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CARLSON THERAPY NETWORK SAVINGS & RETIREMENT PLAN 401k Plan overview

Plan NameCARLSON THERAPY NETWORK SAVINGS & RETIREMENT PLAN
Plan identification number 001

CARLSON THERAPY NETWORK SAVINGS & RETIREMENT PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • Profit-sharing
  • 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

CARLSON THERAPY NETWORK, P.C. has sponsored the creation of one or more 401k plans.

Company Name:CARLSON THERAPY NETWORK, P.C.
Employer identification number (EIN):061245772
NAIC Classification:621340
NAIC Description:Offices of Physical, Occupational and Speech Therapists, and Audiologists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CARLSON THERAPY NETWORK SAVINGS & RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01BENJAMIN CARLSON2023-08-03
0012021-01-01BENJAMIN CARLSON2022-10-13
0012020-01-01BENJAMIN CARLSON2021-10-14
0012019-01-01BENJAMIN CARLSON2020-10-01
0012018-01-01BENJAMIN CARLSON2019-08-26
0012017-01-01RICHARD CARLSON2018-07-17
0012016-01-01RICHARD CARLSON2017-07-27
0012015-01-01DEBORAH KORNIEWICZ2016-04-20
0012014-01-01DEBORAH KORNIEWICZ2015-07-09
0012013-01-01JUDITH MONTANER
0012012-01-01JUDITH MONTANER
0012011-01-01JUDITH MONTANER
0012010-01-01JUDITH MONTANER
0012009-01-01JUDITH MONTANER

Plan Statistics for CARLSON THERAPY NETWORK SAVINGS & RETIREMENT PLAN

401k plan membership statisitcs for CARLSON THERAPY NETWORK SAVINGS & RETIREMENT PLAN

Measure Date Value
2013: CARLSON THERAPY NETWORK SAVINGS & RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01113
Total number of active participants reported on line 7a of the Form 55002013-01-0181
Number of other retired or separated participants entitled to future benefits2013-01-0113
Total of all active and inactive participants2013-01-0194
Total participants2013-01-0194
Number of participants with account balances2013-01-0174
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: CARLSON THERAPY NETWORK SAVINGS & RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01122
Total number of active participants reported on line 7a of the Form 55002012-01-0195
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0115
Total of all active and inactive participants2012-01-01110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01110
Number of participants with account balances2012-01-0180
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-011
2011: CARLSON THERAPY NETWORK SAVINGS & RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01137
Total number of active participants reported on line 7a of the Form 55002011-01-01104
Number of other retired or separated participants entitled to future benefits2011-01-0115
Total of all active and inactive participants2011-01-01119
Total participants2011-01-01119
Number of participants with account balances2011-01-0186
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-011
2010: CARLSON THERAPY NETWORK SAVINGS & RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01154
Total number of active participants reported on line 7a of the Form 55002010-01-01120
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-0113
Total of all active and inactive participants2010-01-01133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-01133
Number of participants with account balances2010-01-0199
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: CARLSON THERAPY NETWORK SAVINGS & RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01172
Total number of active participants reported on line 7a of the Form 55002009-01-01129
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0114
Total of all active and inactive participants2009-01-01143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01143
Number of participants with account balances2009-01-01108
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on CARLSON THERAPY NETWORK SAVINGS & RETIREMENT PLAN

Measure Date Value
2013 : CARLSON THERAPY NETWORK SAVINGS & RETIREMENT PLAN 2013 401k financial data
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$6,236
Total income from all sources (including contributions)2013-12-31$757,540
Total of all expenses incurred2013-12-31$215,708
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$188,470
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$196,232
Value of total assets at end of year2013-12-31$4,128,533
Value of total assets at beginning of year2013-12-31$3,592,937
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$27,238
Total interest from all sources2013-12-31$3,647
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$557,661
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$557,661
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$500,000
If this is an individual account plan, was there a blackout period2013-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$196,232
Participant contributions at end of year2013-12-31$111,231
Participant contributions at beginning of year2013-12-31$59,601
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$6,236
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$541,832
Value of net assets at end of year (total assets less liabilities)2013-12-31$4,128,533
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$3,586,701
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$3,986,959
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$3,504,245
Interest on participant loans2013-12-31$3,583
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$64
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$30,343
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$29,091
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$188,470
Contract administrator fees2013-12-31$27,238
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31WEINSTEIN & ANASTASIO, P.C.
Accountancy firm EIN2013-12-31060886632
2012 : CARLSON THERAPY NETWORK SAVINGS & RETIREMENT PLAN 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$6,236
Total income from all sources (including contributions)2012-12-31$596,904
Total of all expenses incurred2012-12-31$167,063
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$133,287
Value of total corrective distributions2012-12-31$6,236
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$232,192
Value of total assets at end of year2012-12-31$3,592,937
Value of total assets at beginning of year2012-12-31$3,156,860
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$27,540
Total interest from all sources2012-12-31$2,449
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$500,000
If this is an individual account plan, was there a blackout period2012-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$232,192
Participant contributions at end of year2012-12-31$59,601
Participant contributions at beginning of year2012-12-31$14,886
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-12-31$6,236
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$429,841
Value of net assets at end of year (total assets less liabilities)2012-12-31$3,586,701
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$3,156,860
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$3,504,245
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$3,106,247
Interest on participant loans2012-12-31$2,367
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$82
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$29,091
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$35,727
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$362,263
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$133,287
Contract administrator fees2012-12-31$27,540
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31WEINSTEIN & ANASTASIO, P.C.
Accountancy firm EIN2012-12-31060886632
2011 : CARLSON THERAPY NETWORK SAVINGS & RETIREMENT PLAN 2011 401k financial data
Total income from all sources (including contributions)2011-12-31$216,848
Total of all expenses incurred2011-12-31$676,239
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$648,971
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$278,380
Value of total assets at end of year2011-12-31$3,156,860
Value of total assets at beginning of year2011-12-31$3,616,251
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$27,268
Total interest from all sources2011-12-31$742
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$500,000
If this is an individual account plan, was there a blackout period2011-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$278,380
Participant contributions at end of year2011-12-31$14,886
Participant contributions at beginning of year2011-12-31$10,704
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-459,391
Value of net assets at end of year (total assets less liabilities)2011-12-31$3,156,860
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$3,616,251
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$3,106,247
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$3,581,971
Interest on participant loans2011-12-31$458
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$284
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$35,727
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$23,576
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$-62,274
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$648,971
Contract administrator fees2011-12-31$27,268
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31WEINSTEIN & ANASTASIO, P.C.
Accountancy firm EIN2011-12-31060886632
2010 : CARLSON THERAPY NETWORK SAVINGS & RETIREMENT PLAN 2010 401k financial data
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$50
Total income from all sources (including contributions)2010-12-31$712,376
Total of all expenses incurred2010-12-31$351,819
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$323,872
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$333,970
Value of total assets at end of year2010-12-31$3,616,251
Value of total assets at beginning of year2010-12-31$3,255,744
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$27,947
Total interest from all sources2010-12-31$854
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$500,000
If this is an individual account plan, was there a blackout period2010-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$333,970
Participant contributions at end of year2010-12-31$10,704
Participant contributions at beginning of year2010-12-31$12,436
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$50
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$360,557
Value of net assets at end of year (total assets less liabilities)2010-12-31$3,616,251
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$3,255,694
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$3,581,971
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$3,220,742
Income. Interest from loans (other than to participants)2010-12-31$537
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$317
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$23,576
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$22,566
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$377,552
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$323,872
Contract administrator fees2010-12-31$27,947
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31WEINSTEIN & ANASTASIO, P.C.
Accountancy firm EIN2010-12-31060886632
2009 : CARLSON THERAPY NETWORK SAVINGS & RETIREMENT PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for CARLSON THERAPY NETWORK SAVINGS & RETIREMENT PLAN

2013: CARLSON THERAPY NETWORK SAVINGS & RETIREMENT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: CARLSON THERAPY NETWORK SAVINGS & RETIREMENT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: CARLSON THERAPY NETWORK SAVINGS & RETIREMENT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: CARLSON THERAPY NETWORK SAVINGS & RETIREMENT PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedYes
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: CARLSON THERAPY NETWORK SAVINGS & RETIREMENT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number21721
Policy instance 1
Insurance contract or identification number21721
Number of Individuals Covered74
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $15,376
Total amount of fees paid to insurance companyUSD $2,206
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Commission paid to Insurance BrokerUSD $15,376
Insurance broker organization code?4
Amount paid for insurance broker fees2206
Insurance broker nameGREER BENEFIT CONSULTANTS, INC.
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number21721
Policy instance 1
Insurance contract or identification number21721
Number of Individuals Covered83
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $14,207
Total amount of fees paid to insurance companyUSD $1,684
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,207
Additional information about fees paid to insurance brokerCOMMISSIONS
Insurance broker organization code?4
Amount paid for insurance broker fees1676
Insurance broker nameFIDELITY MANAGEMENT & RESEARCH COMP
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number21721
Policy instance 1
Insurance contract or identification number21721
Number of Individuals Covered89
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $14,763
Total amount of fees paid to insurance companyUSD $1,743
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number21721
Policy instance 1
Insurance contract or identification number21721
Number of Individuals Covered101
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $15,159
Total amount of fees paid to insurance companyUSD $1,317
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Commission paid to Insurance BrokerUSD $15,159
Additional information about fees paid to insurance brokerCOMMISSIONS
Insurance broker organization code?4
Amount paid for insurance broker fees1298
Insurance broker nameVANGUARD GROUP, INC.

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