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ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 401k Plan overview

Plan NameST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN
Plan identification number 001

ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) 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
  • 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

ST. LUKES EMERGENCY CARE GROUP, LLC has sponsored the creation of one or more 401k plans.

Company Name:ST. LUKES EMERGENCY CARE GROUP, LLC
Employer identification number (EIN):900315590
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01KATHERINE V. CONSIDINE, MD2023-03-17 KATHERINE V. CONSIDINE, MD2023-03-17
0012021-01-01KATHERINE V. CONSIDINE2022-02-23 KATHERINE V. CONSIDINE2022-02-23
0012020-01-01KATHERINE V. CONSIDINE, MD2021-03-15 KATHERINE V. CONSIDINE, MD2021-03-15
0012019-01-01KATHERINE V. CONSIDINE, MD2020-02-25 KATHERINE V. CONSIDINE, MD2020-02-25
0012019-01-01KATHERINE V. CONSIDINE, MD2021-02-26 KATHERINE V. CONSIDINE, MD2021-02-26
0012018-01-01
0012017-01-01
0012016-01-01
0012015-01-01
0012014-01-01
0012013-01-01
0012012-01-01KATHERINE V. CONSIDINE, MD KATHERINE V. CONSIDINE, MD2013-05-28

Plan Statistics for ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN

401k plan membership statisitcs for ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN

Measure Date Value
2022: ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-018
Total number of active participants reported on line 7a of the Form 55002022-01-010
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-010
Number of participants with account balances2022-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0110
Total number of active participants reported on line 7a of the Form 55002021-01-011
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-017
Total of all active and inactive participants2021-01-018
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-018
Number of participants with account balances2021-01-018
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0111
Total number of active participants reported on line 7a of the Form 55002020-01-0110
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-0110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-0110
Number of participants with account balances2020-01-018
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0110
Total number of active participants reported on line 7a of the Form 55002019-01-0110
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-011
Total of all active and inactive participants2019-01-0111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0111
Number of participants with account balances2019-01-019
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-019
Total number of active participants reported on line 7a of the Form 55002018-01-019
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 participants2018-01-019
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-019
Number of participants with account balances2018-01-018
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-019
Total number of active participants reported on line 7a of the Form 55002017-01-019
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-011
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 balances2017-01-018
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-011
2016: ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-016
Total number of active participants reported on line 7a of the Form 55002016-01-017
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-017
Number of participants with account balances2016-01-016
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-015
Total number of active participants reported on line 7a of the Form 55002015-01-016
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-016
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-016
Number of participants with account balances2015-01-015
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-015
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 benefits2014-01-010
Total of all active and inactive participants2014-01-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-015
Number of participants with account balances2014-01-014
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-015
Total number of active participants reported on line 7a of the Form 55002013-01-015
Total of all active and inactive participants2013-01-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-015
Number of participants with account balances2013-01-014
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-010
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 benefits2012-01-010
Total of all active and inactive participants2012-01-015
Total participants2012-01-015
Number of participants with account balances2012-01-014
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010

Financial Data on ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN

Measure Date Value
2022 : ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2022 401k financial data
Total plan liabilities at end of year2022-12-31$0
Total plan liabilities at beginning of year2022-12-31$0
Total income from all sources2022-12-31$-48,375
Expenses. Total of all expenses incurred2022-12-31$967,158
Benefits paid (including direct rollovers)2022-12-31$966,133
Total plan assets at end of year2022-12-31$0
Total plan assets at beginning of year2022-12-31$1,015,533
Value of fidelity bond covering the plan2022-12-31$100,000
Total contributions received or receivable from participants2022-12-31$27,000
Other income received2022-12-31$-95,499
Net income (gross income less expenses)2022-12-31$-1,015,533
Net plan assets at end of year (total assets less liabilities)2022-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$1,015,533
Total contributions received or receivable from employer(s)2022-12-31$20,124
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$1,025
2021 : ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2021 401k financial data
Total income from all sources2021-12-31$166,064
Expenses. Total of all expenses incurred2021-12-31$284,138
Benefits paid (including direct rollovers)2021-12-31$283,988
Total plan assets at end of year2021-12-31$1,015,533
Total plan assets at beginning of year2021-12-31$1,133,607
Value of fidelity bond covering the plan2021-12-31$100,000
Total contributions received or receivable from participants2021-12-31$48,586
Other income received2021-12-31$65,983
Net income (gross income less expenses)2021-12-31$-118,074
Net plan assets at end of year (total assets less liabilities)2021-12-31$1,015,533
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$1,133,607
Total contributions received or receivable from employer(s)2021-12-31$51,495
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$150
2020 : ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2020 401k financial data
Total income from all sources2020-12-31$208,414
Expenses. Total of all expenses incurred2020-12-31$299,564
Benefits paid (including direct rollovers)2020-12-31$299,289
Total plan assets at end of year2020-12-31$1,133,607
Total plan assets at beginning of year2020-12-31$1,224,757
Value of fidelity bond covering the plan2020-12-31$100,000
Total contributions received or receivable from participants2020-12-31$48,114
Other income received2020-12-31$102,164
Net income (gross income less expenses)2020-12-31$-91,150
Net plan assets at end of year (total assets less liabilities)2020-12-31$1,133,607
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$1,224,757
Total contributions received or receivable from employer(s)2020-12-31$58,136
Value of corrective distributions2020-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$275
2019 : ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2019 401k financial data
Total income from all sources2019-12-31$280,238
Expenses. Total of all expenses incurred2019-12-31$13,521
Benefits paid (including direct rollovers)2019-12-31$13,371
Total plan assets at end of year2019-12-31$1,220,983
Total plan assets at beginning of year2019-12-31$954,266
Value of fidelity bond covering the plan2019-12-31$100,000
Total contributions received or receivable from participants2019-12-31$53,816
Other income received2019-12-31$162,328
Net income (gross income less expenses)2019-12-31$266,717
Net plan assets at end of year (total assets less liabilities)2019-12-31$1,220,983
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$954,266
Total contributions received or receivable from employer(s)2019-12-31$64,094
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$150
2018 : ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2018 401k financial data
Total income from all sources2018-12-31$94,474
Expenses. Total of all expenses incurred2018-12-31$1,757
Benefits paid (including direct rollovers)2018-12-31$1,757
Total plan assets at end of year2018-12-31$954,266
Total plan assets at beginning of year2018-12-31$861,549
Value of fidelity bond covering the plan2018-12-31$100,000
Total contributions received or receivable from participants2018-12-31$74,057
Other income received2018-12-31$-47,323
Net income (gross income less expenses)2018-12-31$92,717
Net plan assets at end of year (total assets less liabilities)2018-12-31$954,266
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$861,549
Total contributions received or receivable from employer(s)2018-12-31$67,740
2017 : ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2017 401k financial data
Total income from all sources2017-12-31$263,507
Expenses. Total of all expenses incurred2017-12-31$83,024
Benefits paid (including direct rollovers)2017-12-31$82,799
Total plan assets at end of year2017-12-31$861,549
Total plan assets at beginning of year2017-12-31$681,066
Value of fidelity bond covering the plan2017-12-31$100,000
Total contributions received or receivable from participants2017-12-31$62,173
Other income received2017-12-31$170,994
Net income (gross income less expenses)2017-12-31$180,483
Net plan assets at end of year (total assets less liabilities)2017-12-31$861,549
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$681,066
Total contributions received or receivable from employer(s)2017-12-31$30,340
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$225
2016 : ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2016 401k financial data
Total income from all sources2016-12-31$179,245
Expenses. Total of all expenses incurred2016-12-31$0
Total plan assets at end of year2016-12-31$681,066
Total plan assets at beginning of year2016-12-31$501,821
Value of fidelity bond covering the plan2016-12-31$100,000
Total contributions received or receivable from participants2016-12-31$88,461
Other income received2016-12-31$33,438
Net income (gross income less expenses)2016-12-31$179,245
Net plan assets at end of year (total assets less liabilities)2016-12-31$681,066
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$501,821
Total contributions received or receivable from employer(s)2016-12-31$57,346
2015 : ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2015 401k financial data
Total income from all sources2015-12-31$136,996
Expenses. Total of all expenses incurred2015-12-31$0
Total plan assets at end of year2015-12-31$501,821
Total plan assets at beginning of year2015-12-31$364,825
Value of fidelity bond covering the plan2015-12-31$100,000
Total contributions received or receivable from participants2015-12-31$87,027
Other income received2015-12-31$-7,273
Net income (gross income less expenses)2015-12-31$136,996
Net plan assets at end of year (total assets less liabilities)2015-12-31$501,821
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$364,825
Total contributions received or receivable from employer(s)2015-12-31$57,242
2014 : ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2014 401k financial data
Total income from all sources2014-12-31$126,772
Expenses. Total of all expenses incurred2014-12-31$0
Total plan assets at end of year2014-12-31$364,825
Total plan assets at beginning of year2014-12-31$238,053
Value of fidelity bond covering the plan2014-12-31$100,000
Total contributions received or receivable from participants2014-12-31$62,686
Other income received2014-12-31$9,861
Net income (gross income less expenses)2014-12-31$126,772
Net plan assets at end of year (total assets less liabilities)2014-12-31$364,825
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$238,053
Total contributions received or receivable from employer(s)2014-12-31$54,225
2013 : ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2013 401k financial data
Total income from all sources2013-12-31$136,546
Expenses. Total of all expenses incurred2013-12-31$0
Total plan assets at end of year2013-12-31$238,053
Total plan assets at beginning of year2013-12-31$101,507
Total contributions received or receivable from participants2013-12-31$64,560
Other income received2013-12-31$18,492
Net income (gross income less expenses)2013-12-31$136,546
Net plan assets at end of year (total assets less liabilities)2013-12-31$238,053
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$101,507
Total contributions received or receivable from employer(s)2013-12-31$53,494
2012 : ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2012 401k financial data
Total income from all sources2012-12-31$101,507
Total plan assets at end of year2012-12-31$101,507
Total plan assets at beginning of year2012-12-31$0
Total contributions received or receivable from participants2012-12-31$49,870
Other income received2012-12-31$356
Net income (gross income less expenses)2012-12-31$101,507
Net plan assets at end of year (total assets less liabilities)2012-12-31$101,507
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$0
Total contributions received or receivable from employer(s)2012-12-31$51,281

Form 5500 Responses for ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN

2022: ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingYes
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: ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: ST. LUKES EMERGENCY CARE GROUP, LLC 401(K) PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01First time form 5500 has been submittedYes
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number108789
Policy instance 1
Insurance contract or identification number108789
Number of Individuals Covered0
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,804
Total amount of fees paid to insurance companyUSD $875
Commission paid to Insurance BrokerUSD $1,804
Insurance broker organization code?3
Amount paid for insurance broker fees875
Additional information about fees paid to insurance brokerTPA FEES
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number108789
Policy instance 1
Insurance contract or identification number108789
Number of Individuals Covered8
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $2,922
Total amount of fees paid to insurance companyUSD $125
Commission paid to Insurance BrokerUSD $2,922
Insurance broker organization code?3
Amount paid for insurance broker fees125
Additional information about fees paid to insurance brokerTPA FEES
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number108789
Policy instance 1
Insurance contract or identification number108789
Number of Individuals Covered9
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $2,339
Total amount of fees paid to insurance companyUSD $250
Commission paid to Insurance BrokerUSD $2,339
Insurance broker organization code?3
Amount paid for insurance broker fees250
Additional information about fees paid to insurance brokerTPA FEES
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number108789
Policy instance 1
Insurance contract or identification number108789
Number of Individuals Covered10
Insurance policy start date2019-12-05
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $2,613
Total amount of fees paid to insurance companyUSD $125
Commission paid to Insurance BrokerUSD $2,613
Insurance broker organization code?3
Amount paid for insurance broker fees125
Additional information about fees paid to insurance brokerTPA FEES
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number108789
Policy instance 1
Insurance contract or identification number108789
Number of Individuals Covered8
Insurance policy start date2018-12-05
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $2,183
Total amount of fees paid to insurance companyUSD $0
Commission paid to Insurance BrokerUSD $2,183
Insurance broker organization code?3
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number108789
Policy instance 1
Insurance contract or identification number108789
Insurance policy start date2017-12-05
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,851
Total amount of fees paid to insurance companyUSD $200
Commission paid to Insurance BrokerUSD $1,851
Insurance broker organization code?3
Amount paid for insurance broker fees200
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker nameTHOMAS M. BLISS

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