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SECTION 403(B) RETIREMENT PLAN FOR THE COUNCIL 401k Plan overview

Plan NameSECTION 403(B) RETIREMENT PLAN FOR THE COUNCIL
Plan identification number 001

SECTION 403(B) RETIREMENT PLAN FOR THE COUNCIL 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 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

THE COUNCIL DBA MILE HIGH BEHAVIORAL HEALTHCARE has sponsored the creation of one or more 401k plans.

Company Name:THE COUNCIL DBA MILE HIGH BEHAVIORAL HEALTHCARE
Employer identification number (EIN):840512896
NAIC Classification:624100
NAIC Description: Individual and Family Services

Additional information about THE COUNCIL DBA MILE HIGH BEHAVIORAL HEALTHCARE

Jurisdiction of Incorporation: Nevada Department of State
Incorporation Date: 2005-05-12
Company Identification Number: 20051308846

More information about THE COUNCIL DBA MILE HIGH BEHAVIORAL HEALTHCARE

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SECTION 403(B) RETIREMENT PLAN FOR THE COUNCIL

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-07-01
0012021-07-01
0012020-07-01
0012019-07-01
0012018-07-01AMY HENDERSON2020-04-14
0012017-07-01KELLY HAMM2019-04-12
0012017-07-01AMY HENDERSON2020-04-14
0012016-07-01KELLY HAMM2018-04-03
0012015-07-01KELLY HAMM2018-04-03
0012015-07-01KELLY HAMM2018-04-05
0012014-07-01KELLY HAMM2016-02-12
0012013-07-01KELLY HAMM2014-10-07
0012012-07-01KELLY HAMM2014-02-13
0012011-07-01KELLY HAMM2013-04-01
0012010-07-01KELLY HAMM2012-10-31

Plan Statistics for SECTION 403(B) RETIREMENT PLAN FOR THE COUNCIL

401k plan membership statisitcs for SECTION 403(B) RETIREMENT PLAN FOR THE COUNCIL

Measure Date Value
2022: SECTION 403(B) RETIREMENT PLAN FOR THE COUNCIL 2022 401k membership
Total participants, beginning-of-year2022-07-01164
Total number of active participants reported on line 7a of the Form 55002022-07-01125
Number of retired or separated participants receiving benefits2022-07-010
Number of other retired or separated participants entitled to future benefits2022-07-0195
Total of all active and inactive participants2022-07-01220
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-07-010
Total participants2022-07-01220
Number of participants with account balances2022-07-01198
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-07-0148
2021: SECTION 403(B) RETIREMENT PLAN FOR THE COUNCIL 2021 401k membership
Total participants, beginning-of-year2021-07-01103
Total number of active participants reported on line 7a of the Form 55002021-07-01126
Number of retired or separated participants receiving benefits2021-07-010
Number of other retired or separated participants entitled to future benefits2021-07-0135
Total of all active and inactive participants2021-07-01161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-07-010
Total participants2021-07-01161
Number of participants with account balances2021-07-01114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-07-010
2020: SECTION 403(B) RETIREMENT PLAN FOR THE COUNCIL 2020 401k membership
Total participants, beginning-of-year2020-07-01148
Total number of active participants reported on line 7a of the Form 55002020-07-01154
Number of retired or separated participants receiving benefits2020-07-010
Number of other retired or separated participants entitled to future benefits2020-07-0162
Total of all active and inactive participants2020-07-01216
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-07-010
Total participants2020-07-01216
Number of participants with account balances2020-07-010
2019: SECTION 403(B) RETIREMENT PLAN FOR THE COUNCIL 2019 401k membership
Total participants, beginning-of-year2019-07-01133
Total number of active participants reported on line 7a of the Form 55002019-07-0187
Number of retired or separated participants receiving benefits2019-07-010
Number of other retired or separated participants entitled to future benefits2019-07-0161
Total of all active and inactive participants2019-07-01148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-07-010
Total participants2019-07-01148
Number of participants with account balances2019-07-01123
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-07-0122

Financial Data on SECTION 403(B) RETIREMENT PLAN FOR THE COUNCIL

Measure Date Value
2023 : SECTION 403(B) RETIREMENT PLAN FOR THE COUNCIL 2023 401k financial data
Total unrealized appreciation/depreciation of assets2023-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-06-30$0
Total income from all sources (including contributions)2023-06-30$418,169
Total loss/gain on sale of assets2023-06-30$0
Total of all expenses incurred2023-06-30$66,186
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-06-30$58,728
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-06-30$301,968
Value of total assets at end of year2023-06-30$1,240,923
Value of total assets at beginning of year2023-06-30$888,940
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-06-30$7,458
Total interest from all sources2023-06-30$1,326
Total dividends received (eg from common stock, registered investment company shares)2023-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-06-30No
Was this plan covered by a fidelity bond2023-06-30Yes
Value of fidelity bond cover2023-06-30$1,000,000
If this is an individual account plan, was there a blackout period2023-06-30No
Were there any nonexempt tranactions with any party-in-interest2023-06-30No
Contributions received from participants2023-06-30$83,353
Participant contributions at end of year2023-06-30$13,483
Participant contributions at beginning of year2023-06-30$17,573
Other income not declared elsewhere2023-06-30$571
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-06-30No
Value of net income/loss2023-06-30$351,983
Value of net assets at end of year (total assets less liabilities)2023-06-30$1,240,923
Value of net assets at beginning of year (total assets less liabilities)2023-06-30$888,940
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2023-06-30No
Were any leases to which the plan was party in default or uncollectible2023-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2023-06-30$1,183,996
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2023-06-30$829,800
Interest on participant loans2023-06-30$1,326
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2023-06-30$43,444
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2023-06-30$41,567
Net investment gain/loss from registered investment companies (e.g. mutual funds)2023-06-30$114,304
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-06-30No
Was there a failure to transmit to the plan any participant contributions2023-06-30No
Has the plan failed to provide any benefit when due under the plan2023-06-30No
Contributions received in cash from employer2023-06-30$218,615
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-06-30$58,728
Contract administrator fees2023-06-30$7,458
Did the plan have assets held for investment2023-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-06-30No
Opinion of an independent qualified public accountant for this plan2023-06-30Disclaimer
Accountancy firm name2023-06-30KUNDINGER, CORDER & MONTOYA, P.C.
Accountancy firm EIN2023-06-30841255164
2022 : SECTION 403(B) RETIREMENT PLAN FOR THE COUNCIL 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-06-30$0
Total income from all sources (including contributions)2022-06-30$-30,255
Total loss/gain on sale of assets2022-06-30$0
Total of all expenses incurred2022-06-30$75,651
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-06-30$67,071
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-06-30$118,323
Value of total assets at end of year2022-06-30$888,940
Value of total assets at beginning of year2022-06-30$994,846
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-06-30$8,580
Total interest from all sources2022-06-30$1,467
Total dividends received (eg from common stock, registered investment company shares)2022-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-06-30No
Was this plan covered by a fidelity bond2022-06-30Yes
Value of fidelity bond cover2022-06-30$100,000
If this is an individual account plan, was there a blackout period2022-06-30No
Were there any nonexempt tranactions with any party-in-interest2022-06-30No
Contributions received from participants2022-06-30$54,976
Participant contributions at end of year2022-06-30$17,573
Participant contributions at beginning of year2022-06-30$27,408
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-06-30No
Value of net income/loss2022-06-30$-105,906
Value of net assets at end of year (total assets less liabilities)2022-06-30$888,940
Value of net assets at beginning of year (total assets less liabilities)2022-06-30$994,846
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2022-06-30No
Were any leases to which the plan was party in default or uncollectible2022-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-06-30$829,800
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-06-30$883,062
Interest on participant loans2022-06-30$1,467
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-06-30$41,567
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-06-30$84,376
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-06-30$-150,045
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-06-30No
Was there a failure to transmit to the plan any participant contributions2022-06-30No
Has the plan failed to provide any benefit when due under the plan2022-06-30No
Contributions received in cash from employer2022-06-30$63,347
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-06-30$67,071
Contract administrator fees2022-06-30$8,580
Did the plan have assets held for investment2022-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-06-30No
Opinion of an independent qualified public accountant for this plan2022-06-30Disclaimer
Accountancy firm name2022-06-30KUNDINGER, CORDER & MONTOYA, P.C.
Accountancy firm EIN2022-06-30841255164
2021 : SECTION 403(B) RETIREMENT PLAN FOR THE COUNCIL 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-06-30$0
Total income from all sources (including contributions)2021-06-30$408,143
Total loss/gain on sale of assets2021-06-30$0
Total of all expenses incurred2021-06-30$126,994
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-06-30$118,792
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-06-30$180,481
Value of total assets at end of year2021-06-30$994,846
Value of total assets at beginning of year2021-06-30$713,697
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-06-30$8,202
Total interest from all sources2021-06-30$2,035
Total dividends received (eg from common stock, registered investment company shares)2021-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-06-30No
Was this plan covered by a fidelity bond2021-06-30Yes
Value of fidelity bond cover2021-06-30$100,000
If this is an individual account plan, was there a blackout period2021-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-06-30$0
Were there any nonexempt tranactions with any party-in-interest2021-06-30No
Contributions received from participants2021-06-30$59,264
Participant contributions at end of year2021-06-30$27,408
Participant contributions at beginning of year2021-06-30$36,024
Income. Received or receivable in cash from other sources (including rollovers)2021-06-30$7,574
Other income not declared elsewhere2021-06-30$957
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-06-30No
Value of net income/loss2021-06-30$281,149
Value of net assets at end of year (total assets less liabilities)2021-06-30$994,846
Value of net assets at beginning of year (total assets less liabilities)2021-06-30$713,697
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2021-06-30No
Were any leases to which the plan was party in default or uncollectible2021-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-06-30$883,062
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-06-30$599,840
Interest on participant loans2021-06-30$2,035
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-06-30$84,376
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-06-30$77,833
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-06-30$224,670
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-06-30No
Was there a failure to transmit to the plan any participant contributions2021-06-30No
Has the plan failed to provide any benefit when due under the plan2021-06-30No
Contributions received in cash from employer2021-06-30$113,643
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-06-30$118,792
Contract administrator fees2021-06-30$8,202
Did the plan have assets held for investment2021-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-06-30No
Opinion of an independent qualified public accountant for this plan2021-06-30Disclaimer
Accountancy firm name2021-06-30KUNDINGER, CORDER & MONTOYA, P.C.
Accountancy firm EIN2021-06-30841255164
2020 : SECTION 403(B) RETIREMENT PLAN FOR THE COUNCIL 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-06-30$0
Total income from all sources (including contributions)2020-06-30$191,873
Total loss/gain on sale of assets2020-06-30$0
Total of all expenses incurred2020-06-30$132,948
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-06-30$125,968
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-06-30$172,335
Value of total assets at end of year2020-06-30$713,697
Value of total assets at beginning of year2020-06-30$654,772
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-06-30$6,980
Total interest from all sources2020-06-30$2,718
Total dividends received (eg from common stock, registered investment company shares)2020-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-06-30No
Was this plan covered by a fidelity bond2020-06-30No
If this is an individual account plan, was there a blackout period2020-06-30No
Were there any nonexempt tranactions with any party-in-interest2020-06-30No
Contributions received from participants2020-06-30$45,317
Participant contributions at end of year2020-06-30$36,024
Participant contributions at beginning of year2020-06-30$37,395
Income. Received or receivable in cash from other sources (including rollovers)2020-06-30$2,105
Other income not declared elsewhere2020-06-30$1,050
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-06-30No
Value of net income/loss2020-06-30$58,925
Value of net assets at end of year (total assets less liabilities)2020-06-30$713,697
Value of net assets at beginning of year (total assets less liabilities)2020-06-30$654,772
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2020-06-30No
Were any leases to which the plan was party in default or uncollectible2020-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-06-30$599,840
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-06-30$567,292
Interest on participant loans2020-06-30$2,718
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-06-30$77,833
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-06-30$50,085
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-06-30$15,770
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-06-30No
Was there a failure to transmit to the plan any participant contributions2020-06-30No
Has the plan failed to provide any benefit when due under the plan2020-06-30No
Contributions received in cash from employer2020-06-30$124,913
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-06-30$125,968
Contract administrator fees2020-06-30$6,980
Did the plan have assets held for investment2020-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-06-30Yes
Opinion of an independent qualified public accountant for this plan2020-06-30Disclaimer
Accountancy firm name2020-06-30KUNDINGER, CORDER & ENGLE, P.C.
Accountancy firm EIN2020-06-30841255164

Form 5500 Responses for SECTION 403(B) RETIREMENT PLAN FOR THE COUNCIL

2022: SECTION 403(B) RETIREMENT PLAN FOR THE COUNCIL 2022 form 5500 responses
2022-07-01Type of plan entitySingle employer plan
2022-07-01Submission has been amendedNo
2022-07-01This submission is the final filingNo
2022-07-01This return/report is a short plan year return/report (less than 12 months)No
2022-07-01Plan is a collectively bargained planNo
2022-07-01Plan funding arrangement – InsuranceYes
2022-07-01Plan funding arrangement – TrustYes
2022-07-01Plan benefit arrangement – InsuranceYes
2022-07-01Plan benefit arrangement - TrustYes
2021: SECTION 403(B) RETIREMENT PLAN FOR THE COUNCIL 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Submission has been amendedNo
2021-07-01This submission is the final filingNo
2021-07-01This return/report is a short plan year return/report (less than 12 months)No
2021-07-01Plan is a collectively bargained planNo
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan funding arrangement – TrustYes
2021-07-01Plan benefit arrangement – InsuranceYes
2021-07-01Plan benefit arrangement - TrustYes
2020: SECTION 403(B) RETIREMENT PLAN FOR THE COUNCIL 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Submission has been amendedNo
2020-07-01This submission is the final filingNo
2020-07-01This return/report is a short plan year return/report (less than 12 months)No
2020-07-01Plan is a collectively bargained planNo
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – TrustYes
2020-07-01Plan benefit arrangement – InsuranceYes
2020-07-01Plan benefit arrangement - TrustYes
2019: SECTION 403(B) RETIREMENT PLAN FOR THE COUNCIL 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Submission has been amendedNo
2019-07-01This submission is the final filingNo
2019-07-01This return/report is a short plan year return/report (less than 12 months)No
2019-07-01Plan is a collectively bargained planNo
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan funding arrangement – TrustYes
2019-07-01Plan benefit arrangement – InsuranceYes
2019-07-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberMR 62727-1
Policy instance 1
Insurance contract or identification numberMR 62727-1
Number of Individuals Covered21
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $140
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
Commission paid to Insurance BrokerUSD $140
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerNA
Insurance broker organization code?3
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberMR 62727-1
Policy instance 1
Insurance contract or identification numberMR 62727-1
Number of Individuals Covered154
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $880
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
Commission paid to Insurance BrokerUSD $443
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerNA
Insurance broker organization code?3
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberMR 62727-1
Policy instance 1
Insurance contract or identification numberMR 62727-1
Number of Individuals Covered0
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $657
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
Commission paid to Insurance BrokerUSD $327
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerNA
Insurance broker organization code?3

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