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TAOS PUEBLO 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan NameTAOS PUEBLO 401(K) PROFIT SHARING PLAN
Plan identification number 001

TAOS PUEBLO 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.
  • 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.
  • 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 sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

TAOS PUEBLO has sponsored the creation of one or more 401k plans.

Company Name:TAOS PUEBLO
Employer identification number (EIN):850472150
NAIC Classification:921000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TAOS PUEBLO 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012024-01-01ROBERT PALMER
0012023-01-01
0012023-01-01ROBERT PALMER
0012022-01-01
0012022-01-01ROBERT PALMER
0012021-01-01
0012021-01-01
0012021-01-01ROBET PALMER

Financial Data on TAOS PUEBLO 401(K) PROFIT SHARING PLAN

Measure Date Value
2023 : TAOS PUEBLO 401(K) PROFIT SHARING PLAN 2023 401k financial data
Total unrealized appreciation/depreciation of assets2023-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$24,823
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$17,327
Total income from all sources (including contributions)2023-12-31$2,050,974
Total loss/gain on sale of assets2023-12-31$0
Total of all expenses incurred2023-12-31$772,372
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-12-31$660,351
Value of total corrective distributions2023-12-31$13,965
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-12-31$966,247
Value of total assets at end of year2023-12-31$8,204,206
Value of total assets at beginning of year2023-12-31$6,918,108
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-12-31$98,056
Total interest from all sources2023-12-31$21,951
Total dividends received (eg from common stock, registered investment company shares)2023-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-12-31No
Was this plan covered by a fidelity bond2023-12-31Yes
Value of fidelity bond cover2023-12-31$500,000
If this is an individual account plan, was there a blackout period2023-12-31No
Were there any nonexempt tranactions with any party-in-interest2023-12-31No
Contributions received from participants2023-12-31$451,575
Participant contributions at end of year2023-12-31$466,134
Participant contributions at beginning of year2023-12-31$477,463
Participant contributions at end of year2023-12-31$81
Participant contributions at beginning of year2023-12-31$7,268
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2023-12-31$24,823
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2023-12-31$17,327
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Value of net income/loss2023-12-31$1,278,602
Value of net assets at end of year (total assets less liabilities)2023-12-31$8,179,383
Value of net assets at beginning of year (total assets less liabilities)2023-12-31$6,900,781
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-12-31No
Were any leases to which the plan was party in default or uncollectible2023-12-31No
Value of interest in pooled separate accounts at end of year2023-12-31$7,726,887
Value of interest in pooled separate accounts at beginning of year2023-12-31$6,424,132
Income. Interest from loans (other than to participants)2023-12-31$21,951
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2023-12-31$10,859
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2023-12-31$2,086
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2023-12-31$2,086
Net investment gain/loss from pooled separate accounts2023-12-31$1,062,776
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-12-31No
Was there a failure to transmit to the plan any participant contributions2023-12-31Yes
Has the plan failed to provide any benefit when due under the plan2023-12-31No
Contributions received in cash from employer2023-12-31$514,672
Employer contributions (assets) at end of year2023-12-31$245
Employer contributions (assets) at beginning of year2023-12-31$7,159
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-12-31$660,351
Contract administrator fees2023-12-31$65,838
Did the plan have assets held for investment2023-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-12-31No
Opinion of an independent qualified public accountant for this plan2023-12-31Unqualified
Accountancy firm name2023-12-31MOSS ADAMS, LLP
Accountancy firm EIN2023-12-31910189318
Total unrealized appreciation/depreciation of assets2023-01-01$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-01-01$24,823
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-01-01$17,327
Total income from all sources (including contributions)2023-01-01$2,050,974
Total loss/gain on sale of assets2023-01-01$0
Total of all expenses incurred2023-01-01$772,372
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-01-01$660,351
Value of total corrective distributions2023-01-01$13,965
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-01-01$966,247
Value of total assets at end of year2023-01-01$8,204,206
Value of total assets at beginning of year2023-01-01$6,918,108
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-01-01$98,056
Total interest from all sources2023-01-01$21,951
Total dividends received (eg from common stock, registered investment company shares)2023-01-01$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-01-01No
Was this plan covered by a fidelity bond2023-01-01Yes
Value of fidelity bond cover2023-01-01$500,000
If this is an individual account plan, was there a blackout period2023-01-01No
Were there any nonexempt tranactions with any party-in-interest2023-01-01No
Contributions received from participants2023-01-01$451,575
Participant contributions at end of year2023-01-01$466,134
Participant contributions at beginning of year2023-01-01$477,463
Participant contributions at end of year2023-01-01$81
Participant contributions at beginning of year2023-01-01$7,268
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2023-01-01$24,823
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2023-01-01$17,327
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-01-01No
Value of net income/loss2023-01-01$1,278,602
Value of net assets at end of year (total assets less liabilities)2023-01-01$8,179,383
Value of net assets at beginning of year (total assets less liabilities)2023-01-01$6,900,781
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-01-01No
Were any loans by the plan or fixed income obligations due to the plan in default2023-01-01No
Were any leases to which the plan was party in default or uncollectible2023-01-01No
Value of interest in pooled separate accounts at end of year2023-01-01$7,726,887
Value of interest in pooled separate accounts at beginning of year2023-01-01$6,424,132
Income. Interest from loans (other than to participants)2023-01-01$21,951
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2023-01-01$10,859
Net investment gain/loss from pooled separate accounts2023-01-01$1,062,776
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-01-01No
Was there a failure to transmit to the plan any participant contributions2023-01-01Yes
Has the plan failed to provide any benefit when due under the plan2023-01-01No
Contributions received in cash from employer2023-01-01$514,672
Employer contributions (assets) at end of year2023-01-01$245
Employer contributions (assets) at beginning of year2023-01-01$7,159
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-01-01$660,351
Contract administrator fees2023-01-01$65,838
Did the plan have assets held for investment2023-01-01Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-01-01No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-01-01No
Opinion of an independent qualified public accountant for this plan2023-01-011
Accountancy firm name2023-01-01MOSS ADAMS, LLP
Accountancy firm EIN2023-01-01910189318
2022 : TAOS PUEBLO 401(K) PROFIT SHARING 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$17,327
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$22,510
Total income from all sources (including contributions)2022-12-31$-312,627
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$810,777
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$710,700
Value of total corrective distributions2022-12-31$15,241
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$915,479
Value of total assets at end of year2022-12-31$6,918,108
Value of total assets at beginning of year2022-12-31$8,046,695
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$84,836
Total interest from all sources2022-12-31$19,539
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
Administrative expenses professional fees incurred2022-12-31$22,373
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$434,135
Participant contributions at end of year2022-12-31$477,463
Participant contributions at beginning of year2022-12-31$529,861
Participant contributions at end of year2022-12-31$7,268
Participant contributions at beginning of year2022-12-31$2,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$17,327
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$22,510
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-1,123,404
Value of net assets at end of year (total assets less liabilities)2022-12-31$6,900,781
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$8,024,185
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 pooled separate accounts at end of year2022-12-31$6,424,132
Value of interest in pooled separate accounts at beginning of year2022-12-31$7,513,255
Interest on participant loans2022-12-31$19,539
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$2,086
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$0
Net investment gain/loss from pooled separate accounts2022-12-31$-1,247,645
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 contributions2022-12-31Yes
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$481,344
Employer contributions (assets) at end of year2022-12-31$7,159
Employer contributions (assets) at beginning of year2022-12-31$1,579
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$710,700
Contract administrator fees2022-12-31$62,463
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
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31MOSS ADAMS, LLP
Accountancy firm EIN2022-12-31910189318
Total unrealized appreciation/depreciation of assets2022-01-01$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-01$17,327
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-01$22,510
Total income from all sources (including contributions)2022-01-01$-312,627
Total loss/gain on sale of assets2022-01-01$0
Total of all expenses incurred2022-01-01$810,777
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-01-01$710,700
Value of total corrective distributions2022-01-01$15,241
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-01-01$915,479
Value of total assets at end of year2022-01-01$6,918,108
Value of total assets at beginning of year2022-01-01$8,046,695
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-01-01$84,836
Total interest from all sources2022-01-01$19,539
Total dividends received (eg from common stock, registered investment company shares)2022-01-01$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-01-01No
Administrative expenses professional fees incurred2022-01-01$22,373
Was this plan covered by a fidelity bond2022-01-01Yes
Value of fidelity bond cover2022-01-01$500,000
If this is an individual account plan, was there a blackout period2022-01-01No
Were there any nonexempt tranactions with any party-in-interest2022-01-01No
Contributions received from participants2022-01-01$434,135
Participant contributions at end of year2022-01-01$477,463
Participant contributions at beginning of year2022-01-01$529,861
Participant contributions at end of year2022-01-01$7,268
Participant contributions at beginning of year2022-01-01$2,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-01-01$17,327
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-01-01$22,510
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-01-01No
Value of net income/loss2022-01-01$-1,123,404
Value of net assets at end of year (total assets less liabilities)2022-01-01$6,900,781
Value of net assets at beginning of year (total assets less liabilities)2022-01-01$8,024,185
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-01-01No
Were any loans by the plan or fixed income obligations due to the plan in default2022-01-01No
Were any leases to which the plan was party in default or uncollectible2022-01-01No
Value of interest in pooled separate accounts at end of year2022-01-01$6,424,132
Value of interest in pooled separate accounts at beginning of year2022-01-01$7,513,255
Interest on participant loans2022-01-01$19,539
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-01-01$2,086
Net investment gain/loss from pooled separate accounts2022-01-01$-1,247,645
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-01-01No
Was there a failure to transmit to the plan any participant contributions2022-01-01Yes
Has the plan failed to provide any benefit when due under the plan2022-01-01No
Contributions received in cash from employer2022-01-01$481,344
Employer contributions (assets) at end of year2022-01-01$7,159
Employer contributions (assets) at beginning of year2022-01-01$1,579
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-01-01$710,700
Contract administrator fees2022-01-01$62,463
Did the plan have assets held for investment2022-01-01Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-01-01No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-01-01No
Opinion of an independent qualified public accountant for this plan2022-01-011
Accountancy firm name2022-01-01MOSS ADAMS, LLP
Accountancy firm EIN2022-01-01910189318
2021 : TAOS PUEBLO 401(K) PROFIT SHARING PLAN 2021 401k financial data
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$22,510
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$24,134
Total income from all sources (including contributions)2021-12-31$1,864,139
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$901,248
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$801,267
Value of total corrective distributions2021-12-31$22,510
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$946,208
Value of total assets at end of year2021-12-31$8,046,695
Value of total assets at beginning of year2021-12-31$7,085,428
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$77,471
Total interest from all sources2021-12-31$22,867
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
Administrative expenses professional fees incurred2021-12-31$9,616
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
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$441,983
Participant contributions at end of year2021-12-31$529,861
Participant contributions at beginning of year2021-12-31$615,574
Participant contributions at end of year2021-12-31$2,000
Participant contributions at beginning of year2021-12-31$456
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$25,221
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$22,510
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$24,134
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
Value of net income/loss2021-12-31$962,891
Value of net assets at end of year (total assets less liabilities)2021-12-31$8,024,185
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$7,061,294
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
Value of interest in pooled separate accounts at end of year2021-12-31$7,513,255
Value of interest in pooled separate accounts at beginning of year2021-12-31$6,467,211
Interest on participant loans2021-12-31$22,867
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$2,758
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$2,758
Net investment gain/loss from pooled separate accounts2021-12-31$895,064
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$479,004
Employer contributions (assets) at end of year2021-12-31$1,579
Employer contributions (assets) at beginning of year2021-12-31$-571
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$801,267
Contract administrator fees2021-12-31$67,855
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
Opinion of an independent qualified public accountant for this plan2021-12-31Disclaimer
Accountancy firm name2021-12-31LOFTIS & LOVATO GROUP LLC
Accountancy firm EIN2021-12-31843463346

Form 5500 Responses for TAOS PUEBLO 401(K) PROFIT SHARING PLAN

2023: TAOS PUEBLO 401(K) PROFIT SHARING PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement - TrustYes
2022: TAOS PUEBLO 401(K) PROFIT SHARING 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: TAOS PUEBLO 401(K) PROFIT SHARING 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

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number24210
Policy instance 1
Insurance contract or identification number24210
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $34,610
Total amount of fees paid to insurance companyUSD $23,445
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number24210
Policy instance 1
Insurance contract or identification number24210
Number of Individuals Covered214
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $33,463
Total amount of fees paid to insurance companyUSD $21,638
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number24210
Policy instance 1

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