paid to insurance companyUSD $400
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedGROUP ANNUITY CONTRACT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number1578035
Policy instance 2
Insurance contract or identification number1578035
Number of Individuals Covered1
Insurance policy start date2009-10-01
Insurance policy end date2010-10-01
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number12579
Policy instance 1
Insurance contract or identification number12579
Number of Individuals Covered37
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $8,275
Total amount of fees paid to insurance companyUSD $629
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedGROUP ANNUITY CONTRACT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,275
Insurance broker organization code?3
Amount paid for insurance broker fees229
Additional information about fees paid to insurance brokerMISCELLANEOUS ACCOUNT FEES
Insurance broker nameCREATIVE RETIREMENT SOLUTIONS

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