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C. E. HOLT REFRIGERATION, INC. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan NameC. E. HOLT REFRIGERATION, INC. 401(K) PROFIT SHARING PLAN
Plan identification number 001

C. E. HOLT REFRIGERATION, INC. 401(K) PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • 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(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.
  • 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.

401k Sponsoring company profile

C. E. HOLT REFRIGERATION, INC. has sponsored the creation of one or more 401k plans.

Company Name:C. E. HOLT REFRIGERATION, INC.
Employer identification number (EIN):560900979
NAIC Classification:423400

Form 5500 Filing Information

Submission information for form 5500 for 401k plan C. E. HOLT REFRIGERATION, INC. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012021-01-01JOSEPH M. BOURNE2022-01-12 JOSEPH M. BOURNE2022-01-12
0012021-01-01JOSEPH M. BOURNE2022-01-13 JOSEPH M. BOURNE2022-01-13
0012021-01-01JOSEPH M. BOURNE2022-01-13 JOSEPH M. BOURNE2022-01-13
0012020-01-01JOSEPH M. BOURNE2021-10-10 JOSEPH M. BOURNE2021-10-10
0012019-01-01JOSEPH M. BOURNE2020-04-29 JOSEPH M. BOURNE2020-04-29
0012019-01-01JOSEPH M. BOURNE2020-04-29 JOSEPH M. BOURNE2020-04-29
0012018-01-01JOSEPH M. BOURNE2019-07-02 JOSEPH M. BOURNE2019-07-02
0012017-01-01
0012016-01-01JOSEPH BOURNE2017-08-29
0012015-01-01JOSEPH BOURNE2016-09-26
0012014-01-01JEFF ATKINSON2015-06-30
0012013-01-01
0012012-01-01JEFF ATKINSON2013-04-18 JEFF ATKINSON2013-04-18
0012011-01-01JEFF ATKINSON2013-04-18 JEFF ATKINSON2013-04-18
0012010-01-01JEFF ATKINSON2013-04-18 JEFF ATKINSON2013-04-18

Plan Statistics for C. E. HOLT REFRIGERATION, INC. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for C. E. HOLT REFRIGERATION, INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2021: C. E. HOLT REFRIGERATION, INC. 401(K) PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01123
Total number of active participants reported on line 7a of the Form 55002021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-010
Number of participants with account balances2021-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: C. E. HOLT REFRIGERATION, INC. 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01125
Total number of active participants reported on line 7a of the Form 55002020-01-0190
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0133
Total of all active and inactive participants2020-01-01123
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01123
Number of participants with account balances2020-01-01100
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-015
2019: C. E. HOLT REFRIGERATION, INC. 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01136
Total number of active participants reported on line 7a of the Form 55002019-01-0199
Number of other retired or separated participants entitled to future benefits2019-01-0125
Total of all active and inactive participants2019-01-01124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01124
Number of participants with account balances2019-01-0198
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-018
2018: C. E. HOLT REFRIGERATION, INC. 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01143
Total number of active participants reported on line 7a of the Form 55002018-01-01109
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0124
Total of all active and inactive participants2018-01-01133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01133
Number of participants with account balances2018-01-01103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-016

Financial Data on C. E. HOLT REFRIGERATION, INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2021 : C. E. HOLT REFRIGERATION, INC. 401(K) PROFIT SHARING PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-03-02$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-03-02$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-03-02$0
Total income from all sources (including contributions)2021-03-02$144,562
Total loss/gain on sale of assets2021-03-02$0
Total of all expenses incurred2021-03-02$4,804,708
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-03-02$4,704,481
Expenses. Certain deemed distributions of participant loans2021-03-02$99,991
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-03-02$0
Value of total assets at end of year2021-03-02$0
Value of total assets at beginning of year2021-03-02$4,660,146
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-03-02$236
Total interest from all sources2021-03-02$824
Total dividends received (eg from common stock, registered investment company shares)2021-03-02$0
Was this plan covered by a fidelity bond2021-03-02Yes
Value of fidelity bond cover2021-03-02$300,000
If this is an individual account plan, was there a blackout period2021-03-02Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-03-02$0
Were there any nonexempt tranactions with any party-in-interest2021-03-02No
Assets. Loans (other than to participants) at beginning of year2021-03-02$99,167
Total non interest bearing cash at beginning of year2021-03-02$66
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-03-02No
Value of net income/loss2021-03-02$-4,660,146
Value of net assets at end of year (total assets less liabilities)2021-03-02$0
Value of net assets at beginning of year (total assets less liabilities)2021-03-02$4,660,146
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-03-02No
Were any loans by the plan or fixed income obligations due to the plan in default2021-03-02No
Were any leases to which the plan was party in default or uncollectible2021-03-02No
Value of interest in pooled separate accounts at beginning of year2021-03-02$4,560,913
Interest on participant loans2021-03-02$824
Net investment gain/loss from pooled separate accounts2021-03-02$143,738
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-03-02No
Was there a failure to transmit to the plan any participant contributions2021-03-02No
Has the plan failed to provide any benefit when due under the plan2021-03-02No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-03-02$4,704,481
Contract administrator fees2021-03-02$236
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32021-03-02Yes
Did the plan have assets held for investment2021-03-02No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-03-02No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-03-02Yes
Opinion of an independent qualified public accountant for this plan2021-03-02Disclaimer
Accountancy firm name2021-03-02POWDERLY VUCHNICH
Accountancy firm EIN2021-03-02463705845
2020 : C. E. HOLT REFRIGERATION, INC. 401(K) PROFIT SHARING PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$1,290,377
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$1,052,336
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$1,049,958
Expenses. Certain deemed distributions of participant loans2020-12-31$2,378
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$538,302
Value of total assets at end of year2020-12-31$4,660,146
Value of total assets at beginning of year2020-12-31$4,422,105
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$0
Total interest from all sources2020-12-31$6,507
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$300,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$318,358
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$33,670
Assets. Loans (other than to participants) at end of year2020-12-31$99,167
Assets. Loans (other than to participants) at beginning of year2020-12-31$111,589
Total non interest bearing cash at end of year2020-12-31$66
Total non interest bearing cash at beginning of year2020-12-31$63
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$238,041
Value of net assets at end of year (total assets less liabilities)2020-12-31$4,660,146
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$4,422,105
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in pooled separate accounts at end of year2020-12-31$4,560,913
Value of interest in pooled separate accounts at beginning of year2020-12-31$4,310,453
Interest on participant loans2020-12-31$6,507
Net investment gain/loss from pooled separate accounts2020-12-31$745,568
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$186,274
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$1,049,958
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31POWDERLY VUCHNICH
Accountancy firm EIN2020-12-31463705845
2019 : C. E. HOLT REFRIGERATION, INC. 401(K) PROFIT SHARING PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$1,338,437
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$351,602
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$345,341
Expenses. Certain deemed distributions of participant loans2019-12-31$6,261
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$655,764
Value of total assets at end of year2019-12-31$4,422,105
Value of total assets at beginning of year2019-12-31$3,435,270
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$0
Total interest from all sources2019-12-31$5,932
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$300,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$370,594
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$71,621
Assets. Loans (other than to participants) at end of year2019-12-31$111,589
Assets. Loans (other than to participants) at beginning of year2019-12-31$67,813
Total non interest bearing cash at end of year2019-12-31$63
Total non interest bearing cash at beginning of year2019-12-31$1,750
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$986,835
Value of net assets at end of year (total assets less liabilities)2019-12-31$4,422,105
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$3,435,270
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in pooled separate accounts at end of year2019-12-31$4,310,453
Value of interest in pooled separate accounts at beginning of year2019-12-31$3,365,707
Interest on participant loans2019-12-31$5,932
Net investment gain/loss from pooled separate accounts2019-12-31$676,741
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$213,549
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$345,341
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31POWDERLY VUCHNICH
Accountancy firm EIN2019-12-31463705845
2018 : C. E. HOLT REFRIGERATION, INC. 401(K) PROFIT SHARING PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$274,649
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$211,132
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$171,401
Expenses. Certain deemed distributions of participant loans2018-12-31$39,731
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$529,637
Value of total assets at end of year2018-12-31$3,435,270
Value of total assets at beginning of year2018-12-31$3,371,753
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$0
Total interest from all sources2018-12-31$3,111
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$300,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$340,613
Participant contributions at beginning of year2018-12-31$13
Assets. Loans (other than to participants) at end of year2018-12-31$67,813
Assets. Loans (other than to participants) at beginning of year2018-12-31$86,228
Total non interest bearing cash at end of year2018-12-31$1,750
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$63,517
Value of net assets at end of year (total assets less liabilities)2018-12-31$3,435,270
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$3,371,753
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in pooled separate accounts at end of year2018-12-31$3,365,707
Value of interest in pooled separate accounts at beginning of year2018-12-31$3,284,883
Interest on participant loans2018-12-31$3,111
Net investment gain/loss from pooled separate accounts2018-12-31$-258,099
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$189,024
Employer contributions (assets) at beginning of year2018-12-31$629
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$171,401
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31POWDERLY VUCHNICH
Accountancy firm EIN2018-12-31463705845

Form 5500 Responses for C. E. HOLT REFRIGERATION, INC. 401(K) PROFIT SHARING PLAN

2021: C. E. HOLT REFRIGERATION, INC. 401(K) PROFIT SHARING PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedYes
2021-01-01This submission is the final filingYes
2021-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: C. E. HOLT REFRIGERATION, INC. 401(K) PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement - TrustYes
2019: C. E. HOLT REFRIGERATION, INC. 401(K) PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedYes
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 - TrustYes
2018: C. E. HOLT REFRIGERATION, INC. 401(K) PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement - 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 number28269
Policy instance 1
Insurance contract or identification number28269
Number of Individuals Covered0
Insurance policy start date2021-01-01
Insurance policy end date2021-03-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $2,742
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
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number28269
Policy instance 1
Insurance contract or identification number28269
Number of Individuals Covered110
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $184
Total amount of fees paid to insurance companyUSD $0
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
Commission paid to Insurance BrokerUSD $184
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 number28269
Policy instance 1
Insurance contract or identification number28269
Number of Individuals Covered110
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $15,597
Total amount of fees paid to insurance companyUSD $2,002
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
Commission paid to Insurance BrokerUSD $15,597
Insurance broker organization code?3
Amount paid for insurance broker fees2002
Additional information about fees paid to insurance brokerTPA FEES
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number28269
Policy instance 1
Insurance contract or identification number28269
Number of Individuals Covered116
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $13,620
Total amount of fees paid to insurance companyUSD $5,021
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?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
Amount paid for insurance broker fees5021
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker organization code?5
Commission paid to Insurance BrokerUSD $13,620

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