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WILFRED A. MIYASAKI, D.M.D., INC. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan NameWILFRED A. MIYASAKI, D.M.D., INC. 401(K) PROFIT SHARING PLAN
Plan identification number 004

WILFRED A. MIYASAKI, D.M.D., INC. 401(K) PROFIT SHARING 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.
  • Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of 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.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • 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

WILFRED A. MYASAKI, D.M.D., INC. has sponsored the creation of one or more 401k plans.

Company Name:WILFRED A. MYASAKI, D.M.D., INC.
Employer identification number (EIN):990201445
NAIC Classification:621210
NAIC Description:Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WILFRED A. MIYASAKI, D.M.D., INC. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0042022-01-01
0042021-01-01
0042020-01-01
0042019-01-01
0042018-01-01
0042017-01-01WILFRED A. MIYASAKI

Plan Statistics for WILFRED A. MIYASAKI, D.M.D., INC. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for WILFRED A. MIYASAKI, D.M.D., INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2022: WILFRED A. MIYASAKI, D.M.D., INC. 401(K) PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0114
Total number of active participants reported on line 7a of the Form 55002022-01-0112
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-012
Total of all active and inactive participants2022-01-0114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-0114
Number of participants with account balances2022-01-0114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-011
2021: WILFRED A. MIYASAKI, D.M.D., INC. 401(K) PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0111
Total number of active participants reported on line 7a of the Form 55002021-01-0110
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-011
Total of all active and inactive participants2021-01-0111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-0111
Number of participants with account balances2021-01-0111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: WILFRED A. MIYASAKI, D.M.D., INC. 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0111
Total number of active participants reported on line 7a of the Form 55002020-01-0110
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-011
Total of all active and inactive participants2020-01-0111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-0111
Number of participants with account balances2020-01-0111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: WILFRED A. MIYASAKI, D.M.D., INC. 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0110
Total number of active participants reported on line 7a of the Form 55002019-01-0110
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-011
Total of all active and inactive participants2019-01-0111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0111
Number of participants with account balances2019-01-0111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: WILFRED A. MIYASAKI, D.M.D., INC. 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0110
Total number of active participants reported on line 7a of the Form 55002018-01-019
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-011
Total of all active and inactive participants2018-01-0110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0110
Number of participants with account balances2018-01-0110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: WILFRED A. MIYASAKI, D.M.D., INC. 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0110
Total number of active participants reported on line 7a of the Form 55002017-01-0110
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 participants2017-01-0110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0110
Number of participants with account balances2017-01-0110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010

Financial Data on WILFRED A. MIYASAKI, D.M.D., INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2022 : WILFRED A. MIYASAKI, D.M.D., INC. 401(K) PROFIT SHARING PLAN 2022 401k financial data
Transfers to/from the plan2022-12-31$0
Total plan liabilities at end of year2022-12-31$200,000
Total plan liabilities at beginning of year2022-12-31$0
Total income from all sources2022-12-31$420,582
Expenses. Total of all expenses incurred2022-12-31$467,127
Benefits paid (including direct rollovers)2022-12-31$460,670
Total plan assets at end of year2022-12-31$8,019,911
Total plan assets at beginning of year2022-12-31$7,866,456
Value of fidelity bond covering the plan2022-12-31$5,970,000
Total contributions received or receivable from participants2022-12-31$57,646
Expenses. Other expenses not covered elsewhere2022-12-31$0
Contributions received from other sources (not participants or employers)2022-12-31$0
Other income received2022-12-31$294,196
Noncash contributions received2022-12-31$0
Net income (gross income less expenses)2022-12-31$-46,545
Net plan assets at end of year (total assets less liabilities)2022-12-31$7,819,911
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$7,866,456
Assets. Value of participant loans2022-12-31$28,662
Assets. Value of real-estate (other than employer real property)2022-12-31$5,883,000
Total contributions received or receivable from employer(s)2022-12-31$68,740
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$6,457
2021 : WILFRED A. MIYASAKI, D.M.D., INC. 401(K) PROFIT SHARING PLAN 2021 401k financial data
Transfers to/from the plan2021-12-31$0
Total plan liabilities at end of year2021-12-31$0
Total plan liabilities at beginning of year2021-12-31$0
Total income from all sources2021-12-31$1,686,285
Expenses. Total of all expenses incurred2021-12-31$256,004
Benefits paid (including direct rollovers)2021-12-31$249,680
Total plan assets at end of year2021-12-31$7,866,456
Total plan assets at beginning of year2021-12-31$6,436,175
Value of fidelity bond covering the plan2021-12-31$5,960,000
Total contributions received or receivable from participants2021-12-31$57,535
Expenses. Other expenses not covered elsewhere2021-12-31$0
Contributions received from other sources (not participants or employers)2021-12-31$0
Other income received2021-12-31$1,562,442
Noncash contributions received2021-12-31$0
Net income (gross income less expenses)2021-12-31$1,430,281
Net plan assets at end of year (total assets less liabilities)2021-12-31$7,866,456
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$6,436,175
Assets. Value of participant loans2021-12-31$31,884
Assets. Value of real-estate (other than employer real property)2021-12-31$5,635,300
Total contributions received or receivable from employer(s)2021-12-31$66,308
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$6,324
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$245,000
2020 : WILFRED A. MIYASAKI, D.M.D., INC. 401(K) PROFIT SHARING PLAN 2020 401k financial data
Transfers to/from the plan2020-12-31$0
Total plan liabilities at end of year2020-12-31$0
Total plan liabilities at beginning of year2020-12-31$0
Total income from all sources2020-12-31$878,733
Expenses. Total of all expenses incurred2020-12-31$181,787
Benefits paid (including direct rollovers)2020-12-31$150,000
Total plan assets at end of year2020-12-31$6,436,175
Total plan assets at beginning of year2020-12-31$5,739,229
Value of fidelity bond covering the plan2020-12-31$500,000
Total contributions received or receivable from participants2020-12-31$48,577
Expenses. Other expenses not covered elsewhere2020-12-31$0
Contributions received from other sources (not participants or employers)2020-12-31$0
Other income received2020-12-31$806,930
Noncash contributions received2020-12-31$0
Net income (gross income less expenses)2020-12-31$696,946
Net plan assets at end of year (total assets less liabilities)2020-12-31$6,436,175
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$5,739,229
Assets. Value of participant loans2020-12-31$34,972
Assets. Value of real-estate (other than employer real property)2020-12-31$4,625,000
Total contributions received or receivable from employer(s)2020-12-31$23,226
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$31,787
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
2019 : WILFRED A. MIYASAKI, D.M.D., INC. 401(K) PROFIT SHARING PLAN 2019 401k financial data
Total income from all sources2019-12-31$898,751
Expenses. Total of all expenses incurred2019-12-31$239,884
Benefits paid (including direct rollovers)2019-12-31$169,647
Total plan assets at end of year2019-12-31$5,739,229
Total plan assets at beginning of year2019-12-31$5,080,362
Value of fidelity bond covering the plan2019-12-31$3,701,000
Total contributions received or receivable from participants2019-12-31$47,203
Expenses. Other expenses not covered elsewhere2019-12-31$64,004
Other income received2019-12-31$827,777
Net income (gross income less expenses)2019-12-31$658,867
Net plan assets at end of year (total assets less liabilities)2019-12-31$5,739,229
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$5,080,362
Assets. Value of participant loans2019-12-31$37,933
Assets. Value of real-estate (other than employer real property)2019-12-31$4,415,000
Total contributions received or receivable from employer(s)2019-12-31$23,771
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$6,233
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
2018 : WILFRED A. MIYASAKI, D.M.D., INC. 401(K) PROFIT SHARING PLAN 2018 401k financial data
Total income from all sources2018-12-31$607,225
Expenses. Total of all expenses incurred2018-12-31$213,454
Benefits paid (including direct rollovers)2018-12-31$145,814
Total plan assets at end of year2018-12-31$5,080,362
Total plan assets at beginning of year2018-12-31$4,686,591
Value of fidelity bond covering the plan2018-12-31$3,121,000
Total contributions received or receivable from participants2018-12-31$31,368
Expenses. Other expenses not covered elsewhere2018-12-31$62,377
Other income received2018-12-31$570,215
Net income (gross income less expenses)2018-12-31$393,771
Net plan assets at end of year (total assets less liabilities)2018-12-31$5,080,362
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$4,686,591
Assets. Value of participant loans2018-12-31$40,770
Assets. Value of real-estate (other than employer real property)2018-12-31$3,701,000
Total contributions received or receivable from employer(s)2018-12-31$5,642
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$5,263
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
2017 : WILFRED A. MIYASAKI, D.M.D., INC. 401(K) PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources2017-12-31$4,690,598
Expenses. Total of all expenses incurred2017-12-31$4,007
Total plan assets at end of year2017-12-31$4,686,591
Total plan assets at beginning of year2017-12-31$0
Value of fidelity bond covering the plan2017-12-31$2,600,000
Total contributions received or receivable from participants2017-12-31$23,902
Expenses. Other expenses not covered elsewhere2017-12-31$3,161
Contributions received from other sources (not participants or employers)2017-12-31$4,250,892
Other income received2017-12-31$389,161
Net income (gross income less expenses)2017-12-31$4,686,591
Net plan assets at end of year (total assets less liabilities)2017-12-31$4,686,591
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$0
Assets. Value of participant loans2017-12-31$43,490
Assets. Value of real-estate (other than employer real property)2017-12-31$3,121,000
Total contributions received or receivable from employer(s)2017-12-31$26,643
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$846
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0

Form 5500 Responses for WILFRED A. MIYASAKI, D.M.D., INC. 401(K) PROFIT SHARING PLAN

2022: WILFRED A. MIYASAKI, D.M.D., INC. 401(K) PROFIT SHARING 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: WILFRED A. MIYASAKI, D.M.D., INC. 401(K) PROFIT SHARING 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: WILFRED A. MIYASAKI, D.M.D., INC. 401(K) PROFIT SHARING 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: WILFRED A. MIYASAKI, D.M.D., INC. 401(K) PROFIT SHARING 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: WILFRED A. MIYASAKI, D.M.D., INC. 401(K) PROFIT SHARING 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: WILFRED A. MIYASAKI, D.M.D., INC. 401(K) PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01First time form 5500 has been submittedYes
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

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number343190-000
Policy instance 1
Insurance contract or identification number343190-000
Number of Individuals Covered14
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $6,432
Total amount of fees paid to insurance companyUSD $641
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 $6,432
Amount paid for insurance broker fees0
Additional information about fees paid to insurance broker0
Insurance broker organization code?3
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number343190-000
Policy instance 1
Insurance contract or identification number343190-000
Number of Individuals Covered11
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $6,254
Total amount of fees paid to insurance companyUSD $632
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 $6,254
Amount paid for insurance broker fees0
Additional information about fees paid to insurance broker0
Insurance broker organization code?3
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number343190-000
Policy instance 1
Insurance contract or identification number343190-000
Number of Individuals Covered11
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $4,680
Total amount of fees paid to insurance companyUSD $470
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 $4,680
Amount paid for insurance broker fees0
Additional information about fees paid to insurance broker0
Insurance broker organization code?3
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number343190-000
Policy instance 1
Insurance contract or identification number343190-000
Number of Individuals Covered11
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $4,626
Total amount of fees paid to insurance companyUSD $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?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,626
Amount paid for insurance broker fees0
Additional information about fees paid to insurance broker0
Insurance broker organization code?3
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number343190-000
Policy instance 1
Insurance contract or identification number343190-000
Number of Individuals Covered10
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $4,355
Total amount of fees paid to insurance companyUSD $509
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 $4,355
Amount paid for insurance broker fees0
Additional information about fees paid to insurance broker0
Insurance broker organization code?3
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number21286345
Policy instance 1
Insurance contract or identification number21286345
Number of Individuals Covered1
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $995
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?1
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 $733
Insurance broker organization code?3
Insurance broker nameFRASER GRANT DAVID
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number343190-000
Policy instance 2
Insurance contract or identification number343190-000
Number of Individuals Covered10
Insurance policy start date2017-08-22
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $346
Total amount of fees paid to insurance companyUSD $894
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 $0
Amount paid for insurance broker fees894
Additional information about fees paid to insurance broker0
Insurance broker organization code?5
Insurance broker nameMORGAN STANLEY INSURANCE SERVICES

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