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ROLLING GREENS, INC. 401K PROFIT SHARING PLAN 401k Plan overview

Plan NameROLLING GREENS, INC. 401K PROFIT SHARING PLAN
Plan identification number 002

ROLLING GREENS, INC. 401K PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

ROLLING GREENS, INC has sponsored the creation of one or more 401k plans.

Company Name:ROLLING GREENS, INC
Employer identification number (EIN):541087867
NAIC Classification:111400
NAIC Description:Greenhouse, Nursery, and Floriculture Production

Additional information about ROLLING GREENS, INC

Jurisdiction of Incorporation: Maryland Secretary of State
Incorporation Date:
Company Identification Number: F00935569

More information about ROLLING GREENS, INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ROLLING GREENS, INC. 401K PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022022-11-01MICAH WIGHTMAN2024-05-30
0022021-11-01MICAH WIGHTMAN2023-08-10
0022020-11-01MICAH WIGHTMAN2022-08-11
0022019-11-01
0022018-11-01
0022017-11-01
0022016-11-01YAYOI YAMADA
0022016-11-01
0022015-11-01WILLIAM FENSTERER2017-02-06
0022014-11-01WILLIAM FENSTERER2016-02-18
0022013-11-01PAUL R LEVY2015-07-29
0022012-11-01PAUL R LEVY2014-02-06
0022011-11-01PAUL R LEVY2013-01-16
0022010-11-01PAUL R LEVY2012-07-12

Plan Statistics for ROLLING GREENS, INC. 401K PROFIT SHARING PLAN

401k plan membership statisitcs for ROLLING GREENS, INC. 401K PROFIT SHARING PLAN

Measure Date Value
2019: ROLLING GREENS, INC. 401K PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year2019-11-01128
Total number of active participants reported on line 7a of the Form 55002019-11-0184
Number of retired or separated participants receiving benefits2019-11-010
Number of other retired or separated participants entitled to future benefits2019-11-018
Total of all active and inactive participants2019-11-0192
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-11-010
Total participants2019-11-0192
Number of participants with account balances2019-11-0135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-11-010
2018: ROLLING GREENS, INC. 401K PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year2018-11-01133
Total number of active participants reported on line 7a of the Form 55002018-11-01118
Number of retired or separated participants receiving benefits2018-11-012
Number of other retired or separated participants entitled to future benefits2018-11-017
Total of all active and inactive participants2018-11-01127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-11-010
Total participants2018-11-01127
Number of participants with account balances2018-11-0136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-11-010
2017: ROLLING GREENS, INC. 401K PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-11-01134
Total number of active participants reported on line 7a of the Form 55002017-11-01116
Number of retired or separated participants receiving benefits2017-11-010
Number of other retired or separated participants entitled to future benefits2017-11-0112
Total of all active and inactive participants2017-11-01128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-11-010
Total participants2017-11-01128
Number of participants with account balances2017-11-0142
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-11-010
2016: ROLLING GREENS, INC. 401K PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-11-01127
Total number of active participants reported on line 7a of the Form 55002016-11-01128
Number of retired or separated participants receiving benefits2016-11-010
Number of other retired or separated participants entitled to future benefits2016-11-0110
Total of all active and inactive participants2016-11-01138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-11-010
Total participants2016-11-01138
Number of participants with account balances2016-11-0138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-11-010

Financial Data on ROLLING GREENS, INC. 401K PROFIT SHARING PLAN

Measure Date Value
2020 : ROLLING GREENS, INC. 401K PROFIT SHARING PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-10-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-10-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-10-31$0
Total income from all sources (including contributions)2020-10-31$266,444
Total loss/gain on sale of assets2020-10-31$0
Total of all expenses incurred2020-10-31$137,371
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-10-31$126,941
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-10-31$189,038
Value of total assets at end of year2020-10-31$1,291,868
Value of total assets at beginning of year2020-10-31$1,162,795
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-10-31$10,430
Total interest from all sources2020-10-31$668
Total dividends received (eg from common stock, registered investment company shares)2020-10-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-10-31No
Was this plan covered by a fidelity bond2020-10-31Yes
Value of fidelity bond cover2020-10-31$500,000
If this is an individual account plan, was there a blackout period2020-10-31No
Were there any nonexempt tranactions with any party-in-interest2020-10-31No
Contributions received from participants2020-10-31$115,453
Participant contributions at end of year2020-10-31$9,711
Participant contributions at beginning of year2020-10-31$12,548
Participant contributions at end of year2020-10-31$0
Participant contributions at beginning of year2020-10-31$3,701
Income. Received or receivable in cash from other sources (including rollovers)2020-10-31$24,821
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-10-31No
Value of net income/loss2020-10-31$129,073
Value of net assets at end of year (total assets less liabilities)2020-10-31$1,291,868
Value of net assets at beginning of year (total assets less liabilities)2020-10-31$1,162,795
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-10-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-10-31No
Were any leases to which the plan was party in default or uncollectible2020-10-31No
Investment advisory and management fees2020-10-31$5,772
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-10-31$1,186,797
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-10-31$1,056,595
Interest on participant loans2020-10-31$668
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-10-31$2,639
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-10-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-10-31$76,738
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-10-31No
Was there a failure to transmit to the plan any participant contributions2020-10-31No
Has the plan failed to provide any benefit when due under the plan2020-10-31No
Contributions received in cash from employer2020-10-31$48,764
Employer contributions (assets) at end of year2020-10-31$92,721
Employer contributions (assets) at beginning of year2020-10-31$89,951
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-10-31$126,941
Contract administrator fees2020-10-31$4,658
Did the plan have assets held for investment2020-10-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-10-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-10-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-10-31Yes
Opinion of an independent qualified public accountant for this plan2020-10-31Disclaimer
Accountancy firm name2020-10-31SC&H TEST SERVICES P.C.
Accountancy firm EIN2020-10-31521743645
2019 : ROLLING GREENS, INC. 401K PROFIT SHARING PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-10-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-10-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-10-31$0
Total income from all sources (including contributions)2019-10-31$244,137
Total loss/gain on sale of assets2019-10-31$0
Total of all expenses incurred2019-10-31$117,735
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-10-31$107,640
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-10-31$143,429
Value of total assets at end of year2019-10-31$1,162,795
Value of total assets at beginning of year2019-10-31$1,036,393
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-10-31$10,095
Total interest from all sources2019-10-31$653
Total dividends received (eg from common stock, registered investment company shares)2019-10-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-10-31No
Was this plan covered by a fidelity bond2019-10-31Yes
Value of fidelity bond cover2019-10-31$500,000
If this is an individual account plan, was there a blackout period2019-10-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-10-31$0
Were there any nonexempt tranactions with any party-in-interest2019-10-31No
Contributions received from participants2019-10-31$99,775
Participant contributions at end of year2019-10-31$12,548
Participant contributions at beginning of year2019-10-31$11,427
Participant contributions at end of year2019-10-31$3,701
Participant contributions at beginning of year2019-10-31$2,801
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-10-31No
Value of net income/loss2019-10-31$126,402
Value of net assets at end of year (total assets less liabilities)2019-10-31$1,162,795
Value of net assets at beginning of year (total assets less liabilities)2019-10-31$1,036,393
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-10-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-10-31No
Were any leases to which the plan was party in default or uncollectible2019-10-31No
Investment advisory and management fees2019-10-31$5,386
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-10-31$1,056,595
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-10-31$947,700
Interest on participant loans2019-10-31$653
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-10-31$100,055
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-10-31No
Was there a failure to transmit to the plan any participant contributions2019-10-31No
Has the plan failed to provide any benefit when due under the plan2019-10-31No
Contributions received in cash from employer2019-10-31$43,654
Employer contributions (assets) at end of year2019-10-31$89,951
Employer contributions (assets) at beginning of year2019-10-31$74,465
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-10-31$107,640
Contract administrator fees2019-10-31$4,709
Did the plan have assets held for investment2019-10-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-10-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-10-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-10-31Yes
Opinion of an independent qualified public accountant for this plan2019-10-31Disclaimer
Accountancy firm name2019-10-31SC&H TEST SERVICES P.C.
Accountancy firm EIN2019-10-31521743645
2018 : ROLLING GREENS, INC. 401K PROFIT SHARING PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-10-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-10-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-10-31$0
Total income from all sources (including contributions)2018-10-31$146,786
Total loss/gain on sale of assets2018-10-31$0
Total of all expenses incurred2018-10-31$108,725
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-10-31$89,070
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-10-31$137,252
Value of total assets at end of year2018-10-31$1,036,393
Value of total assets at beginning of year2018-10-31$998,332
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-10-31$19,655
Total interest from all sources2018-10-31$34
Total dividends received (eg from common stock, registered investment company shares)2018-10-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-10-31No
Was this plan covered by a fidelity bond2018-10-31Yes
Value of fidelity bond cover2018-10-31$500,000
If this is an individual account plan, was there a blackout period2018-10-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-10-31$0
Were there any nonexempt tranactions with any party-in-interest2018-10-31No
Contributions received from participants2018-10-31$80,296
Participant contributions at end of year2018-10-31$11,427
Participant contributions at beginning of year2018-10-31$0
Participant contributions at end of year2018-10-31$2,801
Participant contributions at beginning of year2018-10-31$0
Other income not declared elsewhere2018-10-31$140
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-10-31No
Value of net income/loss2018-10-31$38,061
Value of net assets at end of year (total assets less liabilities)2018-10-31$1,036,393
Value of net assets at beginning of year (total assets less liabilities)2018-10-31$998,332
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-10-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-10-31No
Were any leases to which the plan was party in default or uncollectible2018-10-31No
Investment advisory and management fees2018-10-31$3,032
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-10-31$947,700
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-10-31$0
Value of interest in pooled separate accounts at end of year2018-10-31$0
Value of interest in pooled separate accounts at beginning of year2018-10-31$969,861
Interest on participant loans2018-10-31$34
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-10-31$9,360
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-10-31No
Was there a failure to transmit to the plan any participant contributions2018-10-31Yes
Has the plan failed to provide any benefit when due under the plan2018-10-31No
Contributions received in cash from employer2018-10-31$56,956
Employer contributions (assets) at end of year2018-10-31$74,465
Employer contributions (assets) at beginning of year2018-10-31$28,471
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-10-31$89,070
Contract administrator fees2018-10-31$16,623
Did the plan have assets held for investment2018-10-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-10-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-10-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-10-31Yes
Opinion of an independent qualified public accountant for this plan2018-10-31Disclaimer
Accountancy firm name2018-10-31SC&H TEST SERVICES P.C.
Accountancy firm EIN2018-10-31521743645
2017 : ROLLING GREENS, INC. 401K PROFIT SHARING PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-10-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-10-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-10-31$0
Total income from all sources (including contributions)2017-10-31$528,919
Total loss/gain on sale of assets2017-10-31$0
Total of all expenses incurred2017-10-31$1,430,958
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-10-31$1,410,587
Expenses. Certain deemed distributions of participant loans2017-10-31$6,434
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-10-31$286,870
Value of total assets at end of year2017-10-31$998,332
Value of total assets at beginning of year2017-10-31$1,900,371
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-10-31$13,937
Total interest from all sources2017-10-31$227
Total dividends received (eg from common stock, registered investment company shares)2017-10-31$0
Was this plan covered by a fidelity bond2017-10-31Yes
Value of fidelity bond cover2017-10-31$500,000
If this is an individual account plan, was there a blackout period2017-10-31No
Were there any nonexempt tranactions with any party-in-interest2017-10-31No
Contributions received from participants2017-10-31$138,300
Participant contributions at end of year2017-10-31$0
Participant contributions at beginning of year2017-10-31$7,117
Income. Received or receivable in cash from other sources (including rollovers)2017-10-31$85,231
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-10-31No
Value of net income/loss2017-10-31$-902,039
Value of net assets at end of year (total assets less liabilities)2017-10-31$998,332
Value of net assets at beginning of year (total assets less liabilities)2017-10-31$1,900,371
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-10-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-10-31No
Were any leases to which the plan was party in default or uncollectible2017-10-31No
Value of interest in pooled separate accounts at end of year2017-10-31$969,861
Value of interest in pooled separate accounts at beginning of year2017-10-31$1,864,016
Interest on participant loans2017-10-31$227
Net investment gain/loss from pooled separate accounts2017-10-31$241,822
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-10-31No
Was there a failure to transmit to the plan any participant contributions2017-10-31No
Has the plan failed to provide any benefit when due under the plan2017-10-31No
Contributions received in cash from employer2017-10-31$63,339
Employer contributions (assets) at end of year2017-10-31$28,471
Employer contributions (assets) at beginning of year2017-10-31$29,238
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-10-31$1,410,587
Contract administrator fees2017-10-31$13,937
Did the plan have assets held for investment2017-10-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-10-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-10-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-10-31Yes
Opinion of an independent qualified public accountant for this plan2017-10-31Disclaimer
Accountancy firm name2017-10-31SC&H TEST SERVICES P.C.
Accountancy firm EIN2017-10-31521743645

Form 5500 Responses for ROLLING GREENS, INC. 401K PROFIT SHARING PLAN

2019: ROLLING GREENS, INC. 401K PROFIT SHARING PLAN 2019 form 5500 responses
2019-11-01Type of plan entitySingle employer plan
2019-11-01Submission has been amendedNo
2019-11-01This submission is the final filingNo
2019-11-01This return/report is a short plan year return/report (less than 12 months)No
2019-11-01Plan is a collectively bargained planNo
2019-11-01Plan funding arrangement – InsuranceYes
2019-11-01Plan funding arrangement – TrustYes
2019-11-01Plan benefit arrangement – InsuranceYes
2019-11-01Plan benefit arrangement - TrustYes
2018: ROLLING GREENS, INC. 401K PROFIT SHARING PLAN 2018 form 5500 responses
2018-11-01Type of plan entitySingle employer plan
2018-11-01Submission has been amendedNo
2018-11-01This submission is the final filingNo
2018-11-01This return/report is a short plan year return/report (less than 12 months)No
2018-11-01Plan is a collectively bargained planNo
2018-11-01Plan funding arrangement – InsuranceYes
2018-11-01Plan funding arrangement – TrustYes
2018-11-01Plan benefit arrangement – InsuranceYes
2018-11-01Plan benefit arrangement - TrustYes
2017: ROLLING GREENS, INC. 401K PROFIT SHARING PLAN 2017 form 5500 responses
2017-11-01Type of plan entitySingle employer plan
2017-11-01Submission has been amendedNo
2017-11-01This submission is the final filingNo
2017-11-01This return/report is a short plan year return/report (less than 12 months)No
2017-11-01Plan is a collectively bargained planNo
2017-11-01Plan funding arrangement – InsuranceYes
2017-11-01Plan funding arrangement – TrustYes
2017-11-01Plan benefit arrangement – InsuranceYes
2017-11-01Plan benefit arrangement - TrustYes
2016: ROLLING GREENS, INC. 401K PROFIT SHARING PLAN 2016 form 5500 responses
2016-11-01Type of plan entitySingle employer plan
2016-11-01Submission has been amendedNo
2016-11-01This submission is the final filingNo
2016-11-01This return/report is a short plan year return/report (less than 12 months)No
2016-11-01Plan is a collectively bargained planNo
2016-11-01Plan funding arrangement – InsuranceYes
2016-11-01Plan funding arrangement – TrustYes
2016-11-01Plan benefit arrangement – InsuranceYes
2016-11-01Plan 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 number27664
Policy instance 1
Insurance contract or identification number27664
Number of Individuals Covered34
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $556
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 $0
Amount paid for insurance broker fees556
Additional information about fees paid to insurance brokerTPA FEES AND COMPENSATION
Insurance broker organization code?5
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number27664
Policy instance 1
Insurance contract or identification number27664
Number of Individuals Covered35
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $670
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 $0
Amount paid for insurance broker fees670
Additional information about fees paid to insurance brokerTPA FEES AND COMPENSATION
Insurance broker organization code?5
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number27664
Policy instance 1
Insurance contract or identification number27664
Number of Individuals Covered34
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $2,497
Total amount of fees paid to insurance companyUSD $10,398
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

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