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GREAT LAKES PAPER FIBRES, CORP. 401(K) SAVINGS PLA 401k Plan overview

Plan NameGREAT LAKES PAPER FIBRES, CORP. 401(K) SAVINGS PLA
Plan identification number 002

GREAT LAKES PAPER FIBRES, CORP. 401(K) SAVINGS PLA 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(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)).
  • Life insurance

401k Sponsoring company profile

DOM BEN REALTY CORP. has sponsored the creation of one or more 401k plans.

Company Name:DOM BEN REALTY CORP.
Employer identification number (EIN):160462311
NAIC Classification:424100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GREAT LAKES PAPER FIBRES, CORP. 401(K) SAVINGS PLA

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022020-01-01CHRIS BENEDETTO2020-10-07
0022019-01-01CHRISTOPHER BENEDETTO2020-10-07
0022018-01-01CHRIS BENEDETTO2019-07-24 NICK NEMETI2019-07-24
0022017-01-01CHRIS BENEDETTO2018-10-12 NICK NEMETI2018-10-12
0022016-01-01 NICHOLAS J NEMETI2018-07-12
0022015-01-01NICK NEMETI PETER BENEDETTO II2016-06-21
0022014-01-01NICHOLAS NEMETI CHRIS BENEDETTO2015-06-18
0022014-01-01NICHOLAS NEMETI CHRIS BENEDETTO2015-06-23
0022013-01-01NICHOLAS NEMETI CHRIS BENEDETTO2014-06-19
0022012-01-01NICHOLAS NEMETI CHRIS BENEDETTO2013-06-25
0022011-01-01NICHOLAS NEMETI CHRIS BENEDETTO2012-06-25
0022010-01-01NICK NEMETI2011-06-10 CHRIS BENEDETTO2011-06-10

Plan Statistics for GREAT LAKES PAPER FIBRES, CORP. 401(K) SAVINGS PLA

401k plan membership statisitcs for GREAT LAKES PAPER FIBRES, CORP. 401(K) SAVINGS PLA

Measure Date Value
2016: GREAT LAKES PAPER FIBRES, CORP. 401(K) SAVINGS PLA 2016 401k membership
Total participants, beginning-of-year2016-01-0121
Total number of active participants reported on line 7a of the Form 55002016-01-015
Number of retired or separated participants receiving benefits2016-01-011
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-016
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-016
Number of participants with account balances2016-01-013
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: GREAT LAKES PAPER FIBRES, CORP. 401(K) SAVINGS PLA 2015 401k membership
Total participants, beginning-of-year2015-01-0113
Total number of active participants reported on line 7a of the Form 55002015-01-017
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-017
Number of participants with account balances2015-01-013
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: GREAT LAKES PAPER FIBRES, CORP. 401(K) SAVINGS PLA 2014 401k membership
Total participants, beginning-of-year2014-01-018
Total number of active participants reported on line 7a of the Form 55002014-01-019
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-019
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-019
Number of participants with account balances2014-01-015
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: GREAT LAKES PAPER FIBRES, CORP. 401(K) SAVINGS PLA 2013 401k membership
Total participants, beginning-of-year2013-01-018
Total number of active participants reported on line 7a of the Form 55002013-01-018
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-018
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-018
Number of participants with account balances2013-01-015
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: GREAT LAKES PAPER FIBRES, CORP. 401(K) SAVINGS PLA 2012 401k membership
Total participants, beginning-of-year2012-01-019
Total number of active participants reported on line 7a of the Form 55002012-01-018
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-018
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-018
Number of participants with account balances2012-01-015
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: GREAT LAKES PAPER FIBRES, CORP. 401(K) SAVINGS PLA 2011 401k membership
Total participants, beginning-of-year2011-01-0110
Total number of active participants reported on line 7a of the Form 55002011-01-019
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-019
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-019
Number of participants with account balances2011-01-016
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010

Financial Data on GREAT LAKES PAPER FIBRES, CORP. 401(K) SAVINGS PLA

Measure Date Value
2016 : GREAT LAKES PAPER FIBRES, CORP. 401(K) SAVINGS PLA 2016 401k financial data
Total income from all sources2016-12-31$14,327
Expenses. Total of all expenses incurred2016-12-31$4,614
Benefits paid (including direct rollovers)2016-12-31$4,611
Total plan assets at end of year2016-12-31$141,500
Total plan assets at beginning of year2016-12-31$131,787
Value of fidelity bond covering the plan2016-12-31$100,000
Total contributions received or receivable from participants2016-12-31$3,531
Expenses. Other expenses not covered elsewhere2016-12-31$0
Contributions received from other sources (not participants or employers)2016-12-31$0
Other income received2016-12-31$9,560
Net income (gross income less expenses)2016-12-31$9,713
Net plan assets at end of year (total assets less liabilities)2016-12-31$141,500
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$131,787
Total contributions received or receivable from employer(s)2016-12-31$1,236
Value of certain deemed distributions of participant loans2016-12-31$0
Value of corrective distributions2016-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$3
2015 : GREAT LAKES PAPER FIBRES, CORP. 401(K) SAVINGS PLA 2015 401k financial data
Total income from all sources2015-12-31$5,545
Expenses. Total of all expenses incurred2015-12-31$4,065
Benefits paid (including direct rollovers)2015-12-31$4,062
Total plan assets at end of year2015-12-31$131,787
Total plan assets at beginning of year2015-12-31$130,307
Value of fidelity bond covering the plan2015-12-31$100,000
Total contributions received or receivable from participants2015-12-31$3,928
Expenses. Other expenses not covered elsewhere2015-12-31$0
Contributions received from other sources (not participants or employers)2015-12-31$0
Other income received2015-12-31$243
Net income (gross income less expenses)2015-12-31$1,480
Net plan assets at end of year (total assets less liabilities)2015-12-31$131,787
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$130,307
Assets. Value of participant loans2015-12-31$1,542
Total contributions received or receivable from employer(s)2015-12-31$1,374
Value of certain deemed distributions of participant loans2015-12-31$0
Value of corrective distributions2015-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$3
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : GREAT LAKES PAPER FIBRES, CORP. 401(K) SAVINGS PLA 2014 401k financial data
Total income from all sources2014-12-31$14,004
Expenses. Total of all expenses incurred2014-12-31$66,039
Benefits paid (including direct rollovers)2014-12-31$66,036
Total plan assets at end of year2014-12-31$130,307
Total plan assets at beginning of year2014-12-31$182,342
Value of fidelity bond covering the plan2014-12-31$100,000
Total contributions received or receivable from participants2014-12-31$4,146
Expenses. Other expenses not covered elsewhere2014-12-31$0
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$8,399
Net income (gross income less expenses)2014-12-31$-52,035
Net plan assets at end of year (total assets less liabilities)2014-12-31$130,307
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$182,342
Assets. Value of participant loans2014-12-31$3,363
Total contributions received or receivable from employer(s)2014-12-31$1,459
Value of certain deemed distributions of participant loans2014-12-31$0
Value of corrective distributions2014-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$3
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : GREAT LAKES PAPER FIBRES, CORP. 401(K) SAVINGS PLA 2013 401k financial data
Total income from all sources2013-12-31$22,412
Expenses. Total of all expenses incurred2013-12-31$1,279
Benefits paid (including direct rollovers)2013-12-31$1,277
Total plan assets at end of year2013-12-31$182,342
Total plan assets at beginning of year2013-12-31$161,209
Value of fidelity bond covering the plan2013-12-31$40,000
Total contributions received or receivable from participants2013-12-31$4,016
Expenses. Other expenses not covered elsewhere2013-12-31$0
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$17,008
Net income (gross income less expenses)2013-12-31$21,133
Net plan assets at end of year (total assets less liabilities)2013-12-31$182,342
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$161,209
Assets. Value of participant loans2013-12-31$5,090
Total contributions received or receivable from employer(s)2013-12-31$1,388
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$2
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : GREAT LAKES PAPER FIBRES, CORP. 401(K) SAVINGS PLA 2012 401k financial data
Total income from all sources2012-12-31$16,557
Expenses. Total of all expenses incurred2012-12-31$3,404
Benefits paid (including direct rollovers)2012-12-31$3,277
Total plan assets at end of year2012-12-31$161,209
Total plan assets at beginning of year2012-12-31$148,056
Value of fidelity bond covering the plan2012-12-31$100,000
Total contributions received or receivable from participants2012-12-31$4,434
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$10,571
Net income (gross income less expenses)2012-12-31$13,153
Net plan assets at end of year (total assets less liabilities)2012-12-31$161,209
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$148,056
Assets. Value of participant loans2012-12-31$6,728
Total contributions received or receivable from employer(s)2012-12-31$1,552
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$127
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : GREAT LAKES PAPER FIBRES, CORP. 401(K) SAVINGS PLA 2011 401k financial data
Total income from all sources2011-12-31$8,535
Expenses. Total of all expenses incurred2011-12-31$728
Benefits paid (including direct rollovers)2011-12-31$726
Total plan assets at end of year2011-12-31$148,056
Total plan assets at beginning of year2011-12-31$140,249
Value of fidelity bond covering the plan2011-12-31$100,000
Total contributions received or receivable from participants2011-12-31$4,742
Expenses. Other expenses not covered elsewhere2011-12-31$0
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$2,133
Net income (gross income less expenses)2011-12-31$7,807
Net plan assets at end of year (total assets less liabilities)2011-12-31$148,056
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$140,249
Assets. Value of participant loans2011-12-31$871
Total contributions received or receivable from employer(s)2011-12-31$1,660
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$2
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 GREAT LAKES PAPER FIBRES, CORP. 401(K) SAVINGS PLA

2016: GREAT LAKES PAPER FIBRES, CORP. 401(K) SAVINGS PLA 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedYes
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 planYes
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: GREAT LAKES PAPER FIBRES, CORP. 401(K) SAVINGS PLA 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 planYes
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: GREAT LAKES PAPER FIBRES, CORP. 401(K) SAVINGS PLA 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedYes
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 planYes
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: GREAT LAKES PAPER FIBRES, CORP. 401(K) SAVINGS PLA 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 planYes
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: GREAT LAKES PAPER FIBRES, CORP. 401(K) SAVINGS PLA 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 planYes
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: GREAT LAKES PAPER FIBRES, CORP. 401(K) SAVINGS PLA 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
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 planYes
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

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberFL 7726
Policy instance 1
Insurance contract or identification numberFL 7726
Number of Individuals Covered7
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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?Yes
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
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberFL 7726
Policy instance 1
Insurance contract or identification numberFL 7726
Number of Individuals Covered9
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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?Yes
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
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberFL 7726
Policy instance 1
Insurance contract or identification numberFL 7726
Number of Individuals Covered8
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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?Yes
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
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberFL 7726
Policy instance 1
Insurance contract or identification numberFL 7726
Number of Individuals Covered8
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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?Yes
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
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberFL 7726
Policy instance 1
Insurance contract or identification numberFL 7726
Number of Individuals Covered9
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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?Yes
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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