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S.I.C.C. INC. PENSION PLAN 401k Plan overview

Plan NameS.I.C.C. INC. PENSION PLAN
Plan identification number 001

S.I.C.C. INC. PENSION 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(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.

401k Sponsoring company profile

SO EASTERN ILLINOIS COUNSELING has sponsored the creation of one or more 401k plans.

Company Name:SO EASTERN ILLINOIS COUNSELING
Employer identification number (EIN):371095903
NAIC Classification:621420
NAIC Description:Outpatient Mental Health and Substance Abuse Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan S.I.C.C. INC. PENSION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012021-07-01GLENN JACKSON2022-08-15
0012020-07-01GEORGE KRUSE2021-10-05
0012019-07-01GEORGE KRUSE2020-11-11 GEORGE KRUSE2020-11-11
0012018-07-01GLENN JACKSON2019-10-16 GLENN JACKSON2019-10-16
0012017-07-01GLENN JACKSON2019-04-11 GLENN JACKSON2019-04-11
0012016-07-01MARY E. BUCK
0012015-07-01MARY BUCK
0012014-07-01MARY BUCK
0012013-07-01MARY E. BUCK
0012012-07-01MARY E. BUCK
0012011-07-01MARY E. BUCK
0012009-07-01MARY E. BUCK

Plan Statistics for S.I.C.C. INC. PENSION PLAN

401k plan membership statisitcs for S.I.C.C. INC. PENSION PLAN

Measure Date Value
2016: S.I.C.C. INC. PENSION PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-0141
Total number of active participants reported on line 7a of the Form 55002016-07-0122
Number of retired or separated participants receiving benefits2016-07-014
Number of other retired or separated participants entitled to future benefits2016-07-0110
Total of all active and inactive participants2016-07-0136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-07-010
Total participants2016-07-0136
Number of participants with account balances2016-07-0135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-07-010
2015: S.I.C.C. INC. PENSION PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-0146
Total number of active participants reported on line 7a of the Form 55002015-07-0128
Number of retired or separated participants receiving benefits2015-07-013
Number of other retired or separated participants entitled to future benefits2015-07-0110
Total of all active and inactive participants2015-07-0141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-07-010
Total participants2015-07-0141
Number of participants with account balances2015-07-0140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-07-010
2014: S.I.C.C. INC. PENSION PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-0148
Total number of active participants reported on line 7a of the Form 55002014-07-0131
Number of retired or separated participants receiving benefits2014-07-015
Number of other retired or separated participants entitled to future benefits2014-07-0110
Total of all active and inactive participants2014-07-0146
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-07-010
Total participants2014-07-0146
Number of participants with account balances2014-07-0146
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-07-010
2013: S.I.C.C. INC. PENSION PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-0151
Total number of active participants reported on line 7a of the Form 55002013-07-0133
Number of retired or separated participants receiving benefits2013-07-015
Number of other retired or separated participants entitled to future benefits2013-07-0110
Total of all active and inactive participants2013-07-0148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-07-010
Total participants2013-07-0148
Number of participants with account balances2013-07-0147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-07-010
2012: S.I.C.C. INC. PENSION PLAN 2012 401k membership
Total participants, beginning-of-year2012-07-0158
Total number of active participants reported on line 7a of the Form 55002012-07-0137
Number of retired or separated participants receiving benefits2012-07-015
Number of other retired or separated participants entitled to future benefits2012-07-019
Total of all active and inactive participants2012-07-0151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-07-010
Total participants2012-07-0151
Number of participants with account balances2012-07-0151
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-07-010
2011: S.I.C.C. INC. PENSION PLAN 2011 401k membership
Total participants, beginning-of-year2011-07-0167
Total number of active participants reported on line 7a of the Form 55002011-07-0146
Number of retired or separated participants receiving benefits2011-07-014
Number of other retired or separated participants entitled to future benefits2011-07-018
Total of all active and inactive participants2011-07-0158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-07-010
Total participants2011-07-0158
Number of participants with account balances2011-07-0158
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-07-012
2009: S.I.C.C. INC. PENSION PLAN 2009 401k membership
Total participants, beginning-of-year2009-07-0169
Total number of active participants reported on line 7a of the Form 55002009-07-0155
Number of retired or separated participants receiving benefits2009-07-014
Number of other retired or separated participants entitled to future benefits2009-07-017
Total of all active and inactive participants2009-07-0166
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-07-010
Total participants2009-07-0166
Number of participants with account balances2009-07-0166
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-07-010

Financial Data on S.I.C.C. INC. PENSION PLAN

Measure Date Value
2017 : S.I.C.C. INC. PENSION PLAN 2017 401k financial data
Total income from all sources2017-06-30$128,535
Expenses. Total of all expenses incurred2017-06-30$328,403
Benefits paid (including direct rollovers)2017-06-30$327,723
Total plan assets at end of year2017-06-30$1,751,616
Total plan assets at beginning of year2017-06-30$1,951,484
Value of fidelity bond covering the plan2017-06-30$500,000
Total contributions received or receivable from participants2017-06-30$13,425
Expenses. Other expenses not covered elsewhere2017-06-30$0
Contributions received from other sources (not participants or employers)2017-06-30$0
Other income received2017-06-30$115,110
Net income (gross income less expenses)2017-06-30$-199,868
Net plan assets at end of year (total assets less liabilities)2017-06-30$1,751,616
Net plan assets at beginning of year (total assets less liabilities)2017-06-30$1,951,484
Assets. Value of participant loans2017-06-30$0
Total contributions received or receivable from employer(s)2017-06-30$0
Value of certain deemed distributions of participant loans2017-06-30$0
Value of corrective distributions2017-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2017-06-30$680
2016 : S.I.C.C. INC. PENSION PLAN 2016 401k financial data
Total income from all sources2016-06-30$18,390
Expenses. Total of all expenses incurred2016-06-30$530,209
Benefits paid (including direct rollovers)2016-06-30$527,494
Total plan assets at end of year2016-06-30$1,951,483
Total plan assets at beginning of year2016-06-30$2,463,302
Value of fidelity bond covering the plan2016-06-30$500,000
Total contributions received or receivable from participants2016-06-30$5,666
Expenses. Other expenses not covered elsewhere2016-06-30$0
Contributions received from other sources (not participants or employers)2016-06-30$0
Other income received2016-06-30$12,724
Net income (gross income less expenses)2016-06-30$-511,819
Net plan assets at end of year (total assets less liabilities)2016-06-30$1,951,483
Net plan assets at beginning of year (total assets less liabilities)2016-06-30$2,463,302
Assets. Value of participant loans2016-06-30$3,659
Total contributions received or receivable from employer(s)2016-06-30$0
Value of certain deemed distributions of participant loans2016-06-30$1,515
Value of corrective distributions2016-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2016-06-30$1,200
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-06-30$0
2015 : S.I.C.C. INC. PENSION PLAN 2015 401k financial data
Total income from all sources2015-06-30$125,885
Expenses. Total of all expenses incurred2015-06-30$482,939
Benefits paid (including direct rollovers)2015-06-30$482,144
Total plan assets at end of year2015-06-30$2,463,302
Total plan assets at beginning of year2015-06-30$2,820,356
Value of fidelity bond covering the plan2015-06-30$500,000
Total contributions received or receivable from participants2015-06-30$46,022
Expenses. Other expenses not covered elsewhere2015-06-30$0
Contributions received from other sources (not participants or employers)2015-06-30$0
Other income received2015-06-30$79,863
Net income (gross income less expenses)2015-06-30$-357,054
Net plan assets at end of year (total assets less liabilities)2015-06-30$2,463,302
Net plan assets at beginning of year (total assets less liabilities)2015-06-30$2,820,356
Assets. Value of participant loans2015-06-30$20,610
Total contributions received or receivable from employer(s)2015-06-30$0
Value of certain deemed distributions of participant loans2015-06-30$0
Value of corrective distributions2015-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2015-06-30$795
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-06-30$0
2014 : S.I.C.C. INC. PENSION PLAN 2014 401k financial data
Total income from all sources2014-06-30$320,102
Expenses. Total of all expenses incurred2014-06-30$491,235
Benefits paid (including direct rollovers)2014-06-30$490,295
Total plan assets at end of year2014-06-30$2,820,355
Total plan assets at beginning of year2014-06-30$2,991,488
Value of fidelity bond covering the plan2014-06-30$500,000
Total contributions received or receivable from participants2014-06-30$47,537
Expenses. Other expenses not covered elsewhere2014-06-30$0
Contributions received from other sources (not participants or employers)2014-06-30$0
Other income received2014-06-30$272,565
Net income (gross income less expenses)2014-06-30$-171,133
Net plan assets at end of year (total assets less liabilities)2014-06-30$2,820,355
Net plan assets at beginning of year (total assets less liabilities)2014-06-30$2,991,488
Assets. Value of participant loans2014-06-30$45,837
Total contributions received or receivable from employer(s)2014-06-30$0
Value of certain deemed distributions of participant loans2014-06-30$0
Value of corrective distributions2014-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2014-06-30$940
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-06-30$0
2013 : S.I.C.C. INC. PENSION PLAN 2013 401k financial data
Total income from all sources2013-06-30$291,502
Expenses. Total of all expenses incurred2013-06-30$532,411
Benefits paid (including direct rollovers)2013-06-30$509,386
Total plan assets at end of year2013-06-30$2,991,488
Total plan assets at beginning of year2013-06-30$3,232,397
Value of fidelity bond covering the plan2013-06-30$500,000
Total contributions received or receivable from participants2013-06-30$64,286
Expenses. Other expenses not covered elsewhere2013-06-30$0
Contributions received from other sources (not participants or employers)2013-06-30$0
Other income received2013-06-30$226,923
Net income (gross income less expenses)2013-06-30$-240,909
Net plan assets at end of year (total assets less liabilities)2013-06-30$2,991,488
Net plan assets at beginning of year (total assets less liabilities)2013-06-30$3,232,397
Assets. Value of participant loans2013-06-30$86,992
Total contributions received or receivable from employer(s)2013-06-30$293
Value of certain deemed distributions of participant loans2013-06-30$21,725
Value of corrective distributions2013-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2013-06-30$1,300
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-06-30$0
2012 : S.I.C.C. INC. PENSION PLAN 2012 401k financial data
Total income from all sources2012-06-30$237,664
Expenses. Total of all expenses incurred2012-06-30$223,891
Benefits paid (including direct rollovers)2012-06-30$221,801
Total plan assets at end of year2012-06-30$3,232,397
Total plan assets at beginning of year2012-06-30$3,218,624
Value of fidelity bond covering the plan2012-06-30$500,000
Total contributions received or receivable from participants2012-06-30$102,372
Expenses. Other expenses not covered elsewhere2012-06-30$0
Contributions received from other sources (not participants or employers)2012-06-30$0
Other income received2012-06-30$71,305
Net income (gross income less expenses)2012-06-30$13,773
Net plan assets at end of year (total assets less liabilities)2012-06-30$3,232,397
Net plan assets at beginning of year (total assets less liabilities)2012-06-30$3,218,624
Assets. Value of participant loans2012-06-30$176,818
Total contributions received or receivable from employer(s)2012-06-30$63,987
Value of certain deemed distributions of participant loans2012-06-30$0
Value of corrective distributions2012-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2012-06-30$2,090
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-06-30$0
2011 : S.I.C.C. INC. PENSION PLAN 2011 401k financial data
Total income from all sources2011-06-30$505,208
Expenses. Total of all expenses incurred2011-06-30$252,705
Benefits paid (including direct rollovers)2011-06-30$221,223
Total plan assets at end of year2011-06-30$3,218,624
Total plan assets at beginning of year2011-06-30$2,966,121
Value of fidelity bond covering the plan2011-06-30$500,000
Total contributions received or receivable from participants2011-06-30$91,261
Expenses. Other expenses not covered elsewhere2011-06-30$0
Contributions received from other sources (not participants or employers)2011-06-30$0
Other income received2011-06-30$312,857
Net income (gross income less expenses)2011-06-30$252,503
Net plan assets at end of year (total assets less liabilities)2011-06-30$3,218,624
Net plan assets at beginning of year (total assets less liabilities)2011-06-30$2,966,121
Assets. Value of participant loans2011-06-30$190,184
Total contributions received or receivable from employer(s)2011-06-30$101,090
Value of certain deemed distributions of participant loans2011-06-30$29,657
Value of corrective distributions2011-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2011-06-30$1,825
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-06-30$0
2010 : S.I.C.C. INC. PENSION PLAN 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-06-30$0

Form 5500 Responses for S.I.C.C. INC. PENSION PLAN

2016: S.I.C.C. INC. PENSION PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Submission has been amendedNo
2016-07-01This submission is the final filingNo
2016-07-01This return/report is a short plan year return/report (less than 12 months)No
2016-07-01Plan is a collectively bargained planNo
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan funding arrangement – TrustYes
2016-07-01Plan benefit arrangement – InsuranceYes
2016-07-01Plan benefit arrangement - TrustYes
2015: S.I.C.C. INC. PENSION PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan funding arrangement – TrustYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-07-01Plan benefit arrangement - TrustYes
2014: S.I.C.C. INC. PENSION PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan funding arrangement – TrustYes
2014-07-01Plan benefit arrangement – InsuranceYes
2014-07-01Plan benefit arrangement - TrustYes
2013: S.I.C.C. INC. PENSION PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan funding arrangement – TrustYes
2013-07-01Plan benefit arrangement – InsuranceYes
2013-07-01Plan benefit arrangement - TrustYes
2012: S.I.C.C. INC. PENSION PLAN 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan funding arrangement – TrustYes
2012-07-01Plan benefit arrangement – InsuranceYes
2012-07-01Plan benefit arrangement - TrustYes
2011: S.I.C.C. INC. PENSION PLAN 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan funding arrangement – TrustYes
2011-07-01Plan benefit arrangement – InsuranceYes
2011-07-01Plan benefit arrangement - TrustYes
2009: S.I.C.C. INC. PENSION PLAN 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan funding arrangement – TrustYes
2009-07-01Plan benefit arrangement – InsuranceYes
2009-07-01Plan 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 7122
Policy instance 1
Insurance contract or identification numberFL 7122
Number of Individuals Covered41
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $2,246
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
Commission paid to Insurance BrokerUSD $2,246
Insurance broker organization code?1
Insurance broker nameWOODBURY FIN SVCS INC
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberFL 7122
Policy instance 1
Insurance contract or identification numberFL 7122
Number of Individuals Covered46
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $2,499
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
Commission paid to Insurance BrokerUSD $2,499
Insurance broker organization code?1
Insurance broker nameWOODBURY FIN SVCS INC
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberFL 7122
Policy instance 1
Insurance contract or identification numberFL 7122
Number of Individuals Covered48
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
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 7122
Policy instance 1
Insurance contract or identification numberFL 7122
Number of Individuals Covered51
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
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 7122
Policy instance 1
Insurance contract or identification numberFL 7122
Number of Individuals Covered58
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
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 7122
Policy instance 1
Insurance contract or identification numberFL 7122
Number of Individuals Covered67
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
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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