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THE WHOLE CHILD 401(K) PLAN 401k Plan overview

Plan NameTHE WHOLE CHILD 401(K) PLAN
Plan identification number 001

THE WHOLE CHILD 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • 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.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • 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

THE WHOLE CHILD has sponsored the creation of one or more 401k plans.

Company Name:THE WHOLE CHILD
Employer identification number (EIN):952031148
NAIC Classification:621330
NAIC Description:Offices of Mental Health Practitioners (except Physicians)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE WHOLE CHILD 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012021-07-01TRACY WEST-GRUBB2023-04-12
0012020-07-01DENISE CLAVESILLA2022-04-12
0012019-07-01CONSTANZA PACHON2021-04-14
0012018-07-01FRANZ JORDAN2020-07-05
0012017-07-01
0012016-07-01
0012015-07-01
0012014-07-01
0012013-07-01
0012012-07-01DIANE HEBERT2014-01-27
0012011-07-01DIANE HEBERT2013-04-10
0012010-07-01JAN RICCIARDELLI2012-04-16

Plan Statistics for THE WHOLE CHILD 401(K) PLAN

401k plan membership statisitcs for THE WHOLE CHILD 401(K) PLAN

Measure Date Value
2021: THE WHOLE CHILD 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-01196
Total number of active participants reported on line 7a of the Form 55002021-07-01151
Number of retired or separated participants receiving benefits2021-07-010
Number of other retired or separated participants entitled to future benefits2021-07-0148
Total of all active and inactive participants2021-07-01199
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-07-010
Total participants2021-07-01199
Number of participants with account balances2021-07-01127
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-07-010
2020: THE WHOLE CHILD 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-07-01199
Total number of active participants reported on line 7a of the Form 55002020-07-01152
Number of retired or separated participants receiving benefits2020-07-010
Number of other retired or separated participants entitled to future benefits2020-07-0156
Total of all active and inactive participants2020-07-01208
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-07-010
Total participants2020-07-01208
Number of participants with account balances2020-07-01130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-07-010
2019: THE WHOLE CHILD 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-01168
Total number of active participants reported on line 7a of the Form 55002019-07-01153
Number of retired or separated participants receiving benefits2019-07-010
Number of other retired or separated participants entitled to future benefits2019-07-0144
Total of all active and inactive participants2019-07-01197
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-07-010
Total participants2019-07-01197
Number of participants with account balances2019-07-01128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-07-010
2018: THE WHOLE CHILD 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-07-01125
Total number of active participants reported on line 7a of the Form 55002018-07-01128
Number of retired or separated participants receiving benefits2018-07-010
Number of other retired or separated participants entitled to future benefits2018-07-0136
Total of all active and inactive participants2018-07-01164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-07-010
Total participants2018-07-01164
Number of participants with account balances2018-07-01101
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-07-010

Financial Data on THE WHOLE CHILD 401(K) PLAN

Measure Date Value
2022 : THE WHOLE CHILD 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-06-30$1
Total income from all sources (including contributions)2022-06-30$-160,330
Total loss/gain on sale of assets2022-06-30$0
Total of all expenses incurred2022-06-30$291,716
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-06-30$285,777
Value of total corrective distributions2022-06-30$4,621
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-06-30$609,834
Value of total assets at end of year2022-06-30$4,537,104
Value of total assets at beginning of year2022-06-30$4,989,151
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-06-30$1,318
Total interest from all sources2022-06-30$-770,164
Total dividends received (eg from common stock, registered investment company shares)2022-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-06-30No
Was this plan covered by a fidelity bond2022-06-30Yes
Value of fidelity bond cover2022-06-30$200,000
If this is an individual account plan, was there a blackout period2022-06-30No
Were there any nonexempt tranactions with any party-in-interest2022-06-30No
Contributions received from participants2022-06-30$392,879
Participant contributions at end of year2022-06-30$65,969
Participant contributions at beginning of year2022-06-30$39,964
Administrative expenses (other) incurred2022-06-30$1,318
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-06-30No
Value of net income/loss2022-06-30$-452,046
Value of net assets at end of year (total assets less liabilities)2022-06-30$4,537,104
Value of net assets at beginning of year (total assets less liabilities)2022-06-30$4,989,150
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2022-06-30No
Were any leases to which the plan was party in default or uncollectible2022-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-06-30$51,497
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-06-30$51,410
Value of interest in pooled separate accounts at end of year2022-06-30$4,419,638
Value of interest in pooled separate accounts at beginning of year2022-06-30$4,897,777
Interest on participant loans2022-06-30$2,831
Interest earned on other investments2022-06-30$125
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-06-30$-773,120
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-06-30No
Was there a failure to transmit to the plan any participant contributions2022-06-30No
Has the plan failed to provide any benefit when due under the plan2022-06-30No
Contributions received in cash from employer2022-06-30$216,955
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-06-30$285,777
Did the plan have assets held for investment2022-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-06-30No
Liabilities. Value of acquisition indebtedness at beginning of year2022-06-30$1
Opinion of an independent qualified public accountant for this plan2022-06-30Unqualified
Accountancy firm name2022-06-30HARRINGTON GROUP, CPA, LLP
Accountancy firm EIN2022-06-30954557617
2021 : THE WHOLE CHILD 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-06-30$0
Total income from all sources (including contributions)2021-06-30$1,748,662
Total loss/gain on sale of assets2021-06-30$0
Total of all expenses incurred2021-06-30$148,934
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-06-30$139,478
Value of total corrective distributions2021-06-30$8,337
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-06-30$598,223
Value of total assets at end of year2021-06-30$4,988,864
Value of total assets at beginning of year2021-06-30$3,389,136
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-06-30$1,119
Total interest from all sources2021-06-30$1,150,439
Total dividends received (eg from common stock, registered investment company shares)2021-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-06-30No
Was this plan covered by a fidelity bond2021-06-30Yes
Value of fidelity bond cover2021-06-30$200,000
If this is an individual account plan, was there a blackout period2021-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-06-30$0
Were there any nonexempt tranactions with any party-in-interest2021-06-30No
Contributions received from participants2021-06-30$395,057
Participant contributions at end of year2021-06-30$39,678
Participant contributions at beginning of year2021-06-30$56,717
Participant contributions at beginning of year2021-06-30$11,427
Administrative expenses (other) incurred2021-06-30$1,119
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-06-30No
Value of net income/loss2021-06-30$1,599,728
Value of net assets at end of year (total assets less liabilities)2021-06-30$4,988,864
Value of net assets at beginning of year (total assets less liabilities)2021-06-30$3,389,136
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2021-06-30No
Were any leases to which the plan was party in default or uncollectible2021-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-06-30$51,410
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-06-30$37,971
Value of interest in pooled separate accounts at end of year2021-06-30$4,897,776
Value of interest in pooled separate accounts at beginning of year2021-06-30$3,272,434
Interest on participant loans2021-06-30$1,941
Interest earned on other investments2021-06-30$605
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-06-30$1,147,893
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-06-30No
Was there a failure to transmit to the plan any participant contributions2021-06-30No
Has the plan failed to provide any benefit when due under the plan2021-06-30No
Contributions received in cash from employer2021-06-30$203,166
Employer contributions (assets) at beginning of year2021-06-30$10,587
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-06-30$139,478
Did the plan have assets held for investment2021-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-06-30No
2020 : THE WHOLE CHILD 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-06-30$0
Total income from all sources (including contributions)2020-06-30$709,388
Total loss/gain on sale of assets2020-06-30$0
Total of all expenses incurred2020-06-30$115,492
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-06-30$112,313
Expenses. Certain deemed distributions of participant loans2020-06-30$1,535
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-06-30$635,594
Value of total assets at end of year2020-06-30$3,389,136
Value of total assets at beginning of year2020-06-30$2,795,240
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-06-30$1,644
Total interest from all sources2020-06-30$52,378
Total dividends received (eg from common stock, registered investment company shares)2020-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-06-30No
Was this plan covered by a fidelity bond2020-06-30Yes
Value of fidelity bond cover2020-06-30$200,000
If this is an individual account plan, was there a blackout period2020-06-30No
Were there any nonexempt tranactions with any party-in-interest2020-06-30No
Contributions received from participants2020-06-30$331,257
Participant contributions at end of year2020-06-30$56,717
Participant contributions at beginning of year2020-06-30$24,366
Participant contributions at end of year2020-06-30$11,427
Participant contributions at beginning of year2020-06-30$11,427
Income. Received or receivable in cash from other sources (including rollovers)2020-06-30$122,103
Administrative expenses (other) incurred2020-06-30$1,644
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-06-30No
Income. Non cash contributions2020-06-30$0
Value of net income/loss2020-06-30$593,896
Value of net assets at end of year (total assets less liabilities)2020-06-30$3,389,136
Value of net assets at beginning of year (total assets less liabilities)2020-06-30$2,795,240
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2020-06-30No
Were any leases to which the plan was party in default or uncollectible2020-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-06-30$37,971
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-06-30$37,298
Value of interest in pooled separate accounts at end of year2020-06-30$3,272,434
Value of interest in pooled separate accounts at beginning of year2020-06-30$2,703,351
Interest on participant loans2020-06-30$2,014
Interest earned on other investments2020-06-30$598
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-06-30$49,766
Net investment gain/loss from pooled separate accounts2020-06-30$21,416
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-06-30No
Was there a failure to transmit to the plan any participant contributions2020-06-30No
Has the plan failed to provide any benefit when due under the plan2020-06-30No
Contributions received in cash from employer2020-06-30$182,234
Employer contributions (assets) at end of year2020-06-30$10,587
Employer contributions (assets) at beginning of year2020-06-30$18,798
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-06-30$112,313
Did the plan have assets held for investment2020-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-06-30Yes
Opinion of an independent qualified public accountant for this plan2020-06-30Disclaimer
Accountancy firm name2020-06-30HARRINGTON GROUP, CPA, LLP
Accountancy firm EIN2020-06-30954557617
2019 : THE WHOLE CHILD 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-06-30$0
Total income from all sources (including contributions)2019-06-30$514,164
Total loss/gain on sale of assets2019-06-30$0
Total of all expenses incurred2019-06-30$234,953
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-06-30$231,217
Expenses. Certain deemed distributions of participant loans2019-06-30$2,262
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-06-30$409,009
Value of total assets at end of year2019-06-30$2,795,240
Value of total assets at beginning of year2019-06-30$2,516,029
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-06-30$1,474
Total interest from all sources2019-06-30$1,042
Total dividends received (eg from common stock, registered investment company shares)2019-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-06-30No
Was this plan covered by a fidelity bond2019-06-30Yes
Value of fidelity bond cover2019-06-30$200,000
If this is an individual account plan, was there a blackout period2019-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-06-30$0
Were there any nonexempt tranactions with any party-in-interest2019-06-30No
Contributions received from participants2019-06-30$257,080
Participant contributions at end of year2019-06-30$24,366
Participant contributions at beginning of year2019-06-30$12,904
Participant contributions at end of year2019-06-30$11,427
Participant contributions at beginning of year2019-06-30$10,031
Income. Received or receivable in cash from other sources (including rollovers)2019-06-30$3,640
Administrative expenses (other) incurred2019-06-30$1,474
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-06-30No
Value of net income/loss2019-06-30$279,211
Value of net assets at end of year (total assets less liabilities)2019-06-30$2,795,240
Value of net assets at beginning of year (total assets less liabilities)2019-06-30$2,516,029
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2019-06-30No
Were any leases to which the plan was party in default or uncollectible2019-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-06-30$37,298
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-06-30$79,035
Value of interest in pooled separate accounts at end of year2019-06-30$2,703,351
Value of interest in pooled separate accounts at beginning of year2019-06-30$2,394,647
Interest on participant loans2019-06-30$320
Interest earned on other investments2019-06-30$722
Net investment gain/loss from pooled separate accounts2019-06-30$104,113
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-06-30No
Was there a failure to transmit to the plan any participant contributions2019-06-30No
Has the plan failed to provide any benefit when due under the plan2019-06-30No
Contributions received in cash from employer2019-06-30$148,289
Employer contributions (assets) at end of year2019-06-30$18,798
Employer contributions (assets) at beginning of year2019-06-30$19,412
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-06-30$231,217
Did the plan have assets held for investment2019-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-06-30Yes
Opinion of an independent qualified public accountant for this plan2019-06-30Disclaimer
Accountancy firm name2019-06-30HARRINGTON GROUP, CPA, LLP
Accountancy firm EIN2019-06-30954557617

Form 5500 Responses for THE WHOLE CHILD 401(K) PLAN

2021: THE WHOLE CHILD 401(K) PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Submission has been amendedNo
2021-07-01This submission is the final filingNo
2021-07-01This return/report is a short plan year return/report (less than 12 months)No
2021-07-01Plan is a collectively bargained planNo
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan funding arrangement – TrustYes
2021-07-01Plan benefit arrangement – InsuranceYes
2021-07-01Plan benefit arrangement - TrustYes
2020: THE WHOLE CHILD 401(K) PLAN 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Submission has been amendedNo
2020-07-01This submission is the final filingNo
2020-07-01This return/report is a short plan year return/report (less than 12 months)No
2020-07-01Plan is a collectively bargained planNo
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – TrustYes
2020-07-01Plan benefit arrangement – InsuranceYes
2020-07-01Plan benefit arrangement - TrustYes
2019: THE WHOLE CHILD 401(K) PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Submission has been amendedNo
2019-07-01This submission is the final filingNo
2019-07-01This return/report is a short plan year return/report (less than 12 months)No
2019-07-01Plan is a collectively bargained planNo
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan funding arrangement – TrustYes
2019-07-01Plan benefit arrangement – InsuranceYes
2019-07-01Plan benefit arrangement - TrustYes
2018: THE WHOLE CHILD 401(K) PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Submission has been amendedNo
2018-07-01This submission is the final filingNo
2018-07-01This return/report is a short plan year return/report (less than 12 months)No
2018-07-01Plan is a collectively bargained planNo
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan funding arrangement – TrustYes
2018-07-01Plan benefit arrangement – InsuranceYes
2018-07-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number757237-01
Policy instance 1
Insurance contract or identification number757237-01
Number of Individuals Covered140
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $574
Total amount of fees paid to insurance companyUSD $0
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?Yes
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
Other information about contractGROUP ANNUITY CONTRACT
Commission paid to Insurance BrokerUSD $574
Insurance broker organization code?3
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number839440
Policy instance 1
Insurance contract or identification number839440
Number of Individuals Covered133
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $12,051
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
Amount paid for insurance broker fees12051
Insurance broker organization code?3
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number839440
Policy instance 1
Insurance contract or identification number839440
Number of Individuals Covered128
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $10,501
Total amount of fees paid to insurance companyUSD $0
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
Commission paid to Insurance BrokerUSD $10,501
Insurance broker organization code?3
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number839440
Policy instance 1
Insurance contract or identification number839440
Number of Individuals Covered114
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $8,022
Total amount of fees paid to insurance companyUSD $0
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
Commission paid to Insurance BrokerUSD $8,022
Insurance broker organization code?3

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