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A. J. BLOSENSKI, INC. 401(K) PLAN 401k Plan overview

Plan NameA. J. BLOSENSKI, INC. 401(K) PLAN
Plan identification number 001

A. J. BLOSENSKI, 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

A. J. BLOSENSKI, INC. has sponsored the creation of one or more 401k plans.

Company Name:A. J. BLOSENSKI, INC.
Employer identification number (EIN):232785764
NAIC Classification:562000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan A. J. BLOSENSKI, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01JASON SCHROEDER2023-10-12
0012021-01-01ANTHONY BLOSENSKI2022-10-17
0012021-01-01JASON SCHROEDER2023-07-11
0012020-01-01ANTHONY BLOSENSKI2021-10-04
0012019-01-01ANTHONY BLOSENSKI2020-10-15
0012018-01-01ANTHONY BLOSENSKI2019-10-14
0012017-01-01
0012016-01-01
0012015-01-01
0012014-01-01ANTHONY BLOSENSKI
0012013-01-01ANTHONY BLOSENSKI
0012012-01-01ANTHONY BLOSENSKI
0012011-01-01ANTHONY BLOSENSKI2012-07-26
0012010-01-01ANTHONY BLOSENSKI2011-07-05 ANTHONY BLOSENSKI2011-07-05

Plan Statistics for A. J. BLOSENSKI, INC. 401(K) PLAN

401k plan membership statisitcs for A. J. BLOSENSKI, INC. 401(K) PLAN

Measure Date Value
2022: A. J. BLOSENSKI, INC. 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01253
Total number of active participants reported on line 7a of the Form 55002022-01-01193
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0132
Total of all active and inactive participants2022-01-01225
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01225
Number of participants with account balances2022-01-01103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: A. J. BLOSENSKI, INC. 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01238
Total number of active participants reported on line 7a of the Form 55002021-01-01200
Number of retired or separated participants receiving benefits2021-01-0111
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01211
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01211
Number of participants with account balances2021-01-01114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-013
2020: A. J. BLOSENSKI, INC. 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01222
Total number of active participants reported on line 7a of the Form 55002020-01-01208
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-019
Total of all active and inactive participants2020-01-01217
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01217
Number of participants with account balances2020-01-01113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-013
2019: A. J. BLOSENSKI, INC. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01214
Total number of active participants reported on line 7a of the Form 55002019-01-01194
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0116
Total of all active and inactive participants2019-01-01210
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01210
Number of participants with account balances2019-01-01117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-015
2018: A. J. BLOSENSKI, INC. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01210
Total number of active participants reported on line 7a of the Form 55002018-01-01191
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-019
Total of all active and inactive participants2018-01-01200
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01200
Number of participants with account balances2018-01-01117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-016
2017: A. J. BLOSENSKI, INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01198
Total number of active participants reported on line 7a of the Form 55002017-01-01190
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-015
Total of all active and inactive participants2017-01-01195
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01195
Number of participants with account balances2017-01-01102
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-012
2016: A. J. BLOSENSKI, INC. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01181
Total number of active participants reported on line 7a of the Form 55002016-01-01172
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-019
Total of all active and inactive participants2016-01-01181
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01181
Number of participants with account balances2016-01-0193
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-015
2015: A. J. BLOSENSKI, INC. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01167
Total number of active participants reported on line 7a of the Form 55002015-01-01163
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-016
Total of all active and inactive participants2015-01-01169
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01169
Number of participants with account balances2015-01-0184
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-011
2014: A. J. BLOSENSKI, INC. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01148
Total number of active participants reported on line 7a of the Form 55002014-01-01155
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 participants2014-01-01159
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01159
Number of participants with account balances2014-01-0172
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: A. J. BLOSENSKI, INC. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01132
Total number of active participants reported on line 7a of the Form 55002013-01-01142
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-012
Total of all active and inactive participants2013-01-01144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01144
Number of participants with account balances2013-01-0156
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-011
2012: A. J. BLOSENSKI, INC. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01127
Total number of active participants reported on line 7a of the Form 55002012-01-01119
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-013
Total of all active and inactive participants2012-01-01122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01122
Number of participants with account balances2012-01-0153
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-012

Financial Data on A. J. BLOSENSKI, INC. 401(K) PLAN

Measure Date Value
2022 : A. J. BLOSENSKI, INC. 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Expenses. Interest paid2022-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022022-12-31$0
Total income from all sources (including contributions)2022-12-31$-548,525
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$1,240,449
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$1,190,568
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$476,402
Value of total assets at end of year2022-12-31$4,612,684
Value of total assets at beginning of year2022-12-31$6,401,658
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$49,881
Total interest from all sources2022-12-31$3,898
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$364,478
Participant contributions at end of year2022-12-31$31,670
Participant contributions at beginning of year2022-12-31$156,252
Participant contributions at end of year2022-12-31$0
Participant contributions at beginning of year2022-12-31$0
Total non interest bearing cash at end of year2022-12-31$0
Total non interest bearing cash at beginning of year2022-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-1,788,974
Value of net assets at end of year (total assets less liabilities)2022-12-31$4,612,684
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$6,401,658
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$4,581,014
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$6,245,406
Value of interest in pooled separate accounts at end of year2022-12-31$0
Value of interest in pooled separate accounts at beginning of year2022-12-31$0
Interest on participant loans2022-12-31$3,898
Income. Interest from loans (other than to participants)2022-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-1,028,825
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$111,924
Employer contributions (assets) at end of year2022-12-31$0
Employer contributions (assets) at beginning of year2022-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$1,190,568
Contract administrator fees2022-12-31$49,881
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
2021 : A. J. BLOSENSKI, INC. 401(K) PLAN 2021 401k financial data
Unrealized appreciation/depreciation of real estate assets2021-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2021-12-31$0
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$1,279,185
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$212,143
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$175,627
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$605,477
Value of total assets at end of year2021-12-31$6,401,658
Value of total assets at beginning of year2021-12-31$5,334,616
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$36,516
Total income from rents2021-12-31$0
Total interest from all sources2021-12-31$673,708
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$0
Administrative expenses professional fees incurred2021-12-31$0
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$474,058
Participant contributions at end of year2021-12-31$156,252
Participant contributions at beginning of year2021-12-31$133,527
Participant contributions at end of year2021-12-31$0
Participant contributions at beginning of year2021-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2021-12-31$0
Other income not declared elsewhere2021-12-31$0
Administrative expenses (other) incurred2021-12-31$0
Total non interest bearing cash at end of year2021-12-31$0
Total non interest bearing cash at beginning of year2021-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Income. Non cash contributions2021-12-31$0
Value of net income/loss2021-12-31$1,067,042
Value of net assets at end of year (total assets less liabilities)2021-12-31$6,401,658
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$5,334,616
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Investment advisory and management fees2021-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$6,245,406
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$5,201,089
Value of interest in pooled separate accounts at end of year2021-12-31$0
Value of interest in pooled separate accounts at beginning of year2021-12-31$0
Interest on participant loans2021-12-31$5,508
Income. Interest from loans (other than to participants)2021-12-31$0
Interest earned on other investments2021-12-31$0
Income. Interest from US Government securities2021-12-31$0
Income. Interest from corporate debt instruments2021-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$668,200
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$0
Net investment gain/loss from pooled separate accounts2021-12-31$0
Net investment gain or loss from common/collective trusts2021-12-31$0
Net gain/loss from 103.12 investment entities2021-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$131,419
Employer contributions (assets) at end of year2021-12-31$0
Employer contributions (assets) at beginning of year2021-12-31$0
Income. Dividends from preferred stock2021-12-31$0
Income. Dividends from common stock2021-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$175,627
Contract administrator fees2021-12-31$36,516
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Aggregate proceeds on sale of assets2021-12-31$0
Aggregate carrying amount (costs) on sale of assets2021-12-31$0
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31ALBERO KUPFERMAN & ASSOCIATES LLC
Accountancy firm EIN2021-12-31260645306
2020 : A. J. BLOSENSKI, INC. 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$1,257,308
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$579,984
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$545,070
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$603,396
Value of total assets at end of year2020-12-31$5,356,164
Value of total assets at beginning of year2020-12-31$4,678,840
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$34,914
Total interest from all sources2020-12-31$6,810
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Administrative expenses professional fees incurred2020-12-31$34,914
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$454,377
Participant contributions at end of year2020-12-31$133,527
Participant contributions at beginning of year2020-12-31$140,429
Participant contributions at end of year2020-12-31$15,795
Participant contributions at beginning of year2020-12-31$14,685
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$13,043
Total non interest bearing cash at end of year2020-12-31$0
Total non interest bearing cash at beginning of year2020-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$677,324
Value of net assets at end of year (total assets less liabilities)2020-12-31$5,356,164
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$4,678,840
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$5,201,089
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$4,518,528
Value of interest in pooled separate accounts at end of year2020-12-31$0
Value of interest in pooled separate accounts at beginning of year2020-12-31$0
Income. Interest from loans (other than to participants)2020-12-31$6,810
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$647,102
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$135,976
Employer contributions (assets) at end of year2020-12-31$5,753
Employer contributions (assets) at beginning of year2020-12-31$5,198
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$545,070
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31ALBERO KUPFERMAN & ASSOCIATES LLC
Accountancy firm EIN2020-12-31260645306
2019 : A. J. BLOSENSKI, INC. 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$1,755,289
Total income from all sources (including contributions)2019-12-31$1,755,289
Total loss/gain on sale of assets2019-12-31$0
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$675,280
Total of all expenses incurred2019-12-31$675,280
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$642,650
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$642,650
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$971,710
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$971,710
Value of total assets at end of year2019-12-31$4,678,840
Value of total assets at end of year2019-12-31$4,678,840
Value of total assets at beginning of year2019-12-31$3,598,831
Value of total assets at beginning of year2019-12-31$3,598,831
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$32,630
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$32,630
Total interest from all sources2019-12-31$8,493
Total interest from all sources2019-12-31$8,493
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Administrative expenses professional fees incurred2019-12-31$32,630
Administrative expenses professional fees incurred2019-12-31$32,630
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$451,738
Contributions received from participants2019-12-31$451,738
Participant contributions at end of year2019-12-31$140,429
Participant contributions at end of year2019-12-31$140,429
Participant contributions at beginning of year2019-12-31$173,099
Participant contributions at beginning of year2019-12-31$173,099
Participant contributions at end of year2019-12-31$14,685
Participant contributions at end of year2019-12-31$14,685
Participant contributions at beginning of year2019-12-31$13,957
Participant contributions at beginning of year2019-12-31$13,957
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$387,733
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$387,733
Total non interest bearing cash at end of year2019-12-31$0
Total non interest bearing cash at end of year2019-12-31$0
Total non interest bearing cash at beginning of year2019-12-31$0
Total non interest bearing cash at beginning of year2019-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$1,080,009
Value of net income/loss2019-12-31$1,080,009
Value of net assets at end of year (total assets less liabilities)2019-12-31$4,678,840
Value of net assets at end of year (total assets less liabilities)2019-12-31$4,678,840
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$3,598,831
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$3,598,831
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$4,518,528
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$4,518,528
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$3,406,670
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$3,406,670
Value of interest in pooled separate accounts at end of year2019-12-31$0
Value of interest in pooled separate accounts at end of year2019-12-31$0
Value of interest in pooled separate accounts at beginning of year2019-12-31$0
Value of interest in pooled separate accounts at beginning of year2019-12-31$0
Interest on participant loans2019-12-31$8,493
Interest on participant loans2019-12-31$8,493
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$775,086
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$775,086
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$132,239
Contributions received in cash from employer2019-12-31$132,239
Employer contributions (assets) at end of year2019-12-31$5,198
Employer contributions (assets) at end of year2019-12-31$5,198
Employer contributions (assets) at beginning of year2019-12-31$5,105
Employer contributions (assets) at beginning of year2019-12-31$5,105
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$642,650
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$642,650
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31ALBERO KUPFERMAN & ASSOCIATES LLC
Accountancy firm name2019-12-31ALBERO KUPFERMAN & ASSOCIATES LLC
Accountancy firm EIN2019-12-31260645306
Accountancy firm EIN2019-12-31260645306
2018 : A. J. BLOSENSKI, INC. 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$438,949
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$140,221
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$120,577
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$594,099
Value of total assets at end of year2018-12-31$3,598,831
Value of total assets at beginning of year2018-12-31$3,300,103
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$19,644
Total interest from all sources2018-12-31$8,713
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Administrative expenses professional fees incurred2018-12-31$19,644
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$419,585
Participant contributions at end of year2018-12-31$173,099
Participant contributions at beginning of year2018-12-31$155,420
Participant contributions at end of year2018-12-31$13,957
Participant contributions at beginning of year2018-12-31$10,303
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$39,271
Total non interest bearing cash at end of year2018-12-31$0
Total non interest bearing cash at beginning of year2018-12-31$4,593
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$298,728
Value of net assets at end of year (total assets less liabilities)2018-12-31$3,598,831
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$3,300,103
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$3,406,670
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$0
Value of interest in pooled separate accounts at end of year2018-12-31$0
Value of interest in pooled separate accounts at beginning of year2018-12-31$3,125,656
Interest on participant loans2018-12-31$8,713
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-163,863
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$135,243
Employer contributions (assets) at end of year2018-12-31$5,105
Employer contributions (assets) at beginning of year2018-12-31$4,131
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$120,577
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31ALBERO KUPFERMAN & ASSOCIATES LLC
Accountancy firm EIN2018-12-31260645306
2017 : A. J. BLOSENSKI, INC. 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$859,616
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$270,568
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$251,070
Expenses. Certain deemed distributions of participant loans2017-12-31$7,381
Value of total corrective distributions2017-12-31$9,085
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$533,637
Value of total assets at end of year2017-12-31$3,300,103
Value of total assets at beginning of year2017-12-31$2,711,055
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$3,032
Total interest from all sources2017-12-31$6,742
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Administrative expenses professional fees incurred2017-12-31$3,032
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$299,998
Participant contributions at end of year2017-12-31$155,420
Participant contributions at beginning of year2017-12-31$168,686
Participant contributions at end of year2017-12-31$10,303
Participant contributions at beginning of year2017-12-31$10,346
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$131,503
Total non interest bearing cash at end of year2017-12-31$4,593
Total non interest bearing cash at beginning of year2017-12-31$5,551
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$589,048
Value of net assets at end of year (total assets less liabilities)2017-12-31$3,300,103
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$2,711,055
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in pooled separate accounts at end of year2017-12-31$3,125,656
Value of interest in pooled separate accounts at beginning of year2017-12-31$2,522,350
Interest on participant loans2017-12-31$6,742
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$319,237
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$102,136
Employer contributions (assets) at end of year2017-12-31$4,131
Employer contributions (assets) at beginning of year2017-12-31$4,122
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$251,070
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31ALBERO KUPFERMAN & ASSOCIATES LLC
Accountancy firm EIN2017-12-31260645306
2016 : A. J. BLOSENSKI, INC. 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total income from all sources (including contributions)2016-12-31$556,749
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$56,995
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$53,697
Expenses. Certain deemed distributions of participant loans2016-12-31$950
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$395,250
Value of total assets at end of year2016-12-31$2,711,055
Value of total assets at beginning of year2016-12-31$2,211,301
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$2,348
Total interest from all sources2016-12-31$6,389
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Administrative expenses professional fees incurred2016-12-31$2,348
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$290,557
Participant contributions at end of year2016-12-31$168,686
Participant contributions at beginning of year2016-12-31$152,595
Participant contributions at end of year2016-12-31$10,346
Participant contributions at beginning of year2016-12-31$0
Total non interest bearing cash at end of year2016-12-31$5,551
Total non interest bearing cash at beginning of year2016-12-31$4,268
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$499,754
Value of net assets at end of year (total assets less liabilities)2016-12-31$2,711,055
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$2,211,301
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in pooled separate accounts at end of year2016-12-31$2,522,350
Value of interest in pooled separate accounts at beginning of year2016-12-31$2,054,438
Interest on participant loans2016-12-31$6,389
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$155,110
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$104,693
Employer contributions (assets) at end of year2016-12-31$4,122
Employer contributions (assets) at beginning of year2016-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$53,697
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31ALBERO KUPFERMAN & ASSOCIATES LLC
Accountancy firm EIN2016-12-31260645306
2015 : A. J. BLOSENSKI, INC. 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
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$290,765
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$114,955
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$100,928
Expenses. Certain deemed distributions of participant loans2015-12-31$13,788
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$324,510
Value of total assets at end of year2015-12-31$2,211,301
Value of total assets at beginning of year2015-12-31$2,035,491
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$239
Total interest from all sources2015-12-31$6,428
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 year2015-12-31No
Administrative expenses professional fees incurred2015-12-31$239
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$242,089
Participant contributions at end of year2015-12-31$152,595
Participant contributions at beginning of year2015-12-31$142,676
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$116
Total non interest bearing cash at end of year2015-12-31$4,268
Total non interest bearing cash at beginning of year2015-12-31$5,350
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$175,810
Value of net assets at end of year (total assets less liabilities)2015-12-31$2,211,301
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$2,035,491
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in pooled separate accounts at end of year2015-12-31$2,054,438
Value of interest in pooled separate accounts at beginning of year2015-12-31$1,887,465
Interest on participant loans2015-12-31$6,428
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-40,173
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$82,305
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$100,928
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31ALBERO KUPFERMAN & ASSOCIATES LLC
Accountancy firm EIN2015-12-31260645306
2014 : A. J. BLOSENSKI, INC. 401(K) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$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$356,090
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$13,782
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$11,147
Value of total corrective distributions2014-12-31$1,307
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$276,270
Value of total assets at end of year2014-12-31$2,035,491
Value of total assets at beginning of year2014-12-31$1,693,183
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$1,328
Total interest from all sources2014-12-31$5,327
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 year2014-12-31No
Administrative expenses professional fees incurred2014-12-31$1,328
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
If this is an individual account plan, was there a blackout period2014-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$209,505
Participant contributions at end of year2014-12-31$142,676
Participant contributions at beginning of year2014-12-31$127,281
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$237
Total non interest bearing cash at end of year2014-12-31$5,350
Total non interest bearing cash at beginning of year2014-12-31$15,032
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$342,308
Value of net assets at end of year (total assets less liabilities)2014-12-31$2,035,491
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$1,693,183
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in pooled separate accounts at end of year2014-12-31$1,887,465
Value of interest in pooled separate accounts at beginning of year2014-12-31$1,550,870
Interest on participant loans2014-12-31$5,327
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$74,493
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$66,528
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$11,147
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31ALBERO KUPFERMAN & ASSOCIATES LLC
Accountancy firm EIN2014-12-31260645306
2013 : A. J. BLOSENSKI, INC. 401(K) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$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$386,293
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$47,343
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$39,167
Expenses. Certain deemed distributions of participant loans2013-12-31$4,174
Value of total corrective distributions2013-12-31$2,206
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$222,569
Value of total assets at end of year2013-12-31$1,693,183
Value of total assets at beginning of year2013-12-31$1,354,233
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$1,796
Total interest from all sources2013-12-31$4,466
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 year2013-12-31No
Administrative expenses professional fees incurred2013-12-31$1,796
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$500,000
If this is an individual account plan, was there a blackout period2013-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$164,498
Participant contributions at end of year2013-12-31$127,281
Participant contributions at beginning of year2013-12-31$104,090
Total non interest bearing cash at end of year2013-12-31$15,032
Total non interest bearing cash at beginning of year2013-12-31$13,103
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$338,950
Value of net assets at end of year (total assets less liabilities)2013-12-31$1,693,183
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$1,354,233
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in pooled separate accounts at end of year2013-12-31$1,550,870
Value of interest in pooled separate accounts at beginning of year2013-12-31$1,237,040
Interest on participant loans2013-12-31$4,466
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$159,258
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$58,071
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$39,167
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31ALBERO KUPFERMAN & ASSOCIATES LLC
Accountancy firm EIN2013-12-31260645306
2012 : A. J. BLOSENSKI, INC. 401(K) PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total income from all sources (including contributions)2012-12-31$323,392
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$31,135
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$29,455
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$213,377
Value of total assets at end of year2012-12-31$1,354,233
Value of total assets at beginning of year2012-12-31$1,061,976
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$1,680
Total interest from all sources2012-12-31$3,755
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Administrative expenses professional fees incurred2012-12-31$1,664
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$500,000
If this is an individual account plan, was there a blackout period2012-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$152,852
Participant contributions at end of year2012-12-31$104,090
Participant contributions at beginning of year2012-12-31$62,647
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$3,029
Administrative expenses (other) incurred2012-12-31$16
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$292,257
Value of net assets at end of year (total assets less liabilities)2012-12-31$1,354,233
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$1,061,976
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in pooled separate accounts at end of year2012-12-31$1,237,040
Value of interest in pooled separate accounts at beginning of year2012-12-31$987,255
Interest on participant loans2012-12-31$3,755
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$13,103
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$12,074
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$12,074
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$106,260
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$57,496
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$29,455
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31ALBERO KUPFERMAN & ASSOCIATES LLC
Accountancy firm EIN2012-12-31260645306

Form 5500 Responses for A. J. BLOSENSKI, INC. 401(K) PLAN

2022: A. J. BLOSENSKI, INC. 401(K) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: A. J. BLOSENSKI, INC. 401(K) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: A. J. BLOSENSKI, INC. 401(K) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: A. J. BLOSENSKI, INC. 401(K) PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: A. J. BLOSENSKI, 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: A. J. BLOSENSKI, 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: A. J. BLOSENSKI, 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: A. J. BLOSENSKI, 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: A. J. BLOSENSKI, 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: A. J. BLOSENSKI, 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: A. J. BLOSENSKI, 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

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number102194
Policy instance 1
Insurance contract or identification number102194
Number of Individuals Covered0
Insurance policy start date2018-01-01
Insurance policy end date2018-02-12
Total amount of commissions paid to insurance brokerUSD $1,593
Total amount of fees paid to insurance companyUSD $392
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?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 $1,593
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSALES/ADMINISTRATION
Insurance broker organization code?3
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number102194
Policy instance 1
Insurance contract or identification number102194
Number of Individuals Covered102
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $8,249
Total amount of fees paid to insurance companyUSD $3,523
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?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 $8,249
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSALES/ADMINISTRATION
Insurance broker organization code?3
Insurance broker nameCONTINENTAL BENEFITS GROUP, INC.
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number102194
Policy instance 1
Insurance contract or identification number102194
Number of Individuals Covered84
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $5,918
Total amount of fees paid to insurance companyUSD $2,596
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?No
Commission paid to Insurance BrokerUSD $5,918
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSALES/ADMINISTRATION
Insurance broker organization code?3
Insurance broker nameCONTINENTAL BENEFITS GROUP, INC.
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number102194
Policy instance 1
Insurance contract or identification number102194
Number of Individuals Covered72
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $6,542
Total amount of fees paid to insurance companyUSD $2,154
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?No
Commission paid to Insurance BrokerUSD $6,542
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSALES/ADMINISTRATION
Insurance broker organization code?3
Insurance broker nameCONTINENTAL BENEFITS GROUP, INC.
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number102194
Policy instance 1
Insurance contract or identification number102194
Number of Individuals Covered56
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $5,536
Total amount of fees paid to insurance companyUSD $1,936
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?No
Commission paid to Insurance BrokerUSD $5,536
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSALES/ADMINISTRATION
Insurance broker organization code?3
Insurance broker nameCONTINENTAL BENEFITS GROUP, INC.
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number102194
Policy instance 1
Insurance contract or identification number102194
Number of Individuals Covered53
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $3,111
Total amount of fees paid to insurance companyUSD $3,051
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?No
Commission paid to Insurance BrokerUSD $3,111
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSALES/ADMINISTRATION
Insurance broker organization code?3
Insurance broker nameCONTINENTAL BENEFITS GROUP, INC.

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