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CD & H COMPANIES 401(K) PLAN 401k Plan overview

Plan NameCD & H COMPANIES 401(K) PLAN
Plan identification number 001

CD & H COMPANIES 401(K) 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.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

CD & H, INC. has sponsored the creation of one or more 401k plans.

Company Name:CD & H, INC.
Employer identification number (EIN):481224426
NAIC Classification:561110
NAIC Description:Office Administrative Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CD & H COMPANIES 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012023-01-01
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01SHAWN HARRIS2020-07-16 SHAWN HARRIS2020-07-16
0012018-01-01SHAWN HARRIS2019-08-16 SHAWN HARRIS2019-08-16

Plan Statistics for CD & H COMPANIES 401(K) PLAN

401k plan membership statisitcs for CD & H COMPANIES 401(K) PLAN

Measure Date Value
2023: CD & H COMPANIES 401(K) PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01156
Total number of active participants reported on line 7a of the Form 55002023-01-0158
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-0153
Total of all active and inactive participants2023-01-01111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2023-01-010
Total participants2023-01-01111
Number of participants with account balances2023-01-0196
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2023-01-010
2022: CD & H COMPANIES 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01169
Total number of active participants reported on line 7a of the Form 55002022-01-0198
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0152
Total of all active and inactive participants2022-01-01150
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01150
Number of participants with account balances2022-01-01115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: CD & H COMPANIES 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01199
Total number of active participants reported on line 7a of the Form 55002021-01-01122
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0143
Total of all active and inactive participants2021-01-01165
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01165
Number of participants with account balances2021-01-01107
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: CD & H COMPANIES 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01124
Total number of active participants reported on line 7a of the Form 55002020-01-0193
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0123
Total of all active and inactive participants2020-01-01116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01116
Number of participants with account balances2020-01-0187
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010

Financial Data on CD & H COMPANIES 401(K) PLAN

Measure Date Value
2023 : CD & H COMPANIES 401(K) PLAN 2023 401k financial data
Total unrealized appreciation/depreciation of assets2023-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$0
Total income from all sources (including contributions)2023-12-31$1,109,510
Total loss/gain on sale of assets2023-12-31$0
Total of all expenses incurred2023-12-31$240,528
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-12-31$226,046
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-12-31$662,621
Value of total assets at end of year2023-12-31$4,008,845
Value of total assets at beginning of year2023-12-31$3,139,863
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-12-31$14,482
Total interest from all sources2023-12-31$7,522
Total dividends received (eg from common stock, registered investment company shares)2023-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-12-31No
Was this plan covered by a fidelity bond2023-12-31Yes
Value of fidelity bond cover2023-12-31$500,000
If this is an individual account plan, was there a blackout period2023-12-31No
Were there any nonexempt tranactions with any party-in-interest2023-12-31No
Contributions received from participants2023-12-31$400,367
Participant contributions at end of year2023-12-31$211,819
Participant contributions at beginning of year2023-12-31$68,629
Participant contributions at end of year2023-12-31$6,126
Participant contributions at beginning of year2023-12-31$21,194
Assets. Other investments not covered elsewhere at end of year2023-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2023-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2023-12-31$110,910
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Value of net income/loss2023-12-31$868,982
Value of net assets at end of year (total assets less liabilities)2023-12-31$4,008,845
Value of net assets at beginning of year (total assets less liabilities)2023-12-31$3,139,863
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-12-31No
Were any leases to which the plan was party in default or uncollectible2023-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2023-12-31$3,784,866
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2023-12-31$3,009,155
Interest on participant loans2023-12-31$7,522
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2023-12-31$1,435
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2023-12-31$1
Net investment gain/loss from registered investment companies (e.g. mutual funds)2023-12-31$439,367
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-12-31No
Was there a failure to transmit to the plan any participant contributions2023-12-31No
Has the plan failed to provide any benefit when due under the plan2023-12-31No
Contributions received in cash from employer2023-12-31$151,344
Employer contributions (assets) at end of year2023-12-31$4,599
Employer contributions (assets) at beginning of year2023-12-31$40,884
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-12-31$226,046
Did the plan have assets held for investment2023-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-12-31No
Opinion of an independent qualified public accountant for this plan2023-12-31Unqualified
Accountancy firm name2023-12-31KOCH SIEDHOFF HAND & DUNN LLP
Accountancy firm EIN2023-12-31480922808
2022 : CD & H COMPANIES 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$-95,924
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$320,370
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$296,551
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$524,185
Value of total assets at end of year2022-12-31$3,139,863
Value of total assets at beginning of year2022-12-31$3,556,157
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$23,819
Total interest from all sources2022-12-31$2,873
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Administrative expenses professional fees incurred2022-12-31$1,875
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$375,573
Participant contributions at end of year2022-12-31$68,629
Participant contributions at beginning of year2022-12-31$86,966
Participant contributions at end of year2022-12-31$21,194
Participant contributions at beginning of year2022-12-31$6,181
Assets. Other investments not covered elsewhere at end of year2022-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2022-12-31$5,000
Administrative expenses (other) incurred2022-12-31$13,800
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-416,294
Value of net assets at end of year (total assets less liabilities)2022-12-31$3,139,863
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$3,556,157
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Investment advisory and management fees2022-12-31$8,144
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$3,009,155
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$3,446,336
Interest on participant loans2022-12-31$2,873
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$1
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$351
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-622,982
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$148,612
Employer contributions (assets) at end of year2022-12-31$40,884
Employer contributions (assets) at beginning of year2022-12-31$11,323
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$296,551
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31KOCH SIEDHOFF HAND & DUNN LLP
Accountancy firm EIN2022-12-31480922808
2021 : CD & H COMPANIES 401(K) PLAN 2021 401k financial data
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$951,473
Total of all expenses incurred2021-12-31$96,919
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$71,401
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$616,299
Value of total assets at end of year2021-12-31$3,556,157
Value of total assets at beginning of year2021-12-31$2,701,603
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$25,518
Total interest from all sources2021-12-31$4,600
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Administrative expenses professional fees incurred2021-12-31$1,275
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$410,090
Participant contributions at end of year2021-12-31$86,966
Participant contributions at beginning of year2021-12-31$84,728
Participant contributions at end of year2021-12-31$6,181
Participant contributions at beginning of year2021-12-31$6,010
Assets. Other investments not covered elsewhere at end of year2021-12-31$5,000
Assets. Other investments not covered elsewhere at beginning of year2021-12-31$2,090
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$11,965
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$854,554
Value of net assets at end of year (total assets less liabilities)2021-12-31$3,556,157
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$2,701,603
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Investment advisory and management fees2021-12-31$9,102
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$3,446,336
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$2,605,356
Interest on participant loans2021-12-31$4,600
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$351
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$345
Net investment gain/loss from pooled separate accounts2021-12-31$330,574
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$194,244
Employer contributions (assets) at end of year2021-12-31$11,323
Employer contributions (assets) at beginning of year2021-12-31$3,074
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$71,401
Contract administrator fees2021-12-31$15,141
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Disclaimer
Accountancy firm name2021-12-31KOCH SIEDHOFF HAND & DUNN, LLP
Accountancy firm EIN2021-12-31480922808
2020 : CD & H COMPANIES 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$866,433
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$144,086
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$118,298
Expenses. Certain deemed distributions of participant loans2020-12-31$2,360
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$518,060
Value of total assets at end of year2020-12-31$2,701,603
Value of total assets at beginning of year2020-12-31$1,979,256
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$23,428
Total interest from all sources2020-12-31$3,195
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Administrative expenses professional fees incurred2020-12-31$2,025
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$300,000
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$338,908
Participant contributions at end of year2020-12-31$84,728
Participant contributions at beginning of year2020-12-31$35,028
Participant contributions at end of year2020-12-31$6,010
Participant contributions at beginning of year2020-12-31$2,997
Assets. Other investments not covered elsewhere at end of year2020-12-31$2,090
Assets. Other investments not covered elsewhere at beginning of year2020-12-31$2,626
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$0
Administrative expenses (other) incurred2020-12-31$21,403
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$722,347
Value of net assets at end of year (total assets less liabilities)2020-12-31$2,701,603
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$1,979,256
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$2,605,356
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$1,938,334
Interest on participant loans2020-12-31$3,195
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$345
Net investment gain/loss from pooled separate accounts2020-12-31$345,178
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$179,152
Employer contributions (assets) at end of year2020-12-31$3,074
Employer contributions (assets) at beginning of year2020-12-31$271
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$118,298
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31KOCH SIEDHOFF HAND & DUNN, LLP
Accountancy firm EIN2020-12-31480922808

Form 5500 Responses for CD & H COMPANIES 401(K) PLAN

2023: CD & H COMPANIES 401(K) PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement - TrustYes
2022: CD & H COMPANIES 401(K) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: CD & H COMPANIES 401(K) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: CD & H COMPANIES 401(K) PLAN 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 – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number815-80018
Policy instance 1
Insurance contract or identification number815-80018
Number of Individuals Covered96
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
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
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number133646
Policy instance 1
Insurance contract or identification number133646
Number of Individuals Covered0
Insurance policy start date2022-01-01
Insurance policy end date2022-12-27
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,413
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
Amount paid for insurance broker fees3413
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker organization code?5
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number133646
Policy instance 1
Insurance contract or identification number133646
Number of Individuals Covered107
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $2,800
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees2800
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker organization code?5
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number133646
Policy instance 1
Insurance contract or identification number133646
Number of Individuals Covered87
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,094
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees2894
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker organization code?5

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