401k Plan data: MERCK SHARP & DOHME (I.A.) CORPORATION PENSION PLAN plan

MERCK SHARP & DOHME (I.A.) CORPORATION PENSION PLAN 401k Plan overview

Plan Name	MERCK SHARP & DOHME (I.A.) CORPORATION PENSION PLAN
Plan identification number	007

MERCK SHARP & DOHME (I.A.) CORPORATION PENSION PLAN Benefits

401k Plan Type

Defined Benefit Pension

Plan Features/Benefits

Benefits are primarily pay related
Cash balance or similar plan - Plan has a "cash balance" formula. For this purpose, a "cash balance" formula is a benefit formula in a defined benefit plan by whatever name (for example, personal account plan, pension equity plan, life cycle plan, cash account plan, etc.) that rather than, or in addition to, expressing the accrued benefit as a life annuity commencing at normal retirement age, defines benefits for each employee in terms more common to a defined contribution plan such as a single sum distribution amount (for example, 10 percent of final average pay times years of service, or the amount of the employee's hypothetical account balance).
Plan not intended to be qualified - A plan not intended to be qualified under Code sections 401, 403, or 408.
U.S.-based plan that covers residents of Puerto Rico and is qualified under both Code section 401 and section 1165 of the Puerto Rico Code.

401k Sponsoring company profile

MSD INTERNATIONAL GMBH (PUERTO RICO BRANCH) LLC has sponsored the creation of one or more 401k plans.

Company Name: MSD INTERNATIONAL GMBH (PUERTO RICO BRANCH) LLC

Employer identification number (EIN): 980658260

NAIC Classification: 325410

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MERCK SHARP & DOHME (I.A.) CORPORATION PENSION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
007 2015-01-01 ROBERTA MORALEZ GONZALEZ LAGRANA
007 2014-01-01 VANESSA GONZALEZ
007 2013-01-01 JOSE A. SANCHEZ

Plan id#	Filing Submission Date	Name of Administrator
007	2015-01-01	ROBERTA MORALEZ GONZALEZ LAGRANA
007	2014-01-01	VANESSA GONZALEZ
007	2013-01-01	JOSE A. SANCHEZ

Plan Statistics for MERCK SHARP & DOHME (I.A.) CORPORATION PENSION PLAN

401k plan membership statisitcs for MERCK SHARP & DOHME (I.A.) CORPORATION PENSION PLAN

Measure Date Value
2015: MERCK SHARP & DOHME (I.A.) CORPORATION PENSION PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 456
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 0
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 3
2014: MERCK SHARP & DOHME (I.A.) CORPORATION PENSION PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 456
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 149
Number of retired or separated participants receiving benefits 2014-01-01 65
Number of other retired or separated participants entitled to future benefits 2014-01-01 230
Total of all active and inactive participants 2014-01-01 444
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 12
Total participants 2014-01-01 456
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 2
2013: MERCK SHARP & DOHME (I.A.) CORPORATION PENSION PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 449
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 151
Number of retired or separated participants receiving benefits 2013-01-01 60
Number of other retired or separated participants entitled to future benefits 2013-01-01 224
Total of all active and inactive participants 2013-01-01 435
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 11
Total participants 2013-01-01 446
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 4

Measure	Date	Value
2015: MERCK SHARP & DOHME (I.A.) CORPORATION PENSION PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	456
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	0
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	3
2014: MERCK SHARP & DOHME (I.A.) CORPORATION PENSION PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	456
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	149
Number of retired or separated participants receiving benefits	2014-01-01	65
Number of other retired or separated participants entitled to future benefits	2014-01-01	230
Total of all active and inactive participants	2014-01-01	444
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	12
Total participants	2014-01-01	456
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	2
2013: MERCK SHARP & DOHME (I.A.) CORPORATION PENSION PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	449
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	151
Number of retired or separated participants receiving benefits	2013-01-01	60
Number of other retired or separated participants entitled to future benefits	2013-01-01	224
Total of all active and inactive participants	2013-01-01	435
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	11
Total participants	2013-01-01	446
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	4

Financial Data on MERCK SHARP & DOHME (I.A.) CORPORATION PENSION PLAN

Measure	Date	Value
2015 : MERCK SHARP & DOHME (I.A.) CORPORATION PENSION PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total transfer of assets from this plan	2015-12-31	$48,038,935
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	$1,584,660
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$1,798,483
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$1,631,837
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$0
Value of total assets at end of year	2015-12-31	$0
Value of total assets at beginning of year	2015-12-31	$48,252,758
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$166,646
Total interest from all sources	2015-12-31	$665,379
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 year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$45,000,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-213,823
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$48,252,758
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Investment advisory and management fees	2015-12-31	$140,899
Value of interest in pooled separate accounts at end of year	2015-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$27,527,712
Interest earned on other investments	2015-12-31	$665,379
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$20,725,046
Net investment gain/loss from pooled separate accounts	2015-12-31	$919,281
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$1,631,837
Contract administrator fees	2015-12-31	$25,747
Did the plan have assets held for investment	2015-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	PRICEWATERHOUSECOOPERS LLP
Accountancy firm EIN	2015-12-31	134008324
2014 : MERCK SHARP & DOHME (I.A.) CORPORATION PENSION PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$3,095,771
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$1,839,242
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$1,672,246
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$0
Value of total assets at end of year	2014-12-31	$48,252,758
Value of total assets at beginning of year	2014-12-31	$46,996,229
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$166,996
Total interest from all sources	2014-12-31	$732,790
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$45,000,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$1,256,529
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$48,252,758
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$46,996,229
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Investment advisory and management fees	2014-12-31	$166,996
Value of interest in pooled separate accounts at end of year	2014-12-31	$27,527,712
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$27,994,274
Interest earned on other investments	2014-12-31	$732,790
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$20,725,046
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$19,001,955
Net investment gain/loss from pooled separate accounts	2014-12-31	$2,362,981
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$1,672,246
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	PRICEWATERHOUSECOOPERS LLP
Accountancy firm EIN	2014-12-31	134008324
2013 : MERCK SHARP & DOHME (I.A.) CORPORATION PENSION PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$4,420,143
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$1,674,671
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$1,510,634
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$0
Value of total assets at end of year	2013-12-31	$46,996,229
Value of total assets at beginning of year	2013-12-31	$44,250,757
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$164,037
Total interest from all sources	2013-12-31	$741,708
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$45,000,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$2,745,472
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$46,996,229
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$44,250,757
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Investment advisory and management fees	2013-12-31	$164,037
Value of interest in pooled separate accounts at end of year	2013-12-31	$27,994,274
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$26,873,276
Interest earned on other investments	2013-12-31	$741,708
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$19,001,955
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$17,377,481
Net investment gain/loss from pooled separate accounts	2013-12-31	$3,678,435
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Employer contributions (assets) at beginning of year	2013-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$1,510,634
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	PRICEWATERHOUSECOOPERS LLP
Accountancy firm EIN	2013-12-31	134008324

Form 5500 Responses for MERCK SHARP & DOHME (I.A.) CORPORATION PENSION PLAN

2015: MERCK SHARP & DOHME (I.A.) CORPORATION PENSION PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	Yes
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: MERCK SHARP & DOHME (I.A.) CORPORATION PENSION PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: MERCK SHARP & DOHME (I.A.) CORPORATION PENSION PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60690 )

Policy contract number

P: 52

Policy instance

Insurance contract or identification number	P: 52
Number of Individuals Covered	0
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

GAC-2801

Policy instance

Insurance contract or identification number	GAC-2801
Number of Individuals Covered	0
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	Yes
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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

AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60690 )

Policy contract number

P: 52

Policy instance

Insurance contract or identification number	P: 52
Number of Individuals Covered	456
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

GAC-2801

Policy instance

Insurance contract or identification number	GAC-2801
Number of Individuals Covered	74
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	Yes
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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

AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60690 )

Policy contract number

P: 52

Policy instance

Insurance contract or identification number	P: 52
Number of Individuals Covered	446
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

GAC-2801

Policy instance

Insurance contract or identification number	GAC-2801
Number of Individuals Covered	68
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	Yes
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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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Company Name:	MSD INTERNATIONAL GMBH (PUERTO RICO BRANCH) LLC
Employer identification number (EIN):	980658260
NAIC Classification:	325410