BUSHEY ORAL & MAXILLOFACIAL SURGERY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN
401k plan membership statisitcs for MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN
| Measure | Date | Value |
|---|
| 2021: MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 11 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 8 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 1 |
| Total of all active and inactive participants | 2021-01-01 | 11 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2021-01-01 | 0 |
| Total participants | 2021-01-01 | 11 |
| Number of participants with account balances | 2021-01-01 | 11 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2021-01-01 | 0 |
| 2020: MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 13 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 8 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 2 |
| Total of all active and inactive participants | 2020-01-01 | 11 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2020-01-01 | 0 |
| Total participants | 2020-01-01 | 11 |
| Number of participants with account balances | 2020-01-01 | 11 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2020-01-01 | 0 |
| 2019: MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 13 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 8 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 4 |
| Total of all active and inactive participants | 2019-01-01 | 13 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2019-01-01 | 0 |
| Total participants | 2019-01-01 | 13 |
| Number of participants with account balances | 2019-01-01 | 13 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2019-01-01 | 0 |
| 2018: MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 13 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 12 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 1 |
| Total of all active and inactive participants | 2018-01-01 | 13 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2018-01-01 | 0 |
| Total participants | 2018-01-01 | 13 |
| Number of participants with account balances | 2018-01-01 | 13 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2018-01-01 | 0 |
| 2017: MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 13 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 10 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 2 |
| Total of all active and inactive participants | 2017-01-01 | 12 |
| Total participants | 2017-01-01 | 12 |
| Number of participants with account balances | 2017-01-01 | 12 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2017-01-01 | 0 |
| 2016: MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 14 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 11 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 2 |
| Total of all active and inactive participants | 2016-01-01 | 14 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2016-01-01 | 0 |
| Total participants | 2016-01-01 | 14 |
| Number of participants with account balances | 2016-01-01 | 13 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2016-01-01 | 0 |
| 2015: MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 14 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 10 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 3 |
| Total of all active and inactive participants | 2015-01-01 | 14 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2015-01-01 | 0 |
| Total participants | 2015-01-01 | 14 |
| Number of participants with account balances | 2015-01-01 | 13 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2015-01-01 | 1 |
| 2014: MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 9 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 11 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 2 |
| Total of all active and inactive participants | 2014-01-01 | 13 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-01-01 | 0 |
| Total participants | 2014-01-01 | 13 |
| Number of participants with account balances | 2014-01-01 | 12 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2014-01-01 | 0 |
| 2013: MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 10 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 7 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 2 |
| Total of all active and inactive participants | 2013-01-01 | 9 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-01-01 | 0 |
| Total participants | 2013-01-01 | 9 |
| Number of participants with account balances | 2013-01-01 | 8 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-01-01 | 1 |
| 2012: MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 10 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 8 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 2 |
| Total of all active and inactive participants | 2012-01-01 | 10 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-01-01 | 0 |
| Total participants | 2012-01-01 | 10 |
| Number of participants with account balances | 2012-01-01 | 9 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-01-01 | 0 |
| 2011: MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 9 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 7 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 2 |
| Total of all active and inactive participants | 2011-01-01 | 9 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-01-01 | 0 |
| Total participants | 2011-01-01 | 9 |
| Number of participants with account balances | 2011-01-01 | 9 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2011-01-01 | 0 |
| 2009: MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 9 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 9 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 0 |
| Total of all active and inactive participants | 2009-01-01 | 9 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-01-01 | 0 |
| Total participants | 2009-01-01 | 9 |
| Number of participants with account balances | 2009-01-01 | 9 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-01-01 | 0 |
| Measure | Date | Value |
|---|
| 2021 : MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2021 401k financial data |
|---|
| Total plan liabilities at end of year | 2021-12-31 | $2,536 |
| Total plan liabilities at beginning of year | 2021-12-31 | $3,557 |
| Total income from all sources | 2021-12-31 | $189,604 |
| Expenses. Total of all expenses incurred | 2021-12-31 | $3,303 |
| Benefits paid (including direct rollovers) | 2021-12-31 | $2,061 |
| Total plan assets at end of year | 2021-12-31 | $2,557,620 |
| Total plan assets at beginning of year | 2021-12-31 | $2,372,340 |
| Value of fidelity bond covering the plan | 2021-12-31 | $200,000 |
| Total contributions received or receivable from participants | 2021-12-31 | $39,555 |
| Expenses. Other expenses not covered elsewhere | 2021-12-31 | $1,242 |
| Other income received | 2021-12-31 | $94,692 |
| Net income (gross income less expenses) | 2021-12-31 | $186,301 |
| Net plan assets at end of year (total assets less liabilities) | 2021-12-31 | $2,555,084 |
| Net plan assets at beginning of year (total assets less liabilities) | 2021-12-31 | $2,368,783 |
| Total contributions received or receivable from employer(s) | 2021-12-31 | $55,357 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2021-12-31 | $0 |
| 2020 : MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2020 401k financial data |
|---|
| Total plan liabilities at end of year | 2020-12-31 | $3,557 |
| Total plan liabilities at beginning of year | 2020-12-31 | $3,560 |
| Total income from all sources | 2020-12-31 | $262,275 |
| Expenses. Total of all expenses incurred | 2020-12-31 | $326,359 |
| Benefits paid (including direct rollovers) | 2020-12-31 | $326,359 |
| Total plan assets at end of year | 2020-12-31 | $2,372,340 |
| Total plan assets at beginning of year | 2020-12-31 | $2,436,427 |
| Value of fidelity bond covering the plan | 2020-12-31 | $200,000 |
| Total contributions received or receivable from participants | 2020-12-31 | $52,814 |
| Other income received | 2020-12-31 | $151,153 |
| Net income (gross income less expenses) | 2020-12-31 | $-64,084 |
| Net plan assets at end of year (total assets less liabilities) | 2020-12-31 | $2,368,783 |
| Net plan assets at beginning of year (total assets less liabilities) | 2020-12-31 | $2,432,867 |
| Total contributions received or receivable from employer(s) | 2020-12-31 | $58,308 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2020-12-31 | $0 |
| 2019 : MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2019 401k financial data |
|---|
| Total plan liabilities at end of year | 2019-12-31 | $3,560 |
| Total plan liabilities at beginning of year | 2019-12-31 | $3,511 |
| Total income from all sources | 2019-12-31 | $298,626 |
| Expenses. Total of all expenses incurred | 2019-12-31 | $0 |
| Total plan assets at end of year | 2019-12-31 | $2,436,427 |
| Total plan assets at beginning of year | 2019-12-31 | $2,137,752 |
| Value of fidelity bond covering the plan | 2019-12-31 | $200,000 |
| Total contributions received or receivable from participants | 2019-12-31 | $57,774 |
| Other income received | 2019-12-31 | $183,279 |
| Net income (gross income less expenses) | 2019-12-31 | $298,626 |
| Net plan assets at end of year (total assets less liabilities) | 2019-12-31 | $2,432,867 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-12-31 | $2,134,241 |
| Total contributions received or receivable from employer(s) | 2019-12-31 | $57,573 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2019-12-31 | $0 |
| 2018 : MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2018 401k financial data |
|---|
| Total plan liabilities at end of year | 2018-12-31 | $3,511 |
| Total plan liabilities at beginning of year | 2018-12-31 | $1,720 |
| Total income from all sources | 2018-12-31 | $1,479,165 |
| Expenses. Total of all expenses incurred | 2018-12-31 | $1,415,125 |
| Benefits paid (including direct rollovers) | 2018-12-31 | $1,372,805 |
| Total plan assets at end of year | 2018-12-31 | $2,137,752 |
| Total plan assets at beginning of year | 2018-12-31 | $2,071,921 |
| Value of fidelity bond covering the plan | 2018-12-31 | $200,000 |
| Total contributions received or receivable from participants | 2018-12-31 | $45,431 |
| Expenses. Other expenses not covered elsewhere | 2018-12-31 | $42,320 |
| Contributions received from other sources (not participants or employers) | 2018-12-31 | $1,372,805 |
| Net income (gross income less expenses) | 2018-12-31 | $64,040 |
| Net plan assets at end of year (total assets less liabilities) | 2018-12-31 | $2,134,241 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-12-31 | $2,070,201 |
| Total contributions received or receivable from employer(s) | 2018-12-31 | $60,929 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2018-12-31 | $0 |
| 2017 : MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2017 401k financial data |
|---|
| Total plan liabilities at end of year | 2017-12-31 | $1,720 |
| Total plan liabilities at beginning of year | 2017-12-31 | $2,304 |
| Total income from all sources | 2017-12-31 | $315,263 |
| Expenses. Total of all expenses incurred | 2017-12-31 | $125 |
| Benefits paid (including direct rollovers) | 2017-12-31 | $125 |
| Total plan assets at end of year | 2017-12-31 | $2,071,921 |
| Total plan assets at beginning of year | 2017-12-31 | $1,757,367 |
| Value of fidelity bond covering the plan | 2017-12-31 | $100,000 |
| Total contributions received or receivable from participants | 2017-12-31 | $53,430 |
| Other income received | 2017-12-31 | $173,279 |
| Net income (gross income less expenses) | 2017-12-31 | $315,138 |
| Net plan assets at end of year (total assets less liabilities) | 2017-12-31 | $2,070,201 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-12-31 | $1,755,063 |
| Total contributions received or receivable from employer(s) | 2017-12-31 | $88,554 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2017-12-31 | $0 |
| 2016 : MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2016 401k financial data |
|---|
| Transfers to/from the plan | 2016-12-31 | $0 |
| Total plan liabilities at end of year | 2016-12-31 | $2,304 |
| Total plan liabilities at beginning of year | 2016-12-31 | $0 |
| Total income from all sources | 2016-12-31 | $167,809 |
| Expenses. Total of all expenses incurred | 2016-12-31 | $7,170 |
| Benefits paid (including direct rollovers) | 2016-12-31 | $5,798 |
| Total plan assets at end of year | 2016-12-31 | $1,757,367 |
| Total plan assets at beginning of year | 2016-12-31 | $1,594,424 |
| Value of fidelity bond covering the plan | 2016-12-31 | $100,000 |
| Total contributions received or receivable from participants | 2016-12-31 | $53,103 |
| Expenses. Other expenses not covered elsewhere | 2016-12-31 | $1,372 |
| Contributions received from other sources (not participants or employers) | 2016-12-31 | $2,544 |
| Other income received | 2016-12-31 | $23,911 |
| Net income (gross income less expenses) | 2016-12-31 | $160,639 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-31 | $1,755,063 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-31 | $1,594,424 |
| Total contributions received or receivable from employer(s) | 2016-12-31 | $88,251 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2016-12-31 | $0 |
| 2015 : MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2015 401k financial data |
|---|
| Transfers to/from the plan | 2015-12-31 | $0 |
| Total plan liabilities at end of year | 2015-12-31 | $0 |
| Total plan liabilities at beginning of year | 2015-12-31 | $463 |
| Total income from all sources | 2015-12-31 | $106,206 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $49,683 |
| Benefits paid (including direct rollovers) | 2015-12-31 | $49,683 |
| Total plan assets at end of year | 2015-12-31 | $1,594,424 |
| Total plan assets at beginning of year | 2015-12-31 | $1,538,364 |
| Value of fidelity bond covering the plan | 2015-12-31 | $100,000 |
| Total contributions received or receivable from participants | 2015-12-31 | $53,236 |
| Other income received | 2015-12-31 | $-34,655 |
| Net income (gross income less expenses) | 2015-12-31 | $56,523 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $1,594,424 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $1,537,901 |
| Total contributions received or receivable from employer(s) | 2015-12-31 | $87,625 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2015-12-31 | $0 |
| 2014 : MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2014 401k financial data |
|---|
| Transfers to/from the plan | 2014-12-31 | $0 |
| Total plan liabilities at end of year | 2014-12-31 | $463 |
| Total plan liabilities at beginning of year | 2014-12-31 | $463 |
| Total income from all sources | 2014-12-31 | $225,795 |
| Expenses. Total of all expenses incurred | 2014-12-31 | $0 |
| Total plan assets at end of year | 2014-12-31 | $1,538,364 |
| Total plan assets at beginning of year | 2014-12-31 | $1,312,569 |
| Value of fidelity bond covering the plan | 2014-12-31 | $100,000 |
| Total contributions received or receivable from participants | 2014-12-31 | $49,564 |
| Other income received | 2014-12-31 | $90,792 |
| Net income (gross income less expenses) | 2014-12-31 | $225,795 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $1,537,901 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $1,312,106 |
| Total contributions received or receivable from employer(s) | 2014-12-31 | $85,439 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2014-12-31 | $0 |
| 2013 : MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2013 401k financial data |
|---|
| Transfers to/from the plan | 2013-12-31 | $0 |
| Total plan liabilities at end of year | 2013-12-31 | $463 |
| Total plan liabilities at beginning of year | 2013-12-31 | $0 |
| Total income from all sources | 2013-12-31 | $98,273 |
| Expenses. Total of all expenses incurred | 2013-12-31 | $2,771 |
| Benefits paid (including direct rollovers) | 2013-12-31 | $1,043 |
| Total plan assets at end of year | 2013-12-31 | $1,312,569 |
| Total plan assets at beginning of year | 2013-12-31 | $1,216,604 |
| Value of fidelity bond covering the plan | 2013-12-31 | $100,000 |
| Total contributions received or receivable from participants | 2013-12-31 | $34,907 |
| Expenses. Other expenses not covered elsewhere | 2013-12-31 | $1,728 |
| Other income received | 2013-12-31 | $5,134 |
| Net income (gross income less expenses) | 2013-12-31 | $95,502 |
| Net plan assets at end of year (total assets less liabilities) | 2013-12-31 | $1,312,106 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-12-31 | $1,216,604 |
| Total contributions received or receivable from employer(s) | 2013-12-31 | $58,232 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2013-12-31 | $0 |
| 2012 : MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2012 401k financial data |
|---|
| Transfers to/from the plan | 2012-12-31 | $0 |
| Total plan liabilities at end of year | 2012-12-31 | $0 |
| Total plan liabilities at beginning of year | 2012-12-31 | $0 |
| Total income from all sources | 2012-12-31 | $92,681 |
| Expenses. Total of all expenses incurred | 2012-12-31 | $209,996 |
| Benefits paid (including direct rollovers) | 2012-12-31 | $209,996 |
| Total plan assets at end of year | 2012-12-31 | $1,216,604 |
| Total plan assets at beginning of year | 2012-12-31 | $1,333,919 |
| Value of fidelity bond covering the plan | 2012-12-31 | $100,000 |
| Total contributions received or receivable from participants | 2012-12-31 | $28,242 |
| Other income received | 2012-12-31 | $18,247 |
| Net income (gross income less expenses) | 2012-12-31 | $-117,315 |
| Net plan assets at end of year (total assets less liabilities) | 2012-12-31 | $1,216,604 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-12-31 | $1,333,919 |
| Total contributions received or receivable from employer(s) | 2012-12-31 | $46,192 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2012-12-31 | $0 |
| 2011 : MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2011 401k financial data |
|---|
| Transfers to/from the plan | 2011-12-31 | $0 |
| Total plan liabilities at end of year | 2011-12-31 | $0 |
| Total plan liabilities at beginning of year | 2011-12-31 | $0 |
| Total income from all sources | 2011-12-31 | $63,589 |
| Expenses. Total of all expenses incurred | 2011-12-31 | $0 |
| Benefits paid (including direct rollovers) | 2011-12-31 | $0 |
| Total plan assets at end of year | 2011-12-31 | $1,333,919 |
| Total plan assets at beginning of year | 2011-12-31 | $1,270,330 |
| Value of fidelity bond covering the plan | 2011-12-31 | $100,000 |
| Total contributions received or receivable from participants | 2011-12-31 | $27,948 |
| Other income received | 2011-12-31 | $-12,665 |
| Net income (gross income less expenses) | 2011-12-31 | $63,589 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-31 | $1,333,919 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-31 | $1,270,330 |
| Total contributions received or receivable from employer(s) | 2011-12-31 | $48,306 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2011-12-31 | $0 |
| 2010 : MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2010 401k financial data |
|---|
| Transfers to/from the plan | 2010-12-31 | $0 |
| Total plan liabilities at end of year | 2010-12-31 | $0 |
| Total plan liabilities at beginning of year | 2010-12-31 | $0 |
| Total income from all sources | 2010-12-31 | $128,890 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $0 |
| Total plan assets at end of year | 2010-12-31 | $1,270,330 |
| Total plan assets at beginning of year | 2010-12-31 | $1,141,440 |
| Value of fidelity bond covering the plan | 2010-12-31 | $100,000 |
| Total contributions received or receivable from participants | 2010-12-31 | $28,249 |
| Other income received | 2010-12-31 | $49,404 |
| Net income (gross income less expenses) | 2010-12-31 | $128,890 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $1,270,330 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $1,141,440 |
| Total contributions received or receivable from employer(s) | 2010-12-31 | $51,237 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2010-12-31 | $0 |
| 2009 : MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2009 401k financial data |
|---|
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2009-12-31 | $0 |
| 2021: MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Submission has been amended | No |
| 2021-01-01 | This submission is the final filing | No |
| 2021-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-01-01 | Plan is a collectively bargained plan | No |
| 2021-01-01 | Plan funding arrangement – Trust | Yes |
| 2021-01-01 | Plan benefit arrangement - Trust | Yes |
| 2020: MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Submission has been amended | No |
| 2020-01-01 | This submission is the final filing | No |
| 2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-01-01 | Plan is a collectively bargained plan | No |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – Trust | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement - Trust | Yes |
| 2019: MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Submission has been amended | No |
| 2019-01-01 | This submission is the final filing | No |
| 2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-01-01 | Plan is a collectively bargained plan | No |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – Trust | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement - Trust | Yes |
| 2018: MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Submission has been amended | No |
| 2018-01-01 | This submission is the final filing | No |
| 2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-01-01 | Plan is a collectively bargained plan | No |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – Trust | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement - Trust | Yes |
| 2017: MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | No |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – Trust | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement - Trust | Yes |
| 2016: MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – Trust | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement - Trust | Yes |
| 2015: MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – Trust | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement - Trust | Yes |
| 2014: MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Submission has been amended | No |
| 2014-01-01 | This submission is the final filing | No |
| 2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-01-01 | Plan is a collectively bargained plan | No |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – Trust | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement - Trust | Yes |
| 2013: MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Submission has been amended | No |
| 2013-01-01 | This submission is the final filing | No |
| 2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-01-01 | Plan is a collectively bargained plan | No |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – Trust | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement - Trust | Yes |
| 2012: MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Submission has been amended | No |
| 2012-01-01 | This submission is the final filing | No |
| 2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-01-01 | Plan is a collectively bargained plan | No |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – Trust | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement - Trust | Yes |
| 2011: MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Submission has been amended | No |
| 2011-01-01 | This submission is the final filing | No |
| 2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-01-01 | Plan is a collectively bargained plan | No |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan funding arrangement – Trust | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement - Trust | Yes |
| 2009: MICHAEL E. BUSHEY, D. D. S. , INC. 401(K) PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Submission has been amended | No |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan funding arrangement – Trust | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement - Trust | Yes |
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 21842 |
| Policy instance | 1 |
| Insurance contract or identification number | 21842 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-05-04 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Amount paid for insurance broker fees | 2482 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 21842 |
| Policy instance | 1 |
| Insurance contract or identification number | 21842 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $5,642 | | 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? | Yes | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Other information about contract | GUARANTEED INTEREST | | Amount paid for insurance broker fees | 5642 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 21842 |
| Policy instance | 1 |
| Insurance contract or identification number | 21842 | | Number of Individuals Covered | 13 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $5,601 | | 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? | Yes | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Other information about contract | GUARANTEED INTEREST | | Amount paid for insurance broker fees | 3716 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 21842 |
| Policy instance | 1 |
| Insurance contract or identification number | 21842 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $2,581 | | 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? | Yes | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Other information about contract | GUARANTEED INTEREST | | Amount paid for insurance broker fees | 2581 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 | | Insurance broker name | CETERA ADVISOR NETWORKS, LLC |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 21842 |
| Policy instance | 1 |
| Insurance contract or identification number | 21842 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $2,136 | | 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? | Yes | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Other information about contract | GUARANTEED INTEREST | | Amount paid for insurance broker fees | 2136 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 | | Insurance broker name | CETERA ADVISOR NETWORKS, LLC |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 21842 |
| Policy instance | 1 |
| Insurance contract or identification number | 21842 | | Number of Individuals Covered | 12 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $1,831 | | 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? | Yes | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Other information about contract | GUARANTEED INTEREST | | Amount paid for insurance broker fees | 1831 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 | | Insurance broker name | CETERA ADVISOR NETWORKS, LLC |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 21842 |
| Policy instance | 1 |
| Insurance contract or identification number | 21842 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $1,493 | | 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? | Yes | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Other information about contract | GUARANTEED INTEREST | | Amount paid for insurance broker fees | 1493 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 | | Insurance broker name | |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 21842 |
| Policy instance | 1 |
| Insurance contract or identification number | 21842 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $2,472 | | 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? | Yes | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Other information about contract | GUARANTEED INTEREST | | Amount paid for insurance broker fees | 2472 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 | | Insurance broker name | |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 21842 |
| Policy instance | 1 |
| Insurance contract or identification number | 21842 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $3,851 | | 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? | Yes | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Other information about contract | GUARANTEED INTEREST |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 21842 |
| Policy instance | 1 |
| Insurance contract or identification number | 21842 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $3,140 | | 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? | Yes | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Other information about contract | GUARANTEED INTEREST | | Amount paid for insurance broker fees | 3140 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 | | Insurance broker name | |
|
