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M & H ENGINEERING CO., INC. 401(K) PLAN 401k Plan overview

Plan NameM & H ENGINEERING CO., INC. 401(K) PLAN
Plan identification number 001

M & H ENGINEERING CO., INC. 401(K) PLAN Benefits

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

M & H ENGINEERING CO., INC. has sponsored the creation of one or more 401k plans.

Company Name:M & H ENGINEERING CO., INC.
Employer identification number (EIN):042392563
NAIC Classification:541330
NAIC Description:Engineering Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan M & H ENGINEERING CO., INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01MICHAEL MARTENS2023-06-26
0012021-01-01MICHAEL MARTENS2022-07-19
0012020-01-01MICHAEL MARTENS2021-09-28
0012019-01-01MICHAEL MARTENS2020-10-07
0012018-01-01MICHAEL MARTENS
0012017-01-01MICHAEL MARTENS
0012016-01-01MICHAEL MARTENS
0012015-01-01MICHAEL MARTENS
0012014-01-01MICHAEL MARTENS
0012013-01-01MICHAEL MARTENS
0012012-01-01MICHAEL MARTENS
0012011-01-01MICHAEL MARTENS
0012009-01-01MICHAEL MARTENS
0012009-01-01MICHAEL MARTENS

Plan Statistics for M & H ENGINEERING CO., INC. 401(K) PLAN

401k plan membership statisitcs for M & H ENGINEERING CO., INC. 401(K) PLAN

Measure Date Value
2018: M & H ENGINEERING CO., INC. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0148
Total number of active participants reported on line 7a of the Form 55002018-01-0152
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-017
Total of all active and inactive participants2018-01-0159
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0159
Number of participants with account balances2018-01-0157
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-013
2017: M & H ENGINEERING CO., INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0145
Total number of active participants reported on line 7a of the Form 55002017-01-0144
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-013
Total of all active and inactive participants2017-01-0147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0147
Number of participants with account balances2017-01-0146
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-013
2016: M & H ENGINEERING CO., INC. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0143
Total number of active participants reported on line 7a of the Form 55002016-01-0139
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-016
Total of all active and inactive participants2016-01-0145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0145
Number of participants with account balances2016-01-0143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: M & H ENGINEERING CO., INC. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0143
Total number of active participants reported on line 7a of the Form 55002015-01-0136
Number of retired or separated participants receiving benefits2015-01-012
Number of other retired or separated participants entitled to future benefits2015-01-016
Total of all active and inactive participants2015-01-0144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0144
Number of participants with account balances2015-01-0137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: M & H ENGINEERING CO., INC. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0142
Total number of active participants reported on line 7a of the Form 55002014-01-0139
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-014
Total of all active and inactive participants2014-01-0143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0143
Number of participants with account balances2014-01-0137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: M & H ENGINEERING CO., INC. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0145
Total number of active participants reported on line 7a of the Form 55002013-01-0136
Number of retired or separated participants receiving benefits2013-01-012
Number of other retired or separated participants entitled to future benefits2013-01-015
Total of all active and inactive participants2013-01-0143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0143
Number of participants with account balances2013-01-0140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-011
2012: M & H ENGINEERING CO., INC. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0149
Total number of active participants reported on line 7a of the Form 55002012-01-0136
Number of retired or separated participants receiving benefits2012-01-012
Number of other retired or separated participants entitled to future benefits2012-01-016
Total of all active and inactive participants2012-01-0144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0144
Number of participants with account balances2012-01-0143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-016
2011: M & H ENGINEERING CO., INC. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0146
Total number of active participants reported on line 7a of the Form 55002011-01-0144
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-015
Total of all active and inactive participants2011-01-0149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0149
Number of participants with account balances2011-01-0149
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-011
2009: M & H ENGINEERING CO., INC. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0142
Total number of active participants reported on line 7a of the Form 55002009-01-0134
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-017
Total of all active and inactive participants2009-01-0141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0141
Number of participants with account balances2009-01-0125
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on M & H ENGINEERING CO., INC. 401(K) PLAN

Measure Date Value
2018 : M & H ENGINEERING CO., INC. 401(K) PLAN 2018 401k financial data
Total income from all sources2018-12-31$214,836
Expenses. Total of all expenses incurred2018-12-31$48,225
Benefits paid (including direct rollovers)2018-12-31$48,225
Total plan assets at end of year2018-12-31$3,305,201
Total plan assets at beginning of year2018-12-31$3,138,590
Value of fidelity bond covering the plan2018-12-31$500,000
Total contributions received or receivable from participants2018-12-31$204,730
Contributions received from other sources (not participants or employers)2018-12-31$38,203
Other income received2018-12-31$-228,133
Net income (gross income less expenses)2018-12-31$166,611
Net plan assets at end of year (total assets less liabilities)2018-12-31$3,305,201
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$3,138,590
Assets. Value of participant loans2018-12-31$132,580
Total contributions received or receivable from employer(s)2018-12-31$200,036
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
2017 : M & H ENGINEERING CO., INC. 401(K) PLAN 2017 401k financial data
Total income from all sources2017-12-31$868,957
Expenses. Total of all expenses incurred2017-12-31$426,567
Benefits paid (including direct rollovers)2017-12-31$426,567
Total plan assets at end of year2017-12-31$3,138,590
Total plan assets at beginning of year2017-12-31$2,696,200
Value of fidelity bond covering the plan2017-12-31$270,000
Total contributions received or receivable from participants2017-12-31$188,700
Other income received2017-12-31$474,534
Net income (gross income less expenses)2017-12-31$442,390
Net plan assets at end of year (total assets less liabilities)2017-12-31$3,138,590
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$2,696,200
Assets. Value of participant loans2017-12-31$99,722
Total contributions received or receivable from employer(s)2017-12-31$205,723
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : M & H ENGINEERING CO., INC. 401(K) PLAN 2016 401k financial data
Total plan liabilities at beginning of year2016-12-31$0
Total income from all sources2016-12-31$443,883
Expenses. Total of all expenses incurred2016-12-31$46,104
Benefits paid (including direct rollovers)2016-12-31$46,104
Total plan assets at end of year2016-12-31$2,696,200
Total plan assets at beginning of year2016-12-31$2,298,421
Value of fidelity bond covering the plan2016-12-31$270,000
Total contributions received or receivable from participants2016-12-31$152,853
Other income received2016-12-31$106,122
Net income (gross income less expenses)2016-12-31$397,779
Net plan assets at end of year (total assets less liabilities)2016-12-31$2,696,200
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$2,298,421
Assets. Value of participant loans2016-12-31$57,527
Total contributions received or receivable from employer(s)2016-12-31$184,908
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : M & H ENGINEERING CO., INC. 401(K) PLAN 2015 401k financial data
Total plan liabilities at end of year2015-12-31$0
Total income from all sources2015-12-31$187,418
Expenses. Total of all expenses incurred2015-12-31$936,300
Benefits paid (including direct rollovers)2015-12-31$936,300
Total plan assets at end of year2015-12-31$2,298,421
Total plan assets at beginning of year2015-12-31$3,047,303
Value of fidelity bond covering the plan2015-12-31$270,000
Total contributions received or receivable from participants2015-12-31$109,043
Expenses. Other expenses not covered elsewhere2015-12-31$0
Contributions received from other sources (not participants or employers)2015-12-31$0
Other income received2015-12-31$6,574
Noncash contributions received2015-12-31$0
Net income (gross income less expenses)2015-12-31$-748,882
Net plan assets at end of year (total assets less liabilities)2015-12-31$2,298,421
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$3,047,303
Assets. Value of participant loans2015-12-31$67,915
Total contributions received or receivable from employer(s)2015-12-31$71,801
Value of certain deemed distributions of participant loans2015-12-31$0
Value of corrective distributions2015-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : M & H ENGINEERING CO., INC. 401(K) PLAN 2014 401k financial data
Total income from all sources2014-12-31$333,091
Expenses. Total of all expenses incurred2014-12-31$168,334
Benefits paid (including direct rollovers)2014-12-31$168,334
Total plan assets at end of year2014-12-31$3,047,303
Total plan assets at beginning of year2014-12-31$2,882,546
Value of fidelity bond covering the plan2014-12-31$270,000
Total contributions received or receivable from participants2014-12-31$136,149
Other income received2014-12-31$120,833
Net income (gross income less expenses)2014-12-31$164,757
Net plan assets at end of year (total assets less liabilities)2014-12-31$3,047,303
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$2,882,546
Assets. Value of participant loans2014-12-31$63,561
Total contributions received or receivable from employer(s)2014-12-31$76,109
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : M & H ENGINEERING CO., INC. 401(K) PLAN 2013 401k financial data
Total income from all sources2013-12-31$637,787
Expenses. Total of all expenses incurred2013-12-31$93,807
Benefits paid (including direct rollovers)2013-12-31$93,807
Total plan assets at end of year2013-12-31$2,882,546
Total plan assets at beginning of year2013-12-31$2,338,566
Value of fidelity bond covering the plan2013-12-31$270,000
Total contributions received or receivable from participants2013-12-31$125,265
Other income received2013-12-31$443,422
Net income (gross income less expenses)2013-12-31$543,980
Net plan assets at end of year (total assets less liabilities)2013-12-31$2,882,546
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$2,338,566
Assets. Value of participant loans2013-12-31$38,134
Total contributions received or receivable from employer(s)2013-12-31$69,100
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : M & H ENGINEERING CO., INC. 401(K) PLAN 2012 401k financial data
Total income from all sources2012-12-31$461,216
Expenses. Total of all expenses incurred2012-12-31$81,447
Benefits paid (including direct rollovers)2012-12-31$81,447
Total plan assets at end of year2012-12-31$2,338,566
Total plan assets at beginning of year2012-12-31$1,958,797
Value of fidelity bond covering the plan2012-12-31$185,000
Total contributions received or receivable from participants2012-12-31$157,757
Other income received2012-12-31$220,456
Net income (gross income less expenses)2012-12-31$379,769
Net plan assets at end of year (total assets less liabilities)2012-12-31$2,338,566
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$1,958,797
Assets. Value of participant loans2012-12-31$34,277
Total contributions received or receivable from employer(s)2012-12-31$83,003
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : M & H ENGINEERING CO., INC. 401(K) PLAN 2011 401k financial data
Total income from all sources2011-12-31$271,781
Expenses. Total of all expenses incurred2011-12-31$33,208
Benefits paid (including direct rollovers)2011-12-31$33,208
Total plan assets at end of year2011-12-31$1,958,797
Total plan assets at beginning of year2011-12-31$1,720,224
Value of fidelity bond covering the plan2011-12-31$165,000
Total contributions received or receivable from participants2011-12-31$160,870
Other income received2011-12-31$-61,788
Net income (gross income less expenses)2011-12-31$238,573
Net plan assets at end of year (total assets less liabilities)2011-12-31$1,958,797
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$1,720,224
Assets. Value of participant loans2011-12-31$22,553
Total contributions received or receivable from employer(s)2011-12-31$172,699
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : M & H ENGINEERING CO., INC. 401(K) PLAN 2010 401k financial data
Total income from all sources2010-12-31$427,970
Expenses. Total of all expenses incurred2010-12-31$36,617
Total plan assets at end of year2010-12-31$1,720,224
Total plan assets at beginning of year2010-12-31$1,328,871
Value of fidelity bond covering the plan2010-12-31$130,000
Total contributions received or receivable from participants2010-12-31$98,368
Other income received2010-12-31$174,113
Net income (gross income less expenses)2010-12-31$391,353
Net plan assets at end of year (total assets less liabilities)2010-12-31$1,720,224
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$1,328,871
Assets. Value of participant loans2010-12-31$25,209
Total contributions received or receivable from employer(s)2010-12-31$155,489
Value of corrective distributions2010-12-31$36,617
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
2009 : M & H ENGINEERING CO., INC. 401(K) PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for M & H ENGINEERING CO., INC. 401(K) PLAN

2018: M & H ENGINEERING CO., INC. 401(K) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: M & H ENGINEERING CO., INC. 401(K) PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: M & H ENGINEERING CO., INC. 401(K) PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: M & H ENGINEERING CO., INC. 401(K) PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: M & H ENGINEERING CO., INC. 401(K) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: M & H ENGINEERING CO., INC. 401(K) PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: M & H ENGINEERING CO., INC. 401(K) PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: M & H ENGINEERING CO., INC. 401(K) PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: M & H ENGINEERING CO., INC. 401(K) PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number50819
Policy instance 1
Insurance contract or identification number50819
Number of Individuals Covered54
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $30,715
Total amount of fees paid to insurance companyUSD $3,517
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?Yes
Commission paid to Insurance BrokerUSD $30,715
Insurance broker organization code?3
Amount paid for insurance broker fees1975
Additional information about fees paid to insurance brokerTPA FEES
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number50819
Policy instance 1
Insurance contract or identification number50819
Number of Individuals Covered44
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $25,178
Total amount of fees paid to insurance companyUSD $3,014
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?Yes
Commission paid to Insurance BrokerUSD $25,178
Insurance broker organization code?3
Amount paid for insurance broker fees1750
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker nameSWERDLIN NORTHEAST LLC
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number50819
Policy instance 1
Insurance contract or identification number50819
Number of Individuals Covered39
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $21,568
Total amount of fees paid to insurance companyUSD $2,038
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?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?Yes
Commission paid to Insurance BrokerUSD $21,568
Insurance broker organization code?3
Amount paid for insurance broker fees1088
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker nameSWERDLIN NORTHEAST LLC
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number50819
Policy instance 1
Insurance contract or identification number50819
Number of Individuals Covered39
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $23,486
Total amount of fees paid to insurance companyUSD $2,281
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?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?Yes
Commission paid to Insurance BrokerUSD $23,486
Insurance broker organization code?3
Amount paid for insurance broker fees1181
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker nameSWERDLIN NORTHEAST LLC
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number50819
Policy instance 1
Insurance contract or identification number50819
Number of Individuals Covered38
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $19,906
Total amount of fees paid to insurance companyUSD $1,600
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?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?Yes
Commission paid to Insurance BrokerUSD $19,906
Insurance broker organization code?3
Amount paid for insurance broker fees1000
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker namePENRET SERVICES, INC.
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number50819
Policy instance 1
Insurance contract or identification number50819
Number of Individuals Covered42
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $17,865
Total amount of fees paid to insurance companyUSD $2,200
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?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?Yes
Commission paid to Insurance BrokerUSD $10,279
Insurance broker organization code?3
Amount paid for insurance broker fees1300
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker namePENRET SERVICES, INC
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number50819
Policy instance 1
Insurance contract or identification number50819
Number of Individuals Covered47
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $16,664
Total amount of fees paid to insurance companyUSD $1,628
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number50819
Policy instance 1
Insurance contract or identification number50819
Number of Individuals Covered35
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $18,386
Total amount of fees paid to insurance companyUSD $659
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $18,386
Insurance broker organization code?3
Amount paid for insurance broker fees659
Additional information about fees paid to insurance brokerTPA FORUM COMPENSATION
Insurance broker namePENRET SERVICES, INC.

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