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THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS 401k Plan overview

Plan NameTHE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS
Plan identification number 004

THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • 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.
  • 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

MY MEDICAL ACCESS has sponsored the creation of one or more 401k plans.

Company Name:MY MEDICAL ACCESS
Employer identification number (EIN):453167104
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0042020-01-01TERRANCE P. POWER2021-10-11
0042019-01-01LEE D. VOGT2020-10-09
0042018-01-01LEE D. VOGT2019-10-14
0042017-01-01
0042016-01-01
0042015-01-01
0042014-01-01LEE D. VOGT
0042013-01-01LEE D. VOGT
0042012-01-01LEE D. VOGT

Plan Statistics for THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS

401k plan membership statisitcs for THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS

Measure Date Value
2020: THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS 2020 401k membership
Total participants, beginning-of-year2020-01-0124
Total number of active participants reported on line 7a of the Form 55002020-01-0121
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-0121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-0121
Number of participants with account balances2020-01-0118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS 2019 401k membership
Total participants, beginning-of-year2019-01-0121
Total number of active participants reported on line 7a of the Form 55002019-01-0117
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-017
Total of all active and inactive participants2019-01-0124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0124
Number of participants with account balances2019-01-0119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS 2018 401k membership
Total participants, beginning-of-year2018-01-0135
Total number of active participants reported on line 7a of the Form 55002018-01-0135
Number of retired or separated participants receiving benefits2018-01-015
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-0140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0140
Number of participants with account balances2018-01-0117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS 2017 401k membership
Total participants, beginning-of-year2017-01-0122
Total number of active participants reported on line 7a of the Form 55002017-01-0135
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-0135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0135
Number of participants with account balances2017-01-0122
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS 2016 401k membership
Total participants, beginning-of-year2016-01-0130
Total number of active participants reported on line 7a of the Form 55002016-01-0135
Number of retired or separated participants receiving benefits2016-01-012
Number of other retired or separated participants entitled to future benefits2016-01-013
Total of all active and inactive participants2016-01-0140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0140
Number of participants with account balances2016-01-0122
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS 2015 401k membership
Total participants, beginning-of-year2015-01-0128
Total number of active participants reported on line 7a of the Form 55002015-01-0127
Number of retired or separated participants receiving benefits2015-01-011
Number of other retired or separated participants entitled to future benefits2015-01-012
Total of all active and inactive participants2015-01-0130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0130
Number of participants with account balances2015-01-0120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS 2014 401k membership
Total participants, beginning-of-year2014-01-0127
Total number of active participants reported on line 7a of the Form 55002014-01-0126
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-012
Total of all active and inactive participants2014-01-0128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0128
Number of participants with account balances2014-01-0121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS 2013 401k membership
Total participants, beginning-of-year2013-01-0134
Total number of active participants reported on line 7a of the Form 55002013-01-0148
Number of retired or separated participants receiving benefits2013-01-012
Number of other retired or separated participants entitled to future benefits2013-01-016
Total of all active and inactive participants2013-01-0156
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0156
Number of participants with account balances2013-01-0117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS 2012 401k membership
Total participants, beginning-of-year2012-01-010
Total number of active participants reported on line 7a of the Form 55002012-01-0134
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-0134
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0134
Number of participants with account balances2012-01-0120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010

Financial Data on THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS

Measure Date Value
2020 : THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS 2020 401k financial data
Total income from all sources2020-12-31$445,464
Expenses. Total of all expenses incurred2020-12-31$20,212
Total plan assets at end of year2020-12-31$2,149,894
Total plan assets at beginning of year2020-12-31$1,724,642
Value of fidelity bond covering the plan2020-12-31$100,000
Total contributions received or receivable from participants2020-12-31$122,444
Other income received2020-12-31$299,895
Net income (gross income less expenses)2020-12-31$425,252
Net plan assets at end of year (total assets less liabilities)2020-12-31$2,149,894
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$1,724,642
Assets. Value of participant loans2020-12-31$3,320
Total contributions received or receivable from employer(s)2020-12-31$23,125
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$20,212
2019 : THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS 2019 401k financial data
Total income from all sources2019-12-31$425,070
Expenses. Total of all expenses incurred2019-12-31$7,765
Benefits paid (including direct rollovers)2019-12-31$678
Total plan assets at end of year2019-12-31$1,724,642
Total plan assets at beginning of year2019-12-31$1,307,337
Value of fidelity bond covering the plan2019-12-31$100,000
Total contributions received or receivable from participants2019-12-31$116,781
Other income received2019-12-31$286,053
Net income (gross income less expenses)2019-12-31$417,305
Net plan assets at end of year (total assets less liabilities)2019-12-31$1,724,642
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$1,307,337
Assets. Value of participant loans2019-12-31$0
Total contributions received or receivable from employer(s)2019-12-31$22,236
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$7,087
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
2018 : THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS 2018 401k financial data
Total income from all sources2018-12-31$100,904
Expenses. Total of all expenses incurred2018-12-31$307,038
Benefits paid (including direct rollovers)2018-12-31$301,109
Total plan assets at end of year2018-12-31$1,307,337
Total plan assets at beginning of year2018-12-31$1,513,471
Value of fidelity bond covering the plan2018-12-31$100,000
Total contributions received or receivable from participants2018-12-31$164,707
Contributions received from other sources (not participants or employers)2018-12-31$799
Other income received2018-12-31$-89,560
Net income (gross income less expenses)2018-12-31$-206,134
Net plan assets at end of year (total assets less liabilities)2018-12-31$1,307,337
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$1,513,471
Assets. Value of participant loans2018-12-31$2,022
Total contributions received or receivable from employer(s)2018-12-31$24,958
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$5,929
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
2017 : THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS 2017 401k financial data
Total income from all sources2017-12-31$384,892
Expenses. Total of all expenses incurred2017-12-31$5,310
Total plan assets at end of year2017-12-31$1,513,471
Total plan assets at beginning of year2017-12-31$1,133,889
Value of fidelity bond covering the plan2017-12-31$100,000
Total contributions received or receivable from participants2017-12-31$156,292
Other income received2017-12-31$194,580
Net income (gross income less expenses)2017-12-31$379,582
Net plan assets at end of year (total assets less liabilities)2017-12-31$1,513,471
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$1,133,889
Assets. Value of participant loans2017-12-31$12,814
Total contributions received or receivable from employer(s)2017-12-31$34,020
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$5,310
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS 2016 401k financial data
Total income from all sources2016-12-31$247,044
Expenses. Total of all expenses incurred2016-12-31$50,773
Benefits paid (including direct rollovers)2016-12-31$42,436
Total plan assets at end of year2016-12-31$1,133,889
Total plan assets at beginning of year2016-12-31$937,618
Value of fidelity bond covering the plan2016-12-31$100,000
Total contributions received or receivable from participants2016-12-31$142,645
Expenses. Other expenses not covered elsewhere2016-12-31$4,347
Other income received2016-12-31$69,403
Net income (gross income less expenses)2016-12-31$196,271
Net plan assets at end of year (total assets less liabilities)2016-12-31$1,133,889
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$937,618
Assets. Value of participant loans2016-12-31$31,850
Total contributions received or receivable from employer(s)2016-12-31$34,996
Value of certain deemed distributions of participant loans2016-12-31$2,372
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$1,618
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS 2015 401k financial data
Total income from all sources2015-12-31$164,866
Expenses. Total of all expenses incurred2015-12-31$14,098
Benefits paid (including direct rollovers)2015-12-31$6,771
Total plan assets at end of year2015-12-31$937,618
Total plan assets at beginning of year2015-12-31$786,850
Value of fidelity bond covering the plan2015-12-31$100,000
Total contributions received or receivable from participants2015-12-31$134,905
Expenses. Other expenses not covered elsewhere2015-12-31$881
Other income received2015-12-31$-8,772
Net income (gross income less expenses)2015-12-31$150,768
Net plan assets at end of year (total assets less liabilities)2015-12-31$937,618
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$786,850
Assets. Value of participant loans2015-12-31$48,732
Total contributions received or receivable from employer(s)2015-12-31$38,733
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$6,446
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS 2014 401k financial data
Total income from all sources2014-12-31$211,367
Expenses. Total of all expenses incurred2014-12-31$8,090
Benefits paid (including direct rollovers)2014-12-31$1,815
Total plan assets at end of year2014-12-31$786,850
Total plan assets at beginning of year2014-12-31$583,573
Total contributions received or receivable from participants2014-12-31$134,350
Expenses. Other expenses not covered elsewhere2014-12-31$667
Other income received2014-12-31$33,860
Net income (gross income less expenses)2014-12-31$203,277
Net plan assets at end of year (total assets less liabilities)2014-12-31$786,850
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$583,573
Assets. Value of participant loans2014-12-31$62,793
Total contributions received or receivable from employer(s)2014-12-31$43,157
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$5,608
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS 2013 401k financial data
Total income from all sources2013-12-31$209,766
Expenses. Total of all expenses incurred2013-12-31$17,132
Benefits paid (including direct rollovers)2013-12-31$12,472
Total plan assets at end of year2013-12-31$583,573
Total plan assets at beginning of year2013-12-31$390,939
Total contributions received or receivable from participants2013-12-31$98,908
Expenses. Other expenses not covered elsewhere2013-12-31$489
Other income received2013-12-31$76,834
Net income (gross income less expenses)2013-12-31$192,634
Net plan assets at end of year (total assets less liabilities)2013-12-31$583,573
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$390,939
Assets. Value of participant loans2013-12-31$4,389
Total contributions received or receivable from employer(s)2013-12-31$34,024
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$4,171
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS 2012 401k financial data
Transfers to/from the plan2012-12-31$349,541
Total income from all sources2012-12-31$41,534
Expenses. Total of all expenses incurred2012-12-31$136
Total plan assets at end of year2012-12-31$390,939
Total plan assets at beginning of year2012-12-31$0
Total contributions received or receivable from participants2012-12-31$32,724
Expenses. Other expenses not covered elsewhere2012-12-31$134
Other income received2012-12-31$2,612
Net income (gross income less expenses)2012-12-31$41,398
Net plan assets at end of year (total assets less liabilities)2012-12-31$390,939
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$0
Assets. Value of participant loans2012-12-31$5,690
Total contributions received or receivable from employer(s)2012-12-31$6,198
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$2
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0

Form 5500 Responses for THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS

2020: THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS 2020 form 5500 responses
2020-01-01Type of plan entityMulitple employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement - TrustYes
2019: THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS 2019 form 5500 responses
2019-01-01Type of plan entityMulitple employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement - TrustYes
2018: THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS 2018 form 5500 responses
2018-01-01Type of plan entityMulitple employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement - TrustYes
2017: THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS 2017 form 5500 responses
2017-01-01Type of plan entityMulitple employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement - TrustYes
2016: THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS 2016 form 5500 responses
2016-01-01Type of plan entityMulitple 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 – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS 2015 form 5500 responses
2015-01-01Type of plan entityMulitple 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 – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2014: THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS 2014 form 5500 responses
2014-01-01Type of plan entityMulitple 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 – TrustYes
2014-01-01Plan benefit arrangement - TrustYes
2013: THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS 2013 form 5500 responses
2013-01-01Type of plan entityMulitple 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 – TrustYes
2013-01-01Plan benefit arrangement - TrustYes
2012: THE PLATINUM 401(K) RETIREMENT SAVINGS PLAN FBO MY MEDICAL ACCESS 2012 form 5500 responses
2012-01-01Type of plan entityMulitple employer plan
2012-01-01First time form 5500 has been submittedYes
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 – TrustYes
2012-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number106939
Policy instance 1
Insurance contract or identification number106939
Number of Individuals Covered20
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $7,985
Total amount of fees paid to insurance companyUSD $5,125
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,095
Insurance broker organization code?3
Amount paid for insurance broker fees5125
Additional information about fees paid to insurance brokerSALES/ADMINISTRATION
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number106939
Policy instance 1
Insurance contract or identification number106939
Number of Individuals Covered20
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $6,814
Total amount of fees paid to insurance companyUSD $4,461
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,056
Insurance broker organization code?3
Amount paid for insurance broker fees4461
Additional information about fees paid to insurance brokerSALES/ADMINISTRATION
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number106939
Policy instance 1
Insurance contract or identification number106939
Number of Individuals Covered19
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $6,204
Total amount of fees paid to insurance companyUSD $4,418
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,510
Insurance broker organization code?3
Amount paid for insurance broker fees4418
Additional information about fees paid to insurance brokerSALES/ADMINISTRATION
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number106939
Policy instance 1
Insurance contract or identification number106939
Number of Individuals Covered24
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $5,752
Total amount of fees paid to insurance companyUSD $3,942
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,102
Insurance broker organization code?3
Amount paid for insurance broker fees3942
Additional information about fees paid to insurance brokerSALES/ADMINISTRATION
Insurance broker nameINDEPENDENT FINANCIAL PARTNERS
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number106939
Policy instance 1
Insurance contract or identification number106939
Number of Individuals Covered22
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $3,698
Total amount of fees paid to insurance companyUSD $3,737
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $437
Amount paid for insurance broker fees2856
Additional information about fees paid to insurance brokerSALES/ADMINISTRATION
Insurance broker organization code?5
Insurance broker name
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number106939
Policy instance 1
Insurance contract or identification number106939
Number of Individuals Covered23
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $2,723
Total amount of fees paid to insurance companyUSD $2,657
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?No
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 $327
Amount paid for insurance broker fees2657
Additional information about fees paid to insurance brokerSALES/ADMINISTRATION
Insurance broker organization code?5
Insurance broker nameFINANCIAL TELESIS, INC.
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number106939
Policy instance 1
Insurance contract or identification number106939
Number of Individuals Covered21
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2,859
Total amount of fees paid to insurance companyUSD $2,643
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?No
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 $1,274
Amount paid for insurance broker fees2154
Additional information about fees paid to insurance brokerSALES/ADMINISTRATION
Insurance broker organization code?5
Insurance broker nameINDEPENDENT FINANCIAL PARTNERS
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number106939
Policy instance 1
Insurance contract or identification number106939
Number of Individuals Covered20
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $544
Total amount of fees paid to insurance companyUSD $257
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?No
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 $544
Insurance broker organization code?3
Amount paid for insurance broker fees219
Additional information about fees paid to insurance brokerSALES/ADMINISTRATION
Insurance broker nameFINANCIAL TELESIS, INC.

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