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WHITE PLAINS HOSPITAL AFFILIATED ENTITY, PC 401(K) PLAN 401k Plan overview

Plan NameWHITE PLAINS HOSPITAL AFFILIATED ENTITY, PC 401(K) PLAN
Plan identification number 003

WHITE PLAINS HOSPITAL AFFILIATED ENTITY, PC 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • 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.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

WHITE PLAINS MEDICAL SERVICES, PC has sponsored the creation of one or more 401k plans.

Company Name:WHITE PLAINS MEDICAL SERVICES, PC
Employer identification number (EIN):815369152
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WHITE PLAINS HOSPITAL AFFILIATED ENTITY, PC 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0032022-01-01
0032021-01-01
0032020-01-01
0032019-01-01
0032018-01-01
0032017-01-01MARK MCKENNA

Plan Statistics for WHITE PLAINS HOSPITAL AFFILIATED ENTITY, PC 401(K) PLAN

401k plan membership statisitcs for WHITE PLAINS HOSPITAL AFFILIATED ENTITY, PC 401(K) PLAN

Measure Date Value
2022: WHITE PLAINS HOSPITAL AFFILIATED ENTITY, PC 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0142
Total number of active participants reported on line 7a of the Form 55002022-01-0141
Number of retired or separated participants receiving benefits2022-01-012
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-0143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-0143
Number of participants with account balances2022-01-0143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: WHITE PLAINS HOSPITAL AFFILIATED ENTITY, PC 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0142
Total number of active participants reported on line 7a of the Form 55002021-01-0142
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-0142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-0142
Number of participants with account balances2021-01-0142
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: WHITE PLAINS HOSPITAL AFFILIATED ENTITY, PC 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0147
Total number of active participants reported on line 7a of the Form 55002020-01-0142
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-0142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-0142
Number of participants with account balances2020-01-0142
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: WHITE PLAINS HOSPITAL AFFILIATED ENTITY, PC 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0140
Total number of active participants reported on line 7a of the Form 55002019-01-0140
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-0140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0140
Number of participants with account balances2019-01-0138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: WHITE PLAINS HOSPITAL AFFILIATED ENTITY, PC 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0141
Total number of active participants reported on line 7a of the Form 55002018-01-0140
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-0140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0140
Number of participants with account balances2018-01-0138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: WHITE PLAINS HOSPITAL AFFILIATED ENTITY, PC 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-015
Total number of active participants reported on line 7a of the Form 55002017-01-0141
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-0141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0141
Number of participants with account balances2017-01-0112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010

Financial Data on WHITE PLAINS HOSPITAL AFFILIATED ENTITY, PC 401(K) PLAN

Measure Date Value
2022 : WHITE PLAINS HOSPITAL AFFILIATED ENTITY, PC 401(K) PLAN 2022 401k financial data
Transfers to/from the plan2022-12-31$0
Total plan liabilities at end of year2022-12-31$0
Total plan liabilities at beginning of year2022-12-31$0
Total income from all sources2022-12-31$-296,085
Expenses. Total of all expenses incurred2022-12-31$670,650
Benefits paid (including direct rollovers)2022-12-31$658,493
Total plan assets at end of year2022-12-31$9,867,080
Total plan assets at beginning of year2022-12-31$10,833,815
Total contributions received or receivable from participants2022-12-31$796,983
Expenses. Other expenses not covered elsewhere2022-12-31$3,226
Contributions received from other sources (not participants or employers)2022-12-31$62,158
Other income received2022-12-31$-2,120,077
Noncash contributions received2022-12-31$0
Net income (gross income less expenses)2022-12-31$-966,735
Net plan assets at end of year (total assets less liabilities)2022-12-31$9,867,080
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$10,833,815
Total contributions received or receivable from employer(s)2022-12-31$964,851
Value of certain deemed distributions of participant loans2022-12-31$0
Value of corrective distributions2022-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$8,931
2021 : WHITE PLAINS HOSPITAL AFFILIATED ENTITY, PC 401(K) PLAN 2021 401k financial data
Total income from all sources2021-12-31$2,804,575
Expenses. Total of all expenses incurred2021-12-31$200,966
Benefits paid (including direct rollovers)2021-12-31$191,229
Total plan assets at end of year2021-12-31$10,833,815
Total plan assets at beginning of year2021-12-31$8,230,206
Total contributions received or receivable from participants2021-12-31$772,070
Expenses. Other expenses not covered elsewhere2021-12-31$1,148
Contributions received from other sources (not participants or employers)2021-12-31$0
Other income received2021-12-31$1,412,331
Net income (gross income less expenses)2021-12-31$2,603,609
Net plan assets at end of year (total assets less liabilities)2021-12-31$10,833,815
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$8,230,206
Total contributions received or receivable from employer(s)2021-12-31$620,174
Value of certain deemed distributions of participant loans2021-12-31$0
Value of corrective distributions2021-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$8,589
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
2020 : WHITE PLAINS HOSPITAL AFFILIATED ENTITY, PC 401(K) PLAN 2020 401k financial data
Total income from all sources2020-12-31$2,621,184
Expenses. Total of all expenses incurred2020-12-31$123,496
Benefits paid (including direct rollovers)2020-12-31$112,926
Total plan assets at end of year2020-12-31$8,230,206
Total plan assets at beginning of year2020-12-31$5,732,518
Total contributions received or receivable from participants2020-12-31$714,507
Expenses. Other expenses not covered elsewhere2020-12-31$2,070
Contributions received from other sources (not participants or employers)2020-12-31$133,100
Other income received2020-12-31$1,338,412
Net income (gross income less expenses)2020-12-31$2,497,688
Net plan assets at end of year (total assets less liabilities)2020-12-31$8,230,206
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$5,732,518
Assets. Value of participant loans2020-12-31$4,154
Total contributions received or receivable from employer(s)2020-12-31$435,165
Value of certain deemed distributions of participant loans2020-12-31$0
Value of corrective distributions2020-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$8,500
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
2019 : WHITE PLAINS HOSPITAL AFFILIATED ENTITY, PC 401(K) PLAN 2019 401k financial data
Total income from all sources2019-12-31$2,167,082
Expenses. Total of all expenses incurred2019-12-31$13,496
Benefits paid (including direct rollovers)2019-12-31$0
Total plan assets at end of year2019-12-31$5,732,518
Total plan assets at beginning of year2019-12-31$3,578,932
Value of fidelity bond covering the plan2019-12-31$86,284
Total contributions received or receivable from participants2019-12-31$585,793
Expenses. Other expenses not covered elsewhere2019-12-31$420
Contributions received from other sources (not participants or employers)2019-12-31$41,755
Other income received2019-12-31$925,178
Net income (gross income less expenses)2019-12-31$2,153,586
Net plan assets at end of year (total assets less liabilities)2019-12-31$5,732,518
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$3,578,932
Assets. Value of participant loans2019-12-31$15,644
Total contributions received or receivable from employer(s)2019-12-31$614,356
Value of certain deemed distributions of participant loans2019-12-31$0
Value of corrective distributions2019-12-31$7,258
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$5,818
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
2018 : WHITE PLAINS HOSPITAL AFFILIATED ENTITY, PC 401(K) PLAN 2018 401k financial data
Total income from all sources2018-12-31$2,138,933
Expenses. Total of all expenses incurred2018-12-31$48,869
Benefits paid (including direct rollovers)2018-12-31$41,733
Total plan assets at end of year2018-12-31$3,578,932
Total plan assets at beginning of year2018-12-31$1,488,868
Value of fidelity bond covering the plan2018-12-31$86,284
Total contributions received or receivable from participants2018-12-31$579,959
Contributions received from other sources (not participants or employers)2018-12-31$1,185,474
Other income received2018-12-31$-171,359
Net income (gross income less expenses)2018-12-31$2,090,064
Net plan assets at end of year (total assets less liabilities)2018-12-31$3,578,932
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$1,488,868
Total contributions received or receivable from employer(s)2018-12-31$544,859
Value of corrective distributions2018-12-31$4,363
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$2,773
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
2017 : WHITE PLAINS HOSPITAL AFFILIATED ENTITY, PC 401(K) PLAN 2017 401k financial data
Total income from all sources2017-12-31$434,852
Expenses. Total of all expenses incurred2017-12-31$5,478
Total plan assets at end of year2017-12-31$1,488,868
Total plan assets at beginning of year2017-12-31$1,059,494
Value of fidelity bond covering the plan2017-12-31$86,284
Total contributions received or receivable from participants2017-12-31$162,879
Expenses. Other expenses not covered elsewhere2017-12-31$4,860
Contributions received from other sources (not participants or employers)2017-12-31$44,793
Other income received2017-12-31$227,180
Net income (gross income less expenses)2017-12-31$429,374
Net plan assets at end of year (total assets less liabilities)2017-12-31$1,488,868
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$1,059,494
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$618

Form 5500 Responses for WHITE PLAINS HOSPITAL AFFILIATED ENTITY, PC 401(K) PLAN

2022: WHITE PLAINS HOSPITAL AFFILIATED ENTITY, PC 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: WHITE PLAINS HOSPITAL AFFILIATED ENTITY, PC 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: WHITE PLAINS HOSPITAL AFFILIATED ENTITY, PC 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: WHITE PLAINS HOSPITAL AFFILIATED ENTITY, PC 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: WHITE PLAINS HOSPITAL AFFILIATED ENTITY, PC 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: WHITE PLAINS HOSPITAL AFFILIATED ENTITY, PC 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

Insurance Providers Used on plan

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number765687
Policy instance 1
Insurance contract or identification number765687
Number of Individuals Covered4
Insurance policy start date2022-06-18
Insurance policy end date2022-12-31
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
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberMR 62562
Policy instance 1
Insurance contract or identification numberMR 62562
Number of Individuals Covered42
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberMR 62562
Policy instance 1
Insurance contract or identification numberMR 62562
Number of Individuals Covered42
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberMR 62562
Policy instance 1
Insurance contract or identification numberMR 62562
Number of Individuals Covered40
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberMR 62562
Policy instance 1
Insurance contract or identification numberMR 62562
Number of Individuals Covered40
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberMR 62562
Policy instance 1
Insurance contract or identification numberMR 62562
Number of Individuals Covered41
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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