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PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 401k Plan overview

Plan NamePROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C.
Plan identification number 001

PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • Plan covering Self-Employed individuals.
  • 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

JOHN D. MCLAUGHLIN, M.D., P.C. has sponsored the creation of one or more 401k plans.

Company Name:JOHN D. MCLAUGHLIN, M.D., P.C.
Employer identification number (EIN):930749947
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Additional information about JOHN D. MCLAUGHLIN, M.D., P.C.

Jurisdiction of Incorporation: Colorado Department of State
Incorporation Date: 1979-11-30
Company Identification Number: 19871386699
Legal Registered Office Address: 1421 S POTOMAC ST, SUITE 200

AURORA
United States of America (USA)
80012

More information about JOHN D. MCLAUGHLIN, M.D., P.C.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012023-01-01JOHN D MCLAUGHLIN, II2024-10-14
0012022-01-01JOHN D MCLAUGHLIN, II2023-09-25
0012021-01-01JOHN D MCLAUGHLIN, II2022-10-11
0012020-01-01JOHN D MCLAUGHLIN, II2021-10-05
0012019-01-01JOHN D MCLAUGHLIN, II2020-06-18
0012018-01-01JOHN D MCLAUGHLIN, II2019-09-30
0012017-01-01
0012016-01-01
0012015-01-01
0012014-01-01JOHN D MCLAUGHLIN, II
0012013-01-01JOHN D MCLAUGHLIN
0012012-01-01JOHN D MCLAUGHLIN
0012011-01-01JOHN D MCLAUGHLIN
0012010-01-01MARGARET DIEHL FOR CBIZ
0012009-01-01JOHN MCLAUGHLIN
0012009-01-01JOHN MCLAUGHLIN
0012009-01-01JOHN MCLAUGHLIN

Financial Data on PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C.

Measure Date Value
2024 : PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 2024 401k financial data
Total income from all sources2024-01-01$125,787
Expenses. Total of all expenses incurred2024-01-01$200
Total plan assets at end of year2024-01-01$1,566,782
Total plan assets at beginning of year2024-01-01$1,441,195
Value of fidelity bond covering the plan2024-01-01$150,000
Other income received2024-01-01$125,787
Net income (gross income less expenses)2024-01-01$125,587
Net plan assets at end of year (total assets less liabilities)2024-01-01$1,566,782
Net plan assets at beginning of year (total assets less liabilities)2024-01-01$1,441,195
Assets. Value of assets in partnership/joint-venture interests2024-01-01$99,412
Expenses. Administrative service providers (salaries,fees and commissions)2024-01-01$200
2023 : PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 2023 401k financial data
Total income from all sources2023-12-31$117,706
Expenses. Total of all expenses incurred2023-12-31$264
Total plan assets at end of year2023-12-31$1,441,195
Total plan assets at beginning of year2023-12-31$1,323,753
Value of fidelity bond covering the plan2023-12-31$132,376
Other income received2023-12-31$77,706
Net income (gross income less expenses)2023-12-31$117,442
Net plan assets at end of year (total assets less liabilities)2023-12-31$1,441,195
Net plan assets at beginning of year (total assets less liabilities)2023-12-31$1,323,753
Assets. Value of assets in partnership/joint-venture interests2023-12-31$99,039
Total contributions received or receivable from employer(s)2023-12-31$40,000
Expenses. Administrative service providers (salaries,fees and commissions)2023-12-31$264
2022 : PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 2022 401k financial data
Total income from all sources2022-12-31$-229,925
Expenses. Total of all expenses incurred2022-12-31$70
Total plan assets at end of year2022-12-31$1,323,753
Total plan assets at beginning of year2022-12-31$1,553,748
Value of fidelity bond covering the plan2022-12-31$155,375
Other income received2022-12-31$-259,925
Net income (gross income less expenses)2022-12-31$-229,995
Net plan assets at end of year (total assets less liabilities)2022-12-31$1,323,753
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$1,553,748
Assets. Value of assets in partnership/joint-venture interests2022-12-31$98,806
Total contributions received or receivable from employer(s)2022-12-31$30,000
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$70
2021 : PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 2021 401k financial data
Total income from all sources2021-12-31$204,973
Expenses. Total of all expenses incurred2021-12-31$1,138
Total plan assets at end of year2021-12-31$1,553,748
Total plan assets at beginning of year2021-12-31$1,349,913
Value of fidelity bond covering the plan2021-12-31$150,000
Other income received2021-12-31$174,973
Net income (gross income less expenses)2021-12-31$203,835
Net plan assets at end of year (total assets less liabilities)2021-12-31$1,553,748
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$1,349,913
Assets. Value of assets in partnership/joint-venture interests2021-12-31$99,003
Total contributions received or receivable from employer(s)2021-12-31$30,000
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$1,138
2020 : PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 2020 401k financial data
Total income from all sources2020-12-31$143,519
Expenses. Total of all expenses incurred2020-12-31$251,290
Benefits paid (including direct rollovers)2020-12-31$240,731
Total plan assets at end of year2020-12-31$1,349,913
Total plan assets at beginning of year2020-12-31$1,457,684
Value of fidelity bond covering the plan2020-12-31$150,000
Other income received2020-12-31$113,519
Net income (gross income less expenses)2020-12-31$-107,771
Net plan assets at end of year (total assets less liabilities)2020-12-31$1,349,913
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$1,457,684
Assets. Value of assets in partnership/joint-venture interests2020-12-31$99,122
Total contributions received or receivable from employer(s)2020-12-31$30,000
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$10,559
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
2019 : PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 2019 401k financial data
Total income from all sources2019-12-31$287,530
Expenses. Total of all expenses incurred2019-12-31$70
Total plan assets at end of year2019-12-31$1,457,684
Total plan assets at beginning of year2019-12-31$1,170,224
Value of fidelity bond covering the plan2019-12-31$150,000
Other income received2019-12-31$287,530
Net income (gross income less expenses)2019-12-31$287,460
Net plan assets at end of year (total assets less liabilities)2019-12-31$1,457,684
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$1,170,224
Assets. Value of assets in partnership/joint-venture interests2019-12-31$100,000
Value of certain deemed distributions of participant loans2019-12-31$70
2018 : PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 2018 401k financial data
Total income from all sources2018-12-31$-82,311
Expenses. Total of all expenses incurred2018-12-31$70
Total plan assets at end of year2018-12-31$1,170,224
Total plan assets at beginning of year2018-12-31$1,252,605
Value of fidelity bond covering the plan2018-12-31$150,000
Other income received2018-12-31$-82,311
Net income (gross income less expenses)2018-12-31$-82,381
Net plan assets at end of year (total assets less liabilities)2018-12-31$1,170,224
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$1,252,605
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$70
2017 : PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 2017 401k financial data
Total income from all sources2017-12-31$154,030
Expenses. Total of all expenses incurred2017-12-31$0
Total plan assets at end of year2017-12-31$1,252,605
Total plan assets at beginning of year2017-12-31$1,098,575
Value of fidelity bond covering the plan2017-12-31$150,000
Other income received2017-12-31$124,030
Net income (gross income less expenses)2017-12-31$154,030
Net plan assets at end of year (total assets less liabilities)2017-12-31$1,252,605
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$1,098,575
Total contributions received or receivable from employer(s)2017-12-31$30,000
2016 : PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 2016 401k financial data
Total income from all sources2016-12-31$56,145
Expenses. Total of all expenses incurred2016-12-31$38,183
Total plan assets at end of year2016-12-31$1,098,575
Total plan assets at beginning of year2016-12-31$1,080,613
Value of fidelity bond covering the plan2016-12-31$150,000
Other income received2016-12-31$26,145
Net income (gross income less expenses)2016-12-31$17,962
Net plan assets at end of year (total assets less liabilities)2016-12-31$1,098,575
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$1,080,613
Total contributions received or receivable from employer(s)2016-12-31$30,000
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$38,183
2015 : PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 2015 401k financial data
Total income from all sources2015-12-31$10,780
Expenses. Total of all expenses incurred2015-12-31$35
Total plan assets at end of year2015-12-31$1,080,613
Total plan assets at beginning of year2015-12-31$1,069,868
Value of fidelity bond covering the plan2015-12-31$150,000
Other income received2015-12-31$-19,220
Net income (gross income less expenses)2015-12-31$10,745
Net plan assets at end of year (total assets less liabilities)2015-12-31$1,080,613
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$1,069,868
Total contributions received or receivable from employer(s)2015-12-31$30,000
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$35
2014 : PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 2014 401k financial data
Total income from all sources2014-12-31$91,930
Expenses. Total of all expenses incurred2014-12-31$75
Total plan assets at end of year2014-12-31$1,069,868
Total plan assets at beginning of year2014-12-31$978,013
Value of fidelity bond covering the plan2014-12-31$150,000
Expenses. Other expenses not covered elsewhere2014-12-31$75
Other income received2014-12-31$61,930
Net income (gross income less expenses)2014-12-31$91,855
Net plan assets at end of year (total assets less liabilities)2014-12-31$1,069,868
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$978,013
Total contributions received or receivable from employer(s)2014-12-31$30,000
2013 : PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 2013 401k financial data
Total income from all sources2013-12-31$126,164
Expenses. Total of all expenses incurred2013-12-31$0
Total plan assets at end of year2013-12-31$978,013
Total plan assets at beginning of year2013-12-31$851,849
Value of fidelity bond covering the plan2013-12-31$150,000
Other income received2013-12-31$106,164
Net income (gross income less expenses)2013-12-31$126,164
Net plan assets at end of year (total assets less liabilities)2013-12-31$978,013
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$851,849
Total contributions received or receivable from employer(s)2013-12-31$20,000
2012 : PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 2012 401k financial data
Total income from all sources2012-12-31$111,399
Expenses. Total of all expenses incurred2012-12-31$0
Total plan assets at end of year2012-12-31$851,849
Total plan assets at beginning of year2012-12-31$740,450
Value of fidelity bond covering the plan2012-12-31$150,000
Other income received2012-12-31$91,399
Net income (gross income less expenses)2012-12-31$111,399
Net plan assets at end of year (total assets less liabilities)2012-12-31$851,849
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$740,450
Total contributions received or receivable from employer(s)2012-12-31$20,000
2011 : PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 2011 401k financial data
Total income from all sources2011-12-31$39,488
Expenses. Total of all expenses incurred2011-12-31$0
Total plan assets at end of year2011-12-31$740,450
Total plan assets at beginning of year2011-12-31$700,962
Value of fidelity bond covering the plan2011-12-31$150,000
Other income received2011-12-31$9,488
Net income (gross income less expenses)2011-12-31$39,488
Net plan assets at end of year (total assets less liabilities)2011-12-31$740,450
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$700,962
Total contributions received or receivable from employer(s)2011-12-31$30,000
2010 : PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 2010 401k financial data
Total income from all sources2010-12-31$102,261
Expenses. Total of all expenses incurred2010-12-31$35,656
Benefits paid (including direct rollovers)2010-12-31$35,647
Total plan assets at end of year2010-12-31$700,962
Total plan assets at beginning of year2010-12-31$634,357
Value of fidelity bond covering the plan2010-12-31$65,000
Other income received2010-12-31$82,261
Net income (gross income less expenses)2010-12-31$66,605
Net plan assets at end of year (total assets less liabilities)2010-12-31$700,962
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$634,357
Total contributions received or receivable from employer(s)2010-12-31$20,000
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$9

Form 5500 Responses for PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C.

2023: PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 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: PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 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: PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 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: PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 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: PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 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 funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 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 funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 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: PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 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 funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 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: PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 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 funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 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 funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
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 funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 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 – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 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 – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: PROFIT SHARING PLAN OF JOHN D. MCLAUGHLIN, M.D., P.C. 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract numberVR16000597
Policy instance 1
Insurance contract or identification numberVR16000597
Number of Individuals Covered5
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
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?Yes
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract numberVR16000597
Policy instance 1
Insurance contract or identification numberVR16000597
Number of Individuals Covered4
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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?Yes
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract numberVR16000597
Policy instance 1
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract numberVR16000597
Policy instance 1
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract numberVR16000597
Policy instance 1
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number711287966
Policy instance 1
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract numberVR16000597
Policy instance 2
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number711287966
Policy instance 1
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract numberVR16000597
Policy instance 2

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