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BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan NameBOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN
Plan identification number 003

BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • 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.
  • Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of 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.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • 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.
  • Life insurance

401k Sponsoring company profile

BOCA RADIOLOGY GROUP, P.A. has sponsored the creation of one or more 401k plans.

Company Name:BOCA RADIOLOGY GROUP, P.A.
Employer identification number (EIN):591301771
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Additional information about BOCA RADIOLOGY GROUP, P.A.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations
Incorporation Date: 1970-08-20
Company Identification Number: 602349
Legal Registered Office Address: 951 NW 13 STREET

BOCA RATON

33486

More information about BOCA RADIOLOGY GROUP, P.A.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0032022-01-01JAMIE BRYAN2023-10-13
0032021-01-01JOSEPH KLEINMAN2022-10-14 JAMIE BRYAN2022-08-24
0032020-01-01JOSEPH KLEINMAN2021-08-04 JAMIE BRYAN2021-08-04
0032019-01-01JAMIE BRYAN2020-07-15
0032018-01-01JAMIE BRYAN2019-07-29
0032017-01-01JAMIE BRYAN
0032016-01-01JAMIE BRYAN
0032015-01-01JAMIE BRYAN
0032014-01-01JAMIE BRYAN
0032013-01-01JAMIE BRYAN
0032012-01-01JAMIE BRYAN
0032011-01-01JAMIE BRYAN
0032010-01-01JOSEPH KLEINMAN
0032009-01-01JOSEPH KLEINMAN

Plan Statistics for BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN

Measure Date Value
2017: BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0151
Total number of active participants reported on line 7a of the Form 55002017-01-0148
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-013
Total of all active and inactive participants2017-01-0151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0151
Number of participants with account balances2017-01-0149
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-011
2016: BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0149
Total number of active participants reported on line 7a of the Form 55002016-01-0143
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-014
Total of all active and inactive participants2016-01-0147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0147
Number of participants with account balances2016-01-0146
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0147
Total number of active participants reported on line 7a of the Form 55002015-01-0146
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-013
Total of all active and inactive participants2015-01-0149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0149
Number of participants with account balances2015-01-0146
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-011
2014: BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0149
Total number of active participants reported on line 7a of the Form 55002014-01-0145
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-011
Total of all active and inactive participants2014-01-0146
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0146
Number of participants with account balances2014-01-0145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0145
Total number of active participants reported on line 7a of the Form 55002013-01-0142
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-015
Total of all active and inactive participants2013-01-0147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0147
Number of participants with account balances2013-01-0145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0143
Total number of active participants reported on line 7a of the Form 55002012-01-0142
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-012
Total of all active and inactive participants2012-01-0144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0144
Number of participants with account balances2012-01-0143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-011
2011: BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0149
Total number of active participants reported on line 7a of the Form 55002011-01-0140
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-012
Total of all active and inactive participants2011-01-0142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0142
Number of participants with account balances2011-01-0142
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0146
Total number of active participants reported on line 7a of the Form 55002010-01-0144
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-014
Total of all active and inactive participants2010-01-0148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0148
Number of participants with account balances2010-01-0148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0142
Total number of active participants reported on line 7a of the Form 55002009-01-0143
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-013
Total of all active and inactive participants2009-01-0146
Total participants2009-01-0146

Financial Data on BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN

Measure Date Value
2017 : BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources2017-12-31$4,063,841
Expenses. Total of all expenses incurred2017-12-31$204,475
Benefits paid (including direct rollovers)2017-12-31$187,825
Total plan assets at end of year2017-12-31$19,126,075
Total plan assets at beginning of year2017-12-31$15,266,709
Value of fidelity bond covering the plan2017-12-31$500,000
Total contributions received or receivable from participants2017-12-31$633,725
Contributions received from other sources (not participants or employers)2017-12-31$0
Other income received2017-12-31$2,779,644
Net income (gross income less expenses)2017-12-31$3,859,366
Net plan assets at end of year (total assets less liabilities)2017-12-31$19,126,075
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$15,266,709
Assets. Value of participant loans2017-12-31$78,386
Total contributions received or receivable from employer(s)2017-12-31$650,472
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$16,650
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources2016-12-31$2,169,760
Expenses. Total of all expenses incurred2016-12-31$260,590
Benefits paid (including direct rollovers)2016-12-31$256,333
Total plan assets at end of year2016-12-31$15,266,709
Total plan assets at beginning of year2016-12-31$13,357,539
Value of fidelity bond covering the plan2016-12-31$500,000
Total contributions received or receivable from participants2016-12-31$567,718
Other income received2016-12-31$987,011
Net income (gross income less expenses)2016-12-31$1,909,170
Net plan assets at end of year (total assets less liabilities)2016-12-31$15,266,709
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$13,357,539
Assets. Value of participant loans2016-12-31$80,757
Total contributions received or receivable from employer(s)2016-12-31$615,031
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$4,257
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources2015-12-31$1,262,450
Expenses. Total of all expenses incurred2015-12-31$743,358
Benefits paid (including direct rollovers)2015-12-31$740,766
Total plan assets at end of year2015-12-31$13,357,539
Total plan assets at beginning of year2015-12-31$12,838,447
Value of fidelity bond covering the plan2015-12-31$900,000
Total contributions received or receivable from participants2015-12-31$563,285
Contributions received from other sources (not participants or employers)2015-12-31$14,094
Other income received2015-12-31$77,832
Net income (gross income less expenses)2015-12-31$519,092
Net plan assets at end of year (total assets less liabilities)2015-12-31$13,357,539
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$12,838,447
Assets. Value of participant loans2015-12-31$100,769
Total contributions received or receivable from employer(s)2015-12-31$607,239
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$2,592
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources2014-12-31$1,667,604
Expenses. Total of all expenses incurred2014-12-31$1,315,703
Benefits paid (including direct rollovers)2014-12-31$1,315,322
Total plan assets at end of year2014-12-31$12,838,447
Total plan assets at beginning of year2014-12-31$12,486,546
Value of fidelity bond covering the plan2014-12-31$900,000
Total contributions received or receivable from participants2014-12-31$508,123
Other income received2014-12-31$579,452
Net income (gross income less expenses)2014-12-31$351,901
Net plan assets at end of year (total assets less liabilities)2014-12-31$12,838,447
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$12,486,546
Assets. Value of participant loans2014-12-31$80,485
Total contributions received or receivable from employer(s)2014-12-31$580,029
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$381
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources2013-12-31$2,640,792
Expenses. Total of all expenses incurred2013-12-31$308,445
Benefits paid (including direct rollovers)2013-12-31$307,994
Total plan assets at end of year2013-12-31$12,486,546
Total plan assets at beginning of year2013-12-31$10,154,199
Value of fidelity bond covering the plan2013-12-31$900,000
Total contributions received or receivable from participants2013-12-31$496,991
Other income received2013-12-31$1,571,635
Net income (gross income less expenses)2013-12-31$2,332,347
Net plan assets at end of year (total assets less liabilities)2013-12-31$12,486,546
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$10,154,199
Assets. Value of participant loans2013-12-31$50,261
Total contributions received or receivable from employer(s)2013-12-31$572,166
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$451
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources2012-12-31$2,307,039
Expenses. Total of all expenses incurred2012-12-31$2,694,123
Benefits paid (including direct rollovers)2012-12-31$2,693,216
Total plan assets at end of year2012-12-31$10,154,199
Total plan assets at beginning of year2012-12-31$10,541,283
Value of fidelity bond covering the plan2012-12-31$900,000
Total contributions received or receivable from participants2012-12-31$507,050
Contributions received from other sources (not participants or employers)2012-12-31$43,036
Other income received2012-12-31$1,196,122
Net income (gross income less expenses)2012-12-31$-387,084
Net plan assets at end of year (total assets less liabilities)2012-12-31$10,154,199
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$10,541,283
Assets. Value of participant loans2012-12-31$59,617
Total contributions received or receivable from employer(s)2012-12-31$560,831
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$907
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN 2011 401k financial data
Transfers to/from the plan2011-12-31$0
Total income from all sources2011-12-31$334,636
Expenses. Total of all expenses incurred2011-12-31$3,468
Benefits paid (including direct rollovers)2011-12-31$2,612
Total plan assets at end of year2011-12-31$10,541,283
Total plan assets at beginning of year2011-12-31$10,210,115
Value of fidelity bond covering the plan2011-12-31$900,000
Total contributions received or receivable from participants2011-12-31$487,773
Contributions received from other sources (not participants or employers)2011-12-31$33,542
Other income received2011-12-31$-186,679
Net income (gross income less expenses)2011-12-31$331,168
Net plan assets at end of year (total assets less liabilities)2011-12-31$10,541,283
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$10,210,115
Assets. Value of participant loans2011-12-31$56,152
Total contributions received or receivable from employer(s)2011-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$856
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN 2010 401k financial data
Total income from all sources2010-12-31$1,696,543
Expenses. Total of all expenses incurred2010-12-31$1,687
Benefits paid (including direct rollovers)2010-12-31$309
Total plan assets at end of year2010-12-31$10,210,115
Total plan assets at beginning of year2010-12-31$8,515,259
Value of fidelity bond covering the plan2010-12-31$900,000
Total contributions received or receivable from participants2010-12-31$445,175
Other income received2010-12-31$687,067
Net income (gross income less expenses)2010-12-31$1,694,856
Net plan assets at end of year (total assets less liabilities)2010-12-31$10,210,115
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$8,515,259
Assets. Value of assets in partnership/joint-venture interests2010-12-31$111,500
Total contributions received or receivable from employer(s)2010-12-31$564,301
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$1,378
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
2009 : BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN

2017: BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle 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 – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle 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 – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle 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 – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle 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 – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final 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 – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: BOCA RADIOLOGY GROUP, P.A. 401(K) PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number7136503/7136511
Policy instance 1
Insurance contract or identification number7136503/7136511
Number of Individuals Covered2
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $229
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?1
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 BenefitYes
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 $229
Insurance broker organization code?3
Insurance broker namePETER J LEBLANC
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number7136503/7136511
Policy instance 1
Insurance contract or identification number7136503/7136511
Number of Individuals Covered2
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $229
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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 BenefitYes
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 $229
Insurance broker organization code?3
Insurance broker namePETER J LEBLANC
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number7136503/7136511
Policy instance 1
Insurance contract or identification number7136503/7136511
Number of Individuals Covered2
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $229
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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 BenefitYes
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 $229
Insurance broker organization code?3
Insurance broker namePETER J LEBLANC
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number7136503/7136511
Policy instance 1
Insurance contract or identification number7136503/7136511
Number of Individuals Covered2
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $229
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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 BenefitYes
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 $229
Insurance broker organization code?3
Insurance broker namePETER J LEBLANC
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number7136503
Policy instance 1
Insurance contract or identification number7136503
Number of Individuals Covered1
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $100
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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 BenefitYes
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 $100
Insurance broker organization code?3
Insurance broker namePETER J LEBLANC
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number7136511
Policy instance 2
Insurance contract or identification number7136511
Number of Individuals Covered1
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $129
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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 BenefitYes
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 $129
Insurance broker organization code?3
Insurance broker namePETER J LEBLANC
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number7136503
Policy instance 1
Insurance contract or identification number7136503
Number of Individuals Covered1
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Are there contracts with allocated funds for individual policies?Yes
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 BenefitYes
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?Yes
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number7136511
Policy instance 2
Insurance contract or identification number7136511
Number of Individuals Covered1
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Are there contracts with allocated funds for individual policies?Yes
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 BenefitYes
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?Yes
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number7136503, ETC.
Policy instance 1
Insurance contract or identification number7136503, ETC.
Number of Individuals Covered1
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $100
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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 BenefitYes
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 $100
Insurance broker organization code?3
Insurance broker namePETER J. LEBLANC, CLU

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