401k Plan data: CHRISTIAN CHURCH HOMES 403(B) PLAN plan

CHRISTIAN CHURCH HOMES 403(B) PLAN 401k Plan overview

Plan Name	CHRISTIAN CHURCH HOMES 403(B) PLAN
Plan identification number	003

CHRISTIAN CHURCH HOMES 403(B) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

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

Company Name: CCH

Employer identification number (EIN): 946077407

NAIC Classification: 531310

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CHRISTIAN CHURCH HOMES 403(B) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2016-07-01 VICKI GABRIEL VICKI GABRIEL 2018-03-28
003 2015-07-01 VICKI GABRIEL
003 2012-07-01 TONI SMITH TONI SMITH 2014-06-17
003 2012-05-01 WINTHROP F MARSHALL WINTHROP F MARSHALL 2013-04-15
003 2012-05-01 WINTHROP F MARSHALL WINTHROP F MARSHALL 2013-04-18

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
003	2016-07-01	VICKI GABRIEL	VICKI GABRIEL	2018-03-28
003	2015-07-01	VICKI GABRIEL
003	2012-07-01	TONI SMITH	TONI SMITH	2014-06-17
003	2012-05-01	WINTHROP F MARSHALL	WINTHROP F MARSHALL	2013-04-15
003	2012-05-01	WINTHROP F MARSHALL	WINTHROP F MARSHALL	2013-04-18

Plan Statistics for CHRISTIAN CHURCH HOMES 403(B) PLAN

401k plan membership statisitcs for CHRISTIAN CHURCH HOMES 403(B) PLAN

Measure Date Value
2016: CHRISTIAN CHURCH HOMES 403(B) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-07-01 185
Total number of active participants reported on line 7a of the Form 5500 2016-07-01 208
Number of retired or separated participants receiving benefits 2016-07-01 1
Number of other retired or separated participants entitled to future benefits 2016-07-01 12
Total of all active and inactive participants 2016-07-01 221
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-07-01 0
Total participants 2016-07-01 221
Number of participants with account balances 2016-07-01 221
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-07-01 0
2015: CHRISTIAN CHURCH HOMES 403(B) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 83
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 161
Number of retired or separated participants receiving benefits 2015-07-01 1
Number of other retired or separated participants entitled to future benefits 2015-07-01 2
Total of all active and inactive participants 2015-07-01 164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-07-01 0
Total participants 2015-07-01 164
Number of participants with account balances 2015-07-01 90
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-07-01 0
2012: CHRISTIAN CHURCH HOMES 403(B) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-07-01 7
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 35
Number of retired or separated participants receiving benefits 2012-07-01 0
Number of other retired or separated participants entitled to future benefits 2012-07-01 0
Total of all active and inactive participants 2012-07-01 35
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-07-01 0
Total participants 2012-07-01 35
Number of participants with account balances 2012-07-01 30
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-07-01 1
Total participants, beginning-of-year 2012-05-01 0
Total number of active participants reported on line 7a of the Form 5500 2012-05-01 7
Number of retired or separated participants receiving benefits 2012-05-01 0
Number of other retired or separated participants entitled to future benefits 2012-05-01 0
Total of all active and inactive participants 2012-05-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-05-01 0
Total participants 2012-05-01 7
Number of participants with account balances 2012-05-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-05-01 0

Measure	Date	Value
2016: CHRISTIAN CHURCH HOMES 403(B) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-07-01	185
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	208
Number of retired or separated participants receiving benefits	2016-07-01	1
Number of other retired or separated participants entitled to future benefits	2016-07-01	12
Total of all active and inactive participants	2016-07-01	221
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-07-01	0
Total participants	2016-07-01	221
Number of participants with account balances	2016-07-01	221
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-07-01	0
2015: CHRISTIAN CHURCH HOMES 403(B) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	83
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	161
Number of retired or separated participants receiving benefits	2015-07-01	1
Number of other retired or separated participants entitled to future benefits	2015-07-01	2
Total of all active and inactive participants	2015-07-01	164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-07-01	0
Total participants	2015-07-01	164
Number of participants with account balances	2015-07-01	90
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-07-01	0
2012: CHRISTIAN CHURCH HOMES 403(B) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-07-01	7
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	35
Number of retired or separated participants receiving benefits	2012-07-01	0
Number of other retired or separated participants entitled to future benefits	2012-07-01	0
Total of all active and inactive participants	2012-07-01	35
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-07-01	0
Total participants	2012-07-01	35
Number of participants with account balances	2012-07-01	30
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-07-01	1
Total participants, beginning-of-year	2012-05-01	0
Total number of active participants reported on line 7a of the Form 5500	2012-05-01	7
Number of retired or separated participants receiving benefits	2012-05-01	0
Number of other retired or separated participants entitled to future benefits	2012-05-01	0
Total of all active and inactive participants	2012-05-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-05-01	0
Total participants	2012-05-01	7
Number of participants with account balances	2012-05-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-05-01	0

Financial Data on CHRISTIAN CHURCH HOMES 403(B) PLAN

Measure	Date	Value
2017 : CHRISTIAN CHURCH HOMES 403(B) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-06-30	$0
Total transfer of assets to this plan	2017-06-30	$23,314
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-06-30	$0
Total income from all sources (including contributions)	2017-06-30	$1,451,171
Total loss/gain on sale of assets	2017-06-30	$0
Total of all expenses incurred	2017-06-30	$178,269
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-06-30	$146,647
Expenses. Certain deemed distributions of participant loans	2017-06-30	$5,390
Value of total corrective distributions	2017-06-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-06-30	$1,261,677
Value of total assets at end of year	2017-06-30	$2,732,781
Value of total assets at beginning of year	2017-06-30	$1,436,565
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-06-30	$26,232
Total interest from all sources	2017-06-30	$8,397
Total dividends received (eg from common stock, registered investment company shares)	2017-06-30	$66,541
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-06-30	$66,541
Administrative expenses professional fees incurred	2017-06-30	$0
Was this plan covered by a fidelity bond	2017-06-30	No
If this is an individual account plan, was there a blackout period	2017-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2017-06-30	No
Contributions received from participants	2017-06-30	$463,519
Participant contributions at end of year	2017-06-30	$81,375
Participant contributions at beginning of year	2017-06-30	$40,049
Assets. Other investments not covered elsewhere at end of year	2017-06-30	$0
Assets. Other investments not covered elsewhere at beginning of year	2017-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2017-06-30	$91,827
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2017-06-30	$0
Other income not declared elsewhere	2017-06-30	$0
Administrative expenses (other) incurred	2017-06-30	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-06-30	No
Value of net income/loss	2017-06-30	$1,272,902
Value of net assets at end of year (total assets less liabilities)	2017-06-30	$2,732,781
Value of net assets at beginning of year (total assets less liabilities)	2017-06-30	$1,436,565
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-06-30	No
Were any leases to which the plan was party in default or uncollectible	2017-06-30	No
Investment advisory and management fees	2017-06-30	$21,732
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-06-30	$2,189,394
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-06-30	$1,059,512
Value of interest in pooled separate accounts at end of year	2017-06-30	$0
Value of interest in pooled separate accounts at beginning of year	2017-06-30	$0
Interest on participant loans	2017-06-30	$1,911
Interest earned on other investments	2017-06-30	$6,486
Value of interest in common/collective trusts at end of year	2017-06-30	$0
Value of interest in common/collective trusts at beginning of year	2017-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-06-30	$462,012
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-06-30	$337,004
Expenses. Payments to insurance carriers foe the provision of benefits	2017-06-30	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-06-30	$114,556
Net investment gain/loss from pooled separate accounts	2017-06-30	$0
Net investment gain or loss from common/collective trusts	2017-06-30	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-06-30	Yes
Was there a failure to transmit to the plan any participant contributions	2017-06-30	No
Has the plan failed to provide any benefit when due under the plan	2017-06-30	No
Assets. Invements in employer securities at end of year	2017-06-30	$0
Assets. Invements in employer securities at beginning of year	2017-06-30	$0
Contributions received in cash from employer	2017-06-30	$706,331
Income. Dividends from common stock	2017-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-06-30	$146,647
Contract administrator fees	2017-06-30	$4,500
Did the plan have assets held for investment	2017-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2017-06-30	Disclaimer
2016 : CHRISTIAN CHURCH HOMES 403(B) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-06-30	$0
Total income from all sources (including contributions)	2016-06-30	$554,348
Total loss/gain on sale of assets	2016-06-30	$0
Total of all expenses incurred	2016-06-30	$163,971
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-06-30	$139,637
Expenses. Certain deemed distributions of participant loans	2016-06-30	$6,473
Value of total corrective distributions	2016-06-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-06-30	$563,801
Value of total assets at end of year	2016-06-30	$1,436,565
Value of total assets at beginning of year	2016-06-30	$1,046,188
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-06-30	$17,861
Total interest from all sources	2016-06-30	$5,094
Total dividends received (eg from common stock, registered investment company shares)	2016-06-30	$43,033
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-06-30	$43,033
Administrative expenses professional fees incurred	2016-06-30	$0
Was this plan covered by a fidelity bond	2016-06-30	No
If this is an individual account plan, was there a blackout period	2016-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2016-06-30	No
Contributions received from participants	2016-06-30	$199,890
Participant contributions at end of year	2016-06-30	$40,049
Participant contributions at beginning of year	2016-06-30	$43,356
Assets. Other investments not covered elsewhere at end of year	2016-06-30	$0
Assets. Other investments not covered elsewhere at beginning of year	2016-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-06-30	$78,160
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2016-06-30	$0
Other income not declared elsewhere	2016-06-30	$0
Administrative expenses (other) incurred	2016-06-30	$125
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-06-30	No
Value of net income/loss	2016-06-30	$390,377
Value of net assets at end of year (total assets less liabilities)	2016-06-30	$1,436,565
Value of net assets at beginning of year (total assets less liabilities)	2016-06-30	$1,046,188
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-06-30	No
Were any leases to which the plan was party in default or uncollectible	2016-06-30	No
Investment advisory and management fees	2016-06-30	$15,206
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-06-30	$1,059,512
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-06-30	$886,317
Value of interest in pooled separate accounts at end of year	2016-06-30	$0
Value of interest in pooled separate accounts at beginning of year	2016-06-30	$0
Interest on participant loans	2016-06-30	$1,746
Interest earned on other investments	2016-06-30	$3,348
Value of interest in common/collective trusts at end of year	2016-06-30	$0
Value of interest in common/collective trusts at beginning of year	2016-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-06-30	$337,004
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-06-30	$116,515
Expenses. Payments to insurance carriers foe the provision of benefits	2016-06-30	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-06-30	$-57,580
Net investment gain/loss from pooled separate accounts	2016-06-30	$0
Net investment gain or loss from common/collective trusts	2016-06-30	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-06-30	No
Was there a failure to transmit to the plan any participant contributions	2016-06-30	No
Has the plan failed to provide any benefit when due under the plan	2016-06-30	No
Assets. Invements in employer securities at end of year	2016-06-30	$0
Assets. Invements in employer securities at beginning of year	2016-06-30	$0
Contributions received in cash from employer	2016-06-30	$285,751
Income. Dividends from common stock	2016-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-06-30	$139,637
Contract administrator fees	2016-06-30	$2,530
Did the plan have assets held for investment	2016-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-06-30	No
Opinion of an independent qualified public accountant for this plan	2016-06-30	Disclaimer
2013 : CHRISTIAN CHURCH HOMES 403(B) PLAN 2013 401k financial data
Total income from all sources	2013-06-30	$292,084
Expenses. Total of all expenses incurred	2013-06-30	$4,317
Benefits paid (including direct rollovers)	2013-06-30	$1,637
Total plan assets at end of year	2013-06-30	$293,202
Total plan assets at beginning of year	2013-06-30	$5,435
Total contributions received or receivable from participants	2013-06-30	$46,328
Expenses. Other expenses not covered elsewhere	2013-06-30	$0
Contributions received from other sources (not participants or employers)	2013-06-30	$174,459
Other income received	2013-06-30	$5,325
Net income (gross income less expenses)	2013-06-30	$287,767
Net plan assets at end of year (total assets less liabilities)	2013-06-30	$293,202
Net plan assets at beginning of year (total assets less liabilities)	2013-06-30	$5,435
Assets. Value of participant loans	2013-06-30	$25,498
Total contributions received or receivable from employer(s)	2013-06-30	$65,972
Value of certain deemed distributions of participant loans	2013-06-30	$0
Value of corrective distributions	2013-06-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2013-06-30	$2,680
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-06-30	$0
2012 : CHRISTIAN CHURCH HOMES 403(B) PLAN 2012 401k financial data
Total income from all sources	2012-06-30	$5,439
Expenses. Total of all expenses incurred	2012-06-30	$4
Benefits paid (including direct rollovers)	2012-06-30	$0
Total plan assets at end of year	2012-06-30	$5,435
Total plan assets at beginning of year	2012-06-30	$0
Value of fidelity bond covering the plan	2012-06-30	$500,000
Total contributions received or receivable from participants	2012-06-30	$3,457
Expenses. Other expenses not covered elsewhere	2012-06-30	$0
Contributions received from other sources (not participants or employers)	2012-06-30	$0
Other income received	2012-06-30	$50
Net income (gross income less expenses)	2012-06-30	$5,435
Net plan assets at end of year (total assets less liabilities)	2012-06-30	$5,435
Net plan assets at beginning of year (total assets less liabilities)	2012-06-30	$0
Total contributions received or receivable from employer(s)	2012-06-30	$1,932
Value of certain deemed distributions of participant loans	2012-06-30	$0
Value of corrective distributions	2012-06-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2012-06-30	$4

Form 5500 Responses for CHRISTIAN CHURCH HOMES 403(B) PLAN

2016: CHRISTIAN CHURCH HOMES 403(B) PLAN 2016 form 5500 responses
2016-07-01	Type of plan entity	Single employer plan
2016-07-01	Submission has been amended	No
2016-07-01	This submission is the final filing	No
2016-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-07-01	Plan is a collectively bargained plan	No
2016-07-01	Plan funding arrangement – Insurance	Yes
2016-07-01	Plan funding arrangement – Trust	Yes
2016-07-01	Plan benefit arrangement – Insurance	Yes
2016-07-01	Plan benefit arrangement - Trust	Yes
2015: CHRISTIAN CHURCH HOMES 403(B) PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	Submission has been amended	No
2015-07-01	This submission is the final filing	No
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-07-01	Plan is a collectively bargained plan	No
2015-07-01	Plan funding arrangement – Insurance	Yes
2015-07-01	Plan funding arrangement – Trust	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement - Trust	Yes
2012: CHRISTIAN CHURCH HOMES 403(B) PLAN 2012 form 5500 responses
2012-07-01	Type of plan entity	Single employer plan
2012-07-01	Submission has been amended	No
2012-07-01	This submission is the final filing	No
2012-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-07-01	Plan is a collectively bargained plan	No
2012-07-01	Plan funding arrangement – Insurance	Yes
2012-07-01	Plan funding arrangement – Trust	Yes
2012-07-01	Plan benefit arrangement – Insurance	Yes
2012-07-01	Plan benefit arrangement - Trust	Yes
2012-05-01	Type of plan entity	Single employer plan
2012-05-01	First time form 5500 has been submitted	Yes
2012-05-01	Submission has been amended	No
2012-05-01	This submission is the final filing	No
2012-05-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2012-05-01	Plan is a collectively bargained plan	No
2012-05-01	Plan funding arrangement – Insurance	Yes
2012-05-01	Plan funding arrangement – Trust	Yes
2012-05-01	Plan benefit arrangement – Insurance	Yes
2012-05-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 60847

Policy instance

Insurance contract or identification number	MR 60847
Number of Individuals Covered	164
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 60847

Policy instance

Insurance contract or identification number	MR 60847
Number of Individuals Covered	35
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $8
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8
Insurance broker organization code?	1
Insurance broker name	LPL FINANCIAL CORPORATION

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 60847

Policy instance

Insurance contract or identification number	MR 60847
Number of Individuals Covered	7
Insurance policy start date	2012-05-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	CCH
Employer identification number (EIN):	946077407
NAIC Classification:	531310