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MASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN 401k Plan overview

Plan NameMASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN
Plan identification number 002

MASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN Benefits

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

MASON INSURANCE AGENCY, INC. has sponsored the creation of one or more 401k plans.

Company Name:MASON INSURANCE AGENCY, INC.
Employer identification number (EIN):540294680
NAIC Classification:524210
NAIC Description:Insurance Agencies and Brokerages

Additional information about MASON INSURANCE AGENCY, INC.

Jurisdiction of Incorporation: Alabama Secretary of State
Incorporation Date: 2000-05-24
Company Identification Number: 209-989
Legal Registered Office Address: 1104 GAULT AVE S FORT PAYNE, AL 35967-4920


United States of America (USA)

More information about MASON INSURANCE AGENCY, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022022-01-01KYLE GRIMMER2023-05-05
0022021-01-01KYLE GRIMMER2022-03-25
0022020-01-01KYLE GRIMMER2021-03-09
0022019-01-01KYLE GRIMMER2020-04-27
0022018-01-01HARRY C. MASON, JR.2019-08-02
0022017-01-01CHUCK MASON
0022016-01-01CHUCK MASON
0022015-01-01CHUCK MASON
0022014-01-01GEORGE EUDAILEY JR.2015-04-14
0022013-01-01GEORGE EUDAILEY JR.2014-04-16
0022012-01-01GEORGE EUDAILEY JR.2013-06-09
0022011-01-01GEORGE EUDAILEY JR.2012-03-16
0022010-01-01GEORGE EUDAILEY JR.2011-03-22

Plan Statistics for MASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN

401k plan membership statisitcs for MASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN

Measure Date Value
2022: MASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-017
Total number of active participants reported on line 7a of the Form 55002022-01-017
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-017
Number of participants with account balances2022-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: MASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-017
Total number of active participants reported on line 7a of the Form 55002021-01-017
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-017
Number of participants with account balances2021-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: MASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-017
Total number of active participants reported on line 7a of the Form 55002020-01-017
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 participants2020-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-017
Number of participants with account balances2020-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: MASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-018
Total number of active participants reported on line 7a of the Form 55002019-01-017
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-017
Number of participants with account balances2019-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: MASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-018
Total number of active participants reported on line 7a of the Form 55002018-01-017
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-011
Total of all active and inactive participants2018-01-018
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-018
Number of participants with account balances2018-01-018
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: MASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-017
Total number of active participants reported on line 7a of the Form 55002017-01-017
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-011
Total of all active and inactive participants2017-01-018
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-018
Number of participants with account balances2017-01-018
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: MASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-017
Total number of active participants reported on line 7a of the Form 55002016-01-016
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-011
Total of all active and inactive participants2016-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-017
Number of participants with account balances2016-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: MASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-017
Total number of active participants reported on line 7a of the Form 55002015-01-016
Number of other retired or separated participants entitled to future benefits2015-01-011
Total of all active and inactive participants2015-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-017
Number of participants with account balances2015-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010

Financial Data on MASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN

Measure Date Value
2022 : MASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2022 401k financial data
Total plan liabilities at end of year2022-12-31$0
Total plan liabilities at beginning of year2022-12-31$0
Total income from all sources2022-12-31$-332,705
Expenses. Total of all expenses incurred2022-12-31$104,554
Benefits paid (including direct rollovers)2022-12-31$79,535
Total plan assets at end of year2022-12-31$2,629,000
Total plan assets at beginning of year2022-12-31$3,066,259
Value of fidelity bond covering the plan2022-12-31$400,000
Total contributions received or receivable from participants2022-12-31$0
Expenses. Other expenses not covered elsewhere2022-12-31$25,019
Contributions received from other sources (not participants or employers)2022-12-31$0
Other income received2022-12-31$-407,705
Noncash contributions received2022-12-31$0
Net income (gross income less expenses)2022-12-31$-437,259
Net plan assets at end of year (total assets less liabilities)2022-12-31$2,629,000
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$3,066,259
Assets. Value of real-estate (other than employer real property)2022-12-31$0
Total contributions received or receivable from employer(s)2022-12-31$75,000
Value of certain deemed distributions of participant loans2022-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$0
2021 : MASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2021 401k financial data
Transfers to/from the plan2021-12-31$0
Total plan liabilities at end of year2021-12-31$0
Total plan liabilities at beginning of year2021-12-31$0
Total income from all sources2021-12-31$425,922
Expenses. Total of all expenses incurred2021-12-31$1,148,394
Benefits paid (including direct rollovers)2021-12-31$1,116,606
Total plan assets at end of year2021-12-31$3,066,259
Total plan assets at beginning of year2021-12-31$3,788,731
Value of fidelity bond covering the plan2021-12-31$400,000
Total contributions received or receivable from participants2021-12-31$0
Expenses. Other expenses not covered elsewhere2021-12-31$31,788
Contributions received from other sources (not participants or employers)2021-12-31$0
Other income received2021-12-31$380,922
Noncash contributions received2021-12-31$0
Net income (gross income less expenses)2021-12-31$-722,472
Net plan assets at end of year (total assets less liabilities)2021-12-31$3,066,259
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$3,788,731
Assets. Value of real-estate (other than employer real property)2021-12-31$35,000
Total contributions received or receivable from employer(s)2021-12-31$45,000
Value of certain deemed distributions of participant loans2021-12-31$0
Value of corrective distributions2021-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
2020 : MASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2020 401k financial data
Total plan liabilities at end of year2020-12-31$0
Total plan liabilities at beginning of year2020-12-31$0
Total income from all sources2020-12-31$470,780
Expenses. Total of all expenses incurred2020-12-31$132,002
Benefits paid (including direct rollovers)2020-12-31$104,790
Total plan assets at end of year2020-12-31$3,788,731
Total plan assets at beginning of year2020-12-31$3,449,953
Total contributions received or receivable from participants2020-12-31$0
Expenses. Other expenses not covered elsewhere2020-12-31$27,212
Contributions received from other sources (not participants or employers)2020-12-31$0
Other income received2020-12-31$395,780
Noncash contributions received2020-12-31$0
Net income (gross income less expenses)2020-12-31$338,778
Net plan assets at end of year (total assets less liabilities)2020-12-31$3,788,731
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$3,449,953
Assets. Value of real-estate (other than employer real property)2020-12-31$35,000
Total contributions received or receivable from employer(s)2020-12-31$75,000
Value of certain deemed distributions of participant loans2020-12-31$0
Value of corrective distributions2020-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
2019 : MASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2019 401k financial data
Transfers to/from the plan2019-12-31$0
Total plan liabilities at end of year2019-12-31$0
Total plan liabilities at beginning of year2019-12-31$0
Total income from all sources2019-12-31$504,289
Expenses. Total of all expenses incurred2019-12-31$156,944
Benefits paid (including direct rollovers)2019-12-31$134,781
Total plan assets at end of year2019-12-31$3,449,953
Total plan assets at beginning of year2019-12-31$3,102,608
Value of fidelity bond covering the plan2019-12-31$315,000
Total contributions received or receivable from participants2019-12-31$0
Expenses. Other expenses not covered elsewhere2019-12-31$22,163
Contributions received from other sources (not participants or employers)2019-12-31$0
Other income received2019-12-31$384,289
Noncash contributions received2019-12-31$0
Net income (gross income less expenses)2019-12-31$347,345
Net plan assets at end of year (total assets less liabilities)2019-12-31$3,449,953
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$3,102,608
Assets. Value of real-estate (other than employer real property)2019-12-31$35,000
Total contributions received or receivable from employer(s)2019-12-31$120,000
Value of certain deemed distributions of participant loans2019-12-31$0
Value of corrective distributions2019-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
2018 : MASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2018 401k financial data
Total plan liabilities at end of year2018-12-31$0
Total plan liabilities at beginning of year2018-12-31$0
Total income from all sources2018-12-31$-1,881
Expenses. Total of all expenses incurred2018-12-31$60,299
Benefits paid (including direct rollovers)2018-12-31$42,063
Total plan assets at end of year2018-12-31$3,102,608
Total plan assets at beginning of year2018-12-31$3,164,788
Value of fidelity bond covering the plan2018-12-31$315,000
Total contributions received or receivable from participants2018-12-31$0
Expenses. Other expenses not covered elsewhere2018-12-31$18,236
Contributions received from other sources (not participants or employers)2018-12-31$0
Other income received2018-12-31$-116,881
Noncash contributions received2018-12-31$0
Net income (gross income less expenses)2018-12-31$-62,180
Net plan assets at end of year (total assets less liabilities)2018-12-31$3,102,608
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$3,164,788
Assets. Value of real-estate (other than employer real property)2018-12-31$50,000
Total contributions received or receivable from employer(s)2018-12-31$115,000
Value of certain deemed distributions of participant loans2018-12-31$0
Value of corrective distributions2018-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
2017 : MASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources2017-12-31$286,193
Expenses. Total of all expenses incurred2017-12-31$64,977
Benefits paid (including direct rollovers)2017-12-31$37,687
Total plan assets at end of year2017-12-31$3,164,788
Total plan assets at beginning of year2017-12-31$2,943,572
Value of fidelity bond covering the plan2017-12-31$315,000
Expenses. Other expenses not covered elsewhere2017-12-31$1,066
Other income received2017-12-31$205,127
Net income (gross income less expenses)2017-12-31$221,216
Net plan assets at end of year (total assets less liabilities)2017-12-31$3,164,788
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$2,943,572
Assets. Value of real-estate (other than employer real property)2017-12-31$42,000
Total contributions received or receivable from employer(s)2017-12-31$81,066
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$26,224
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : MASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources2016-12-31$273,088
Expenses. Total of all expenses incurred2016-12-31$62,798
Benefits paid (including direct rollovers)2016-12-31$37,726
Total plan assets at end of year2016-12-31$2,943,572
Total plan assets at beginning of year2016-12-31$2,733,282
Value of fidelity bond covering the plan2016-12-31$370,000
Expenses. Other expenses not covered elsewhere2016-12-31$1,065
Other income received2016-12-31$152,023
Net income (gross income less expenses)2016-12-31$210,290
Net plan assets at end of year (total assets less liabilities)2016-12-31$2,943,572
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$2,733,282
Assets. Value of real-estate (other than employer real property)2016-12-31$45,000
Total contributions received or receivable from employer(s)2016-12-31$121,065
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$24,007
2015 : MASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources2015-12-31$125,590
Expenses. Total of all expenses incurred2015-12-31$51,517
Benefits paid (including direct rollovers)2015-12-31$35,777
Total plan assets at end of year2015-12-31$2,733,282
Total plan assets at beginning of year2015-12-31$2,659,209
Value of fidelity bond covering the plan2015-12-31$370,000
Expenses. Other expenses not covered elsewhere2015-12-31$15,740
Other income received2015-12-31$2,077
Net income (gross income less expenses)2015-12-31$74,073
Net plan assets at end of year (total assets less liabilities)2015-12-31$2,733,282
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$2,659,209
Assets. Value of real-estate (other than employer real property)2015-12-31$45,000
Total contributions received or receivable from employer(s)2015-12-31$123,513
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0

Form 5500 Responses for MASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN

2022: MASON INSURANCE AGENCY, INC. PROFIT SHARING 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 – TrustYes
2022-01-01Plan benefit arrangement - TrustYes
2021: MASON INSURANCE AGENCY, INC. PROFIT SHARING 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 – TrustYes
2021-01-01Plan benefit arrangement - TrustYes
2020: MASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle 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: MASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle 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 – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: MASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle 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 – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: MASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: MASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: MASON INSURANCE AGENCY, INC. PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan 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 number120805
Policy instance 1
Insurance contract or identification number120805
Number of Individuals Covered7
Insurance policy start date2019-01-01
Insurance policy end date2019-07-17
Total amount of commissions paid to insurance brokerUSD $1,702
Total amount of fees paid to insurance companyUSD $284
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 $1,702
Insurance broker organization code?4
Amount paid for insurance broker fees284
Additional information about fees paid to insurance brokerADMINISTRATOR
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number120805
Policy instance 1
Insurance contract or identification number120805
Number of Individuals Covered7
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $3,362
Total amount of fees paid to insurance companyUSD $1,168
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 fees1168
Additional information about fees paid to insurance brokerADMINISTRATOR
Insurance broker organization code?5
Commission paid to Insurance BrokerUSD $3,362
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number120805
Policy instance 1
Insurance contract or identification number120805
Number of Individuals Covered7
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $3,027
Total amount of fees paid to insurance companyUSD $715
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,027
Insurance broker organization code?4
Amount paid for insurance broker fees650
Additional information about fees paid to insurance brokerADMIN FEES
Insurance broker nameLOREN D. STARK COMPANY
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number006360849
Policy instance 1
Insurance contract or identification number006360849
Number of Individuals Covered6
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $62
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $62
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameGEORGE S KINIGOPOULOS

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