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FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST 401k Plan overview

Plan NameFIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST
Plan identification number 002

FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST 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.
  • Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • ESOP other than a leveraged ESOP - A completed Schedule E must be attached to a Form 5500 filed for an Employee Stock Ownership Plan (ESOP).
  • 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.
  • Plan requiring that all or part of employer contributions be invested and held, at least for a limited period, in employer securities.

401k Sponsoring company profile

FIRST NATIONAL BANK IN WADENA has sponsored the creation of one or more 401k plans.

Company Name:FIRST NATIONAL BANK IN WADENA
Employer identification number (EIN):410256910
NAIC Classification:522110
NAIC Description:Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022018-01-01JAMIE PETTIT
0022017-01-01JAMIE PETTIT
0022016-01-01CORY PETTIT
0022016-01-01
0022015-01-01CORY PETTIT
0022015-01-01CORY PETTIT
0022014-01-01SCOTT PETTIT
0022013-01-01SCOTT PETTIT
0022012-01-01CORY C. PETTIT
0022011-01-01SCOTT PETTIT
0022010-01-01SCOTT PETTIT

Plan Statistics for FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST

401k plan membership statisitcs for FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST

Measure Date Value
2018: FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST 2018 401k membership
Total participants, beginning-of-year2018-01-0113
Total number of active participants reported on line 7a of the Form 55002018-01-010
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-010
Number of participants with account balances2018-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST 2017 401k membership
Total participants, beginning-of-year2017-01-0122
Total number of active participants reported on line 7a of the Form 55002017-01-0111
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-012
Total of all active and inactive participants2017-01-0113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0113
Number of participants with account balances2017-01-0113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST 2016 401k membership
Total participants, beginning-of-year2016-01-0121
Total number of active participants reported on line 7a of the Form 55002016-01-0119
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-012
Total of all active and inactive participants2016-01-0121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0121
Number of participants with account balances2016-01-0121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST 2015 401k membership
Total participants, beginning-of-year2015-01-0121
Total number of active participants reported on line 7a of the Form 55002015-01-0118
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-013
Total of all active and inactive participants2015-01-0121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0121
Number of participants with account balances2015-01-0120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST 2014 401k membership
Total participants, beginning-of-year2014-01-0120
Total number of active participants reported on line 7a of the Form 55002014-01-0118
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-013
Total of all active and inactive participants2014-01-0121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0121
Number of participants with account balances2014-01-0121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST 2013 401k membership
Total participants, beginning-of-year2013-01-0122
Total number of active participants reported on line 7a of the Form 55002013-01-0118
Number of retired or separated participants receiving benefits2013-01-011
Number of other retired or separated participants entitled to future benefits2013-01-011
Total of all active and inactive participants2013-01-0120
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0120
Number of participants with account balances2013-01-0120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST 2012 401k membership
Total participants, beginning-of-year2012-01-0122
Total number of active participants reported on line 7a of the Form 55002012-01-0118
Number of retired or separated participants receiving benefits2012-01-011
Number of other retired or separated participants entitled to future benefits2012-01-013
Total of all active and inactive participants2012-01-0122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0122
Number of participants with account balances2012-01-0122
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST 2011 401k membership
Total participants, beginning-of-year2011-01-0121
Total number of active participants reported on line 7a of the Form 55002011-01-0121
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-0121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0121
Number of participants with account balances2011-01-0121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST 2010 401k membership
Total participants, beginning-of-year2010-01-0121
Total number of active participants reported on line 7a of the Form 55002010-01-0121
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-0121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0121
Number of participants with account balances2010-01-0121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010

Financial Data on FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST

Measure Date Value
2018 : FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST 2018 401k financial data
Total income from all sources2018-12-31$-4,011
Expenses. Total of all expenses incurred2018-12-31$13,555
Benefits paid (including direct rollovers)2018-12-31$13,555
Total plan assets at end of year2018-12-31$0
Total plan assets at beginning of year2018-12-31$17,566
Value of fidelity bond covering the plan2018-12-31$1,675,000
Other income received2018-12-31$-4,011
Net income (gross income less expenses)2018-12-31$-17,566
Net plan assets at end of year (total assets less liabilities)2018-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$17,566
Assets. Value of employer securities2018-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
2017 : FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST 2017 401k financial data
Total income from all sources2017-12-31$43,717
Expenses. Total of all expenses incurred2017-12-31$1,871,587
Benefits paid (including direct rollovers)2017-12-31$1,871,587
Total plan assets at end of year2017-12-31$17,566
Total plan assets at beginning of year2017-12-31$1,845,436
Value of fidelity bond covering the plan2017-12-31$1,675,000
Total contributions received or receivable from participants2017-12-31$9,194
Other income received2017-12-31$34,523
Net income (gross income less expenses)2017-12-31$-1,827,870
Net plan assets at end of year (total assets less liabilities)2017-12-31$17,566
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$1,845,436
Assets. Value of employer securities2017-12-31$17,566
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST 2016 401k financial data
Total income from all sources2016-12-31$751,091
Expenses. Total of all expenses incurred2016-12-31$6,100
Benefits paid (including direct rollovers)2016-12-31$6,100
Total plan assets at end of year2016-12-31$1,845,522
Total plan assets at beginning of year2016-12-31$1,100,531
Value of fidelity bond covering the plan2016-12-31$1,675,000
Total contributions received or receivable from participants2016-12-31$34,188
Other income received2016-12-31$704,559
Net income (gross income less expenses)2016-12-31$744,991
Net plan assets at end of year (total assets less liabilities)2016-12-31$1,845,522
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$1,100,531
Assets. Value of employer securities2016-12-31$1,589,035
Total contributions received or receivable from employer(s)2016-12-31$12,344
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST 2015 401k financial data
Total income from all sources2015-12-31$132,831
Expenses. Total of all expenses incurred2015-12-31$2,485
Benefits paid (including direct rollovers)2015-12-31$2,485
Total plan assets at end of year2015-12-31$1,122,523
Total plan assets at beginning of year2015-12-31$992,177
Value of fidelity bond covering the plan2015-12-31$1,675,000
Total contributions received or receivable from participants2015-12-31$30,502
Contributions received from other sources (not participants or employers)2015-12-31$32,665
Other income received2015-12-31$54,664
Net income (gross income less expenses)2015-12-31$130,346
Net plan assets at end of year (total assets less liabilities)2015-12-31$1,122,523
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$992,177
Assets. Value of employer securities2015-12-31$920,256
Total contributions received or receivable from employer(s)2015-12-31$15,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST 2014 401k financial data
Total income from all sources2014-12-31$92,016
Expenses. Total of all expenses incurred2014-12-31$2,458
Benefits paid (including direct rollovers)2014-12-31$2,458
Total plan assets at end of year2014-12-31$992,177
Total plan assets at beginning of year2014-12-31$902,619
Value of fidelity bond covering the plan2014-12-31$1,675,000
Other income received2014-12-31$77,016
Net income (gross income less expenses)2014-12-31$89,558
Net plan assets at end of year (total assets less liabilities)2014-12-31$992,177
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$902,619
Assets. Value of participant loans2014-12-31$0
Total contributions received or receivable from employer(s)2014-12-31$15,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST 2013 401k financial data
Total income from all sources2013-12-31$49,065
Expenses. Total of all expenses incurred2013-12-31$93,312
Benefits paid (including direct rollovers)2013-12-31$93,312
Total plan assets at end of year2013-12-31$902,619
Total plan assets at beginning of year2013-12-31$946,866
Value of fidelity bond covering the plan2013-12-31$1,675,000
Other income received2013-12-31$39,065
Net income (gross income less expenses)2013-12-31$-44,247
Net plan assets at end of year (total assets less liabilities)2013-12-31$902,619
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$946,866
Assets. Value of participant loans2013-12-31$15,000
Total contributions received or receivable from employer(s)2013-12-31$10,000
2012 : FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST 2012 401k financial data
Transfers to/from the plan2012-12-31$0
Total plan liabilities at end of year2012-12-31$0
Total plan liabilities at beginning of year2012-12-31$0
Total income from all sources2012-12-31$0
Expenses. Total of all expenses incurred2012-12-31$0
Benefits paid (including direct rollovers)2012-12-31$0
Total plan assets at end of year2012-12-31$808,808
Total plan assets at beginning of year2012-12-31$808,808
Value of fidelity bond covering the plan2012-12-31$1,675,000
Total contributions received or receivable from participants2012-12-31$0
Expenses. Other expenses not covered elsewhere2012-12-31$0
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$0
Noncash contributions received2012-12-31$0
Net income (gross income less expenses)2012-12-31$0
Net plan assets at end of year (total assets less liabilities)2012-12-31$808,808
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$808,808
Assets. Value of participant loans2012-12-31$15,000
Assets. Value of employer securities2012-12-31$808,808
Total contributions received or receivable from employer(s)2012-12-31$0
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST 2011 401k financial data
Transfers to/from the plan2011-12-31$0
Total plan liabilities at end of year2011-12-31$0
Total plan liabilities at beginning of year2011-12-31$0
Total income from all sources2011-12-31$0
Expenses. Total of all expenses incurred2011-12-31$0
Benefits paid (including direct rollovers)2011-12-31$0
Total plan assets at end of year2011-12-31$808,808
Total plan assets at beginning of year2011-12-31$808,808
Value of fidelity bond covering the plan2011-12-31$1,675,000
Total contributions received or receivable from participants2011-12-31$0
Expenses. Other expenses not covered elsewhere2011-12-31$0
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$0
Noncash contributions received2011-12-31$0
Net income (gross income less expenses)2011-12-31$0
Net plan assets at end of year (total assets less liabilities)2011-12-31$808,808
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$808,808
Total contributions received or receivable from employer(s)2011-12-31$0
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$0
2010 : FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST 2010 401k financial data
Transfers to/from the plan2010-12-31$808,808
Total plan liabilities at end of year2010-12-31$0
Total plan liabilities at beginning of year2010-12-31$0
Total income from all sources2010-12-31$0
Expenses. Total of all expenses incurred2010-12-31$0
Benefits paid (including direct rollovers)2010-12-31$0
Total plan assets at end of year2010-12-31$808,808
Total plan assets at beginning of year2010-12-31$0
Value of fidelity bond covering the plan2010-12-31$1,675,000
Total contributions received or receivable from participants2010-12-31$0
Expenses. Other expenses not covered elsewhere2010-12-31$0
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$0
Noncash contributions received2010-12-31$0
Net income (gross income less expenses)2010-12-31$0
Net plan assets at end of year (total assets less liabilities)2010-12-31$808,808
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$0
Total contributions received or receivable from employer(s)2010-12-31$0
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$0

Form 5500 Responses for FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST

2018: FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST 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 filingYes
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 – TrustYes
2018-01-01Plan benefit arrangement - TrustYes
2017: FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST 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: FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedYes
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: FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST 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: FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST 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 – TrustYes
2014-01-01Plan benefit arrangement - TrustYes
2013: FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST 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 – TrustYes
2013-01-01Plan benefit arrangement - TrustYes
2012: FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedYes
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 – TrustYes
2012-01-01Plan benefit arrangement - TrustYes
2011: FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement - TrustYes
2010: FIRST NATIONAL BANK IN WADENA 401K PROFIT SHARING/ ESOP PLAN AND TRUST 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan 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 number118890
Policy instance 1
Insurance contract or identification number118890
Number of Individuals Covered0
Insurance policy start date2017-01-01
Insurance policy end date2017-05-15
Total amount of commissions paid to insurance brokerUSD $480
Total amount of fees paid to insurance companyUSD $150
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 $437
Insurance broker organization code?7
Amount paid for insurance broker fees150
Additional information about fees paid to insurance brokerTPA DISTRIBUTION FEES
Insurance broker nameCDS ADMINISTRATIVE SERVICES, LLC
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number118890
Policy instance 1
Insurance contract or identification number118890
Number of Individuals Covered19
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
Total amount of commissions paid to insurance brokerUSD $1,275
Total amount of fees paid to insurance companyUSD $75
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 $857
Insurance broker organization code?7
Amount paid for insurance broker fees75
Additional information about fees paid to insurance brokerTPA DISTRIBUTION FEES
Insurance broker nameCDS ADMINISTRATIVE SERVICES, LLC
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number65838
Policy instance 1
Insurance contract or identification number65838
Number of Individuals Covered18
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $2,579
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $1,934
Insurance broker organization code?7
Insurance broker nameCDS ADMINISTRATIVE SERVICES, LLC

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