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PREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE 401k Plan overview

Plan NamePREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE
Plan identification number 005

PREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE 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.
  • Plan covering Self-Employed individuals.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

BS&B SAFETY SYSTEMS, LLC has sponsored the creation of one or more 401k plans.

Company Name:BS&B SAFETY SYSTEMS, LLC
Employer identification number (EIN):730785967
NAIC Classification:332900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0052021-07-01DAVID GARRISON2023-04-17 DAVID GARRISON2023-04-17
0052020-07-01DR. CHARLES HART2021-10-25 DR. CHARLES HART2021-10-25
0052019-07-01DR. CHARLES HART2020-12-08 DR. CHARLES HART2020-12-08
0052018-07-01DR. CHARLES HART2020-04-15
0052017-07-01DR. CHARLES HART2019-03-27
0052016-07-01DR. CHARLES HART DR. CHARLES HART2018-04-12
0052015-07-01DR. CHARLES C HART
0052015-07-01DR. CHARLES C HART
0052015-07-01
0052014-07-01DR. CHARLES HART DR. CHARLES HART2015-09-24
0052013-07-01DR. CHARLES C. HART DR. CHARLES C. HART2014-12-22
0052012-07-01DR. CHARLES HART DR. CHARLES HART2015-01-20
0052011-07-01DR. CHARLES HART DR. CHARLES HART2013-04-15
0052009-07-01DR. CHARLES HART A.R. HUSE2011-04-13

Plan Statistics for PREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE

401k plan membership statisitcs for PREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE

Measure Date Value
2016: PREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE 2016 401k membership
Total participants, beginning-of-year2016-07-0141
Total number of active participants reported on line 7a of the Form 55002016-07-0132
Number of retired or separated participants receiving benefits2016-07-011
Number of other retired or separated participants entitled to future benefits2016-07-014
Total of all active and inactive participants2016-07-0137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-07-010
Total participants2016-07-0137
Number of participants with account balances2016-07-0137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-07-014
2015: PREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE 2015 401k membership
Total participants, beginning-of-year2015-07-0146
Total number of active participants reported on line 7a of the Form 55002015-07-0136
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-015
Total of all active and inactive participants2015-07-0141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-07-010
Total participants2015-07-0141
Number of participants with account balances2015-07-0141
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-07-010
2014: PREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE 2014 401k membership
Total participants, beginning-of-year2014-07-0142
Total number of active participants reported on line 7a of the Form 55002014-07-0141
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-015
Total of all active and inactive participants2014-07-0146
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-07-010
Total participants2014-07-0146
Number of participants with account balances2014-07-0146
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-07-011
2013: PREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE 2013 401k membership
Total participants, beginning-of-year2013-07-0140
Total number of active participants reported on line 7a of the Form 55002013-07-0138
Number of retired or separated participants receiving benefits2013-07-010
Number of other retired or separated participants entitled to future benefits2013-07-014
Total of all active and inactive participants2013-07-0142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-07-010
Total participants2013-07-0142
Number of participants with account balances2013-07-0142
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-07-012
2012: PREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE 2012 401k membership
Total participants, beginning-of-year2012-07-0140
Total number of active participants reported on line 7a of the Form 55002012-07-0137
Number of retired or separated participants receiving benefits2012-07-010
Number of other retired or separated participants entitled to future benefits2012-07-013
Total of all active and inactive participants2012-07-0140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-07-010
Total participants2012-07-0140
Number of participants with account balances2012-07-0140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-07-012
2011: PREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE 2011 401k membership
Total participants, beginning-of-year2011-07-0132
Total number of active participants reported on line 7a of the Form 55002011-07-0136
Number of retired or separated participants receiving benefits2011-07-010
Number of other retired or separated participants entitled to future benefits2011-07-014
Total of all active and inactive participants2011-07-0140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-07-010
Total participants2011-07-0140
Number of participants with account balances2011-07-0139
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-07-012
2009: PREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE 2009 401k membership
Total participants, beginning-of-year2009-07-0125
Total number of active participants reported on line 7a of the Form 55002009-07-0127
Number of retired or separated participants receiving benefits2009-07-010
Number of other retired or separated participants entitled to future benefits2009-07-014
Total of all active and inactive participants2009-07-0131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-07-010
Total participants2009-07-0131
Number of participants with account balances2009-07-0131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-07-011

Financial Data on PREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE

Measure Date Value
2017 : PREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE 2017 401k financial data
Total income from all sources2017-06-30$379,475
Expenses. Total of all expenses incurred2017-06-30$182,297
Benefits paid (including direct rollovers)2017-06-30$177,675
Total plan assets at end of year2017-06-30$2,710,339
Total plan assets at beginning of year2017-06-30$2,513,161
Total contributions received or receivable from participants2017-06-30$69,807
Expenses. Other expenses not covered elsewhere2017-06-30$0
Contributions received from other sources (not participants or employers)2017-06-30$0
Other income received2017-06-30$228,313
Net income (gross income less expenses)2017-06-30$197,178
Net plan assets at end of year (total assets less liabilities)2017-06-30$2,710,339
Net plan assets at beginning of year (total assets less liabilities)2017-06-30$2,513,161
Assets. Value of participant loans2017-06-30$118,294
Total contributions received or receivable from employer(s)2017-06-30$81,355
Value of certain deemed distributions of participant loans2017-06-30$0
Value of corrective distributions2017-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2017-06-30$4,622
2016 : PREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE 2016 401k financial data
Total income from all sources2016-06-30$157,090
Expenses. Total of all expenses incurred2016-06-30$127,541
Benefits paid (including direct rollovers)2016-06-30$123,162
Total plan assets at end of year2016-06-30$2,513,161
Total plan assets at beginning of year2016-06-30$2,483,612
Total contributions received or receivable from participants2016-06-30$71,285
Expenses. Other expenses not covered elsewhere2016-06-30$0
Contributions received from other sources (not participants or employers)2016-06-30$0
Other income received2016-06-30$-760
Net income (gross income less expenses)2016-06-30$29,549
Net plan assets at end of year (total assets less liabilities)2016-06-30$2,513,161
Net plan assets at beginning of year (total assets less liabilities)2016-06-30$2,483,612
Assets. Value of participant loans2016-06-30$77,680
Total contributions received or receivable from employer(s)2016-06-30$86,565
Value of certain deemed distributions of participant loans2016-06-30$0
Value of corrective distributions2016-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2016-06-30$4,379
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-06-30$0
2015 : PREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE 2015 401k financial data
Total income from all sources2015-06-30$243,540
Expenses. Total of all expenses incurred2015-06-30$48,014
Benefits paid (including direct rollovers)2015-06-30$43,333
Total plan assets at end of year2015-06-30$2,483,612
Total plan assets at beginning of year2015-06-30$2,288,086
Total contributions received or receivable from participants2015-06-30$79,631
Expenses. Other expenses not covered elsewhere2015-06-30$0
Contributions received from other sources (not participants or employers)2015-06-30$0
Other income received2015-06-30$65,991
Net income (gross income less expenses)2015-06-30$195,526
Net plan assets at end of year (total assets less liabilities)2015-06-30$2,483,612
Net plan assets at beginning of year (total assets less liabilities)2015-06-30$2,288,086
Assets. Value of participant loans2015-06-30$112,450
Total contributions received or receivable from employer(s)2015-06-30$97,918
Value of certain deemed distributions of participant loans2015-06-30$0
Value of corrective distributions2015-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2015-06-30$4,681
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-06-30$0
2014 : PREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE 2014 401k financial data
Total income from all sources2014-06-30$392,295
Expenses. Total of all expenses incurred2014-06-30$279,212
Benefits paid (including direct rollovers)2014-06-30$275,158
Total plan assets at end of year2014-06-30$2,288,086
Total plan assets at beginning of year2014-06-30$2,175,003
Value of fidelity bond covering the plan2014-06-30$1,000,000
Total contributions received or receivable from participants2014-06-30$58,986
Expenses. Other expenses not covered elsewhere2014-06-30$0
Contributions received from other sources (not participants or employers)2014-06-30$514
Other income received2014-06-30$251,479
Net income (gross income less expenses)2014-06-30$113,083
Net plan assets at end of year (total assets less liabilities)2014-06-30$2,288,086
Net plan assets at beginning of year (total assets less liabilities)2014-06-30$2,175,003
Assets. Value of participant loans2014-06-30$74,420
Total contributions received or receivable from employer(s)2014-06-30$81,316
Value of certain deemed distributions of participant loans2014-06-30$0
Value of corrective distributions2014-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2014-06-30$4,054
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-06-30$0
2013 : PREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE 2013 401k financial data
Total income from all sources2013-06-30$352,258
Expenses. Total of all expenses incurred2013-06-30$66,646
Benefits paid (including direct rollovers)2013-06-30$63,189
Total plan assets at end of year2013-06-30$2,175,003
Total plan assets at beginning of year2013-06-30$1,889,391
Value of fidelity bond covering the plan2013-06-30$1,000,000
Total contributions received or receivable from participants2013-06-30$63,997
Contributions received from other sources (not participants or employers)2013-06-30$10,020
Other income received2013-06-30$195,664
Net income (gross income less expenses)2013-06-30$285,612
Net plan assets at end of year (total assets less liabilities)2013-06-30$2,175,003
Net plan assets at beginning of year (total assets less liabilities)2013-06-30$1,889,391
Assets. Value of participant loans2013-06-30$133,710
Total contributions received or receivable from employer(s)2013-06-30$82,577
Expenses. Administrative service providers (salaries,fees and commissions)2013-06-30$3,457
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-06-30$0
2012 : PREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE 2012 401k financial data
Total income from all sources2012-06-30$156,132
Expenses. Total of all expenses incurred2012-06-30$1,187
Benefits paid (including direct rollovers)2012-06-30$0
Total plan assets at end of year2012-06-30$1,889,391
Total plan assets at beginning of year2012-06-30$1,734,446
Value of fidelity bond covering the plan2012-06-30$1,000,000
Total contributions received or receivable from participants2012-06-30$65,964
Expenses. Other expenses not covered elsewhere2012-06-30$0
Contributions received from other sources (not participants or employers)2012-06-30$739
Other income received2012-06-30$17,714
Net income (gross income less expenses)2012-06-30$154,945
Net plan assets at end of year (total assets less liabilities)2012-06-30$1,889,391
Net plan assets at beginning of year (total assets less liabilities)2012-06-30$1,734,446
Assets. Value of participant loans2012-06-30$125,548
Total contributions received or receivable from employer(s)2012-06-30$71,715
Value of certain deemed distributions of participant loans2012-06-30$0
Value of corrective distributions2012-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2012-06-30$1,187
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-06-30$0
2011 : PREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE 2011 401k financial data
Total income from all sources2011-06-30$330,993
Expenses. Total of all expenses incurred2011-06-30$188,736
Benefits paid (including direct rollovers)2011-06-30$185,386
Total plan assets at end of year2011-06-30$1,734,446
Total plan assets at beginning of year2011-06-30$1,592,189
Value of fidelity bond covering the plan2011-06-30$1,000,000
Total contributions received or receivable from participants2011-06-30$65,508
Expenses. Other expenses not covered elsewhere2011-06-30$0
Contributions received from other sources (not participants or employers)2011-06-30$0
Other income received2011-06-30$199,594
Net income (gross income less expenses)2011-06-30$142,257
Net plan assets at end of year (total assets less liabilities)2011-06-30$1,734,446
Net plan assets at beginning of year (total assets less liabilities)2011-06-30$1,592,189
Assets. Value of participant loans2011-06-30$124,430
Total contributions received or receivable from employer(s)2011-06-30$65,891
Value of certain deemed distributions of participant loans2011-06-30$0
Value of corrective distributions2011-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2011-06-30$3,350
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-06-30$0
2010 : PREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-06-30$0

Form 5500 Responses for PREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE

2016: PREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Submission has been amendedNo
2016-07-01This submission is the final filingNo
2016-07-01This return/report is a short plan year return/report (less than 12 months)No
2016-07-01Plan is a collectively bargained planNo
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan funding arrangement – TrustYes
2016-07-01Plan benefit arrangement – InsuranceYes
2016-07-01Plan benefit arrangement - TrustYes
2015: PREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan funding arrangement – TrustYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-07-01Plan benefit arrangement - TrustYes
2014: PREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan funding arrangement – TrustYes
2014-07-01Plan benefit arrangement – InsuranceYes
2014-07-01Plan benefit arrangement - TrustYes
2013: PREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan funding arrangement – TrustYes
2013-07-01Plan benefit arrangement – InsuranceYes
2013-07-01Plan benefit arrangement - TrustYes
2012: PREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedYes
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan funding arrangement – TrustYes
2012-07-01Plan benefit arrangement – InsuranceYes
2012-07-01Plan benefit arrangement - TrustYes
2011: PREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan funding arrangement – TrustYes
2011-07-01Plan benefit arrangement – InsuranceYes
2011-07-01Plan benefit arrangement - TrustYes
2009: PREMCO, L.L.C. EMPLOYEES 401(K) SAVINGS AND RETIRE 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan funding arrangement – TrustYes
2009-07-01Plan benefit arrangement – InsuranceYes
2009-07-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberSF 7061
Policy instance 1
Insurance contract or identification numberSF 7061
Number of Individuals Covered41
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $7,525
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,806
Insurance broker organization code?3
Insurance broker nameTHOMAS CONKLIN
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberSF 7061
Policy instance 1
Insurance contract or identification numberSF 7061
Number of Individuals Covered46
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $7,032
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,926
Insurance broker organization code?3
Insurance broker nameTHOMAS CONKLIN
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberSF 7061
Policy instance 1
Insurance contract or identification numberSF 7061
Number of Individuals Covered42
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $6,207
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,207
Insurance broker organization code?3
Insurance broker nameTHOMAS CONKLIN
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberSF 7061
Policy instance 1
Insurance contract or identification numberSF 7061
Number of Individuals Covered40
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $6,568
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,314
Insurance broker organization code?3
Insurance broker nameTHOMAS CONKLIN
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberSF 7061
Policy instance 1
Insurance contract or identification numberSF 7061
Number of Individuals Covered40
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $5,031
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberSF 7061
Policy instance 1
Insurance contract or identification numberSF 7061
Number of Individuals Covered32
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $4,881
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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