PRESBYTERIAN HOMES OF GEORGIA has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan PRESBYTERIAN HOMES OF GEORGIA INC 401K PLAN
| Measure | Date | Value |
|---|
| 2014: PRESBYTERIAN HOMES OF GEORGIA INC 401K PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 23 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 16 |
| 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 | 1 |
| Total of all active and inactive participants | 2014-01-01 | 17 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-01-01 | 0 |
| Total participants | 2014-01-01 | 17 |
| Number of participants with account balances | 2014-01-01 | 17 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2014-01-01 | 0 |
| 2013: PRESBYTERIAN HOMES OF GEORGIA INC 401K PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 22 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 21 |
| 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 | 1 |
| Total of all active and inactive participants | 2013-01-01 | 22 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-01-01 | 0 |
| Total participants | 2013-01-01 | 22 |
| Number of participants with account balances | 2013-01-01 | 18 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-01-01 | 0 |
| 2012: PRESBYTERIAN HOMES OF GEORGIA INC 401K PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 22 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 21 |
| 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 | 1 |
| Total of all active and inactive participants | 2012-01-01 | 22 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-01-01 | 0 |
| Total participants | 2012-01-01 | 22 |
| Number of participants with account balances | 2012-01-01 | 18 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-01-01 | 0 |
| 2011: PRESBYTERIAN HOMES OF GEORGIA INC 401K PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 21 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 21 |
| 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 | 0 |
| Total of all active and inactive participants | 2011-01-01 | 21 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-01-01 | 0 |
| Total participants | 2011-01-01 | 21 |
| Number of participants with account balances | 2011-01-01 | 17 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2011-01-01 | 0 |
| 2010: PRESBYTERIAN HOMES OF GEORGIA INC 401K PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 25 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 20 |
| Number of retired or separated participants receiving benefits | 2010-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2010-01-01 | 2 |
| Total of all active and inactive participants | 2010-01-01 | 22 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2010-01-01 | 0 |
| Total participants | 2010-01-01 | 22 |
| Number of participants with account balances | 2010-01-01 | 19 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2010-01-01 | 0 |
| 2009: PRESBYTERIAN HOMES OF GEORGIA INC 401K PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 28 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 22 |
| 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 | 1 |
| Total of all active and inactive participants | 2009-01-01 | 23 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-01-01 | 0 |
| Total participants | 2009-01-01 | 23 |
| Number of participants with account balances | 2009-01-01 | 17 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-01-01 | 0 |
| Measure | Date | Value |
|---|
| 2014 : PRESBYTERIAN HOMES OF GEORGIA INC 401K PLAN 2014 401k financial data |
|---|
| Total plan liabilities at end of year | 2014-12-31 | $0 |
| Total plan liabilities at beginning of year | 2014-12-31 | $0 |
| Total income from all sources | 2014-12-31 | $231,405 |
| Expenses. Total of all expenses incurred | 2014-12-31 | $150,514 |
| Benefits paid (including direct rollovers) | 2014-12-31 | $149,918 |
| Total plan assets at end of year | 2014-12-31 | $1,486,610 |
| Total plan assets at beginning of year | 2014-12-31 | $1,405,719 |
| Value of fidelity bond covering the plan | 2014-12-31 | $500,000 |
| Total contributions received or receivable from participants | 2014-12-31 | $78,544 |
| Expenses. Other expenses not covered elsewhere | 2014-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2014-12-31 | $63,049 |
| Other income received | 2014-12-31 | $38,942 |
| Noncash contributions received | 2014-12-31 | $0 |
| Net income (gross income less expenses) | 2014-12-31 | $80,891 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $1,486,610 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $1,405,719 |
| Assets. Value of participant loans | 2014-12-31 | $92,655 |
| Total contributions received or receivable from employer(s) | 2014-12-31 | $50,870 |
| Value of certain deemed distributions of participant loans | 2014-12-31 | $0 |
| Value of corrective distributions | 2014-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2014-12-31 | $596 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2014-12-31 | $0 |
| 2013 : PRESBYTERIAN HOMES OF GEORGIA INC 401K PLAN 2013 401k financial data |
|---|
| Total income from all sources | 2013-12-31 | $279,699 |
| Expenses. Total of all expenses incurred | 2013-12-31 | $219 |
| Benefits paid (including direct rollovers) | 2013-12-31 | $0 |
| Total plan assets at end of year | 2013-12-31 | $1,405,719 |
| Total plan assets at beginning of year | 2013-12-31 | $1,126,239 |
| Value of fidelity bond covering the plan | 2013-12-31 | $500,000 |
| Total contributions received or receivable from participants | 2013-12-31 | $72,688 |
| Contributions received from other sources (not participants or employers) | 2013-12-31 | $9,494 |
| Other income received | 2013-12-31 | $147,307 |
| Net income (gross income less expenses) | 2013-12-31 | $279,480 |
| Net plan assets at end of year (total assets less liabilities) | 2013-12-31 | $1,405,719 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-12-31 | $1,126,239 |
| Assets. Value of participant loans | 2013-12-31 | $85,312 |
| Total contributions received or receivable from employer(s) | 2013-12-31 | $50,210 |
| Value of certain deemed distributions of participant loans | 2013-12-31 | $0 |
| Value of corrective distributions | 2013-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2013-12-31 | $219 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2013-12-31 | $0 |
| 2012 : PRESBYTERIAN HOMES OF GEORGIA INC 401K PLAN 2012 401k financial data |
|---|
| Total income from all sources | 2012-12-31 | $219,596 |
| Expenses. Total of all expenses incurred | 2012-12-31 | $333 |
| Benefits paid (including direct rollovers) | 2012-12-31 | $0 |
| Total plan assets at end of year | 2012-12-31 | $1,126,239 |
| Total plan assets at beginning of year | 2012-12-31 | $906,976 |
| Value of fidelity bond covering the plan | 2012-12-31 | $500,000 |
| Total contributions received or receivable from participants | 2012-12-31 | $71,447 |
| Expenses. Other expenses not covered elsewhere | 2012-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2012-12-31 | $6,734 |
| Other income received | 2012-12-31 | $91,990 |
| Net income (gross income less expenses) | 2012-12-31 | $219,263 |
| Net plan assets at end of year (total assets less liabilities) | 2012-12-31 | $1,126,239 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-12-31 | $906,976 |
| Assets. Value of participant loans | 2012-12-31 | $95,021 |
| Total contributions received or receivable from employer(s) | 2012-12-31 | $49,425 |
| Value of certain deemed distributions of participant loans | 2012-12-31 | $0 |
| Value of corrective distributions | 2012-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2012-12-31 | $333 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2012-12-31 | $0 |
| 2011 : PRESBYTERIAN HOMES OF GEORGIA INC 401K PLAN 2011 401k financial data |
|---|
| Total income from all sources | 2011-12-31 | $98,007 |
| Expenses. Total of all expenses incurred | 2011-12-31 | $10 |
| Total plan assets at end of year | 2011-12-31 | $906,976 |
| Total plan assets at beginning of year | 2011-12-31 | $808,979 |
| Value of fidelity bond covering the plan | 2011-12-31 | $500,000 |
| Total contributions received or receivable from participants | 2011-12-31 | $71,612 |
| Other income received | 2011-12-31 | $-22,614 |
| Net income (gross income less expenses) | 2011-12-31 | $97,997 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-31 | $906,976 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-31 | $808,979 |
| Assets. Value of participant loans | 2011-12-31 | $38,527 |
| Total contributions received or receivable from employer(s) | 2011-12-31 | $49,009 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2011-12-31 | $10 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2011-12-31 | $0 |
| 2010 : PRESBYTERIAN HOMES OF GEORGIA INC 401K PLAN 2010 401k financial data |
|---|
| Total income from all sources | 2010-12-31 | $190,660 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $116,000 |
| Benefits paid (including direct rollovers) | 2010-12-31 | $115,644 |
| Total plan assets at end of year | 2010-12-31 | $816,870 |
| Total plan assets at beginning of year | 2010-12-31 | $742,210 |
| Value of fidelity bond covering the plan | 2010-12-31 | $200,000 |
| Total contributions received or receivable from participants | 2010-12-31 | $66,497 |
| Other income received | 2010-12-31 | $78,491 |
| Net income (gross income less expenses) | 2010-12-31 | $74,660 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $816,870 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $742,210 |
| Assets. Value of participant loans | 2010-12-31 | $32,572 |
| Total contributions received or receivable from employer(s) | 2010-12-31 | $45,672 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2010-12-31 | $356 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2010-12-31 | $0 |
| 2009 : PRESBYTERIAN HOMES OF GEORGIA INC 401K 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 |
| 2014: PRESBYTERIAN HOMES OF GEORGIA INC 401K 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: PRESBYTERIAN HOMES OF GEORGIA INC 401K 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: PRESBYTERIAN HOMES OF GEORGIA INC 401K 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: PRESBYTERIAN HOMES OF GEORGIA INC 401K 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 |
| 2010: PRESBYTERIAN HOMES OF GEORGIA INC 401K PLAN 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Submission has been amended | No |
| 2010-01-01 | This submission is the final filing | No |
| 2010-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-01-01 | Plan is a collectively bargained plan | No |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan funding arrangement – Trust | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement - Trust | Yes |
| 2009: PRESBYTERIAN HOMES OF GEORGIA INC 401K 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 | 76813 |
| Policy instance | 1 |
| Insurance contract or identification number | 76813 | | Number of Individuals Covered | 20 | | 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 $5,071 | | 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 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? | Yes | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Amount paid for insurance broker fees | 4053 | | Additional information about fees paid to insurance broker | BROKER COMMISSION | | Insurance broker organization code? | 3 | | Insurance broker name | BUSH RETIREMENT PLAN SERVICES |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 76813 |
| Policy instance | 1 |
| Insurance contract or identification number | 76813 | | Number of Individuals Covered | 19 | | 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 $4,027 | | 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 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? | Yes | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Amount paid for insurance broker fees | 3470 | | Additional information about fees paid to insurance broker | BROKER COMMISSION | | Insurance broker organization code? | 3 | | Insurance broker name | BUSH RETIREMENT PLAN SERVICES |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 76813 |
| Policy instance | 1 |
| Insurance contract or identification number | 76813 | | Number of Individuals Covered | 19 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $3,296 | | Total amount of fees paid to insurance company | USD $150 | | 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 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? | Yes | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $2,866 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | BROKER COMMISSION | | Insurance broker organization code? | 3 | | Insurance broker name | BUSH RETIREMENT PLAN SERVICES |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 76813 |
| Policy instance | 1 |
| Insurance contract or identification number | 76813 | | Number of Individuals Covered | 203 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $9,370 | | Total amount of fees paid to insurance company | USD $4,450 | | 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 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? | Yes | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 76813 |
| Policy instance | 1 |
| Insurance contract or identification number | 76813 | | Number of Individuals Covered | 23 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $2,128 | | Total amount of fees paid to insurance company | USD $700 | | 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 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? | Yes | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $2,128 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 700 | | Additional information about fees paid to insurance broker | PARTICIPANT LOANS | | Insurance broker name | BUSH, SABOT & ASSOCIATES, INC. |
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