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PERRY'S RESTAURANTS, LTD. 401(K) PLAN 401k Plan overview

Plan NamePERRY'S RESTAURANTS, LTD. 401(K) PLAN
Plan identification number 001

PERRY'S RESTAURANTS, LTD. 401(K) PLAN Benefits

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

401k Sponsoring company profile

PERRY'S RESTAURANTS, LTD has sponsored the creation of one or more 401k plans.

Company Name:PERRY'S RESTAURANTS, LTD
Employer identification number (EIN):760546229
NAIC Classification:722511
NAIC Description:Full-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PERRY'S RESTAURANTS, LTD. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012023-01-01
0012022-01-01GARY GUTIERREZ2023-08-30
0012021-01-01GARY GUTIERREZ2022-07-27
0012020-01-01GARY GUTIERREZ2021-07-30
0012019-01-01GARY GUTIERREZ2020-07-16
0012018-01-01KATIE BARNES2019-07-25
0012017-01-01
0012016-01-01
0012015-01-01
0012014-01-01RICHARD HENDERSON2015-03-10
0012013-01-01RICHARD HENDERSON2014-04-15
0012012-01-01RICK HENDERSON2013-03-25
0012011-01-01PAMELA J. SULLIVAN2012-03-26
0012010-01-01RICK HENDERSON2011-04-01

Plan Statistics for PERRY'S RESTAURANTS, LTD. 401(K) PLAN

401k plan membership statisitcs for PERRY'S RESTAURANTS, LTD. 401(K) PLAN

Measure Date Value
2022: PERRY'S RESTAURANTS, LTD. 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01285
Total number of active participants reported on line 7a of the Form 55002022-01-01234
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0133
Total of all active and inactive participants2022-01-01267
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01267
Number of participants with account balances2022-01-0191
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-0110
2021: PERRY'S RESTAURANTS, LTD. 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01231
Total number of active participants reported on line 7a of the Form 55002021-01-01201
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0135
Total of all active and inactive participants2021-01-01236
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01236
Number of participants with account balances2021-01-0190
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-0115
2020: PERRY'S RESTAURANTS, LTD. 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01217
Total number of active participants reported on line 7a of the Form 55002020-01-01179
Number of retired or separated participants receiving benefits2020-01-011
Number of other retired or separated participants entitled to future benefits2020-01-0119
Total of all active and inactive participants2020-01-01199
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01199
Number of participants with account balances2020-01-0169
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-019
2019: PERRY'S RESTAURANTS, LTD. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01194
Total number of active participants reported on line 7a of the Form 55002019-01-01189
Number of retired or separated participants receiving benefits2019-01-011
Number of other retired or separated participants entitled to future benefits2019-01-0117
Total of all active and inactive participants2019-01-01207
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01207
Number of participants with account balances2019-01-0177
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-018
2018: PERRY'S RESTAURANTS, LTD. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01157
Total number of active participants reported on line 7a of the Form 55002018-01-01155
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0113
Total of all active and inactive participants2018-01-01168
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01168
Number of participants with account balances2018-01-0160
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-019
2017: PERRY'S RESTAURANTS, LTD. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01143
Total number of active participants reported on line 7a of the Form 55002017-01-01125
Number of retired or separated participants receiving benefits2017-01-011
Number of other retired or separated participants entitled to future benefits2017-01-0111
Total of all active and inactive participants2017-01-01137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01137
Number of participants with account balances2017-01-0147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-013
2016: PERRY'S RESTAURANTS, LTD. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01128
Total number of active participants reported on line 7a of the Form 55002016-01-01117
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-015
Total of all active and inactive participants2016-01-01122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01122
Number of participants with account balances2016-01-0141
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-012
2015: PERRY'S RESTAURANTS, LTD. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01121
Total number of active participants reported on line 7a of the Form 55002015-01-01107
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0110
Total of all active and inactive participants2015-01-01117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01117
Number of participants with account balances2015-01-0128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-013

Financial Data on PERRY'S RESTAURANTS, LTD. 401(K) PLAN

Measure Date Value
2022 : PERRY'S RESTAURANTS, LTD. 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$-76,014
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$144,227
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$123,270
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$244,180
Value of total assets at end of year2022-12-31$1,944,706
Value of total assets at beginning of year2022-12-31$2,164,947
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$20,957
Total interest from all sources2022-12-31$3,771
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$216,495
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$200,978
Participant contributions at end of year2022-12-31$73,456
Participant contributions at beginning of year2022-12-31$40,767
Total non interest bearing cash at end of year2022-12-31$5,965
Total non interest bearing cash at beginning of year2022-12-31$1,775
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-220,241
Value of net assets at end of year (total assets less liabilities)2022-12-31$1,944,706
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$2,164,947
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$0
Value of interest in pooled separate accounts at end of year2022-12-31$1,830,744
Value of interest in pooled separate accounts at beginning of year2022-12-31$2,085,209
Interest on participant loans2022-12-31$3,771
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$34,541
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$37,196
Net investment gain/loss from pooled separate accounts2022-12-31$-323,965
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$43,202
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$123,270
Contract administrator fees2022-12-31$20,957
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31MELTON & MELTON, L.L.P.
Accountancy firm EIN2022-12-31741550819
2021 : PERRY'S RESTAURANTS, LTD. 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$515,863
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$147,997
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$127,363
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$294,316
Value of total assets at end of year2021-12-31$2,164,947
Value of total assets at beginning of year2021-12-31$1,797,081
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$20,634
Total interest from all sources2021-12-31$2,003
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$190,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$217,631
Participant contributions at end of year2021-12-31$40,767
Participant contributions at beginning of year2021-12-31$26,467
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$34,505
Total non interest bearing cash at end of year2021-12-31$1,775
Total non interest bearing cash at beginning of year2021-12-31$10,228
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$367,866
Value of net assets at end of year (total assets less liabilities)2021-12-31$2,164,947
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$1,797,081
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$0
Value of interest in pooled separate accounts at end of year2021-12-31$2,085,209
Value of interest in pooled separate accounts at beginning of year2021-12-31$1,756,565
Interest on participant loans2021-12-31$2,003
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$37,196
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$3,821
Net investment gain/loss from pooled separate accounts2021-12-31$219,544
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$42,180
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$127,363
Contract administrator fees2021-12-31$20,634
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31MELTON & MELTON, L.L.P.
Accountancy firm EIN2021-12-31741550819
2020 : PERRY'S RESTAURANTS, LTD. 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$464,716
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$283,987
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$264,636
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$214,343
Value of total assets at end of year2020-12-31$1,797,081
Value of total assets at beginning of year2020-12-31$1,616,352
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$19,351
Total interest from all sources2020-12-31$3,222
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$250,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$200,013
Participant contributions at end of year2020-12-31$26,467
Participant contributions at beginning of year2020-12-31$63,786
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$0
Total non interest bearing cash at end of year2020-12-31$10,228
Total non interest bearing cash at beginning of year2020-12-31$13,283
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$180,729
Value of net assets at end of year (total assets less liabilities)2020-12-31$1,797,081
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$1,616,352
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$0
Value of interest in pooled separate accounts at end of year2020-12-31$1,756,565
Value of interest in pooled separate accounts at beginning of year2020-12-31$1,537,468
Interest on participant loans2020-12-31$3,222
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$3,821
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$1,815
Net investment gain/loss from pooled separate accounts2020-12-31$247,151
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31Yes
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$14,330
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$264,636
Contract administrator fees2020-12-31$19,351
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31MELTON & MELTON, L.L.P.
Accountancy firm EIN2020-12-31741550819
2019 : PERRY'S RESTAURANTS, LTD. 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$541,659
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$172,337
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$154,557
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$283,883
Value of total assets at end of year2019-12-31$1,616,352
Value of total assets at beginning of year2019-12-31$1,247,030
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$17,780
Total interest from all sources2019-12-31$4,713
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$250,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$226,166
Participant contributions at end of year2019-12-31$63,786
Participant contributions at beginning of year2019-12-31$85,374
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$15,437
Other income not declared elsewhere2019-12-31$0
Total non interest bearing cash at end of year2019-12-31$13,283
Total non interest bearing cash at beginning of year2019-12-31$1,986
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$369,322
Value of net assets at end of year (total assets less liabilities)2019-12-31$1,616,352
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$1,247,030
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$0
Value of interest in pooled separate accounts at end of year2019-12-31$1,537,468
Value of interest in pooled separate accounts at beginning of year2019-12-31$1,148,309
Interest on participant loans2019-12-31$4,713
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$1,815
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$11,361
Net investment gain/loss from pooled separate accounts2019-12-31$253,063
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31Yes
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$42,280
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$154,557
Contract administrator fees2019-12-31$17,780
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31MELTON & MELTON, L.L.P.
Accountancy firm EIN2019-12-31741550819
2018 : PERRY'S RESTAURANTS, LTD. 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$123,547
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$45,452
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$30,146
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$214,674
Value of total assets at end of year2018-12-31$1,247,030
Value of total assets at beginning of year2018-12-31$1,168,935
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$15,306
Total interest from all sources2018-12-31$4,052
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$250,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$151,797
Participant contributions at end of year2018-12-31$85,374
Participant contributions at beginning of year2018-12-31$76,199
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$34,378
Total non interest bearing cash at end of year2018-12-31$1,986
Total non interest bearing cash at beginning of year2018-12-31$1,376
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$78,095
Value of net assets at end of year (total assets less liabilities)2018-12-31$1,247,030
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$1,168,935
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$0
Value of interest in pooled separate accounts at end of year2018-12-31$1,148,309
Value of interest in pooled separate accounts at beginning of year2018-12-31$1,081,978
Interest on participant loans2018-12-31$4,052
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$11,361
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$9,382
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$0
Net investment gain/loss from pooled separate accounts2018-12-31$-95,179
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31Yes
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$28,499
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$30,146
Contract administrator fees2018-12-31$15,306
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31No
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31MELTON & MELTON, L.L.P.
Accountancy firm EIN2018-12-31741550819
2017 : PERRY'S RESTAURANTS, LTD. 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$333,724
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$33,306
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$19,932
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$171,659
Value of total assets at end of year2017-12-31$1,168,935
Value of total assets at beginning of year2017-12-31$868,517
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$13,374
Total interest from all sources2017-12-31$4,242
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$250,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$132,910
Participant contributions at end of year2017-12-31$76,199
Participant contributions at beginning of year2017-12-31$76,813
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$11,176
Total non interest bearing cash at end of year2017-12-31$1,376
Total non interest bearing cash at beginning of year2017-12-31$255
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Income. Non cash contributions2017-12-31$0
Value of net income/loss2017-12-31$300,418
Value of net assets at end of year (total assets less liabilities)2017-12-31$1,168,935
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$868,517
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in pooled separate accounts at end of year2017-12-31$1,081,978
Value of interest in pooled separate accounts at beginning of year2017-12-31$783,893
Interest on participant loans2017-12-31$4,242
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$9,382
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$7,556
Net investment gain/loss from pooled separate accounts2017-12-31$157,823
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31Yes
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$27,573
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$19,932
Contract administrator fees2017-12-31$13,374
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31MELTON & MELTON, L.L.P.
Accountancy firm EIN2017-12-31741550819
2016 : PERRY'S RESTAURANTS, LTD. 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total income from all sources (including contributions)2016-12-31$184,098
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$11,995
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$1,599
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$127,300
Value of total assets at end of year2016-12-31$868,517
Value of total assets at beginning of year2016-12-31$696,414
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$10,396
Total interest from all sources2016-12-31$2,728
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$250,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$98,870
Participant contributions at end of year2016-12-31$76,813
Participant contributions at beginning of year2016-12-31$57,683
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$6,851
Total non interest bearing cash at end of year2016-12-31$255
Total non interest bearing cash at beginning of year2016-12-31$171
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$172,103
Value of net assets at end of year (total assets less liabilities)2016-12-31$868,517
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$696,414
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Investment advisory and management fees2016-12-31$10,396
Value of interest in pooled separate accounts at end of year2016-12-31$783,893
Value of interest in pooled separate accounts at beginning of year2016-12-31$629,150
Interest on participant loans2016-12-31$2,728
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$7,556
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$9,410
Net investment gain/loss from pooled separate accounts2016-12-31$54,070
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31Yes
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$21,579
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$1,599
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31MELTON & MELTON, L.L.P.
Accountancy firm EIN2016-12-31741550819
2015 : PERRY'S RESTAURANTS, LTD. 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$92,545
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$18,253
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$8,863
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$97,935
Value of total assets at end of year2015-12-31$696,414
Value of total assets at beginning of year2015-12-31$622,122
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$9,390
Total interest from all sources2015-12-31$2,450
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$250,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$72,880
Participant contributions at end of year2015-12-31$57,683
Participant contributions at beginning of year2015-12-31$29,474
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$9,820
Total non interest bearing cash at end of year2015-12-31$171
Total non interest bearing cash at beginning of year2015-12-31$8
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$74,292
Value of net assets at end of year (total assets less liabilities)2015-12-31$696,414
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$622,122
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Investment advisory and management fees2015-12-31$9,390
Value of interest in pooled separate accounts at end of year2015-12-31$629,150
Value of interest in pooled separate accounts at beginning of year2015-12-31$585,514
Interest on participant loans2015-12-31$2,450
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$9,410
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$7,126
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-7,840
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31Yes
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$15,235
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$8,863
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31MELTON & MELTON, L.L.P.
Accountancy firm EIN2015-12-31741550819

Form 5500 Responses for PERRY'S RESTAURANTS, LTD. 401(K) PLAN

2022: PERRY'S RESTAURANTS, LTD. 401(K) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: PERRY'S RESTAURANTS, LTD. 401(K) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: PERRY'S RESTAURANTS, LTD. 401(K) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: PERRY'S RESTAURANTS, LTD. 401(K) PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: PERRY'S RESTAURANTS, LTD. 401(K) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: PERRY'S RESTAURANTS, LTD. 401(K) 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: PERRY'S RESTAURANTS, LTD. 401(K) 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: PERRY'S RESTAURANTS, LTD. 401(K) 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

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number47642
Policy instance 1
Insurance contract or identification number47642
Number of Individuals Covered106
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $14,565
Total amount of fees paid to insurance companyUSD $1,824
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 $14,565
Insurance broker organization code?4
Amount paid for insurance broker fees1824
Additional information about fees paid to insurance brokerADMINISTRATOR
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number47642
Policy instance 1
Insurance contract or identification number47642
Number of Individuals Covered104
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $14,952
Total amount of fees paid to insurance companyUSD $1,611
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?Yes
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 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 $14,952
Insurance broker organization code?4
Amount paid for insurance broker fees1611
Additional information about fees paid to insurance brokerADMINISTRATOR
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number47642
Policy instance 1
Insurance contract or identification number47642
Number of Individuals Covered101
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $12,149
Total amount of fees paid to insurance companyUSD $1,463
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?Yes
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 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 $12,149
Insurance broker organization code?4
Amount paid for insurance broker fees1463
Additional information about fees paid to insurance brokerADMINISTRATOR
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number47642
Policy instance 1
Insurance contract or identification number47642
Number of Individuals Covered86
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $10,743
Total amount of fees paid to insurance companyUSD $1,230
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?Yes
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 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 $10,743
Insurance broker organization code?4
Amount paid for insurance broker fees1230
Additional information about fees paid to insurance brokerADMINISTRATOR
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number47642
Policy instance 1
Insurance contract or identification number47642
Number of Individuals Covered71
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $9,311
Total amount of fees paid to insurance companyUSD $952
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?Yes
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 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 $9,311
Insurance broker organization code?4
Amount paid for insurance broker fees952
Additional information about fees paid to insurance brokerADMINISTRATOR
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number47642
Policy instance 1
Insurance contract or identification number47642
Number of Individuals Covered59
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $7,507
Total amount of fees paid to insurance companyUSD $837
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?Yes
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 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 $7,507
Insurance broker organization code?4
Amount paid for insurance broker fees837
Additional information about fees paid to insurance brokerADMINISTRATOR
Insurance broker nameLOREN D. STARK COMPANY
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number47642
Policy instance 1
Insurance contract or identification number47642
Number of Individuals Covered40
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $5,015
Total amount of fees paid to insurance companyUSD $711
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?No
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 $5,015
Insurance broker organization code?4
Amount paid for insurance broker fees711
Additional information about fees paid to insurance brokerADMINISTRATOR
Insurance broker nameLOREN D. STARK COMPANY

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