AUBURN BEAN & GRAIN INC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan AUBURN BEAN & GRAIN INC 401(K) PLAN
| Measure | Date | Value |
|---|
| 2015: AUBURN BEAN & GRAIN INC 401(K) PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 106 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 0 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
| Total of all active and inactive participants | 2015-01-01 | 0 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2015-01-01 | 0 |
| Total participants | 2015-01-01 | 0 |
| Number of participants with account balances | 2015-01-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2015-01-01 | 0 |
| 2014: AUBURN BEAN & GRAIN INC 401(K) PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 82 |
| 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 | 24 |
| Total of all active and inactive participants | 2014-01-01 | 106 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-01-01 | 0 |
| Total participants | 2014-01-01 | 106 |
| Number of participants with account balances | 2014-01-01 | 101 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2014-01-01 | 0 |
| 2013: AUBURN BEAN & GRAIN INC 401(K) PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 102 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 77 |
| 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 | 22 |
| Total of all active and inactive participants | 2013-01-01 | 99 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-01-01 | 0 |
| Total participants | 2013-01-01 | 99 |
| Number of participants with account balances | 2013-01-01 | 98 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-01-01 | 1 |
| 2012: AUBURN BEAN & GRAIN INC 401(K) PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 98 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 77 |
| 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 | 22 |
| Total of all active and inactive participants | 2012-01-01 | 99 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-01-01 | 0 |
| Total participants | 2012-01-01 | 99 |
| Number of participants with account balances | 2012-01-01 | 98 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-01-01 | 0 |
| 2011: AUBURN BEAN & GRAIN INC 401(K) PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 92 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 65 |
| 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 | 22 |
| Total of all active and inactive participants | 2011-01-01 | 87 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-01-01 | 0 |
| Total participants | 2011-01-01 | 87 |
| Number of participants with account balances | 2011-01-01 | 85 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2011-01-01 | 1 |
| 2010: AUBURN BEAN & GRAIN INC 401(K) PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 86 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 64 |
| 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 | 24 |
| Total of all active and inactive participants | 2010-01-01 | 88 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2010-01-01 | 0 |
| Total participants | 2010-01-01 | 88 |
| Number of participants with account balances | 2010-01-01 | 83 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2010-01-01 | 0 |
| 2009: AUBURN BEAN & GRAIN INC 401(K) PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 85 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 62 |
| 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 | 22 |
| Total of all active and inactive participants | 2009-01-01 | 84 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-01-01 | 0 |
| Total participants | 2009-01-01 | 84 |
| Number of participants with account balances | 2009-01-01 | 83 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-01-01 | 0 |
| Measure | Date | Value |
|---|
| 2015 : AUBURN BEAN & GRAIN INC 401(K) PLAN 2015 401k financial data |
|---|
| Total income from all sources | 2015-12-31 | $193,491 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $6,627,338 |
| Benefits paid (including direct rollovers) | 2015-12-31 | $6,627,049 |
| Total plan assets at end of year | 2015-12-31 | $0 |
| Total plan assets at beginning of year | 2015-12-31 | $6,433,847 |
| Value of fidelity bond covering the plan | 2015-12-31 | $500,000 |
| Contributions received from other sources (not participants or employers) | 2015-12-31 | $9,235 |
| Other income received | 2015-12-31 | $177,727 |
| Net income (gross income less expenses) | 2015-12-31 | $-6,433,847 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $6,433,847 |
| Total contributions received or receivable from employer(s) | 2015-12-31 | $6,529 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-12-31 | $289 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2015-12-31 | $0 |
| 2014 : AUBURN BEAN & GRAIN INC 401(K) PLAN 2014 401k financial data |
|---|
| Total income from all sources | 2014-12-31 | $766,044 |
| Expenses. Total of all expenses incurred | 2014-12-31 | $862,750 |
| Benefits paid (including direct rollovers) | 2014-12-31 | $861,988 |
| Total plan assets at end of year | 2014-12-31 | $6,433,847 |
| Total plan assets at beginning of year | 2014-12-31 | $6,530,553 |
| Value of fidelity bond covering the plan | 2014-12-31 | $500,000 |
| Total contributions received or receivable from participants | 2014-12-31 | $245,194 |
| Contributions received from other sources (not participants or employers) | 2014-12-31 | $25,594 |
| Other income received | 2014-12-31 | $349,878 |
| Net income (gross income less expenses) | 2014-12-31 | $-96,706 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $6,433,847 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $6,530,553 |
| Assets. Value of participant loans | 2014-12-31 | $130,195 |
| Total contributions received or receivable from employer(s) | 2014-12-31 | $145,378 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2014-12-31 | $762 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2014-12-31 | $0 |
| 2013 : AUBURN BEAN & GRAIN INC 401(K) PLAN 2013 401k financial data |
|---|
| Total income from all sources | 2013-12-31 | $1,488,990 |
| Expenses. Total of all expenses incurred | 2013-12-31 | $179,124 |
| Benefits paid (including direct rollovers) | 2013-12-31 | $167,768 |
| Total plan assets at end of year | 2013-12-31 | $6,530,553 |
| Total plan assets at beginning of year | 2013-12-31 | $5,220,687 |
| Value of fidelity bond covering the plan | 2013-12-31 | $500,000 |
| Total contributions received or receivable from participants | 2013-12-31 | $276,955 |
| Contributions received from other sources (not participants or employers) | 2013-12-31 | $55,353 |
| Other income received | 2013-12-31 | $942,427 |
| Net income (gross income less expenses) | 2013-12-31 | $1,309,866 |
| Net plan assets at end of year (total assets less liabilities) | 2013-12-31 | $6,530,553 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-12-31 | $5,220,687 |
| Assets. Value of participant loans | 2013-12-31 | $138,725 |
| Total contributions received or receivable from employer(s) | 2013-12-31 | $214,255 |
| Value of certain deemed distributions of participant loans | 2013-12-31 | $8,961 |
| Value of corrective distributions | 2013-12-31 | $1,756 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2013-12-31 | $639 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2013-12-31 | $0 |
| 2012 : AUBURN BEAN & GRAIN INC 401(K) PLAN 2012 401k financial data |
|---|
| Total income from all sources | 2012-12-31 | $996,851 |
| Expenses. Total of all expenses incurred | 2012-12-31 | $174,432 |
| Benefits paid (including direct rollovers) | 2012-12-31 | $173,644 |
| Total plan assets at end of year | 2012-12-31 | $5,220,687 |
| Total plan assets at beginning of year | 2012-12-31 | $4,398,268 |
| Value of fidelity bond covering the plan | 2012-12-31 | $450,000 |
| Total contributions received or receivable from participants | 2012-12-31 | $264,281 |
| Other income received | 2012-12-31 | $522,932 |
| Net income (gross income less expenses) | 2012-12-31 | $822,419 |
| Net plan assets at end of year (total assets less liabilities) | 2012-12-31 | $5,220,687 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-12-31 | $4,398,268 |
| Assets. Value of participant loans | 2012-12-31 | $268,129 |
| Total contributions received or receivable from employer(s) | 2012-12-31 | $209,638 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2012-12-31 | $788 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2012-12-31 | $0 |
| 2011 : AUBURN BEAN & GRAIN INC 401(K) PLAN 2011 401k financial data |
|---|
| Total plan liabilities at beginning of year | 2011-12-31 | $0 |
| Total income from all sources | 2011-12-31 | $232,064 |
| Expenses. Total of all expenses incurred | 2011-12-31 | $247,310 |
| Benefits paid (including direct rollovers) | 2011-12-31 | $246,360 |
| Total plan assets at end of year | 2011-12-31 | $4,398,268 |
| Total plan assets at beginning of year | 2011-12-31 | $4,413,514 |
| Value of fidelity bond covering the plan | 2011-12-31 | $500,000 |
| Total contributions received or receivable from participants | 2011-12-31 | $198,553 |
| Contributions received from other sources (not participants or employers) | 2011-12-31 | $0 |
| Other income received | 2011-12-31 | $-99,665 |
| Noncash contributions received | 2011-12-31 | $0 |
| Net income (gross income less expenses) | 2011-12-31 | $-15,246 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-31 | $4,398,268 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-31 | $4,413,514 |
| Assets. Value of participant loans | 2011-12-31 | $134,002 |
| Total contributions received or receivable from employer(s) | 2011-12-31 | $133,176 |
| Value of certain deemed distributions of participant loans | 2011-12-31 | $0 |
| Value of corrective distributions | 2011-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2011-12-31 | $950 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2011-12-31 | $0 |
| 2010 : AUBURN BEAN & GRAIN INC 401(K) PLAN 2010 401k financial data |
|---|
| Transfers to/from the plan | 2010-12-31 | $0 |
| Total plan liabilities at end of year | 2010-12-31 | $0 |
| Total plan liabilities at beginning of year | 2010-12-31 | $0 |
| Total income from all sources | 2010-12-31 | $806,439 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $158,091 |
| Benefits paid (including direct rollovers) | 2010-12-31 | $157,206 |
| Total plan assets at end of year | 2010-12-31 | $4,413,514 |
| Total plan assets at beginning of year | 2010-12-31 | $3,765,166 |
| Value of fidelity bond covering the plan | 2010-12-31 | $500,000 |
| Total contributions received or receivable from participants | 2010-12-31 | $213,241 |
| Expenses. Other expenses not covered elsewhere | 2010-12-31 | $219 |
| Contributions received from other sources (not participants or employers) | 2010-12-31 | $0 |
| Other income received | 2010-12-31 | $437,063 |
| Noncash contributions received | 2010-12-31 | $0 |
| Net income (gross income less expenses) | 2010-12-31 | $648,348 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $4,413,514 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $3,765,166 |
| Assets. Value of participant loans | 2010-12-31 | $102,762 |
| Total contributions received or receivable from employer(s) | 2010-12-31 | $156,135 |
| Value of certain deemed distributions of participant loans | 2010-12-31 | $0 |
| Value of corrective distributions | 2010-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2010-12-31 | $666 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2010-12-31 | $0 |
| 2009 : AUBURN BEAN & GRAIN INC 401(K) 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 |
| 2015: AUBURN BEAN & GRAIN INC 401(K) PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | Yes |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: AUBURN BEAN & GRAIN INC 401(K) 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 benefit arrangement – Insurance | Yes |
| 2013: AUBURN BEAN & GRAIN INC 401(K) 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 benefit arrangement – Insurance | Yes |
| 2012: AUBURN BEAN & GRAIN INC 401(K) 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 benefit arrangement – Insurance | Yes |
| 2011: AUBURN BEAN & GRAIN INC 401(K) 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 benefit arrangement – Insurance | Yes |
| 2010: AUBURN BEAN & GRAIN INC 401(K) 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 benefit arrangement – Insurance | Yes |
| 2009: AUBURN BEAN & GRAIN INC 401(K) 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 benefit arrangement – Insurance | Yes |
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 35611 |
| Policy instance | 1 |
| Insurance contract or identification number | 35611 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $4,632 | | Total amount of fees paid to insurance company | USD $882 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | Yes | | 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? | No | | Commission paid to Insurance Broker | USD $4,632 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 882 | | Additional information about fees paid to insurance broker | TPA FEES & COMPENSATION | | Insurance broker name | ADMINISTRTION SPECIALISTS INC |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 35611 |
| Policy instance | 1 |
| Insurance contract or identification number | 35611 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $16,181 | | Total amount of fees paid to insurance company | USD $3,493 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | Yes | | 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? | No | | 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? | No | | Commission paid to Insurance Broker | USD $16,181 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 3493 | | Additional information about fees paid to insurance broker | TPA FEES & COMPENSATION | | Insurance broker name | ADMINISTRTION SPECIALISTS INC |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 35611 |
| Policy instance | 1 |
| Insurance contract or identification number | 35611 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $13,938 | | Total amount of fees paid to insurance company | USD $492 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | Yes | | 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? | No | | 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? | No | | Commission paid to Insurance Broker | USD $13,938 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 492 | | Additional information about fees paid to insurance broker | TPA FEES & COMPENSATION | | Insurance broker name | ADMINISTRTION SPECIALISTS INC |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 35611 |
| Policy instance | 1 |
| Insurance contract or identification number | 35611 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $13,142 | | Total amount of fees paid to insurance company | USD $2,799 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | Yes | | 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? | No | | 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? | No | | Commission paid to Insurance Broker | USD $13,142 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 2799 | | Additional information about fees paid to insurance broker | TPA FEES & COMPENSATION | | Insurance broker name | ADMINISTRTION SPECIALISTS INC |
|
| AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 ) |
| Policy contract number | 352536 |
| Policy instance | 1 |
| Insurance contract or identification number | 352536 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | Yes | | 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? | No | | 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? | No |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 35611 |
| Policy instance | 2 |
| Insurance contract or identification number | 35611 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $12,635 | | Total amount of fees paid to insurance company | USD $3,077 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | Yes | | 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? | No | | 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? | No |
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| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 35611 |
| Policy instance | 1 |
| Insurance contract or identification number | 35611 | | Number of Individuals Covered | 88 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $11,726 | | Total amount of fees paid to insurance company | USD $1,870 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | Yes | | 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? | No | | 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? | No | | Commission paid to Insurance Broker | USD $11,726 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1870 | | Additional information about fees paid to insurance broker | TPA FEE & COMPENSATION | | Insurance broker name | ADMINISTRTION SPECIALISTS INC |
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| AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 ) |
| Policy contract number | 352536 |
| Policy instance | 2 |
| Insurance contract or identification number | 352536 | | Number of Individuals Covered | 88 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | Yes | | 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? | No | | 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? | No |
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