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BAY MEDICAL SERVICES, INC. EMPLOYEES' DEFINED CONTRIBUTION PENSION PLAN 401k Plan overview

Plan NameBAY MEDICAL SERVICES, INC. EMPLOYEES' DEFINED CONTRIBUTION PENSION PLAN
Plan identification number 005

BAY MEDICAL SERVICES, INC. EMPLOYEES' DEFINED CONTRIBUTION PENSION PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Money purchase (other than target benefit)
  • 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.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

MCLAREN BAY REGION has sponsored the creation of one or more 401k plans.

Company Name:MCLAREN BAY REGION
Employer identification number (EIN):381976271
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BAY MEDICAL SERVICES, INC. EMPLOYEES' DEFINED CONTRIBUTION PENSION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0052013-01-01SUSAN JOINER
0052012-01-01SUSAN JOINER
0052011-01-01SUSAN JOINER
0052009-01-01BRIAN KAY

Plan Statistics for BAY MEDICAL SERVICES, INC. EMPLOYEES' DEFINED CONTRIBUTION PENSION PLAN

401k plan membership statisitcs for BAY MEDICAL SERVICES, INC. EMPLOYEES' DEFINED CONTRIBUTION PENSION PLAN

Measure Date Value
2013: BAY MEDICAL SERVICES, INC. EMPLOYEES' DEFINED CONTRIBUTION PENSION PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0145
Total number of active participants reported on line 7a of the Form 55002013-01-010
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-010
Number of participants with account balances2013-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: BAY MEDICAL SERVICES, INC. EMPLOYEES' DEFINED CONTRIBUTION PENSION PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01384
Total number of active participants reported on line 7a of the Form 55002012-01-0122
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0123
Total of all active and inactive participants2012-01-0145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0145
Number of participants with account balances2012-01-0135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: BAY MEDICAL SERVICES, INC. EMPLOYEES' DEFINED CONTRIBUTION PENSION PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01305
Total number of active participants reported on line 7a of the Form 55002011-01-01304
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-0180
Total of all active and inactive participants2011-01-01384
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01384
Number of participants with account balances2011-01-01374
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: BAY MEDICAL SERVICES, INC. EMPLOYEES' DEFINED CONTRIBUTION PENSION PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01672
Total number of active participants reported on line 7a of the Form 55002009-01-01371
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01371
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01371
Number of participants with account balances2009-01-01371
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on BAY MEDICAL SERVICES, INC. EMPLOYEES' DEFINED CONTRIBUTION PENSION PLAN

Measure Date Value
2013 : BAY MEDICAL SERVICES, INC. EMPLOYEES' DEFINED CONTRIBUTION PENSION PLAN 2013 401k financial data
Total income from all sources2013-11-25$1,527
Expenses. Total of all expenses incurred2013-11-25$209,759
Benefits paid (including direct rollovers)2013-11-25$208,511
Total plan assets at end of year2013-11-25$0
Total plan assets at beginning of year2013-11-25$208,232
Value of fidelity bond covering the plan2013-11-25$300,000
Total contributions received or receivable from participants2013-11-25$0
Expenses. Other expenses not covered elsewhere2013-11-25$0
Contributions received from other sources (not participants or employers)2013-11-25$0
Other income received2013-11-25$1,527
Net income (gross income less expenses)2013-11-25$-208,232
Net plan assets at end of year (total assets less liabilities)2013-11-25$0
Net plan assets at beginning of year (total assets less liabilities)2013-11-25$208,232
Total contributions received or receivable from employer(s)2013-11-25$0
Value of certain deemed distributions of participant loans2013-11-25$0
Value of corrective distributions2013-11-25$0
Expenses. Administrative service providers (salaries,fees and commissions)2013-11-25$1,248
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-11-25$0
Funding deficiency by the employer to the plan for this plan year2013-11-25$0
Minimum employer required contribution for this plan year2013-11-25$0
Amount contributed by the employer to the plan for this plan year2013-11-25$0
2012 : BAY MEDICAL SERVICES, INC. EMPLOYEES' DEFINED CONTRIBUTION PENSION PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total transfer of assets from this plan2012-12-31$-829,373
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total income from all sources (including contributions)2012-12-31$208,204
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$1,889,044
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$1,881,480
Expenses. Certain deemed distributions of participant loans2012-12-31$0
Value of total corrective distributions2012-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$0
Value of total assets at end of year2012-12-31$208,232
Value of total assets at beginning of year2012-12-31$2,718,445
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$7,564
Total interest from all sources2012-12-31$3,225
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2012-12-31$0
Administrative expenses professional fees incurred2012-12-31$0
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$300,000
If this is an individual account plan, was there a blackout period2012-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Funding deficiency by the employer to the plan for this plan year2012-12-31$0
Minimum employer required contribution for this plan year2012-12-31$0
Amount contributed by the employer to the plan for this plan year2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2012-12-31$0
Other income not declared elsewhere2012-12-31$0
Administrative expenses (other) incurred2012-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$-1,680,840
Value of net assets at end of year (total assets less liabilities)2012-12-31$208,232
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$2,718,445
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Investment advisory and management fees2012-12-31$833
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$203,935
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$2,453,627
Interest on participant loans2012-12-31$0
Interest earned on other investments2012-12-31$3,225
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$4,297
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$264,818
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$204,979
Net investment gain/loss from pooled separate accounts2012-12-31$0
Net investment gain or loss from common/collective trusts2012-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Income. Dividends from common stock2012-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$1,881,480
Contract administrator fees2012-12-31$6,731
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31PLANTE MORAN, PLLC
Accountancy firm EIN2012-12-31381357951
2011 : BAY MEDICAL SERVICES, INC. EMPLOYEES' DEFINED CONTRIBUTION PENSION PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total income from all sources (including contributions)2011-12-31$43,549
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$212,701
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$209,219
Expenses. Certain deemed distributions of participant loans2011-12-31$0
Value of total corrective distributions2011-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$0
Value of total assets at end of year2011-12-31$2,718,445
Value of total assets at beginning of year2011-12-31$2,887,597
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$3,482
Total interest from all sources2011-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$77,881
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$77,881
Administrative expenses professional fees incurred2011-12-31$0
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$300,000
If this is an individual account plan, was there a blackout period2011-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
Funding deficiency by the employer to the plan for this plan year2011-12-31$0
Minimum employer required contribution for this plan year2011-12-31$0
Amount contributed by the employer to the plan for this plan year2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2011-12-31$0
Other income not declared elsewhere2011-12-31$18,069
Administrative expenses (other) incurred2011-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-169,152
Value of net assets at end of year (total assets less liabilities)2011-12-31$2,718,445
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$2,887,597
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Investment advisory and management fees2011-12-31$1,712
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$2,453,627
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$2,462,205
Interest earned on other investments2011-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$264,818
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$425,392
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$-52,401
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$209,219
Contract administrator fees2011-12-31$1,770
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31PLANTE MORAN, PLLC
Accountancy firm EIN2011-12-31038135795
2010 : BAY MEDICAL SERVICES, INC. EMPLOYEES' DEFINED CONTRIBUTION PENSION PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total income from all sources (including contributions)2010-12-31$233,722
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$82,650
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$70,401
Expenses. Certain deemed distributions of participant loans2010-12-31$0
Value of total corrective distributions2010-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$0
Value of total assets at end of year2010-12-31$2,887,597
Value of total assets at beginning of year2010-12-31$2,736,525
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$12,249
Total interest from all sources2010-12-31$7,948
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$110,373
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2010-12-31$0
Total dividends received from registered investment company shares (eg mutual funds)2010-12-31$110,373
Administrative expenses professional fees incurred2010-12-31$7,500
Was this plan covered by a fidelity bond2010-12-31No
If this is an individual account plan, was there a blackout period2010-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Funding deficiency by the employer to the plan for this plan year2010-12-31$0
Minimum employer required contribution for this plan year2010-12-31$0
Amount contributed by the employer to the plan for this plan year2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$0
Participant contributions at end of year2010-12-31$0
Participant contributions at beginning of year2010-12-31$0
Assets. Other investments not covered elsewhere at end of year2010-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2010-12-31$762,347
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2010-12-31$0
Other income not declared elsewhere2010-12-31$0
Administrative expenses (other) incurred2010-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$151,072
Value of net assets at end of year (total assets less liabilities)2010-12-31$2,887,597
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$2,736,525
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Investment advisory and management fees2010-12-31$1,266
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$2,462,205
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$1,907,963
Value of interest in pooled separate accounts at end of year2010-12-31$0
Value of interest in pooled separate accounts at beginning of year2010-12-31$0
Interest on participant loans2010-12-31$0
Interest earned on other investments2010-12-31$7,948
Value of interest in common/collective trusts at end of year2010-12-31$0
Value of interest in common/collective trusts at beginning of year2010-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$425,392
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$66,215
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$115,401
Net investment gain/loss from pooled separate accounts2010-12-31$0
Net investment gain or loss from common/collective trusts2010-12-31$0
Net gain/loss from 103.12 investment entities2010-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31Yes
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Assets. Invements in employer securities at end of year2010-12-31$0
Assets. Invements in employer securities at beginning of year2010-12-31$0
Contributions received in cash from employer2010-12-31$0
Income. Dividends from common stock2010-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$70,401
Contract administrator fees2010-12-31$3,483
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31PLATE MORAN, PLLC
Accountancy firm EIN2010-12-31381357951
2009 : BAY MEDICAL SERVICES, INC. EMPLOYEES' DEFINED CONTRIBUTION PENSION 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
Funding deficiency by the employer to the plan for this plan year2009-12-31$0
Minimum employer required contribution for this plan year2009-12-31$0
Amount contributed by the employer to the plan for this plan year2009-12-31$0

Form 5500 Responses for BAY MEDICAL SERVICES, INC. EMPLOYEES' DEFINED CONTRIBUTION PENSION PLAN

2013: BAY MEDICAL SERVICES, INC. EMPLOYEES' DEFINED CONTRIBUTION PENSION 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 filingYes
2013-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: BAY MEDICAL SERVICES, INC. EMPLOYEES' DEFINED CONTRIBUTION PENSION 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 funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: BAY MEDICAL SERVICES, INC. EMPLOYEES' DEFINED CONTRIBUTION PENSION 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 funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: BAY MEDICAL SERVICES, INC. EMPLOYEES' DEFINED CONTRIBUTION PENSION 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 funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberMR 60473
Policy instance 1
Insurance contract or identification numberMR 60473
Number of Individuals Covered0
Insurance policy start date2013-01-01
Insurance policy end date2013-11-25
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 numberMR 60473
Policy instance 1
Insurance contract or identification numberMR 60473
Number of Individuals Covered45
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberMR 60473
Policy instance 1
Insurance contract or identification numberMR 60473
Number of Individuals Covered384
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number925918
Policy instance 1
Insurance contract or identification number925918
Number of Individuals Covered0
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $108
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
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number925921
Policy instance 2
Insurance contract or identification number925921
Number of Individuals Covered0
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $85
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
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number929080
Policy instance 3
Insurance contract or identification number929080
Number of Individuals Covered0
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $10
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
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberMR 60473
Policy instance 4
Insurance contract or identification numberMR 60473
Number of Individuals Covered305
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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