401k Plan data: WALTER ANDERSON PLUMBING, INC. 401(K) PROFIT SHARING PLAN plan

WALTER ANDERSON PLUMBING, INC. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	WALTER ANDERSON PLUMBING, INC. 401(K) PROFIT SHARING PLAN
Plan identification number	001

WALTER ANDERSON PLUMBING, INC. 401(K) PROFIT SHARING PLAN Benefits

401k Plan Type

Defined 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

WALTER ANDERSON PLUMBING, INC. has sponsored the creation of one or more 401k plans.

Company Name: WALTER ANDERSON PLUMBING, INC.

Employer identification number (EIN): 330159957

NAIC Classification: 238220
NAIC Description: Plumbing, Heating, and Air-Conditioning Contractors

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WALTER ANDERSON PLUMBING, INC. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2021-01-01
001 2020-01-01
001 2019-01-01 CANDACE UDASCO 2020-06-29
001 2018-01-01 LIDIA GODINEZ 2019-10-14
001 2017-01-01 LIDIA GODINEZ 2018-10-15
001 2016-01-01 LIDIA GODINEZ 2017-07-27
001 2015-01-01 DUSTIN THOGMARTIN 2016-10-15
001 2014-01-01 RITA ESPAILLAT 2015-07-08
001 2013-01-01 DEBORAH WILLIAMS 2014-10-15
001 2012-01-01 DEBORAH WILLIAMS 2013-10-15
001 2011-01-01 DEBORAH WILLIAMS 2012-10-15
001 2010-01-01 DEBORAH WILLIAMS 2011-10-17

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2021-01-01
001	2020-01-01
001	2019-01-01	CANDACE UDASCO	2020-06-29
001	2018-01-01	LIDIA GODINEZ	2019-10-14
001	2017-01-01	LIDIA GODINEZ	2018-10-15
001	2016-01-01	LIDIA GODINEZ	2017-07-27
001	2015-01-01	DUSTIN THOGMARTIN	2016-10-15
001	2014-01-01	RITA ESPAILLAT	2015-07-08
001	2013-01-01	DEBORAH WILLIAMS	2014-10-15
001	2012-01-01	DEBORAH WILLIAMS	2013-10-15
001	2011-01-01	DEBORAH WILLIAMS	2012-10-15
001	2010-01-01	DEBORAH WILLIAMS	2011-10-17

Plan Statistics for WALTER ANDERSON PLUMBING, INC. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for WALTER ANDERSON PLUMBING, INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2021: WALTER ANDERSON PLUMBING, INC. 401(K) PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 166
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 0
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 0
Number of participants with account balances 2021-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: WALTER ANDERSON PLUMBING, INC. 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 153
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 130
Number of retired or separated participants receiving benefits 2020-01-01 3
Number of other retired or separated participants entitled to future benefits 2020-01-01 33
Total of all active and inactive participants 2020-01-01 166
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 166
Number of participants with account balances 2020-01-01 128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 17

Measure	Date	Value
2021: WALTER ANDERSON PLUMBING, INC. 401(K) PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	166
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	0
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	0
Number of participants with account balances	2021-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: WALTER ANDERSON PLUMBING, INC. 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	153
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	130
Number of retired or separated participants receiving benefits	2020-01-01	3
Number of other retired or separated participants entitled to future benefits	2020-01-01	33
Total of all active and inactive participants	2020-01-01	166
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	166
Number of participants with account balances	2020-01-01	128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	17

Financial Data on WALTER ANDERSON PLUMBING, INC. 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2021 : WALTER ANDERSON PLUMBING, INC. 401(K) PROFIT SHARING PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$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	$1,024,382
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$4,713,532
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$4,681,000
Value of total corrective distributions	2021-12-31	$5,286
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$487,245
Value of total assets at end of year	2021-12-31	$0
Value of total assets at beginning of year	2021-12-31	$3,689,150
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$27,246
Total interest from all sources	2021-12-31	$4,339
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 year	2021-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2021-12-31	$0
Administrative expenses professional fees incurred	2021-12-31	$7,240
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$334,208
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$116,266
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$6,194
Other income not declared elsewhere	2021-12-31	$31
Total non interest bearing cash at end of year	2021-12-31	$0
Total non interest bearing cash at beginning of year	2021-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$-3,689,150
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$3,689,150
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in pooled separate accounts at end of year	2021-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$3,558,875
Interest on participant loans	2021-12-31	$4,339
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$4,547
Net investment gain/loss from pooled separate accounts	2021-12-31	$532,767
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$153,037
Employer contributions (assets) at end of year	2021-12-31	$0
Employer contributions (assets) at beginning of year	2021-12-31	$3,268
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$4,681,000
Contract administrator fees	2021-12-31	$20,006
Did the plan have assets held for investment	2021-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2021-12-31	Disclaimer
Accountancy firm name	2021-12-31	LAVINE, LOFGREN, MORRIS & ENGELBERG
Accountancy firm EIN	2021-12-31	330690020
Total unrealized appreciation/depreciation of assets	2021-11-05	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-11-05	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-11-05	$0
Total income from all sources (including contributions)	2021-11-05	$1,024,382
Total loss/gain on sale of assets	2021-11-05	$0
Total of all expenses incurred	2021-11-05	$4,713,532
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-11-05	$4,681,000
Value of total corrective distributions	2021-11-05	$5,286
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-11-05	$487,245
Value of total assets at end of year	2021-11-05	$0
Value of total assets at beginning of year	2021-11-05	$3,689,150
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-11-05	$27,246
Total interest from all sources	2021-11-05	$4,370
Total dividends received (eg from common stock, registered investment company shares)	2021-11-05	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-11-05	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2021-11-05	$6,320
Administrative expenses professional fees incurred	2021-11-05	$7,240
Was this plan covered by a fidelity bond	2021-11-05	Yes
Value of fidelity bond cover	2021-11-05	$500,000
If this is an individual account plan, was there a blackout period	2021-11-05	Yes
Were there any nonexempt tranactions with any party-in-interest	2021-11-05	No
Contributions received from participants	2021-11-05	$334,208
Participant contributions at end of year	2021-11-05	$0
Participant contributions at beginning of year	2021-11-05	$116,266
Participant contributions at end of year	2021-11-05	$0
Participant contributions at beginning of year	2021-11-05	$6,194
Total non interest bearing cash at end of year	2021-11-05	$0
Total non interest bearing cash at beginning of year	2021-11-05	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-11-05	No
Value of net income/loss	2021-11-05	$-3,689,150
Value of net assets at end of year (total assets less liabilities)	2021-11-05	$0
Value of net assets at beginning of year (total assets less liabilities)	2021-11-05	$3,689,150
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-11-05	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-11-05	No
Were any leases to which the plan was party in default or uncollectible	2021-11-05	No
Value of interest in pooled separate accounts at end of year	2021-11-05	$0
Value of interest in pooled separate accounts at beginning of year	2021-11-05	$3,558,875
Interest on participant loans	2021-11-05	$4,339
Interest earned on other investments	2021-11-05	$31
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-11-05	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-11-05	$4,547
Net investment gain/loss from pooled separate accounts	2021-11-05	$532,767
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-11-05	No
Was there a failure to transmit to the plan any participant contributions	2021-11-05	No
Has the plan failed to provide any benefit when due under the plan	2021-11-05	No
Contributions received in cash from employer	2021-11-05	$153,037
Employer contributions (assets) at end of year	2021-11-05	$0
Employer contributions (assets) at beginning of year	2021-11-05	$3,268
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-11-05	$4,681,000
Contract administrator fees	2021-11-05	$20,006
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2021-11-05	Yes
Did the plan have assets held for investment	2021-11-05	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-11-05	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-11-05	Yes
Opinion of an independent qualified public accountant for this plan	2021-11-05	Unqualified
Accountancy firm name	2021-11-05	LAVINE, LOFGREN, MORRIS & ENGELBERG
Accountancy firm EIN	2021-11-05	330690020
2020 : WALTER ANDERSON PLUMBING, INC. 401(K) PROFIT SHARING PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$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	$1,173,838
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$156,909
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$128,389
Value of total corrective distributions	2020-12-31	$13,976
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$606,338
Value of total assets at end of year	2020-12-31	$3,689,150
Value of total assets at beginning of year	2020-12-31	$2,672,221
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$14,544
Total interest from all sources	2020-12-31	$4,740
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 year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$403,609
Participant contributions at end of year	2020-12-31	$116,266
Participant contributions at beginning of year	2020-12-31	$83,418
Participant contributions at end of year	2020-12-31	$6,194
Participant contributions at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$25,767
Total non interest bearing cash at end of year	2020-12-31	$0
Total non interest bearing cash at beginning of year	2020-12-31	$305
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$1,016,929
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$3,689,150
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$2,672,221
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in pooled separate accounts at end of year	2020-12-31	$3,558,875
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$2,586,462
Interest on participant loans	2020-12-31	$4,711
Interest earned on other investments	2020-12-31	$29
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$4,547
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$2,036
Net investment gain/loss from pooled separate accounts	2020-12-31	$562,760
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$176,962
Employer contributions (assets) at end of year	2020-12-31	$3,268
Employer contributions (assets) at beginning of year	2020-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$128,389
Contract administrator fees	2020-12-31	$14,544
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	LAVINE, LOFGREN, MORRIS & ENGELBERG
Accountancy firm EIN	2020-12-31	330690020

Form 5500 Responses for WALTER ANDERSON PLUMBING, INC. 401(K) PROFIT SHARING PLAN

2021: WALTER ANDERSON PLUMBING, INC. 401(K) PROFIT SHARING PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	Yes
2021-01-01	This submission is the final filing	Yes
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: WALTER ANDERSON PLUMBING, INC. 401(K) PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

22938

Policy instance

Insurance contract or identification number	22938
Number of Individuals Covered	0
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $8,432
Total amount of fees paid to insurance company	USD $8,908
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	8908
Additional information about fees paid to insurance broker	TPA EXPENSES
Insurance broker organization code?	5
Commission paid to Insurance Broker	USD $8,432

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

Policy contract number

22938

Policy instance

Insurance contract or identification number	22938
Number of Individuals Covered	0
Insurance policy start date	2021-01-01
Insurance policy end date	2021-11-05
Total amount of commissions paid to insurance broker	USD $8,432
Total amount of fees paid to insurance company	USD $8,908
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	8908
Additional information about fees paid to insurance broker	TPA EXPENSES
Insurance broker organization code?	5
Commission paid to Insurance Broker	USD $8,432

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

Policy contract number

22938

Policy instance

Insurance contract or identification number	22938
Number of Individuals Covered	150
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $7,275
Total amount of fees paid to insurance company	USD $2,872
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,275
Insurance broker organization code?	3
Amount paid for insurance broker fees	2872
Additional information about fees paid to insurance broker	TPA EXPENSES

Potentially related plans

WALTER ANDERSON MUSEUM OF ART PLAN 330320 [EIN = 510173731]

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Company Name:	WALTER ANDERSON PLUMBING, INC.
Employer identification number (EIN):	330159957
NAIC Classification:	238220
NAIC Description:	Plumbing, Heating, and Air-Conditioning Contractors