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KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan NameKIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN
Plan identification number 001

KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • 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.
  • 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

KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING P has sponsored the creation of one or more 401k plans.

Company Name:KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING P
Employer identification number (EIN):510568719
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01BYRON COTTON2022-09-15 BYRON COTTON2022-09-15
0012020-01-01BYRON COTTON2021-09-09 BYRON COTTON2021-09-09
0012019-01-01BYRON COTTON2020-07-06 BYRON COTTON2020-07-06
0012018-01-01BYRON COTTON2019-09-13 BYRON COTTON2019-09-13
0012017-01-01
0012016-01-01
0012015-01-01
0012014-01-01
0012013-01-01
0012012-01-01BYRON C. COTTON

Plan Statistics for KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN

Measure Date Value
2021: KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-019
Total number of active participants reported on line 7a of the Form 55002021-01-016
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-015
Total of all active and inactive participants2021-01-0111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-0111
Number of participants with account balances2021-01-0111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-012
2020: KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0112
Total number of active participants reported on line 7a of the Form 55002020-01-015
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-014
Total of all active and inactive participants2020-01-019
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-019
Number of participants with account balances2020-01-019
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-011
2019: KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0114
Total number of active participants reported on line 7a of the Form 55002019-01-016
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-014
Total of all active and inactive participants2019-01-0110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0110
Number of participants with account balances2019-01-0110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0112
Total number of active participants reported on line 7a of the Form 55002018-01-017
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-017
Total of all active and inactive participants2018-01-0114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0114
Number of participants with account balances2018-01-0114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-011
2017: KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0112
Total number of active participants reported on line 7a of the Form 55002017-01-015
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 participants2017-01-0110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0110
Number of participants with account balances2017-01-0110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0112
Total number of active participants reported on line 7a of the Form 55002016-01-015
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-015
Total of all active and inactive participants2016-01-0110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0110
Number of participants with account balances2016-01-0110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-011
2015: KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-019
Total number of active participants reported on line 7a of the Form 55002015-01-014
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 participants2015-01-0110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0110
Number of participants with account balances2015-01-0110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-013
2014: KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0110
Total number of active participants reported on line 7a of the Form 55002014-01-015
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-015
Total of all active and inactive participants2014-01-0110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0110
Number of participants with account balances2014-01-0110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-014
2013: KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-018
Total number of active participants reported on line 7a of the Form 55002013-01-017
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-011
Total of all active and inactive participants2013-01-018
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-018
Number of participants with account balances2013-01-018
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-015
Total number of active participants reported on line 7a of the Form 55002012-01-015
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-011
Total of all active and inactive participants2012-01-016
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-016
Number of participants with account balances2012-01-016
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-011

Financial Data on KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN

Measure Date Value
2021 : KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2021 401k financial data
Total income from all sources2021-12-31$177,061
Expenses. Total of all expenses incurred2021-12-31$231,321
Benefits paid (including direct rollovers)2021-12-31$228,397
Total plan assets at end of year2021-12-31$680,620
Total plan assets at beginning of year2021-12-31$734,880
Value of fidelity bond covering the plan2021-12-31$100,000
Total contributions received or receivable from participants2021-12-31$29,963
Other income received2021-12-31$99,100
Net income (gross income less expenses)2021-12-31$-54,260
Net plan assets at end of year (total assets less liabilities)2021-12-31$680,620
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$734,880
Total contributions received or receivable from employer(s)2021-12-31$47,998
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$2,924
2020 : KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2020 401k financial data
Total income from all sources2020-12-31$152,921
Expenses. Total of all expenses incurred2020-12-31$46,465
Benefits paid (including direct rollovers)2020-12-31$43,821
Total plan assets at end of year2020-12-31$734,880
Total plan assets at beginning of year2020-12-31$628,424
Value of fidelity bond covering the plan2020-12-31$100,000
Total contributions received or receivable from participants2020-12-31$24,409
Other income received2020-12-31$81,640
Net income (gross income less expenses)2020-12-31$106,456
Net plan assets at end of year (total assets less liabilities)2020-12-31$734,880
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$628,424
Assets. Value of participant loans2020-12-31$0
Total contributions received or receivable from employer(s)2020-12-31$46,872
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$2,644
2019 : KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2019 401k financial data
Total income from all sources2019-12-31$174,263
Expenses. Total of all expenses incurred2019-12-31$88,793
Benefits paid (including direct rollovers)2019-12-31$85,879
Total plan assets at end of year2019-12-31$628,424
Total plan assets at beginning of year2019-12-31$542,954
Value of fidelity bond covering the plan2019-12-31$100,000
Total contributions received or receivable from participants2019-12-31$29,415
Other income received2019-12-31$93,978
Net income (gross income less expenses)2019-12-31$85,470
Net plan assets at end of year (total assets less liabilities)2019-12-31$628,424
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$542,954
Total contributions received or receivable from employer(s)2019-12-31$50,870
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$2,914
2018 : KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2018 401k financial data
Total income from all sources2018-12-31$26,329
Expenses. Total of all expenses incurred2018-12-31$3,848
Benefits paid (including direct rollovers)2018-12-31$1,100
Total plan assets at end of year2018-12-31$542,954
Total plan assets at beginning of year2018-12-31$520,473
Value of fidelity bond covering the plan2018-12-31$100,000
Total contributions received or receivable from participants2018-12-31$33,659
Other income received2018-12-31$-58,461
Net income (gross income less expenses)2018-12-31$22,481
Net plan assets at end of year (total assets less liabilities)2018-12-31$542,954
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$520,473
Total contributions received or receivable from employer(s)2018-12-31$51,131
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$2,748
2017 : KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources2017-12-31$137,572
Expenses. Total of all expenses incurred2017-12-31$13,494
Benefits paid (including direct rollovers)2017-12-31$11,249
Total plan assets at end of year2017-12-31$520,473
Total plan assets at beginning of year2017-12-31$396,395
Value of fidelity bond covering the plan2017-12-31$50,000
Total contributions received or receivable from participants2017-12-31$32,294
Other income received2017-12-31$52,847
Net income (gross income less expenses)2017-12-31$124,078
Net plan assets at end of year (total assets less liabilities)2017-12-31$520,473
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$396,395
Total contributions received or receivable from employer(s)2017-12-31$52,431
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$2,245
2016 : KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources2016-12-31$128,573
Expenses. Total of all expenses incurred2016-12-31$3,865
Benefits paid (including direct rollovers)2016-12-31$2,123
Total plan assets at end of year2016-12-31$396,395
Total plan assets at beginning of year2016-12-31$271,687
Value of fidelity bond covering the plan2016-12-31$50,000
Total contributions received or receivable from participants2016-12-31$31,693
Other income received2016-12-31$46,746
Net income (gross income less expenses)2016-12-31$124,708
Net plan assets at end of year (total assets less liabilities)2016-12-31$396,395
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$271,687
Total contributions received or receivable from employer(s)2016-12-31$50,134
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$1,742
2015 : KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources2015-12-31$55,815
Expenses. Total of all expenses incurred2015-12-31$9,769
Benefits paid (including direct rollovers)2015-12-31$8,387
Total plan assets at end of year2015-12-31$271,687
Total plan assets at beginning of year2015-12-31$225,641
Value of fidelity bond covering the plan2015-12-31$20,000
Total contributions received or receivable from participants2015-12-31$29,975
Other income received2015-12-31$-18,490
Net income (gross income less expenses)2015-12-31$46,046
Net plan assets at end of year (total assets less liabilities)2015-12-31$271,687
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$225,641
Total contributions received or receivable from employer(s)2015-12-31$44,330
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$1,382
2014 : KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources2014-12-31$78,488
Expenses. Total of all expenses incurred2014-12-31$3,013
Benefits paid (including direct rollovers)2014-12-31$1,993
Total plan assets at end of year2014-12-31$225,641
Total plan assets at beginning of year2014-12-31$150,166
Value of fidelity bond covering the plan2014-12-31$20,000
Total contributions received or receivable from participants2014-12-31$27,890
Other income received2014-12-31$5,317
Net income (gross income less expenses)2014-12-31$75,475
Net plan assets at end of year (total assets less liabilities)2014-12-31$225,641
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$150,166
Total contributions received or receivable from employer(s)2014-12-31$45,281
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$1,020
2013 : KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources2013-12-31$87,242
Expenses. Total of all expenses incurred2013-12-31$534
Total plan assets at end of year2013-12-31$150,166
Total plan assets at beginning of year2013-12-31$63,458
Value of fidelity bond covering the plan2013-12-31$20,000
Total contributions received or receivable from participants2013-12-31$29,856
Other income received2013-12-31$9,165
Net income (gross income less expenses)2013-12-31$86,708
Net plan assets at end of year (total assets less liabilities)2013-12-31$150,166
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$63,458
Total contributions received or receivable from employer(s)2013-12-31$48,221
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$534
2012 : KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources2012-12-31$63,458
Total plan assets at end of year2012-12-31$63,458
Value of fidelity bond covering the plan2012-12-31$20,000
Total contributions received or receivable from participants2012-12-31$23,255
Net income (gross income less expenses)2012-12-31$63,458
Net plan assets at end of year (total assets less liabilities)2012-12-31$63,458
Total contributions received or receivable from employer(s)2012-12-31$40,203

Form 5500 Responses for KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN

2021: KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
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: KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
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: KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
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: KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
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: KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
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: KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
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: KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
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: KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
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: KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
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: KIDS & TEENS PRIMARY HEALTHCARE OF ATLANTA, PC 401(K) PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01First time form 5500 has been submittedYes
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 number109260
Policy instance 1
Insurance contract or identification number109260
Number of Individuals Covered10
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,982
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees3982
Insurance broker organization code?5
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number109260
Policy instance 1
Insurance contract or identification number109260
Number of Individuals Covered8
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,301
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1778
Insurance broker organization code?3
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number109260
Policy instance 1
Insurance contract or identification number109260
Number of Individuals Covered10
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,313
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees3313
Insurance broker organization code?3
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number109260
Policy instance 1
Insurance contract or identification number109260
Number of Individuals Covered11
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $2,492
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees2400
Insurance broker organization code?3
Insurance broker nameMORGAN STANLEY INSURANCE SERVICES
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number109260
Policy instance 1
Insurance contract or identification number109260
Number of Individuals Covered9
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,392
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,284
Insurance broker organization code?3
Insurance broker nameMORGAN STANLEY SMITH BARNEY
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number109260
Policy instance 1
Insurance contract or identification number109260
Number of Individuals Covered7
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $964
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $856
Insurance broker nameMORGAN STANLEY SMITH BARNEY
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number109260
Policy instance 1
Insurance contract or identification number109260
Number of Individuals Covered8
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $1,546
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1436
Insurance broker nameMORGAN STANLEY SMITH BARNEY
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number109260
Policy instance 1
Insurance contract or identification number109260
Number of Individuals Covered7
Insurance policy start date2012-12-31
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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