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BRIAN J BLOCHER DDS SC PROFIT SHARING PLAN 401k Plan overview

Plan NameBRIAN J BLOCHER DDS SC PROFIT SHARING PLAN
Plan identification number 001

BRIAN J BLOCHER DDS SC 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.
  • 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)).

401k Sponsoring company profile

BRIAN J BLOCHER DDS SC has sponsored the creation of one or more 401k plans.

Company Name:BRIAN J BLOCHER DDS SC
Employer identification number (EIN):391907624
NAIC Classification:621210
NAIC Description:Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BRIAN J BLOCHER DDS SC PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01BRIAN BLOCHER2023-07-21
0012021-01-01BRIAN BLOCHER2022-04-29
0012020-01-01BRIAN BLOCHER2021-09-23
0012019-01-01
0012018-01-01BRIAN BLOCHER
0012017-01-01BRIAN BLOCHER
0012016-01-01BRIAN BLOCHER
0012015-01-01BRIAN BLOCHER
0012014-01-01BRIAN BLOCHER
0012013-01-01BRIAN BLOCHER
0012012-01-01BRIAN BLOCHER
0012011-01-01BRIAN BLOCHER
0012010-01-01BRIAN BLOCHER2011-06-28

Plan Statistics for BRIAN J BLOCHER DDS SC PROFIT SHARING PLAN

401k plan membership statisitcs for BRIAN J BLOCHER DDS SC PROFIT SHARING PLAN

Measure Date Value
2019: BRIAN J BLOCHER DDS SC PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0114
Total number of active participants reported on line 7a of the Form 55002019-01-019
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-017
Total of all active and inactive participants2019-01-0116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0116
Number of participants with account balances2019-01-0114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-011
2018: BRIAN J BLOCHER DDS SC PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0111
Total number of active participants reported on line 7a of the Form 55002018-01-019
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-015
Total of all active and inactive participants2018-01-0114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0114
Number of participants with account balances2018-01-0114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-011
2017: BRIAN J BLOCHER DDS SC PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0111
Total number of active participants reported on line 7a of the Form 55002017-01-0110
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-014
Total of all active and inactive participants2017-01-0114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0114
Number of participants with account balances2017-01-0110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-011
2016: BRIAN J BLOCHER DDS SC PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0113
Total number of active participants reported on line 7a of the Form 55002016-01-017
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-015
Total of all active and inactive participants2016-01-0112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0112
Number of participants with account balances2016-01-0111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: BRIAN J BLOCHER DDS SC PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0114
Total number of active participants reported on line 7a of the Form 55002015-01-019
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-013
Total of all active and inactive participants2015-01-0112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-011
Total participants2015-01-0113
Number of participants with account balances2015-01-0113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-012
2014: BRIAN J BLOCHER DDS SC PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0118
Total number of active participants reported on line 7a of the Form 55002014-01-0110
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-014
Total of all active and inactive participants2014-01-0114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0114
Number of participants with account balances2014-01-0113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: BRIAN J BLOCHER DDS SC PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0118
Total number of active participants reported on line 7a of the Form 55002013-01-0111
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-017
Total of all active and inactive participants2013-01-0118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0118
Number of participants with account balances2013-01-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: BRIAN J BLOCHER DDS SC PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0123
Total number of active participants reported on line 7a of the Form 55002012-01-0113
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-015
Total of all active and inactive participants2012-01-0118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0118
Number of participants with account balances2012-01-0118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: BRIAN J BLOCHER DDS SC PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0117
Total number of active participants reported on line 7a of the Form 55002011-01-0113
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-014
Total of all active and inactive participants2011-01-0117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0117
Number of participants with account balances2011-01-0117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010

Financial Data on BRIAN J BLOCHER DDS SC PROFIT SHARING PLAN

Measure Date Value
2019 : BRIAN J BLOCHER DDS SC PROFIT SHARING PLAN 2019 401k financial data
Total income from all sources2019-12-31$299,156
Expenses. Total of all expenses incurred2019-12-31$3,371
Benefits paid (including direct rollovers)2019-12-31$3,201
Total plan assets at end of year2019-12-31$1,541,377
Total plan assets at beginning of year2019-12-31$1,245,592
Value of fidelity bond covering the plan2019-12-31$225,000
Other income received2019-12-31$226,760
Net income (gross income less expenses)2019-12-31$295,785
Net plan assets at end of year (total assets less liabilities)2019-12-31$1,541,377
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$1,245,592
Total contributions received or receivable from employer(s)2019-12-31$72,396
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$170
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
2018 : BRIAN J BLOCHER DDS SC PROFIT SHARING PLAN 2018 401k financial data
Total income from all sources2018-12-31$-19,907
Expenses. Total of all expenses incurred2018-12-31$0
Total plan assets at end of year2018-12-31$1,245,592
Total plan assets at beginning of year2018-12-31$1,265,499
Value of fidelity bond covering the plan2018-12-31$275,000
Other income received2018-12-31$-87,267
Net income (gross income less expenses)2018-12-31$-19,907
Net plan assets at end of year (total assets less liabilities)2018-12-31$1,245,592
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$1,265,499
Total contributions received or receivable from employer(s)2018-12-31$67,360
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
2017 : BRIAN J BLOCHER DDS SC PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources2017-12-31$219,145
Expenses. Total of all expenses incurred2017-12-31$2,814
Benefits paid (including direct rollovers)2017-12-31$2,729
Total plan assets at end of year2017-12-31$1,265,499
Total plan assets at beginning of year2017-12-31$1,049,168
Value of fidelity bond covering the plan2017-12-31$265,000
Other income received2017-12-31$153,033
Net income (gross income less expenses)2017-12-31$216,331
Net plan assets at end of year (total assets less liabilities)2017-12-31$1,265,499
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$1,049,168
Total contributions received or receivable from employer(s)2017-12-31$66,112
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$85
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : BRIAN J BLOCHER DDS SC PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources2016-12-31$125,076
Expenses. Total of all expenses incurred2016-12-31$29,649
Benefits paid (including direct rollovers)2016-12-31$26,682
Total plan assets at end of year2016-12-31$1,049,168
Total plan assets at beginning of year2016-12-31$953,741
Value of fidelity bond covering the plan2016-12-31$265,000
Other income received2016-12-31$62,853
Net income (gross income less expenses)2016-12-31$95,427
Net plan assets at end of year (total assets less liabilities)2016-12-31$1,049,168
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$953,741
Total contributions received or receivable from employer(s)2016-12-31$62,223
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$2,967
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : BRIAN J BLOCHER DDS SC PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources2015-12-31$20,910
Expenses. Total of all expenses incurred2015-12-31$9,803
Benefits paid (including direct rollovers)2015-12-31$5,954
Total plan assets at end of year2015-12-31$953,741
Total plan assets at beginning of year2015-12-31$942,634
Value of fidelity bond covering the plan2015-12-31$265,000
Other income received2015-12-31$-16,165
Net income (gross income less expenses)2015-12-31$11,107
Net plan assets at end of year (total assets less liabilities)2015-12-31$953,741
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$942,634
Total contributions received or receivable from employer(s)2015-12-31$37,075
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$3,849
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : BRIAN J BLOCHER DDS SC PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources2014-12-31$112,140
Expenses. Total of all expenses incurred2014-12-31$4,621
Benefits paid (including direct rollovers)2014-12-31$1,061
Total plan assets at end of year2014-12-31$942,634
Total plan assets at beginning of year2014-12-31$835,115
Value of fidelity bond covering the plan2014-12-31$265,000
Total contributions received or receivable from participants2014-12-31$5,500
Other income received2014-12-31$40,128
Net income (gross income less expenses)2014-12-31$107,519
Net plan assets at end of year (total assets less liabilities)2014-12-31$942,634
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$835,115
Total contributions received or receivable from employer(s)2014-12-31$66,512
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$3,560
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : BRIAN J BLOCHER DDS SC PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources2013-12-31$160,376
Expenses. Total of all expenses incurred2013-12-31$33,397
Benefits paid (including direct rollovers)2013-12-31$30,313
Total plan assets at end of year2013-12-31$835,115
Total plan assets at beginning of year2013-12-31$708,136
Value of fidelity bond covering the plan2013-12-31$265,000
Total contributions received or receivable from participants2013-12-31$0
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$103,876
Noncash contributions received2013-12-31$0
Net income (gross income less expenses)2013-12-31$126,979
Net plan assets at end of year (total assets less liabilities)2013-12-31$835,115
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$708,136
Total contributions received or receivable from employer(s)2013-12-31$56,500
Value of certain deemed distributions of participant loans2013-12-31$0
Value of corrective distributions2013-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$3,084
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : BRIAN J BLOCHER DDS SC PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources2012-12-31$123,046
Expenses. Total of all expenses incurred2012-12-31$316,626
Benefits paid (including direct rollovers)2012-12-31$313,025
Total plan assets at end of year2012-12-31$708,136
Total plan assets at beginning of year2012-12-31$901,716
Value of fidelity bond covering the plan2012-12-31$265,000
Total contributions received or receivable from participants2012-12-31$0
Expenses. Other expenses not covered elsewhere2012-12-31$0
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$56,711
Noncash contributions received2012-12-31$0
Net income (gross income less expenses)2012-12-31$-193,580
Net plan assets at end of year (total assets less liabilities)2012-12-31$708,136
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$901,716
Total contributions received or receivable from employer(s)2012-12-31$66,335
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$3,601
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : BRIAN J BLOCHER DDS SC PROFIT SHARING PLAN 2011 401k financial data
Total plan liabilities at beginning of year2011-12-31$0
Total income from all sources2011-12-31$81,003
Expenses. Total of all expenses incurred2011-12-31$22,989
Benefits paid (including direct rollovers)2011-12-31$22,849
Total plan assets at end of year2011-12-31$901,716
Total plan assets at beginning of year2011-12-31$843,702
Value of fidelity bond covering the plan2011-12-31$265,000
Other income received2011-12-31$-29,855
Net income (gross income less expenses)2011-12-31$58,014
Net plan assets at end of year (total assets less liabilities)2011-12-31$901,716
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$843,702
Total contributions received or receivable from employer(s)2011-12-31$110,858
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$140
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0

Form 5500 Responses for BRIAN J BLOCHER DDS SC PROFIT SHARING PLAN

2019: BRIAN J BLOCHER DDS SC 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: BRIAN J BLOCHER DDS SC 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: BRIAN J BLOCHER DDS SC 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: BRIAN J BLOCHER DDS SC 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: BRIAN J BLOCHER DDS SC 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: BRIAN J BLOCHER DDS SC 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: BRIAN J BLOCHER DDS SC 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: BRIAN J BLOCHER DDS SC 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: BRIAN J BLOCHER DDS SC PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedYes
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

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number97553
Policy instance 1
Insurance contract or identification number97553
Number of Individuals Covered14
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $801
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 BenefitNo
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
Amount paid for insurance broker fees801
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker organization code?5
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number97553
Policy instance 1
Insurance contract or identification number97553
Number of Individuals Covered14
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $626
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 BenefitNo
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
Amount paid for insurance broker fees626
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker organization code?5
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number97553
Policy instance 1
Insurance contract or identification number97553
Number of Individuals Covered10
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $2,070
Total amount of fees paid to insurance companyUSD $622
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 BenefitNo
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
Commission paid to Insurance BrokerUSD $2,070
Insurance broker organization code?7
Amount paid for insurance broker fees622
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker namePPG RETIREMENT PLAN SERVICES, LTD.
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number97553
Policy instance 1
Insurance contract or identification number97553
Number of Individuals Covered11
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
Total amount of commissions paid to insurance brokerUSD $2,397
Total amount of fees paid to insurance companyUSD $659
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 BenefitNo
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
Commission paid to Insurance BrokerUSD $2,397
Insurance broker organization code?7
Amount paid for insurance broker fees659
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker namePPG RETIREMENT PLAN SERVICES, LTD.
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number97553
Policy instance 1
Insurance contract or identification number97553
Number of Individuals Covered13
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $2,339
Total amount of fees paid to insurance companyUSD $650
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 BenefitNo
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
Commission paid to Insurance BrokerUSD $1,180
Insurance broker organization code?7
Amount paid for insurance broker fees650
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker namePPG RETIREMENT PLAN SERVICES, LTD.
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number97553
Policy instance 1
Insurance contract or identification number97553
Number of Individuals Covered13
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $2,151
Total amount of fees paid to insurance companyUSD $543
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 BenefitNo
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
Commission paid to Insurance BrokerUSD $2,151
Insurance broker organization code?7
Amount paid for insurance broker fees543
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker namePPG RETIREMENT PLAN SERVICES, LTD.
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number97553
Policy instance 1
Insurance contract or identification number97553
Number of Individuals Covered16
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,756
Total amount of fees paid to insurance companyUSD $412
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 BenefitNo
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
Commission paid to Insurance BrokerUSD $1,756
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSIONS
Insurance broker organization code?7
Insurance broker namePPG RETIREMENT PLAN SERVICES, LTD.
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number97553
Policy instance 1
Insurance contract or identification number97553
Number of Individuals Covered18
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $2,197
Total amount of fees paid to insurance companyUSD $620
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 BenefitNo
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
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees620
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker organization code?5
Insurance broker nameMETLIFE SECURITIES INC
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number97553
Policy instance 1
Insurance contract or identification number97553
Number of Individuals Covered15
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $1,218
Total amount of fees paid to insurance companyUSD $1,488
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 BenefitNo
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

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