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QUALITY POOL SUPPLY CO. PROFIT SHARING PLAN 401k Plan overview

Plan NameQUALITY POOL SUPPLY CO. PROFIT SHARING PLAN
Plan identification number 001

QUALITY POOL SUPPLY CO. PROFIT SHARING 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

QUALITY POOL SUPPLY CO. has sponsored the creation of one or more 401k plans.

Company Name:QUALITY POOL SUPPLY CO.
Employer identification number (EIN):381947130
NAIC Classification:238900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan QUALITY POOL SUPPLY CO. PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01
0012017-01-01
0012016-01-01KURT JENNINGS
0012015-01-01KURT JENNINGS KURT JENNINGS2016-07-12
0012014-01-01KURT JENNINGS KURT JENNINGS2015-07-09
0012013-01-01DENNIS S. SANBORN DENNIS S. SANBORN2014-07-23
0012012-01-01DENNIS S. SANBORN
0012011-01-01DENNIS S. SANBORN DENNIS S. SANBORN2012-07-20
0012009-01-01DENNIS S. SANBORN DENNIS S. SANBORN2010-09-09

Plan Statistics for QUALITY POOL SUPPLY CO. PROFIT SHARING PLAN

401k plan membership statisitcs for QUALITY POOL SUPPLY CO. PROFIT SHARING PLAN

Measure Date Value
2016: QUALITY POOL SUPPLY CO. PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0158
Total number of active participants reported on line 7a of the Form 55002016-01-0154
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-013
Total of all active and inactive participants2016-01-0157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0157
Number of participants with account balances2016-01-0152
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: QUALITY POOL SUPPLY CO. PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0159
Total number of active participants reported on line 7a of the Form 55002015-01-0149
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-016
Total of all active and inactive participants2015-01-0155
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0155
Number of participants with account balances2015-01-0149
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: QUALITY POOL SUPPLY CO. PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0165
Total number of active participants reported on line 7a of the Form 55002014-01-0154
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-013
Total of all active and inactive participants2014-01-0157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0157
Number of participants with account balances2014-01-0147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: QUALITY POOL SUPPLY CO. PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0162
Total number of active participants reported on line 7a of the Form 55002013-01-0156
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-018
Total of all active and inactive participants2013-01-0164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0164
Number of participants with account balances2013-01-0147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: QUALITY POOL SUPPLY CO. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0163
Total number of active participants reported on line 7a of the Form 55002012-01-0152
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-018
Total of all active and inactive participants2012-01-0160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0160
Number of participants with account balances2012-01-0147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: QUALITY POOL SUPPLY CO. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0161
Total number of active participants reported on line 7a of the Form 55002011-01-0155
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-016
Total of all active and inactive participants2011-01-0161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0161
Number of participants with account balances2011-01-0148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: QUALITY POOL SUPPLY CO. PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0147
Total number of active participants reported on line 7a of the Form 55002009-01-0145
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-013
Total of all active and inactive participants2009-01-0148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0148
Number of participants with account balances2009-01-0139
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on QUALITY POOL SUPPLY CO. PROFIT SHARING PLAN

Measure Date Value
2016 : QUALITY POOL SUPPLY CO. PROFIT SHARING PLAN 2016 401k financial data
Total plan liabilities at end of year2016-12-31$0
Total plan liabilities at beginning of year2016-12-31$0
Total income from all sources2016-12-31$489,360
Expenses. Total of all expenses incurred2016-12-31$473
Benefits paid (including direct rollovers)2016-12-31$473
Total plan assets at end of year2016-12-31$3,893,841
Total plan assets at beginning of year2016-12-31$3,404,954
Value of fidelity bond covering the plan2016-12-31$0
Total contributions received or receivable from participants2016-12-31$155,828
Contributions received from other sources (not participants or employers)2016-12-31$26,734
Other income received2016-12-31$270,036
Net income (gross income less expenses)2016-12-31$488,887
Net plan assets at end of year (total assets less liabilities)2016-12-31$3,893,841
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$3,404,954
Total contributions received or receivable from employer(s)2016-12-31$36,762
Value of certain deemed distributions of participant loans2016-12-31$0
Value of corrective distributions2016-12-31$0
2015 : QUALITY POOL SUPPLY CO. PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources2015-12-31$198,008
Expenses. Total of all expenses incurred2015-12-31$4,615
Benefits paid (including direct rollovers)2015-12-31$4,003
Total plan assets at end of year2015-12-31$3,404,954
Total plan assets at beginning of year2015-12-31$3,211,561
Total contributions received or receivable from participants2015-12-31$180,900
Contributions received from other sources (not participants or employers)2015-12-31$10,000
Other income received2015-12-31$-32,968
Net income (gross income less expenses)2015-12-31$193,393
Net plan assets at end of year (total assets less liabilities)2015-12-31$3,404,954
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$3,211,561
Total contributions received or receivable from employer(s)2015-12-31$40,076
Value of corrective distributions2015-12-31$566
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$46
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : QUALITY POOL SUPPLY CO. PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources2014-12-31$509,115
Expenses. Total of all expenses incurred2014-12-31$108,526
Benefits paid (including direct rollovers)2014-12-31$107,482
Total plan assets at end of year2014-12-31$3,211,561
Total plan assets at beginning of year2014-12-31$2,810,972
Total contributions received or receivable from participants2014-12-31$150,051
Contributions received from other sources (not participants or employers)2014-12-31$187,345
Other income received2014-12-31$137,110
Net income (gross income less expenses)2014-12-31$400,589
Net plan assets at end of year (total assets less liabilities)2014-12-31$3,211,561
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$2,810,972
Total contributions received or receivable from employer(s)2014-12-31$34,609
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$1,044
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : QUALITY POOL SUPPLY CO. PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources2013-12-31$586,283
Expenses. Total of all expenses incurred2013-12-31$85,231
Benefits paid (including direct rollovers)2013-12-31$84,515
Total plan assets at end of year2013-12-31$2,810,972
Total plan assets at beginning of year2013-12-31$2,309,920
Total contributions received or receivable from participants2013-12-31$152,505
Other income received2013-12-31$399,034
Net income (gross income less expenses)2013-12-31$501,052
Net plan assets at end of year (total assets less liabilities)2013-12-31$2,810,972
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$2,309,920
Total contributions received or receivable from employer(s)2013-12-31$34,744
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$716
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : QUALITY POOL SUPPLY CO. PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources2012-12-31$415,751
Expenses. Total of all expenses incurred2012-12-31$416
Benefits paid (including direct rollovers)2012-12-31$416
Total plan assets at end of year2012-12-31$2,309,920
Total plan assets at beginning of year2012-12-31$1,894,585
Total contributions received or receivable from participants2012-12-31$136,816
Other income received2012-12-31$247,101
Net income (gross income less expenses)2012-12-31$415,335
Net plan assets at end of year (total assets less liabilities)2012-12-31$2,309,920
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$1,894,585
Total contributions received or receivable from employer(s)2012-12-31$31,834
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : QUALITY POOL SUPPLY CO. PROFIT SHARING PLAN 2011 401k financial data
Transfers to/from the plan2011-12-31$0
Total plan liabilities at beginning of year2011-12-31$0
Total income from all sources2011-12-31$61,204
Expenses. Total of all expenses incurred2011-12-31$6,057
Benefits paid (including direct rollovers)2011-12-31$4,868
Total plan assets at end of year2011-12-31$1,894,585
Total plan assets at beginning of year2011-12-31$1,839,438
Total contributions received or receivable from participants2011-12-31$120,133
Expenses. Other expenses not covered elsewhere2011-12-31$0
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-88,324
Noncash contributions received2011-12-31$0
Net income (gross income less expenses)2011-12-31$55,147
Net plan assets at end of year (total assets less liabilities)2011-12-31$1,894,585
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$1,839,438
Total contributions received or receivable from employer(s)2011-12-31$29,395
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$1,189
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : QUALITY POOL SUPPLY CO. PROFIT SHARING PLAN 2010 401k financial data
Transfers to/from the plan2010-12-31$0
Total plan liabilities at end of year2010-12-31$0
Total plan liabilities at beginning of year2010-12-31$0
Total income from all sources2010-12-31$353,877
Expenses. Total of all expenses incurred2010-12-31$5,537
Benefits paid (including direct rollovers)2010-12-31$3,000
Total plan assets at end of year2010-12-31$1,839,438
Total plan assets at beginning of year2010-12-31$1,491,098
Total contributions received or receivable from participants2010-12-31$125,227
Expenses. Other expenses not covered elsewhere2010-12-31$0
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$199,726
Noncash contributions received2010-12-31$0
Net income (gross income less expenses)2010-12-31$348,340
Net plan assets at end of year (total assets less liabilities)2010-12-31$1,839,438
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$1,491,098
Total contributions received or receivable from employer(s)2010-12-31$28,924
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$2,537
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
2009 : QUALITY POOL SUPPLY CO. PROFIT SHARING PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for QUALITY POOL SUPPLY CO. PROFIT SHARING PLAN

2016: QUALITY POOL SUPPLY CO. PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
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 planNo
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: QUALITY POOL SUPPLY CO. PROFIT SHARING PLAN 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 planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: QUALITY POOL SUPPLY CO. PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
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 planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: QUALITY POOL SUPPLY CO. PROFIT SHARING PLAN 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 planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: QUALITY POOL SUPPLY CO. PROFIT SHARING PLAN 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 planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: QUALITY POOL SUPPLY CO. PROFIT SHARING PLAN 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 planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: QUALITY POOL SUPPLY CO. PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number35166
Policy instance 1
Insurance contract or identification number35166
Number of Individuals Covered55
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $6,029
Total amount of fees paid to insurance companyUSD $180
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 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 $6,029
Insurance broker organization code?3
Amount paid for insurance broker fees180
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker nameASI
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number35166
Policy instance 1
Insurance contract or identification number35166
Number of Individuals Covered47
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $5,270
Total amount of fees paid to insurance companyUSD $1,349
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 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 $5,270
Insurance broker organization code?3
Amount paid for insurance broker fees1349
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker nameASI
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number35166
Policy instance 1
Insurance contract or identification number35166
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $5,696
Total amount of fees paid to insurance companyUSD $96
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 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 $5,696
Insurance broker organization code?3
Amount paid for insurance broker fees96
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker nameASI
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number35166
Policy instance 1
Insurance contract or identification number35166
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $6,109
Total amount of fees paid to insurance companyUSD $1,055
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 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 $6,109
Insurance broker organization code?3
Amount paid for insurance broker fees1055
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker nameASI
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number35166
Policy instance 1
Insurance contract or identification number35166
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $5,522
Total amount of fees paid to insurance companyUSD $1,089
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 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
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number35166
Policy instance 1
Insurance contract or identification number35166
Number of Individuals Covered59
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $4,716
Total amount of fees paid to insurance companyUSD $643
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 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 $4,716
Insurance broker organization code?3
Amount paid for insurance broker fees643
Additional information about fees paid to insurance brokerTPA FEE
Insurance broker nameASI

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