ROBERT F. HENRY TILE COMPANY, INC. has sponsored the creation of one or more 401k plans.
Additional information about ROBERT F. HENRY TILE COMPANY, INC.
Submission information for form 5500 for 401k plan ROBERT F. HENRY TILE COMPANY, INC. 401(K) PLAN
401k plan membership statisitcs for ROBERT F. HENRY TILE COMPANY, INC. 401(K) PLAN
| Measure | Date | Value |
|---|
| 2017: ROBERT F. HENRY TILE COMPANY, INC. 401(K) PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-07-01 | 68 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 69 |
| Number of retired or separated participants receiving benefits | 2017-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-07-01 | 7 |
| Total of all active and inactive participants | 2017-07-01 | 76 |
| Total participants | 2017-07-01 | 76 |
| Number of participants with account balances | 2017-07-01 | 45 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2017-07-01 | 0 |
| 2016: ROBERT F. HENRY TILE COMPANY, INC. 401(K) PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-07-01 | 68 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 60 |
| Number of other retired or separated participants entitled to future benefits | 2016-07-01 | 8 |
| Total of all active and inactive participants | 2016-07-01 | 68 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2016-07-01 | 0 |
| Total participants | 2016-07-01 | 68 |
| Number of participants with account balances | 2016-07-01 | 42 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2016-07-01 | 0 |
| 2015: ROBERT F. HENRY TILE COMPANY, INC. 401(K) PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-07-01 | 61 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-07-01 | 61 |
| Number of retired or separated participants receiving benefits | 2015-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-07-01 | 7 |
| Total of all active and inactive participants | 2015-07-01 | 68 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2015-07-01 | 0 |
| Total participants | 2015-07-01 | 68 |
| Number of participants with account balances | 2015-07-01 | 38 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2015-07-01 | 0 |
| 2014: ROBERT F. HENRY TILE COMPANY, INC. 401(K) PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-07-01 | 63 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 56 |
| Number of retired or separated participants receiving benefits | 2014-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-07-01 | 5 |
| Total of all active and inactive participants | 2014-07-01 | 61 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-07-01 | 0 |
| Total participants | 2014-07-01 | 61 |
| Number of participants with account balances | 2014-07-01 | 37 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2014-07-01 | 0 |
| 2013: ROBERT F. HENRY TILE COMPANY, INC. 401(K) PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-07-01 | 52 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 57 |
| Number of retired or separated participants receiving benefits | 2013-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-07-01 | 6 |
| Total of all active and inactive participants | 2013-07-01 | 63 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-07-01 | 0 |
| Total participants | 2013-07-01 | 63 |
| Number of participants with account balances | 2013-07-01 | 39 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-07-01 | 0 |
| 2012: ROBERT F. HENRY TILE COMPANY, INC. 401(K) PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-07-01 | 53 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 45 |
| Number of retired or separated participants receiving benefits | 2012-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-07-01 | 7 |
| Total of all active and inactive participants | 2012-07-01 | 52 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-07-01 | 0 |
| Total participants | 2012-07-01 | 52 |
| Number of participants with account balances | 2012-07-01 | 39 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-07-01 | 0 |
| 2011: ROBERT F. HENRY TILE COMPANY, INC. 401(K) PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-07-01 | 54 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 48 |
| Number of retired or separated participants receiving benefits | 2011-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-07-01 | 5 |
| Total of all active and inactive participants | 2011-07-01 | 53 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-07-01 | 0 |
| Total participants | 2011-07-01 | 53 |
| Number of participants with account balances | 2011-07-01 | 39 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2011-07-01 | 0 |
| 2009: ROBERT F. HENRY TILE COMPANY, INC. 401(K) PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-07-01 | 61 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-07-01 | 55 |
| Number of retired or separated participants receiving benefits | 2009-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-07-01 | 6 |
| Total of all active and inactive participants | 2009-07-01 | 61 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-07-01 | 0 |
| Total participants | 2009-07-01 | 61 |
| Number of participants with account balances | 2009-07-01 | 41 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-07-01 | 0 |
| Measure | Date | Value |
|---|
| 2018 : ROBERT F. HENRY TILE COMPANY, INC. 401(K) PLAN 2018 401k financial data |
|---|
| Total income from all sources | 2018-06-30 | $361,805 |
| Expenses. Total of all expenses incurred | 2018-06-30 | $25,863 |
| Benefits paid (including direct rollovers) | 2018-06-30 | $23,856 |
| Total plan assets at end of year | 2018-06-30 | $2,220,354 |
| Total plan assets at beginning of year | 2018-06-30 | $1,884,412 |
| Value of fidelity bond covering the plan | 2018-06-30 | $162,000 |
| Total contributions received or receivable from participants | 2018-06-30 | $110,135 |
| Contributions received from other sources (not participants or employers) | 2018-06-30 | $10,866 |
| Other income received | 2018-06-30 | $175,795 |
| Net income (gross income less expenses) | 2018-06-30 | $335,942 |
| Net plan assets at end of year (total assets less liabilities) | 2018-06-30 | $2,220,354 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-06-30 | $1,884,412 |
| Total contributions received or receivable from employer(s) | 2018-06-30 | $65,009 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2018-06-30 | $2,007 |
| 2017 : ROBERT F. HENRY TILE COMPANY, INC. 401(K) PLAN 2017 401k financial data |
|---|
| Total income from all sources | 2017-06-30 | $397,833 |
| Expenses. Total of all expenses incurred | 2017-06-30 | $125,194 |
| Benefits paid (including direct rollovers) | 2017-06-30 | $125,194 |
| Total plan assets at end of year | 2017-06-30 | $1,884,412 |
| Total plan assets at beginning of year | 2017-06-30 | $1,611,773 |
| Value of fidelity bond covering the plan | 2017-06-30 | $162,000 |
| Total contributions received or receivable from participants | 2017-06-30 | $96,314 |
| Other income received | 2017-06-30 | $244,280 |
| Net income (gross income less expenses) | 2017-06-30 | $272,639 |
| Net plan assets at end of year (total assets less liabilities) | 2017-06-30 | $1,884,412 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-06-30 | $1,611,773 |
| Total contributions received or receivable from employer(s) | 2017-06-30 | $57,239 |
| 2016 : ROBERT F. HENRY TILE COMPANY, INC. 401(K) PLAN 2016 401k financial data |
|---|
| Total income from all sources | 2016-06-30 | $97,897 |
| Expenses. Total of all expenses incurred | 2016-06-30 | $7,590 |
| Benefits paid (including direct rollovers) | 2016-06-30 | $7,590 |
| Total plan assets at end of year | 2016-06-30 | $1,611,773 |
| Total plan assets at beginning of year | 2016-06-30 | $1,521,466 |
| Value of fidelity bond covering the plan | 2016-06-30 | $150,000 |
| Total contributions received or receivable from participants | 2016-06-30 | $82,812 |
| Other income received | 2016-06-30 | $-34,253 |
| Net income (gross income less expenses) | 2016-06-30 | $90,307 |
| Net plan assets at end of year (total assets less liabilities) | 2016-06-30 | $1,611,773 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-06-30 | $1,521,466 |
| Total contributions received or receivable from employer(s) | 2016-06-30 | $49,338 |
| 2015 : ROBERT F. HENRY TILE COMPANY, INC. 401(K) PLAN 2015 401k financial data |
|---|
| Total income from all sources | 2015-06-30 | $174,250 |
| Expenses. Total of all expenses incurred | 2015-06-30 | $83,240 |
| Benefits paid (including direct rollovers) | 2015-06-30 | $83,240 |
| Total plan assets at end of year | 2015-06-30 | $1,521,466 |
| Total plan assets at beginning of year | 2015-06-30 | $1,430,456 |
| Value of fidelity bond covering the plan | 2015-06-30 | $150,000 |
| Total contributions received or receivable from participants | 2015-06-30 | $80,511 |
| Other income received | 2015-06-30 | $45,500 |
| Net income (gross income less expenses) | 2015-06-30 | $91,010 |
| Net plan assets at end of year (total assets less liabilities) | 2015-06-30 | $1,521,466 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-06-30 | $1,430,456 |
| Total contributions received or receivable from employer(s) | 2015-06-30 | $48,239 |
| 2014 : ROBERT F. HENRY TILE COMPANY, INC. 401(K) PLAN 2014 401k financial data |
|---|
| Total income from all sources | 2014-06-30 | $316,672 |
| Expenses. Total of all expenses incurred | 2014-06-30 | $23,880 |
| Benefits paid (including direct rollovers) | 2014-06-30 | $23,880 |
| Total plan assets at end of year | 2014-06-30 | $1,430,456 |
| Total plan assets at beginning of year | 2014-06-30 | $1,137,664 |
| Value of fidelity bond covering the plan | 2014-06-30 | $150,000 |
| Total contributions received or receivable from participants | 2014-06-30 | $42,301 |
| Other income received | 2014-06-30 | $211,135 |
| Net income (gross income less expenses) | 2014-06-30 | $292,792 |
| Net plan assets at end of year (total assets less liabilities) | 2014-06-30 | $1,430,456 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-06-30 | $1,137,664 |
| Total contributions received or receivable from employer(s) | 2014-06-30 | $63,236 |
| 2013 : ROBERT F. HENRY TILE COMPANY, INC. 401(K) PLAN 2013 401k financial data |
|---|
| Total income from all sources | 2013-06-30 | $221,667 |
| Expenses. Total of all expenses incurred | 2013-06-30 | $52,847 |
| Benefits paid (including direct rollovers) | 2013-06-30 | $52,847 |
| Total plan assets at end of year | 2013-06-30 | $1,137,664 |
| Total plan assets at beginning of year | 2013-06-30 | $968,844 |
| Value of fidelity bond covering the plan | 2013-06-30 | $100,000 |
| Total contributions received or receivable from participants | 2013-06-30 | $56,301 |
| Other income received | 2013-06-30 | $126,579 |
| Net income (gross income less expenses) | 2013-06-30 | $168,820 |
| Net plan assets at end of year (total assets less liabilities) | 2013-06-30 | $1,137,664 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-06-30 | $968,844 |
| Total contributions received or receivable from employer(s) | 2013-06-30 | $38,787 |
| 2012 : ROBERT F. HENRY TILE COMPANY, INC. 401(K) PLAN 2012 401k financial data |
|---|
| Total income from all sources | 2012-06-30 | $87,543 |
| Expenses. Total of all expenses incurred | 2012-06-30 | $17,483 |
| Benefits paid (including direct rollovers) | 2012-06-30 | $17,483 |
| Total plan assets at end of year | 2012-06-30 | $968,844 |
| Total plan assets at beginning of year | 2012-06-30 | $898,784 |
| Value of fidelity bond covering the plan | 2012-06-30 | $100,000 |
| Total contributions received or receivable from participants | 2012-06-30 | $57,812 |
| Other income received | 2012-06-30 | $-8,987 |
| Net income (gross income less expenses) | 2012-06-30 | $70,060 |
| Net plan assets at end of year (total assets less liabilities) | 2012-06-30 | $968,844 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-06-30 | $898,784 |
| Total contributions received or receivable from employer(s) | 2012-06-30 | $38,718 |
| 2011 : ROBERT F. HENRY TILE COMPANY, INC. 401(K) PLAN 2011 401k financial data |
|---|
| Total income from all sources | 2011-06-30 | $240,595 |
| Expenses. Total of all expenses incurred | 2011-06-30 | $40,408 |
| Benefits paid (including direct rollovers) | 2011-06-30 | $40,408 |
| Total plan assets at end of year | 2011-06-30 | $898,784 |
| Total plan assets at beginning of year | 2011-06-30 | $698,597 |
| Value of fidelity bond covering the plan | 2011-06-30 | $100,000 |
| Total contributions received or receivable from participants | 2011-06-30 | $49,171 |
| Other income received | 2011-06-30 | $156,769 |
| Net income (gross income less expenses) | 2011-06-30 | $200,187 |
| Net plan assets at end of year (total assets less liabilities) | 2011-06-30 | $898,784 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-06-30 | $698,597 |
| Total contributions received or receivable from employer(s) | 2011-06-30 | $34,655 |
| 2017: ROBERT F. HENRY TILE COMPANY, INC. 401(K) PLAN 2017 form 5500 responses |
|---|
| 2017-07-01 | Type of plan entity | Single employer plan |
| 2017-07-01 | Submission has been amended | No |
| 2017-07-01 | This submission is the final filing | No |
| 2017-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-07-01 | Plan is a collectively bargained plan | No |
| 2017-07-01 | Plan funding arrangement – Insurance | Yes |
| 2017-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: ROBERT F. HENRY TILE COMPANY, INC. 401(K) PLAN 2016 form 5500 responses |
|---|
| 2016-07-01 | Type of plan entity | Single employer plan |
| 2016-07-01 | Submission has been amended | No |
| 2016-07-01 | This submission is the final filing | No |
| 2016-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-07-01 | Plan is a collectively bargained plan | No |
| 2016-07-01 | Plan funding arrangement – Insurance | Yes |
| 2016-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: ROBERT F. HENRY TILE COMPANY, INC. 401(K) PLAN 2015 form 5500 responses |
|---|
| 2015-07-01 | Type of plan entity | Single employer plan |
| 2015-07-01 | Submission has been amended | No |
| 2015-07-01 | This submission is the final filing | No |
| 2015-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-07-01 | Plan is a collectively bargained plan | No |
| 2015-07-01 | Plan funding arrangement – Insurance | Yes |
| 2015-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: ROBERT F. HENRY TILE COMPANY, INC. 401(K) PLAN 2014 form 5500 responses |
|---|
| 2014-07-01 | Type of plan entity | Single employer plan |
| 2014-07-01 | Submission has been amended | No |
| 2014-07-01 | This submission is the final filing | No |
| 2014-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-07-01 | Plan is a collectively bargained plan | No |
| 2014-07-01 | Plan funding arrangement – Insurance | Yes |
| 2014-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: ROBERT F. HENRY TILE COMPANY, INC. 401(K) PLAN 2013 form 5500 responses |
|---|
| 2013-07-01 | Type of plan entity | Single employer plan |
| 2013-07-01 | Submission has been amended | No |
| 2013-07-01 | This submission is the final filing | No |
| 2013-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-07-01 | Plan is a collectively bargained plan | No |
| 2013-07-01 | Plan funding arrangement – Insurance | Yes |
| 2013-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: ROBERT F. HENRY TILE COMPANY, INC. 401(K) PLAN 2012 form 5500 responses |
|---|
| 2012-07-01 | Type of plan entity | Single employer plan |
| 2012-07-01 | Submission has been amended | No |
| 2012-07-01 | This submission is the final filing | No |
| 2012-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-07-01 | Plan is a collectively bargained plan | No |
| 2012-07-01 | Plan funding arrangement – Insurance | Yes |
| 2012-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: ROBERT F. HENRY TILE COMPANY, INC. 401(K) PLAN 2011 form 5500 responses |
|---|
| 2011-07-01 | Type of plan entity | Single employer plan |
| 2011-07-01 | Submission has been amended | No |
| 2011-07-01 | This submission is the final filing | No |
| 2011-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-07-01 | Plan is a collectively bargained plan | No |
| 2011-07-01 | Plan funding arrangement – Insurance | Yes |
| 2011-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: ROBERT F. HENRY TILE COMPANY, INC. 401(K) PLAN 2009 form 5500 responses |
|---|
| 2009-07-01 | Type of plan entity | Single employer plan |
| 2009-07-01 | Submission has been amended | No |
| 2009-07-01 | This submission is the final filing | No |
| 2009-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-07-01 | Plan is a collectively bargained plan | No |
| 2009-07-01 | Plan funding arrangement – Insurance | Yes |
| 2009-07-01 | Plan benefit arrangement – Insurance | Yes |
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 53885 |
| Policy instance | 1 |
| Insurance contract or identification number | 53885 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $8,632 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,632 | | Insurance broker organization code? | 3 | | Insurance broker name | KESTRA INVESTMENT SERVICES LLC |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 53885 |
| Policy instance | 1 |
| Insurance contract or identification number | 53885 | | Number of Individuals Covered | 43 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $6,823 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,815 | | Insurance broker organization code? | 3 | | Insurance broker name | KESTRA INVESTMENT SERVICES,LLC |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 53885 |
| Policy instance | 1 |
| Insurance contract or identification number | 53885 | | Number of Individuals Covered | 40 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $6,608 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,304 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | NFP ADVISOR SERVICES, LLC |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 53885 |
| Policy instance | 1 |
| Insurance contract or identification number | 53885 | | Number of Individuals Covered | 41 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $5,324 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,662 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | FINANCIAL TELESIS, INC. |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 53885 |
| Policy instance | 1 |
| Insurance contract or identification number | 53885 | | Number of Individuals Covered | 42 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $4,772 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,386 | | Insurance broker organization code? | 3 | | Insurance broker name | FINANCIAL TELESIS, INC. |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 53885 |
| Policy instance | 1 |
| Insurance contract or identification number | 53885 | | Number of Individuals Covered | 43 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $4,422 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 53885 |
| Policy instance | 1 |
| Insurance contract or identification number | 53885 | | Number of Individuals Covered | 43 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $3,674 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,837 | | Insurance broker organization code? | 3 | | Insurance broker name | BENEFITS CONCEPTS, INC. |
|
