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MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN 401k Plan overview

Plan NameMITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN
Plan identification number 001

MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING 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
  • 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.

401k Sponsoring company profile

MITCHELL MACHINERY MOVING, INC. has sponsored the creation of one or more 401k plans.

Company Name:MITCHELL MACHINERY MOVING, INC.
Employer identification number (EIN):113170019
NAIC Classification:484110
NAIC Description:General Freight Trucking, Local

Additional information about MITCHELL MACHINERY MOVING, INC.

Jurisdiction of Incorporation: New York Department of State
Incorporation Date: 1993-05-28
Company Identification Number: 1730582
Legal Registered Office Address: 20 OCEAN AVENUE
Suffolk
COPIAGUE
United States of America (USA)
11726

More information about MITCHELL MACHINERY MOVING, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012016-12-01GLORIA JACOBSON
0012015-12-01GLORIA JACOBSON
0012014-12-01GLORIA JACOBSON
0012013-12-01GLORIA JACOBSON
0012012-12-01GLORIA JACOBSON
0012011-12-01GLORIA JACOBSON
0012010-12-01GLORIA JACOBSON
0012009-12-01GLORIA JACOBSON

Plan Statistics for MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN

401k plan membership statisitcs for MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN

Measure Date Value
2016: MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-12-018
Total number of active participants reported on line 7a of the Form 55002016-12-010
Number of retired or separated participants receiving benefits2016-12-010
Number of other retired or separated participants entitled to future benefits2016-12-010
Total of all active and inactive participants2016-12-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-12-010
Total participants2016-12-010
Number of participants with account balances2016-12-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-12-010
2015: MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-12-013
Total number of active participants reported on line 7a of the Form 55002015-12-016
Number of retired or separated participants receiving benefits2015-12-012
Number of other retired or separated participants entitled to future benefits2015-12-010
Total of all active and inactive participants2015-12-018
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-12-010
Total participants2015-12-018
Number of participants with account balances2015-12-018
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-12-010
2014: MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-12-019
Total number of active participants reported on line 7a of the Form 55002014-12-018
Number of retired or separated participants receiving benefits2014-12-010
Number of other retired or separated participants entitled to future benefits2014-12-012
Total of all active and inactive participants2014-12-0110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-12-010
Total participants2014-12-0110
Number of participants with account balances2014-12-0110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-12-010
2013: MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-12-0112
Total number of active participants reported on line 7a of the Form 55002013-12-018
Number of retired or separated participants receiving benefits2013-12-010
Number of other retired or separated participants entitled to future benefits2013-12-011
Total of all active and inactive participants2013-12-019
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-12-010
Total participants2013-12-019
Number of participants with account balances2013-12-019
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-12-010
2012: MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-12-0110
Total number of active participants reported on line 7a of the Form 55002012-12-0111
Number of retired or separated participants receiving benefits2012-12-010
Number of other retired or separated participants entitled to future benefits2012-12-010
Total of all active and inactive participants2012-12-0111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-12-010
Total participants2012-12-0111
Number of participants with account balances2012-12-0111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-12-010
2011: MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-12-0115
Total number of active participants reported on line 7a of the Form 55002011-12-0110
Number of retired or separated participants receiving benefits2011-12-010
Number of other retired or separated participants entitled to future benefits2011-12-013
Total of all active and inactive participants2011-12-0113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-12-010
Total participants2011-12-0113
Number of participants with account balances2011-12-0110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-12-010
2010: MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year2010-12-0116
Total number of active participants reported on line 7a of the Form 55002010-12-0110
Number of retired or separated participants receiving benefits2010-12-010
Number of other retired or separated participants entitled to future benefits2010-12-015
Total of all active and inactive participants2010-12-0115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-12-010
Total participants2010-12-0115
Number of participants with account balances2010-12-0114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-12-010
2009: MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-12-019
Total number of active participants reported on line 7a of the Form 55002009-12-0110
Number of retired or separated participants receiving benefits2009-12-010
Number of other retired or separated participants entitled to future benefits2009-12-015
Total of all active and inactive participants2009-12-0115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-12-010
Total participants2009-12-0115
Number of participants with account balances2009-12-0115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-12-011

Financial Data on MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN

Measure Date Value
2017 : MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN 2017 401k financial data
Transfers to/from the plan2017-07-31$0
Total plan liabilities at beginning of year2017-07-31$0
Total income from all sources2017-07-31$66,371
Expenses. Total of all expenses incurred2017-07-31$1,043,277
Benefits paid (including direct rollovers)2017-07-31$1,041,153
Total plan assets at end of year2017-07-31$0
Total plan assets at beginning of year2017-07-31$976,906
Value of fidelity bond covering the plan2017-07-31$250,000
Total contributions received or receivable from participants2017-07-31$0
Expenses. Other expenses not covered elsewhere2017-07-31$0
Contributions received from other sources (not participants or employers)2017-07-31$0
Other income received2017-07-31$66,371
Noncash contributions received2017-07-31$0
Net income (gross income less expenses)2017-07-31$-976,906
Net plan assets at end of year (total assets less liabilities)2017-07-31$0
Net plan assets at beginning of year (total assets less liabilities)2017-07-31$976,906
Total contributions received or receivable from employer(s)2017-07-31$0
Value of certain deemed distributions of participant loans2017-07-31$0
Value of corrective distributions2017-07-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2017-07-31$2,124
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-07-31$0
2016 : MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN 2016 401k financial data
Transfers to/from the plan2016-11-30$0
Total plan liabilities at end of year2016-11-30$0
Total plan liabilities at beginning of year2016-11-30$0
Total income from all sources2016-11-30$136,410
Expenses. Total of all expenses incurred2016-11-30$6,528
Benefits paid (including direct rollovers)2016-11-30$6,528
Total plan assets at end of year2016-11-30$976,906
Total plan assets at beginning of year2016-11-30$847,024
Value of fidelity bond covering the plan2016-11-30$250,000
Total contributions received or receivable from participants2016-11-30$69,679
Contributions received from other sources (not participants or employers)2016-11-30$0
Other income received2016-11-30$41,554
Noncash contributions received2016-11-30$0
Net income (gross income less expenses)2016-11-30$129,882
Net plan assets at end of year (total assets less liabilities)2016-11-30$976,906
Net plan assets at beginning of year (total assets less liabilities)2016-11-30$847,024
Total contributions received or receivable from employer(s)2016-11-30$25,177
Value of certain deemed distributions of participant loans2016-11-30$0
Value of corrective distributions2016-11-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2016-11-30$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-11-30$0
2015 : MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN 2015 401k financial data
Transfers to/from the plan2015-11-30$0
Total plan liabilities at end of year2015-11-30$0
Total plan liabilities at beginning of year2015-11-30$0
Total income from all sources2015-11-30$90,987
Expenses. Total of all expenses incurred2015-11-30$19
Benefits paid (including direct rollovers)2015-11-30$19
Total plan assets at end of year2015-11-30$847,024
Total plan assets at beginning of year2015-11-30$756,056
Value of fidelity bond covering the plan2015-11-30$250,000
Total contributions received or receivable from participants2015-11-30$68,629
Expenses. Other expenses not covered elsewhere2015-11-30$0
Contributions received from other sources (not participants or employers)2015-11-30$0
Other income received2015-11-30$94
Noncash contributions received2015-11-30$0
Net income (gross income less expenses)2015-11-30$90,968
Net plan assets at end of year (total assets less liabilities)2015-11-30$847,024
Net plan assets at beginning of year (total assets less liabilities)2015-11-30$756,056
Total contributions received or receivable from employer(s)2015-11-30$22,264
Value of certain deemed distributions of participant loans2015-11-30$0
Value of corrective distributions2015-11-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2015-11-30$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-11-30$0
2014 : MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN 2014 401k financial data
Transfers to/from the plan2014-11-30$0
Total plan liabilities at end of year2014-11-30$0
Total plan liabilities at beginning of year2014-11-30$0
Total income from all sources2014-11-30$122,871
Expenses. Total of all expenses incurred2014-11-30$4,329
Benefits paid (including direct rollovers)2014-11-30$4,279
Total plan assets at end of year2014-11-30$750,432
Total plan assets at beginning of year2014-11-30$631,890
Value of fidelity bond covering the plan2014-11-30$250,000
Total contributions received or receivable from participants2014-11-30$61,400
Expenses. Other expenses not covered elsewhere2014-11-30$0
Contributions received from other sources (not participants or employers)2014-11-30$0
Other income received2014-11-30$36,192
Noncash contributions received2014-11-30$0
Net income (gross income less expenses)2014-11-30$118,542
Net plan assets at end of year (total assets less liabilities)2014-11-30$750,432
Net plan assets at beginning of year (total assets less liabilities)2014-11-30$631,890
Total contributions received or receivable from employer(s)2014-11-30$25,279
Value of certain deemed distributions of participant loans2014-11-30$0
Value of corrective distributions2014-11-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2014-11-30$50
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-11-30$0
2013 : MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN 2013 401k financial data
Transfers to/from the plan2013-11-30$0
Total plan liabilities at end of year2013-11-30$0
Total plan liabilities at beginning of year2013-11-30$0
Total income from all sources2013-11-30$127,546
Expenses. Total of all expenses incurred2013-11-30$1,452
Benefits paid (including direct rollovers)2013-11-30$0
Total plan assets at end of year2013-11-30$631,890
Total plan assets at beginning of year2013-11-30$505,796
Value of fidelity bond covering the plan2013-11-30$150,000
Total contributions received or receivable from participants2013-11-30$59,636
Expenses. Other expenses not covered elsewhere2013-11-30$0
Contributions received from other sources (not participants or employers)2013-11-30$0
Other income received2013-11-30$40,650
Noncash contributions received2013-11-30$0
Net income (gross income less expenses)2013-11-30$126,094
Net plan assets at end of year (total assets less liabilities)2013-11-30$631,890
Net plan assets at beginning of year (total assets less liabilities)2013-11-30$505,796
Total contributions received or receivable from employer(s)2013-11-30$27,260
Value of certain deemed distributions of participant loans2013-11-30$0
Value of corrective distributions2013-11-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2013-11-30$1,452
2012 : MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN 2012 401k financial data
Transfers to/from the plan2012-11-30$0
Total plan liabilities at end of year2012-11-30$0
Total plan liabilities at beginning of year2012-11-30$0
Total income from all sources2012-11-30$130,993
Expenses. Total of all expenses incurred2012-11-30$30,080
Benefits paid (including direct rollovers)2012-11-30$29,805
Total plan assets at end of year2012-11-30$505,796
Total plan assets at beginning of year2012-11-30$404,883
Value of fidelity bond covering the plan2012-11-30$150,000
Total contributions received or receivable from participants2012-11-30$29,741
Expenses. Other expenses not covered elsewhere2012-11-30$0
Contributions received from other sources (not participants or employers)2012-11-30$0
Other income received2012-11-30$45,930
Noncash contributions received2012-11-30$0
Net income (gross income less expenses)2012-11-30$100,913
Net plan assets at end of year (total assets less liabilities)2012-11-30$505,796
Net plan assets at beginning of year (total assets less liabilities)2012-11-30$404,883
Total contributions received or receivable from employer(s)2012-11-30$55,322
Value of certain deemed distributions of participant loans2012-11-30$0
Value of corrective distributions2012-11-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2012-11-30$275
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-11-30$0
2011 : MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN 2011 401k financial data
Transfers to/from the plan2011-11-30$0
Total plan liabilities at end of year2011-11-30$0
Total plan liabilities at beginning of year2011-11-30$0
Total income from all sources2011-11-30$85,149
Expenses. Total of all expenses incurred2011-11-30$50
Benefits paid (including direct rollovers)2011-11-30$0
Total plan assets at end of year2011-11-30$404,883
Total plan assets at beginning of year2011-11-30$319,784
Value of fidelity bond covering the plan2011-11-30$40,000
Total contributions received or receivable from participants2011-11-30$23,095
Expenses. Other expenses not covered elsewhere2011-11-30$0
Contributions received from other sources (not participants or employers)2011-11-30$0
Other income received2011-11-30$7,322
Noncash contributions received2011-11-30$0
Net income (gross income less expenses)2011-11-30$85,099
Net plan assets at end of year (total assets less liabilities)2011-11-30$404,883
Net plan assets at beginning of year (total assets less liabilities)2011-11-30$319,784
Total contributions received or receivable from employer(s)2011-11-30$54,732
Value of certain deemed distributions of participant loans2011-11-30$0
Value of corrective distributions2011-11-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2011-11-30$50
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-11-30$0
2010 : MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-11-30$0

Form 5500 Responses for MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN

2016: MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN 2016 form 5500 responses
2016-12-01Type of plan entitySingle employer plan
2016-12-01Submission has been amendedNo
2016-12-01This submission is the final filingYes
2016-12-01This return/report is a short plan year return/report (less than 12 months)Yes
2016-12-01Plan is a collectively bargained planNo
2016-12-01Plan funding arrangement – InsuranceYes
2016-12-01Plan funding arrangement – TrustYes
2016-12-01Plan benefit arrangement – InsuranceYes
2016-12-01Plan benefit arrangement - TrustYes
2015: MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN 2015 form 5500 responses
2015-12-01Type of plan entitySingle employer plan
2015-12-01Submission has been amendedNo
2015-12-01This submission is the final filingNo
2015-12-01This return/report is a short plan year return/report (less than 12 months)No
2015-12-01Plan is a collectively bargained planNo
2015-12-01Plan funding arrangement – InsuranceYes
2015-12-01Plan funding arrangement – TrustYes
2015-12-01Plan benefit arrangement – InsuranceYes
2015-12-01Plan benefit arrangement - TrustYes
2014: MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN 2014 form 5500 responses
2014-12-01Type of plan entitySingle employer plan
2014-12-01Submission has been amendedNo
2014-12-01This submission is the final filingNo
2014-12-01This return/report is a short plan year return/report (less than 12 months)No
2014-12-01Plan is a collectively bargained planNo
2014-12-01Plan funding arrangement – InsuranceYes
2014-12-01Plan funding arrangement – TrustYes
2014-12-01Plan benefit arrangement - TrustYes
2013: MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN 2013 form 5500 responses
2013-12-01Type of plan entitySingle employer plan
2013-12-01Submission has been amendedNo
2013-12-01This submission is the final filingNo
2013-12-01This return/report is a short plan year return/report (less than 12 months)No
2013-12-01Plan is a collectively bargained planNo
2013-12-01Plan funding arrangement – InsuranceYes
2013-12-01Plan funding arrangement – TrustYes
2013-12-01Plan benefit arrangement – InsuranceYes
2013-12-01Plan benefit arrangement - TrustYes
2012: MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN 2012 form 5500 responses
2012-12-01Type of plan entitySingle employer plan
2012-12-01Submission has been amendedNo
2012-12-01This submission is the final filingNo
2012-12-01This return/report is a short plan year return/report (less than 12 months)No
2012-12-01Plan is a collectively bargained planNo
2012-12-01Plan funding arrangement – InsuranceYes
2012-12-01Plan funding arrangement – TrustYes
2012-12-01Plan benefit arrangement – InsuranceYes
2012-12-01Plan benefit arrangement - TrustYes
2011: MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN 2011 form 5500 responses
2011-12-01Type of plan entitySingle employer plan
2011-12-01Submission has been amendedNo
2011-12-01This submission is the final filingNo
2011-12-01This return/report is a short plan year return/report (less than 12 months)No
2011-12-01Plan is a collectively bargained planNo
2011-12-01Plan funding arrangement – InsuranceYes
2011-12-01Plan funding arrangement – TrustYes
2011-12-01Plan benefit arrangement – InsuranceYes
2011-12-01Plan benefit arrangement - TrustYes
2010: MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN 2010 form 5500 responses
2010-12-01Type of plan entitySingle employer plan
2010-12-01Submission has been amendedNo
2010-12-01This submission is the final filingNo
2010-12-01This return/report is a short plan year return/report (less than 12 months)No
2010-12-01Plan is a collectively bargained planNo
2010-12-01Plan funding arrangement – InsuranceYes
2010-12-01Plan funding arrangement – TrustYes
2010-12-01Plan benefit arrangement – InsuranceYes
2010-12-01Plan benefit arrangement - TrustYes
2009: MITCHELL MACHINERY MOVING, INC. 401K PROFIT SHARING PLAN 2009 form 5500 responses
2009-12-01Type of plan entitySingle employer plan
2009-12-01Submission has been amendedNo
2009-12-01This submission is the final filingNo
2009-12-01This return/report is a short plan year return/report (less than 12 months)No
2009-12-01Plan is a collectively bargained planNo
2009-12-01Plan funding arrangement – InsuranceYes
2009-12-01Plan funding arrangement – TrustYes
2009-12-01Plan benefit arrangement – InsuranceYes
2009-12-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

FIRST GREAT WEST LIFE INSURANCE & ANNUITY CO (National Association of Insurance Commissioners NAIC id number: 60214 )
Policy contract number386559-01
Policy instance 1
Insurance contract or identification number386559-01
Number of Individuals Covered8
Insurance policy start date2015-12-01
Insurance policy end date2016-11-30
Total amount of commissions paid to insurance brokerUSD $8,753
Total amount of fees paid to insurance companyUSD $438
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 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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,753
Insurance broker organization code?3
Amount paid for insurance broker fees438
Additional information about fees paid to insurance brokerTPA ALLOWANCE PAYMENT
Insurance broker nameCREATIVE PLAN DESIGNS, LTD.
FIRST GREAT WEST LIFE INSURANCE & ANNUITY CO (National Association of Insurance Commissioners NAIC id number: 60214 )
Policy contract number386559-01
Policy instance 1
Insurance contract or identification number386559-01
Number of Individuals Covered10
Insurance policy start date2014-12-01
Insurance policy end date2015-11-30
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 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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FIRST GREAT WEST LIFE INSURANCE & ANNUITY CO (National Association of Insurance Commissioners NAIC id number: 60214 )
Policy contract number386559-01
Policy instance 1
Insurance contract or identification number386559-01
Number of Individuals Covered9
Insurance policy start date2013-12-01
Insurance policy end date2014-11-30
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 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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FIRST GREAT WEST LIFE INSURANCE & ANNUITY CO (National Association of Insurance Commissioners NAIC id number: 60214 )
Policy contract number386559-01
Policy instance 1
Insurance contract or identification number386559-01
Number of Individuals Covered11
Insurance policy start date2012-12-01
Insurance policy end date2013-11-30
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 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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )
Policy contract number84693
Policy instance 1
Insurance contract or identification number84693
Number of Individuals Covered10
Insurance policy start date2011-12-01
Insurance policy end date2012-11-30
Total amount of commissions paid to insurance brokerUSD $4,784
Total amount of fees paid to insurance companyUSD $495
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 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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )
Policy contract number84693
Policy instance 1
Insurance contract or identification number84693
Number of Individuals Covered13
Insurance policy start date2010-12-01
Insurance policy end date2011-11-30
Total amount of commissions paid to insurance brokerUSD $3,462
Total amount of fees paid to insurance companyUSD $223
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 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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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