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ZAHM & MATSON, INC. 401(K) PLAN 401k Plan overview

Plan NameZAHM & MATSON, INC. 401(K) PLAN
Plan identification number 001

ZAHM & MATSON, INC. 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

ZAHM & MATSON INC has sponsored the creation of one or more 401k plans.

Company Name:ZAHM & MATSON INC
Employer identification number (EIN):161070303
NAIC Classification:444200
NAIC Description: Lawn and Garden Equipment and Supplies Stores

Additional information about ZAHM & MATSON INC

Jurisdiction of Incorporation: New York Department of State
Incorporation Date: 1974-01-08
Company Identification Number: 334104
Legal Registered Office Address: 1756 LINDQUIST DR
Chautauqua
FALCONER
United States of America (USA)
14733

More information about ZAHM & MATSON INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ZAHM & MATSON, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012017-01-01
0012016-01-01
0012015-01-01TRACY BUCK
0012014-01-01TRACY BUCK
0012013-01-01TRACY BUCK
0012012-01-01TRACY BUCK
0012011-01-01TRACY BUCK
0012010-01-01TRACY BUCK
0012009-01-01TRACY BUCK

Plan Statistics for ZAHM & MATSON, INC. 401(K) PLAN

401k plan membership statisitcs for ZAHM & MATSON, INC. 401(K) PLAN

Measure Date Value
2017: ZAHM & MATSON, INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01139
Total number of active participants reported on line 7a of the Form 55002017-01-010
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-010
Number of participants with account balances2017-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: ZAHM & MATSON, INC. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01114
Total number of active participants reported on line 7a of the Form 55002016-01-01114
Number of retired or separated participants receiving benefits2016-01-012
Number of other retired or separated participants entitled to future benefits2016-01-0116
Total of all active and inactive participants2016-01-01132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01132
Number of participants with account balances2016-01-01117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-014
2015: ZAHM & MATSON, INC. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01144
Total number of active participants reported on line 7a of the Form 55002015-01-01107
Number of retired or separated participants receiving benefits2015-01-016
Number of other retired or separated participants entitled to future benefits2015-01-0127
Total of all active and inactive participants2015-01-01140
Total participants2015-01-01140
Number of participants with account balances2015-01-01113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-018
2014: ZAHM & MATSON, INC. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01131
Total number of active participants reported on line 7a of the Form 55002014-01-01111
Number of retired or separated participants receiving benefits2014-01-017
Number of other retired or separated participants entitled to future benefits2014-01-0121
Total of all active and inactive participants2014-01-01139
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01139
Number of participants with account balances2014-01-01111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-013
2013: ZAHM & MATSON, INC. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01135
Total number of active participants reported on line 7a of the Form 55002013-01-01108
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0123
Total of all active and inactive participants2013-01-01131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01131
Number of participants with account balances2013-01-01106
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-019
2012: ZAHM & MATSON, INC. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01137
Total number of active participants reported on line 7a of the Form 55002012-01-01117
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0112
Total of all active and inactive participants2012-01-01129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01129
Number of participants with account balances2012-01-0198
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-011
2011: ZAHM & MATSON, INC. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01137
Total number of active participants reported on line 7a of the Form 55002011-01-01126
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-0111
Total of all active and inactive participants2011-01-01137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01137
Number of participants with account balances2011-01-0189
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-019
2010: ZAHM & MATSON, INC. 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01128
Total number of active participants reported on line 7a of the Form 55002010-01-01115
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-0114
Total of all active and inactive participants2010-01-01129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-01129
Number of participants with account balances2010-01-0187
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-019
2009: ZAHM & MATSON, INC. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01127
Total number of active participants reported on line 7a of the Form 55002009-01-01107
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 participants2009-01-01121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01121
Number of participants with account balances2009-01-0187
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-016

Financial Data on ZAHM & MATSON, INC. 401(K) PLAN

Measure Date Value
2017 : ZAHM & MATSON, INC. 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-05-02$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-05-02$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-05-02$4,398
Total income from all sources (including contributions)2017-05-02$184,540
Total loss/gain on sale of assets2017-05-02$0
Total of all expenses incurred2017-05-02$4,203,511
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-05-02$4,200,721
Value of total corrective distributions2017-05-02$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-05-02$34,405
Value of total assets at end of year2017-05-02$0
Value of total assets at beginning of year2017-05-02$4,023,369
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-05-02$2,790
Total interest from all sources2017-05-02$3,427
Total dividends received (eg from common stock, registered investment company shares)2017-05-02$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-05-02Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2017-05-02$0
Was this plan covered by a fidelity bond2017-05-02Yes
Value of fidelity bond cover2017-05-02$500,000
If this is an individual account plan, was there a blackout period2017-05-02No
Were there any nonexempt tranactions with any party-in-interest2017-05-02No
Contributions received from participants2017-05-02$29,543
Participant contributions at end of year2017-05-02$0
Participant contributions at beginning of year2017-05-02$78,585
Assets. Other investments not covered elsewhere at end of year2017-05-02$0
Assets. Other investments not covered elsewhere at beginning of year2017-05-02$56,216
Income. Received or receivable in cash from other sources (including rollovers)2017-05-02$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-05-02$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-05-02$4,398
Other income not declared elsewhere2017-05-02$6,746
Administrative expenses (other) incurred2017-05-02$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-05-02No
Value of net income/loss2017-05-02$-4,018,971
Value of net assets at end of year (total assets less liabilities)2017-05-02$0
Value of net assets at beginning of year (total assets less liabilities)2017-05-02$4,018,971
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-05-02No
Were any loans by the plan or fixed income obligations due to the plan in default2017-05-02No
Were any leases to which the plan was party in default or uncollectible2017-05-02No
Investment advisory and management fees2017-05-02$2,640
Value of interest in pooled separate accounts at end of year2017-05-02$0
Value of interest in pooled separate accounts at beginning of year2017-05-02$3,479,048
Interest on participant loans2017-05-02$324
Interest earned on other investments2017-05-02$3,103
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-05-02$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-05-02$409,520
Net investment gain/loss from pooled separate accounts2017-05-02$139,962
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-05-02No
Was there a failure to transmit to the plan any participant contributions2017-05-02No
Has the plan failed to provide any benefit when due under the plan2017-05-02No
Contributions received in cash from employer2017-05-02$4,862
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-05-02$4,200,721
Contract administrator fees2017-05-02$150
Did the plan have assets held for investment2017-05-02No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-05-02No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-05-02Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-05-02Yes
Opinion of an independent qualified public accountant for this plan2017-05-02Disclaimer
Accountancy firm name2017-05-02SCHAFFNER, KNIGHT, MINNAUGH & CO PC
Accountancy firm EIN2017-05-02251690617
2016 : ZAHM & MATSON, INC. 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$4,398
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$5,112
Total income from all sources (including contributions)2016-12-31$654,364
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$323,735
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$308,860
Value of total corrective distributions2016-12-31$569
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$364,154
Value of total assets at end of year2016-12-31$4,023,369
Value of total assets at beginning of year2016-12-31$3,693,454
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$14,306
Total interest from all sources2016-12-31$6,289
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31Yes
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$253,256
Participant contributions at end of year2016-12-31$78,585
Participant contributions at beginning of year2016-12-31$81,174
Assets. Other investments not covered elsewhere at end of year2016-12-31$56,216
Assets. Other investments not covered elsewhere at beginning of year2016-12-31$46,144
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$69,846
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$4,398
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$5,112
Other income not declared elsewhere2016-12-31$37,478
Administrative expenses (other) incurred2016-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$330,629
Value of net assets at end of year (total assets less liabilities)2016-12-31$4,018,971
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$3,688,342
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Investment advisory and management fees2016-12-31$2,273
Value of interest in pooled separate accounts at end of year2016-12-31$3,479,048
Value of interest in pooled separate accounts at beginning of year2016-12-31$3,563,938
Interest on participant loans2016-12-31$3,412
Interest earned on other investments2016-12-31$2,877
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$409,520
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$2,198
Net investment gain/loss from pooled separate accounts2016-12-31$246,443
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$41,052
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$308,860
Contract administrator fees2016-12-31$12,033
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31Yes
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31SCHAFFNER, KNIGHT, MINNAUGH & CO PC
Accountancy firm EIN2016-12-31251690617
2015 : ZAHM & MATSON, INC. 401(K) PLAN 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$5,112
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$4,489
Total income from all sources (including contributions)2015-12-31$188,237
Total of all expenses incurred2015-12-31$157,870
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$144,812
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$295,124
Value of total assets at end of year2015-12-31$3,693,454
Value of total assets at beginning of year2015-12-31$3,662,464
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$13,058
Total interest from all sources2015-12-31$3,140
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$235,580
Participant contributions at end of year2015-12-31$81,174
Participant contributions at beginning of year2015-12-31$71,060
Assets. Other investments not covered elsewhere at end of year2015-12-31$46,144
Assets. Other investments not covered elsewhere at beginning of year2015-12-31$36,346
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$16,567
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$5,112
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$4,489
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$30,367
Value of net assets at end of year (total assets less liabilities)2015-12-31$3,688,342
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$3,657,975
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in pooled separate accounts at end of year2015-12-31$3,563,938
Value of interest in pooled separate accounts at beginning of year2015-12-31$3,553,019
Interest on participant loans2015-12-31$3,140
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$2,198
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$2,039
Net investment gain/loss from pooled separate accounts2015-12-31$-110,027
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$42,977
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$144,812
Contract administrator fees2015-12-31$13,058
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31SCHNAFFER, KNIGHT, MINNAUGH & CO PC
Accountancy firm EIN2015-12-31251690617
2014 : ZAHM & MATSON, INC. 401(K) PLAN 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$4,489
Total income from all sources (including contributions)2014-12-31$456,793
Total of all expenses incurred2014-12-31$575,633
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$564,207
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$301,098
Value of total assets at end of year2014-12-31$3,662,464
Value of total assets at beginning of year2014-12-31$3,776,815
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$11,426
Total interest from all sources2014-12-31$3,176
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$221,344
Participant contributions at end of year2014-12-31$71,060
Participant contributions at beginning of year2014-12-31$63,419
Assets. Other investments not covered elsewhere at end of year2014-12-31$36,346
Assets. Other investments not covered elsewhere at beginning of year2014-12-31$130,809
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$42,162
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$4,489
Other income not declared elsewhere2014-12-31$36,346
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-118,840
Value of net assets at end of year (total assets less liabilities)2014-12-31$3,657,975
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$3,776,815
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in pooled separate accounts at end of year2014-12-31$3,553,019
Value of interest in pooled separate accounts at beginning of year2014-12-31$3,581,514
Interest on participant loans2014-12-31$3,153
Interest earned on other investments2014-12-31$23
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$2,039
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$1,073
Net investment gain/loss from pooled separate accounts2014-12-31$116,173
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31Yes
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$37,592
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$564,207
Contract administrator fees2014-12-31$11,426
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31SCHAFFNER, KNIGHT, MINNAUGH & CO PC
Accountancy firm EIN2014-12-31251690617
2013 : ZAHM & MATSON, INC. 401(K) PLAN 2013 401k financial data
Total income from all sources (including contributions)2013-12-31$804,903
Total of all expenses incurred2013-12-31$132,449
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$123,728
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$338,951
Value of total assets at end of year2013-12-31$3,776,815
Value of total assets at beginning of year2013-12-31$3,104,361
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$8,721
Total interest from all sources2013-12-31$2,201
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
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
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$247,420
Participant contributions at end of year2013-12-31$63,419
Participant contributions at beginning of year2013-12-31$46,893
Assets. Other investments not covered elsewhere at end of year2013-12-31$130,809
Assets. Other investments not covered elsewhere at beginning of year2013-12-31$149,350
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$51,274
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
Income. Non cash contributions2013-12-31$0
Value of net income/loss2013-12-31$672,454
Value of net assets at end of year (total assets less liabilities)2013-12-31$3,776,815
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$3,104,361
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 pooled separate accounts at end of year2013-12-31$3,581,514
Value of interest in pooled separate accounts at beginning of year2013-12-31$2,907,461
Interest on participant loans2013-12-31$2,133
Interest earned on other investments2013-12-31$68
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$1,073
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$657
Net investment gain/loss from pooled separate accounts2013-12-31$463,751
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
Contributions received in cash from employer2013-12-31$40,257
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$123,728
Contract administrator fees2013-12-31$8,721
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 name2013-12-31SCHAFFNER, KNIGHT, MINNAUGH & CO PC
Accountancy firm EIN2013-12-31251690617
2012 : ZAHM & MATSON, INC. 401(K) PLAN 2012 401k financial data
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$4,364
Total income from all sources (including contributions)2012-12-31$640,418
Total of all expenses incurred2012-12-31$140,599
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$139,634
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$284,956
Value of total assets at end of year2012-12-31$3,104,361
Value of total assets at beginning of year2012-12-31$2,608,906
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$965
Total interest from all sources2012-12-31$2,387
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$248,500
Participant contributions at end of year2012-12-31$46,893
Participant contributions at beginning of year2012-12-31$62,877
Assets. Other investments not covered elsewhere at end of year2012-12-31$149,350
Assets. Other investments not covered elsewhere at beginning of year2012-12-31$18,523
Administrative expenses (other) incurred2012-12-31$635
Liabilities. Value of operating payables at beginning of year2012-12-31$4,364
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$499,819
Value of net assets at end of year (total assets less liabilities)2012-12-31$3,104,361
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$2,604,542
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 pooled separate accounts at end of year2012-12-31$2,907,461
Value of interest in pooled separate accounts at beginning of year2012-12-31$2,526,720
Interest on participant loans2012-12-31$2,355
Interest earned on other investments2012-12-31$32
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$657
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$786
Net investment gain/loss from pooled separate accounts2012-12-31$353,075
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
Contributions received in cash from employer2012-12-31$36,456
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$139,634
Contract administrator fees2012-12-31$330
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 name2012-12-31SCHAFFNER, KNIGHT, MINNAUGH & CO PC
Accountancy firm EIN2012-12-31251690617
2011 : ZAHM & MATSON, INC. 401(K) PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$4,364
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$4,693
Total income from all sources (including contributions)2011-12-31$169,867
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$73,357
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$68,096
Value of total corrective distributions2011-12-31$4,364
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$253,289
Value of total assets at end of year2011-12-31$2,608,906
Value of total assets at beginning of year2011-12-31$2,512,725
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$897
Total interest from all sources2011-12-31$2,445
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
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$300,000
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$221,042
Participant contributions at end of year2011-12-31$62,877
Participant contributions at beginning of year2011-12-31$49,764
Assets. Other investments not covered elsewhere at end of year2011-12-31$18,523
Assets. Other investments not covered elsewhere at beginning of year2011-12-31$21,752
Other income not declared elsewhere2011-12-31$0
Administrative expenses (other) incurred2011-12-31$585
Liabilities. Value of operating payables at end of year2011-12-31$4,364
Liabilities. Value of operating payables at beginning of year2011-12-31$4,693
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$96,510
Value of net assets at end of year (total assets less liabilities)2011-12-31$2,604,542
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$2,508,032
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 pooled separate accounts at end of year2011-12-31$2,526,720
Value of interest in pooled separate accounts at beginning of year2011-12-31$2,441,209
Interest on participant loans2011-12-31$2,429
Interest earned on other investments2011-12-31$16
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$786
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$27,546
Net investment gain/loss from pooled separate accounts2011-12-31$-85,867
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
Contributions received in cash from employer2011-12-31$32,247
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$40,550
Contract administrator fees2011-12-31$312
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 name2011-12-31SCHAFFNER, KNIGHT, MINNAUGH & CO PC
Accountancy firm EIN2011-12-31251690617
2010 : ZAHM & MATSON, INC. 401(K) PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$4,693
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$5,520
Total income from all sources (including contributions)2010-12-31$522,973
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$44,252
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$36,810
Expenses. Certain deemed distributions of participant loans2010-12-31$1,732
Value of total corrective distributions2010-12-31$4,693
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$242,187
Value of total assets at end of year2010-12-31$2,512,725
Value of total assets at beginning of year2010-12-31$2,034,831
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$1,017
Total interest from all sources2010-12-31$2,503
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
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$300,000
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$211,880
Participant contributions at end of year2010-12-31$49,764
Participant contributions at beginning of year2010-12-31$36,344
Assets. Other investments not covered elsewhere at end of year2010-12-31$21,752
Assets. Other investments not covered elsewhere at beginning of year2010-12-31$19,407
Administrative expenses (other) incurred2010-12-31$765
Liabilities. Value of operating payables at end of year2010-12-31$4,693
Liabilities. Value of operating payables at beginning of year2010-12-31$5,520
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$478,721
Value of net assets at end of year (total assets less liabilities)2010-12-31$2,508,032
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$2,029,311
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 pooled separate accounts at end of year2010-12-31$2,441,209
Value of interest in pooled separate accounts at beginning of year2010-12-31$1,978,646
Interest on participant loans2010-12-31$2,078
Interest earned on other investments2010-12-31$425
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$434
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$12,500
Net investment gain/loss from pooled separate accounts2010-12-31$278,283
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
Contributions received in cash from employer2010-12-31$30,307
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$24,310
Contract administrator fees2010-12-31$252
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 PBGC2010-12-31No
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 name2010-12-31SHAFFNER, KNIGHT, MINNAUGH & CO PC
Accountancy firm EIN2010-12-31251690617
2009 : ZAHM & MATSON, INC. 401(K) 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 ZAHM & MATSON, INC. 401(K) PLAN

2017: ZAHM & MATSON, INC. 401(K) PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingYes
2017-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: ZAHM & MATSON, INC. 401(K) PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: ZAHM & MATSON, INC. 401(K) PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: ZAHM & MATSON, INC. 401(K) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: ZAHM & MATSON, INC. 401(K) 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: ZAHM & MATSON, INC. 401(K) 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: ZAHM & MATSON, INC. 401(K) PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
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: ZAHM & MATSON, INC. 401(K) PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
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: ZAHM & MATSON, INC. 401(K) PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
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

SENTRY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 68829 )
Policy contract number95-79717-82
Policy instance 1
Insurance contract or identification number95-79717-82
Number of Individuals Covered0
Insurance policy start date2017-01-01
Insurance policy end date2017-05-02
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SECURITY MUTUAL LIFE INSURANCE COMPANY OF NY (National Association of Insurance Commissioners NAIC id number: 68772 )
Policy contract number01006259
Policy instance 2
Insurance contract or identification number01006259
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $301
Total amount of fees paid to insurance companyUSD $75
Commission paid to Insurance BrokerUSD $75
Amount paid for insurance broker fees75
Additional information about fees paid to insurance brokerSERVICE FEES/QUALITY FEES
Insurance broker organization code?3
Insurance broker nameJAMES C WAGNER C/O WAGNER & ASSOC
JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )
Policy contract number84211
Policy instance 1
Insurance contract or identification number84211
Number of Individuals Covered124
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $16,594
Total amount of fees paid to insurance companyUSD $1,530
Commission paid to Insurance BrokerUSD $16,443
Additional information about fees paid to insurance brokerBROKER COMMISSION
Insurance broker organization code?3
Amount paid for insurance broker fees1530
Insurance broker nameLIFETIME BENEFIT SOLUTIONS
JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )
Policy contract number84211
Policy instance 1
Insurance contract or identification number84211
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $16,210
Total amount of fees paid to insurance companyUSD $2,568
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,210
Insurance broker organization code?3
Amount paid for insurance broker fees1843
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker nameLIFETIME BENEFIT SOLUTIONS
SECURITY MUTUAL LIFE INSURANCE COMPANY OF NY (National Association of Insurance Commissioners NAIC id number: 68772 )
Policy contract number01006259
Policy instance 2
Insurance contract or identification number01006259
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $301
Total amount of fees paid to insurance companyUSD $75
Commission paid to Insurance BrokerUSD $75
Amount paid for insurance broker fees75
Additional information about fees paid to insurance brokerSERVICE FEES/QUALITY FEES
Insurance broker organization code?3
Insurance broker nameJAMES C WAGNER C/O WAGNER & ASSOC
SECURITY MUTUAL LIFE INSURANCE COMPANY OF NY (National Association of Insurance Commissioners NAIC id number: 68772 )
Policy contract number01006259
Policy instance 2
Insurance contract or identification number01006259
Number of Individuals Covered2
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $801
Total amount of fees paid to insurance companyUSD $200
Commission paid to Insurance BrokerUSD $200
Amount paid for insurance broker fees200
Additional information about fees paid to insurance brokerSERVICE FEES/QUALITY FEES
Insurance broker organization code?3
Insurance broker nameJAMES C WAGNER C/O WAGNER & ASSOC
JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )
Policy contract number84211
Policy instance 1
Insurance contract or identification number84211
Number of Individuals Covered117
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $15,252
Total amount of fees paid to insurance companyUSD $2,398
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,252
Insurance broker organization code?3
Amount paid for insurance broker fees675
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker nameEBS-RMSCO, INC.
JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )
Policy contract number84211
Policy instance 1
Insurance contract or identification number84211
Number of Individuals Covered103
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $12,796
Total amount of fees paid to insurance companyUSD $2,856
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,796
Insurance broker organization code?3
Amount paid for insurance broker fees1439
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker nameEBS-RMSCO, INC.
SECURITY MUTUAL LIFE INSURANCE COMPANY OF NY (National Association of Insurance Commissioners NAIC id number: 68772 )
Policy contract number01006259
Policy instance 2
Insurance contract or identification number01006259
Number of Individuals Covered2
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $801
Total amount of fees paid to insurance companyUSD $200
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $200
Amount paid for insurance broker fees200
Additional information about fees paid to insurance brokerSERVICE FEES/QUALITY FEES
Insurance broker organization code?3
Insurance broker nameJAMES C WAGNER C/O WAGNER & ASSOC
JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )
Policy contract number84211
Policy instance 1
Insurance contract or identification number84211
Number of Individuals Covered99
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $11,676
Total amount of fees paid to insurance companyUSD $1,872
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
SECURITY MUTUAL LIFE INSURANCE COMPANY OF NY (National Association of Insurance Commissioners NAIC id number: 68772 )
Policy contract number01006259
Policy instance 2
Insurance contract or identification number01006259
Number of Individuals Covered2
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $1,114
Total amount of fees paid to insurance companyUSD $763
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
SECURITY MUTUAL LIFE INSURANCE COMPANY OF NY (National Association of Insurance Commissioners NAIC id number: 68772 )
Policy contract number01006259
Policy instance 2
Insurance contract or identification number01006259
Number of Individuals Covered2
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $8,364
Total amount of fees paid to insurance companyUSD $414
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 )
Policy contract number84211
Policy instance 1
Insurance contract or identification number84211
Number of Individuals Covered101
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $9,945
Total amount of fees paid to insurance companyUSD $1,770
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No

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