TAUNTON CAT HOSPITAL has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan TAUNTON CAT HOSPITAL 401(K) PLAN
| Measure | Date | Value |
|---|
| 2017: TAUNTON CAT HOSPITAL 401(K) PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 4 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 0 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
| Total of all active and inactive participants | 2017-01-01 | 0 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2017-01-01 | 0 |
| Total participants | 2017-01-01 | 0 |
| Number of participants with account balances | 2017-01-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2017-01-01 | 0 |
| 2016: TAUNTON CAT HOSPITAL 401(K) PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 4 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 0 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 4 |
| Total of all active and inactive participants | 2016-01-01 | 4 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2016-01-01 | 0 |
| Total participants | 2016-01-01 | 4 |
| Number of participants with account balances | 2016-01-01 | 4 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2016-01-01 | 0 |
| 2015: TAUNTON CAT HOSPITAL 401(K) PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 5 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 4 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
| Total of all active and inactive participants | 2015-01-01 | 4 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2015-01-01 | 0 |
| Total participants | 2015-01-01 | 4 |
| Number of participants with account balances | 2015-01-01 | 4 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2015-01-01 | 0 |
| 2014: TAUNTON CAT HOSPITAL 401(K) PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 5 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 3 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 2 |
| Total of all active and inactive participants | 2014-01-01 | 5 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-01-01 | 0 |
| Total participants | 2014-01-01 | 5 |
| Number of participants with account balances | 2014-01-01 | 5 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2014-01-01 | 1 |
| 2013: TAUNTON CAT HOSPITAL 401(K) PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 5 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 3 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 1 |
| Total of all active and inactive participants | 2013-01-01 | 4 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-01-01 | 0 |
| Total participants | 2013-01-01 | 4 |
| Number of participants with account balances | 2013-01-01 | 4 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-01-01 | 1 |
| 2012: TAUNTON CAT HOSPITAL 401(K) PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 5 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 4 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 1 |
| Total of all active and inactive participants | 2012-01-01 | 5 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-01-01 | 0 |
| Total participants | 2012-01-01 | 5 |
| Number of participants with account balances | 2012-01-01 | 5 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-01-01 | 0 |
| 2011: TAUNTON CAT HOSPITAL 401(K) PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 4 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 2 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 1 |
| Total of all active and inactive participants | 2011-01-01 | 4 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-01-01 | 0 |
| Total participants | 2011-01-01 | 4 |
| Number of participants with account balances | 2011-01-01 | 4 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2011-01-01 | 1 |
| 2010: TAUNTON CAT HOSPITAL 401(K) PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 4 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 4 |
| Number of retired or separated participants receiving benefits | 2010-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2010-01-01 | 0 |
| Total of all active and inactive participants | 2010-01-01 | 4 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2010-01-01 | 0 |
| Total participants | 2010-01-01 | 4 |
| Number of participants with account balances | 2010-01-01 | 4 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2010-01-01 | 0 |
| 2009: TAUNTON CAT HOSPITAL 401(K) PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 3 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 4 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 0 |
| Total of all active and inactive participants | 2009-01-01 | 4 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-01-01 | 0 |
| Total participants | 2009-01-01 | 4 |
| Number of participants with account balances | 2009-01-01 | 4 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-01-01 | 0 |
| Measure | Date | Value |
|---|
| 2017 : TAUNTON CAT HOSPITAL 401(K) PLAN 2017 401k financial data |
|---|
| Total income from all sources | 2017-03-01 | $12,281 |
| Expenses. Total of all expenses incurred | 2017-03-01 | $705,812 |
| Benefits paid (including direct rollovers) | 2017-03-01 | $705,812 |
| Total plan assets at end of year | 2017-03-01 | $0 |
| Total plan assets at beginning of year | 2017-03-01 | $693,531 |
| Value of fidelity bond covering the plan | 2017-03-01 | $70,000 |
| Other income received | 2017-03-01 | $12,281 |
| Net income (gross income less expenses) | 2017-03-01 | $-693,531 |
| Net plan assets at end of year (total assets less liabilities) | 2017-03-01 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-03-01 | $693,531 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2017-03-01 | $0 |
| 2016 : TAUNTON CAT HOSPITAL 401(K) PLAN 2016 401k financial data |
|---|
| Total income from all sources | 2016-12-31 | $125,937 |
| Expenses. Total of all expenses incurred | 2016-12-31 | $86,585 |
| Benefits paid (including direct rollovers) | 2016-12-31 | $86,382 |
| Total plan assets at end of year | 2016-12-31 | $693,531 |
| Total plan assets at beginning of year | 2016-12-31 | $654,179 |
| Value of fidelity bond covering the plan | 2016-12-31 | $66,000 |
| Total contributions received or receivable from participants | 2016-12-31 | $32,132 |
| Other income received | 2016-12-31 | $44,749 |
| Net income (gross income less expenses) | 2016-12-31 | $39,352 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-31 | $693,531 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-31 | $654,179 |
| Total contributions received or receivable from employer(s) | 2016-12-31 | $49,056 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-12-31 | $203 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2016-12-31 | $0 |
| 2015 : TAUNTON CAT HOSPITAL 401(K) PLAN 2015 401k financial data |
|---|
| Total income from all sources | 2015-12-31 | $42,116 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $1,199 |
| Benefits paid (including direct rollovers) | 2015-12-31 | $1,199 |
| Total plan assets at end of year | 2015-12-31 | $654,179 |
| Total plan assets at beginning of year | 2015-12-31 | $613,262 |
| Value of fidelity bond covering the plan | 2015-12-31 | $62,000 |
| Total contributions received or receivable from participants | 2015-12-31 | $33,418 |
| Other income received | 2015-12-31 | $-16,362 |
| Net income (gross income less expenses) | 2015-12-31 | $40,917 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $654,179 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $613,262 |
| Total contributions received or receivable from employer(s) | 2015-12-31 | $25,060 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2015-12-31 | $0 |
| 2014 : TAUNTON CAT HOSPITAL 401(K) PLAN 2014 401k financial data |
|---|
| Total income from all sources | 2014-12-31 | $96,335 |
| Expenses. Total of all expenses incurred | 2014-12-31 | $0 |
| Total plan assets at end of year | 2014-12-31 | $613,262 |
| Total plan assets at beginning of year | 2014-12-31 | $516,927 |
| Value of fidelity bond covering the plan | 2014-12-31 | $52,000 |
| Total contributions received or receivable from participants | 2014-12-31 | $31,025 |
| Other income received | 2014-12-31 | $26,411 |
| Net income (gross income less expenses) | 2014-12-31 | $96,335 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $613,262 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $516,927 |
| Total contributions received or receivable from employer(s) | 2014-12-31 | $38,899 |
| 2013 : TAUNTON CAT HOSPITAL 401(K) PLAN 2013 401k financial data |
|---|
| Total income from all sources | 2013-12-31 | $117,344 |
| Expenses. Total of all expenses incurred | 2013-12-31 | $46,067 |
| Benefits paid (including direct rollovers) | 2013-12-31 | $46,067 |
| Total plan assets at end of year | 2013-12-31 | $516,927 |
| Total plan assets at beginning of year | 2013-12-31 | $445,650 |
| Value of fidelity bond covering the plan | 2013-12-31 | $45,000 |
| Total contributions received or receivable from participants | 2013-12-31 | $30,208 |
| Other income received | 2013-12-31 | $50,826 |
| Net income (gross income less expenses) | 2013-12-31 | $71,277 |
| Net plan assets at end of year (total assets less liabilities) | 2013-12-31 | $516,927 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-12-31 | $445,650 |
| Total contributions received or receivable from employer(s) | 2013-12-31 | $36,310 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2013-12-31 | $0 |
| 2012 : TAUNTON CAT HOSPITAL 401(K) PLAN 2012 401k financial data |
|---|
| Total income from all sources | 2012-12-31 | $105,464 |
| Expenses. Total of all expenses incurred | 2012-12-31 | $210 |
| Benefits paid (including direct rollovers) | 2012-12-31 | $210 |
| Total plan assets at end of year | 2012-12-31 | $445,650 |
| Total plan assets at beginning of year | 2012-12-31 | $340,396 |
| Value of fidelity bond covering the plan | 2012-12-31 | $40,000 |
| Total contributions received or receivable from participants | 2012-12-31 | $29,598 |
| Other income received | 2012-12-31 | $38,764 |
| Net income (gross income less expenses) | 2012-12-31 | $105,254 |
| Net plan assets at end of year (total assets less liabilities) | 2012-12-31 | $445,650 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-12-31 | $340,396 |
| Total contributions received or receivable from employer(s) | 2012-12-31 | $37,102 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2012-12-31 | $0 |
| 2011 : TAUNTON CAT HOSPITAL 401(K) PLAN 2011 401k financial data |
|---|
| Total income from all sources | 2011-12-31 | $56,271 |
| Expenses. Total of all expenses incurred | 2011-12-31 | $2,269 |
| Benefits paid (including direct rollovers) | 2011-12-31 | $2,269 |
| Total plan assets at end of year | 2011-12-31 | $340,396 |
| Total plan assets at beginning of year | 2011-12-31 | $286,394 |
| Value of fidelity bond covering the plan | 2011-12-31 | $40,000 |
| Total contributions received or receivable from participants | 2011-12-31 | $28,789 |
| Other income received | 2011-12-31 | $-10,648 |
| Net income (gross income less expenses) | 2011-12-31 | $54,002 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-31 | $340,396 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-31 | $286,394 |
| Total contributions received or receivable from employer(s) | 2011-12-31 | $38,130 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2011-12-31 | $0 |
| 2010 : TAUNTON CAT HOSPITAL 401(K) PLAN 2010 401k financial data |
|---|
| Total income from all sources | 2010-12-31 | $90,798 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $0 |
| Total plan assets at end of year | 2010-12-31 | $286,394 |
| Total plan assets at beginning of year | 2010-12-31 | $195,596 |
| Value of fidelity bond covering the plan | 2010-12-31 | $30,000 |
| Total contributions received or receivable from participants | 2010-12-31 | $28,366 |
| Other income received | 2010-12-31 | $23,024 |
| Net income (gross income less expenses) | 2010-12-31 | $90,798 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $286,394 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $195,596 |
| Total contributions received or receivable from employer(s) | 2010-12-31 | $39,408 |
| 2017: TAUNTON CAT HOSPITAL 401(K) PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | Yes |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – Trust | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement - Trust | Yes |
| 2016: TAUNTON CAT HOSPITAL 401(K) PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – Trust | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement - Trust | Yes |
| 2015: TAUNTON CAT HOSPITAL 401(K) PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – Trust | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement - Trust | Yes |
| 2014: TAUNTON CAT HOSPITAL 401(K) PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Submission has been amended | No |
| 2014-01-01 | This submission is the final filing | No |
| 2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-01-01 | Plan is a collectively bargained plan | No |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – Trust | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement - Trust | Yes |
| 2013: TAUNTON CAT HOSPITAL 401(K) PLAN 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Submission has been amended | No |
| 2013-01-01 | This submission is the final filing | No |
| 2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-01-01 | Plan is a collectively bargained plan | No |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – Trust | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement - Trust | Yes |
| 2012: TAUNTON CAT HOSPITAL 401(K) PLAN 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Submission has been amended | No |
| 2012-01-01 | This submission is the final filing | No |
| 2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-01-01 | Plan is a collectively bargained plan | No |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – Trust | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement - Trust | Yes |
| 2011: TAUNTON CAT HOSPITAL 401(K) PLAN 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Submission has been amended | No |
| 2011-01-01 | This submission is the final filing | No |
| 2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-01-01 | Plan is a collectively bargained plan | No |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan funding arrangement – Trust | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement - Trust | Yes |
| 2010: TAUNTON CAT HOSPITAL 401(K) PLAN 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Submission has been amended | No |
| 2010-01-01 | This submission is the final filing | No |
| 2010-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-01-01 | Plan is a collectively bargained plan | No |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan funding arrangement – Trust | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement - Trust | Yes |
| 2009: TAUNTON CAT HOSPITAL 401(K) PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Submission has been amended | No |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan funding arrangement – Trust | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement - Trust | Yes |
| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | 945232-01 |
| Policy instance | 1 |
| Insurance contract or identification number | 945232-01 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2016-01-01 | | Insurance policy end date | 2016-12-31 | | Total amount of commissions paid to insurance broker | USD $3,443 | | 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 $3,443 | | Insurance broker organization code? | 3 | | Insurance broker name | JEFFREY HALL/WINSLOW,EVANS&CROCKER |
|
| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | 945232-01 |
| Policy instance | 1 |
| Insurance contract or identification number | 945232-01 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $3,071 | | 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 $3,071 | | Insurance broker organization code? | 3 | | Insurance broker name | JEFFREY HALL/WINSLOW,EVANS&CROCKER |
|
| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | 945232-01 |
| Policy instance | 1 |
| Insurance contract or identification number | 945232-01 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $2,640 | | 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 $2,640 | | Insurance broker organization code? | 3 | | Insurance broker name | JEFFREY HALL/WINSLOW,EVANS&CROCKER |
|
| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | 945232-01 |
| Policy instance | 1 |
| Insurance contract or identification number | 945232-01 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $2,086 | | 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 $2,086 | | Insurance broker organization code? | 3 | | Insurance broker name | JEFFREY HALL/WINSLOW,EVANS&CROCKER |
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| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 95097 |
| Policy instance | 1 |
| Insurance contract or identification number | 95097 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-02-13 | | Total amount of commissions paid to insurance broker | USD $105 | | Total amount of fees paid to insurance company | USD $10 | | 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? | No | | 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? | Yes | | Commission paid to Insurance Broker | USD $105 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 10 | | Additional information about fees paid to insurance broker | TPA COMPENSATION | | Insurance broker name | PENRET SERVICES, INC. |
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| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | 945232-01 |
| Policy instance | 2 |
| Insurance contract or identification number | 945232-01 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $4,312 | | 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 $4,312 | | Insurance broker organization code? | 3 | | Insurance broker name | JEFFREY HALL/WINSLOW,EVANS&CROCKER |
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| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 95097 |
| Policy instance | 1 |
| Insurance contract or identification number | 95097 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $575 | | Total amount of fees paid to insurance company | USD $114 | | 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? | No | | 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? | Yes |
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| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 95097 |
| Policy instance | 1 |
| Insurance contract or identification number | 95097 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $736 | | Total amount of fees paid to insurance company | USD $916 | | 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? | No | | 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? | Yes | | Commission paid to Insurance Broker | USD $368 | | Amount paid for insurance broker fees | 458 | | Insurance broker organization code? | 5 | | Insurance broker name | QUEST CAPITAL STRATEGIES, INC |
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