ROBERTS-GORDON, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SPECIFIED AIR SOLUTIONS/RAPID UNION 401(K) PLAN
401k plan membership statisitcs for SPECIFIED AIR SOLUTIONS/RAPID UNION 401(K) PLAN
| Measure | Date | Value |
|---|
| 2016: SPECIFIED AIR SOLUTIONS/RAPID UNION 401(K) PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 31 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 40 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 3 |
| Total of all active and inactive participants | 2016-01-01 | 43 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2016-01-01 | 0 |
| Total participants | 2016-01-01 | 43 |
| Number of participants with account balances | 2016-01-01 | 25 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2016-01-01 | 0 |
| 2015: SPECIFIED AIR SOLUTIONS/RAPID UNION 401(K) PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 30 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 29 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 2 |
| Total of all active and inactive participants | 2015-01-01 | 31 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2015-01-01 | 0 |
| Total participants | 2015-01-01 | 31 |
| Number of participants with account balances | 2015-01-01 | 21 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2015-01-01 | 0 |
| 2014: SPECIFIED AIR SOLUTIONS/RAPID UNION 401(K) PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 33 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 28 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 2 |
| Total of all active and inactive participants | 2014-01-01 | 30 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-01-01 | 0 |
| Total participants | 2014-01-01 | 30 |
| Number of participants with account balances | 2014-01-01 | 25 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2014-01-01 | 0 |
| 2013: SPECIFIED AIR SOLUTIONS/RAPID UNION 401(K) PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 27 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 32 |
| Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 1 |
| Total of all active and inactive participants | 2013-01-01 | 33 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-01-01 | 0 |
| Total participants | 2013-01-01 | 33 |
| Number of participants with account balances | 2013-01-01 | 25 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-01-01 | 0 |
| 2012: SPECIFIED AIR SOLUTIONS/RAPID UNION 401(K) PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 26 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 26 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 1 |
| Total of all active and inactive participants | 2012-01-01 | 27 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-01-01 | 0 |
| Total participants | 2012-01-01 | 27 |
| Number of participants with account balances | 2012-01-01 | 23 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-01-01 | 0 |
| 2011: SPECIFIED AIR SOLUTIONS/RAPID UNION 401(K) PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 30 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 24 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 2 |
| Total of all active and inactive participants | 2011-01-01 | 26 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-01-01 | 0 |
| Total participants | 2011-01-01 | 26 |
| Number of participants with account balances | 2011-01-01 | 25 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2011-01-01 | 0 |
| 2010: SPECIFIED AIR SOLUTIONS/RAPID UNION 401(K) PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 31 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 30 |
| Number of retired or separated participants receiving benefits | 2010-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2010-01-01 | 0 |
| Total of all active and inactive participants | 2010-01-01 | 30 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2010-01-01 | 0 |
| Total participants | 2010-01-01 | 30 |
| Number of participants with account balances | 2010-01-01 | 24 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2010-01-01 | 1 |
| 2009: SPECIFIED AIR SOLUTIONS/RAPID UNION 401(K) PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 36 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 31 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 0 |
| Total of all active and inactive participants | 2009-01-01 | 31 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-01-01 | 0 |
| Total participants | 2009-01-01 | 31 |
| Number of participants with account balances | 2009-01-01 | 24 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-01-01 | 4 |
| Measure | Date | Value |
|---|
| 2016 : SPECIFIED AIR SOLUTIONS/RAPID UNION 401(K) PLAN 2016 401k financial data |
|---|
| Total income from all sources | 2016-12-31 | $165,954 |
| Expenses. Total of all expenses incurred | 2016-12-31 | $190,415 |
| Benefits paid (including direct rollovers) | 2016-12-31 | $190,125 |
| Total plan assets at end of year | 2016-12-31 | $1,006,778 |
| Total plan assets at beginning of year | 2016-12-31 | $1,031,239 |
| Value of fidelity bond covering the plan | 2016-12-31 | $1,000,000 |
| Total contributions received or receivable from participants | 2016-12-31 | $35,440 |
| Contributions received from other sources (not participants or employers) | 2016-12-31 | $28,868 |
| Other income received | 2016-12-31 | $84,543 |
| Net income (gross income less expenses) | 2016-12-31 | $-24,461 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-31 | $1,006,778 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-31 | $1,031,239 |
| Assets. Value of participant loans | 2016-12-31 | $9,576 |
| Total contributions received or receivable from employer(s) | 2016-12-31 | $17,103 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-12-31 | $290 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2016-12-31 | $0 |
| 2015 : SPECIFIED AIR SOLUTIONS/RAPID UNION 401(K) PLAN 2015 401k financial data |
|---|
| Total income from all sources | 2015-12-31 | $46,945 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $120,257 |
| Benefits paid (including direct rollovers) | 2015-12-31 | $119,867 |
| Total plan assets at end of year | 2015-12-31 | $1,031,239 |
| Total plan assets at beginning of year | 2015-12-31 | $1,104,551 |
| Value of fidelity bond covering the plan | 2015-12-31 | $1,000,000 |
| Total contributions received or receivable from participants | 2015-12-31 | $35,245 |
| Other income received | 2015-12-31 | $-3,696 |
| Net income (gross income less expenses) | 2015-12-31 | $-73,312 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $1,031,239 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $1,104,551 |
| Assets. Value of participant loans | 2015-12-31 | $14,166 |
| Total contributions received or receivable from employer(s) | 2015-12-31 | $15,396 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-12-31 | $390 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2015-12-31 | $0 |
| 2014 : SPECIFIED AIR SOLUTIONS/RAPID UNION 401(K) PLAN 2014 401k financial data |
|---|
| Total plan liabilities at beginning of year | 2014-12-31 | $0 |
| Total income from all sources | 2014-12-31 | $104,691 |
| Expenses. Total of all expenses incurred | 2014-12-31 | $18,162 |
| Benefits paid (including direct rollovers) | 2014-12-31 | $18,088 |
| Total plan assets at end of year | 2014-12-31 | $1,104,551 |
| Total plan assets at beginning of year | 2014-12-31 | $1,018,022 |
| Value of fidelity bond covering the plan | 2014-12-31 | $1,000,000 |
| Total contributions received or receivable from participants | 2014-12-31 | $35,206 |
| Other income received | 2014-12-31 | $54,028 |
| Net income (gross income less expenses) | 2014-12-31 | $86,529 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $1,104,551 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $1,018,022 |
| Assets. Value of participant loans | 2014-12-31 | $21,982 |
| Total contributions received or receivable from employer(s) | 2014-12-31 | $15,457 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2014-12-31 | $74 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2014-12-31 | $0 |
| 2013 : SPECIFIED AIR SOLUTIONS/RAPID UNION 401(K) PLAN 2013 401k financial data |
|---|
| Transfers to/from the plan | 2013-12-31 | $0 |
| Total plan liabilities at end of year | 2013-12-31 | $0 |
| Total plan liabilities at beginning of year | 2013-12-31 | $0 |
| Total income from all sources | 2013-12-31 | $239,033 |
| Expenses. Total of all expenses incurred | 2013-12-31 | $31,957 |
| Benefits paid (including direct rollovers) | 2013-12-31 | $31,773 |
| Total plan assets at end of year | 2013-12-31 | $1,018,022 |
| Total plan assets at beginning of year | 2013-12-31 | $810,946 |
| Value of fidelity bond covering the plan | 2013-12-31 | $1,000,000 |
| Total contributions received or receivable from participants | 2013-12-31 | $43,414 |
| Expenses. Other expenses not covered elsewhere | 2013-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2013-12-31 | $0 |
| Other income received | 2013-12-31 | $176,313 |
| Noncash contributions received | 2013-12-31 | $0 |
| Net income (gross income less expenses) | 2013-12-31 | $207,076 |
| Net plan assets at end of year (total assets less liabilities) | 2013-12-31 | $1,018,022 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-12-31 | $810,946 |
| Assets. Value of participant loans | 2013-12-31 | $42,697 |
| Total contributions received or receivable from employer(s) | 2013-12-31 | $19,306 |
| Value of certain deemed distributions of participant loans | 2013-12-31 | $0 |
| Value of corrective distributions | 2013-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2013-12-31 | $184 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2013-12-31 | $0 |
| 2012 : SPECIFIED AIR SOLUTIONS/RAPID UNION 401(K) PLAN 2012 401k financial data |
|---|
| Total plan liabilities at end of year | 2012-12-31 | $0 |
| Total plan liabilities at beginning of year | 2012-12-31 | $0 |
| Total income from all sources | 2012-12-31 | $151,562 |
| Expenses. Total of all expenses incurred | 2012-12-31 | $21,237 |
| Benefits paid (including direct rollovers) | 2012-12-31 | $20,969 |
| Total plan assets at end of year | 2012-12-31 | $810,946 |
| Total plan assets at beginning of year | 2012-12-31 | $680,619 |
| Value of fidelity bond covering the plan | 2012-12-31 | $1,000,000 |
| Total contributions received or receivable from participants | 2012-12-31 | $49,720 |
| Expenses. Other expenses not covered elsewhere | 2012-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2012-12-31 | $0 |
| Other income received | 2012-12-31 | $83,263 |
| Noncash contributions received | 2012-12-31 | $0 |
| Net income (gross income less expenses) | 2012-12-31 | $130,325 |
| Net plan assets at end of year (total assets less liabilities) | 2012-12-31 | $810,946 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-12-31 | $680,619 |
| Assets. Value of participant loans | 2012-12-31 | $58,321 |
| Total contributions received or receivable from employer(s) | 2012-12-31 | $18,579 |
| Value of certain deemed distributions of participant loans | 2012-12-31 | $0 |
| Value of corrective distributions | 2012-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2012-12-31 | $268 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2012-12-31 | $0 |
| 2011 : SPECIFIED AIR SOLUTIONS/RAPID UNION 401(K) PLAN 2011 401k financial data |
|---|
| Transfers to/from the plan | 2011-12-31 | $0 |
| Total plan liabilities at end of year | 2011-12-31 | $0 |
| Total plan liabilities at beginning of year | 2011-12-31 | $0 |
| Total income from all sources | 2011-12-31 | $76,655 |
| Expenses. Total of all expenses incurred | 2011-12-31 | $12,410 |
| Benefits paid (including direct rollovers) | 2011-12-31 | $12,348 |
| Total plan assets at end of year | 2011-12-31 | $680,619 |
| Total plan assets at beginning of year | 2011-12-31 | $616,374 |
| Value of fidelity bond covering the plan | 2011-12-31 | $1,000,000 |
| Total contributions received or receivable from participants | 2011-12-31 | $42,665 |
| Expenses. Other expenses not covered elsewhere | 2011-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2011-12-31 | $152 |
| Other income received | 2011-12-31 | $17,557 |
| Noncash contributions received | 2011-12-31 | $0 |
| Net income (gross income less expenses) | 2011-12-31 | $64,245 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-31 | $680,619 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-31 | $616,374 |
| Assets. Value of participant loans | 2011-12-31 | $6,196 |
| Total contributions received or receivable from employer(s) | 2011-12-31 | $16,281 |
| Value of certain deemed distributions of participant loans | 2011-12-31 | $0 |
| Value of corrective distributions | 2011-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2011-12-31 | $62 |
| 2010 : SPECIFIED AIR SOLUTIONS/RAPID UNION 401(K) PLAN 2010 401k financial data |
|---|
| Total income from all sources | 2010-12-31 | $101,012 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $3,612 |
| Benefits paid (including direct rollovers) | 2010-12-31 | $3,571 |
| Total plan assets at end of year | 2010-12-31 | $616,374 |
| Total plan assets at beginning of year | 2010-12-31 | $518,974 |
| Value of fidelity bond covering the plan | 2010-12-31 | $1,000,000 |
| Total contributions received or receivable from participants | 2010-12-31 | $23,056 |
| Expenses. Other expenses not covered elsewhere | 2010-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2010-12-31 | $725 |
| Other income received | 2010-12-31 | $65,778 |
| Net income (gross income less expenses) | 2010-12-31 | $97,400 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $616,374 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $518,974 |
| Assets. Value of participant loans | 2010-12-31 | $8,930 |
| Total contributions received or receivable from employer(s) | 2010-12-31 | $11,453 |
| Value of certain deemed distributions of participant loans | 2010-12-31 | $0 |
| Value of corrective distributions | 2010-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2010-12-31 | $41 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2010-12-31 | $0 |
| 2009 : SPECIFIED AIR SOLUTIONS/RAPID UNION 401(K) PLAN 2009 401k financial data |
|---|
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2009-12-31 | $0 |
| 2016: SPECIFIED AIR SOLUTIONS/RAPID UNION 401(K) PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – Trust | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement - Trust | Yes |
| 2015: SPECIFIED AIR SOLUTIONS/RAPID UNION 401(K) PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – Trust | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement - Trust | Yes |
| 2014: SPECIFIED AIR SOLUTIONS/RAPID UNION 401(K) PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Submission has been amended | No |
| 2014-01-01 | This submission is the final filing | No |
| 2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-01-01 | Plan is a collectively bargained plan | No |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – Trust | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement - Trust | Yes |
| 2013: SPECIFIED AIR SOLUTIONS/RAPID UNION 401(K) PLAN 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Submission has been amended | No |
| 2013-01-01 | This submission is the final filing | No |
| 2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-01-01 | Plan is a collectively bargained plan | No |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – Trust | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement - Trust | Yes |
| 2012: SPECIFIED AIR SOLUTIONS/RAPID UNION 401(K) PLAN 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Submission has been amended | No |
| 2012-01-01 | This submission is the final filing | No |
| 2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-01-01 | Plan is a collectively bargained plan | No |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – Trust | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement - Trust | Yes |
| 2011: SPECIFIED AIR SOLUTIONS/RAPID UNION 401(K) PLAN 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Submission has been amended | No |
| 2011-01-01 | This submission is the final filing | No |
| 2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-01-01 | Plan is a collectively bargained plan | No |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan funding arrangement – Trust | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement - Trust | Yes |
| 2010: SPECIFIED AIR SOLUTIONS/RAPID UNION 401(K) PLAN 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Submission has been amended | No |
| 2010-01-01 | This submission is the final filing | No |
| 2010-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-01-01 | Plan is a collectively bargained plan | Yes |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan funding arrangement – Trust | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement - Trust | Yes |
| 2009: SPECIFIED AIR SOLUTIONS/RAPID UNION 401(K) PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Submission has been amended | No |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | Yes |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan funding arrangement – Trust | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement - Trust | Yes |
| JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 ) |
| Policy contract number | 99912 |
| Policy instance | 1 |
| Insurance contract or identification number | 99912 | | Number of Individuals Covered | 24 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $300 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | Yes | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 300 | | Additional information about fees paid to insurance broker | TPA FEES PAID | | Insurance broker organization code? | 5 | | Insurance broker name | P&A ADMINISTRATIVE SERVICES |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 ) |
| Policy contract number | 99912 |
| Policy instance | 1 |
| Insurance contract or identification number | 99912 | | Number of Individuals Covered | 25 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | Yes | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 5 | | Insurance broker name | P&A ADMINISTRATIVE SERVICES |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 ) |
| Policy contract number | 99912 |
| Policy instance | 1 |
| Insurance contract or identification number | 99912 | | Number of Individuals Covered | 25 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $100 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | Yes | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Amount paid for insurance broker fees | 100 | | Additional information about fees paid to insurance broker | TPA SERVICES | | Insurance broker organization code? | 5 | | Insurance broker name | P&A ADMINISTRATIVE SERVICES |
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| JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 ) |
| Policy contract number | 99912 |
| Policy instance | 1 |
| Insurance contract or identification number | 99912 | | Number of Individuals Covered | 23 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $637 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | Yes | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 609 | | Additional information about fees paid to insurance broker | TPA SERVICES | | Insurance broker organization code? | 5 | | Insurance broker name | P&A RETIREMENT PLAN SERVICES, INC |
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| JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 86375 ) |
| Policy contract number | 99912 |
| Policy instance | 1 |
| Insurance contract or identification number | 99912 | | Number of Individuals Covered | 25 | | Insurance policy start date | 2011-01-13 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $1,669 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | Yes | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No |
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| MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 ) |
| Policy contract number | SF 7949 |
| Policy instance | 2 |
| Insurance contract or identification number | SF 7949 | | Number of Individuals Covered | 30 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-01-13 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | Yes | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No |
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| MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 ) |
| Policy contract number | SF 7949 |
| Policy instance | 1 |
| Insurance contract or identification number | SF 7949 | | Number of Individuals Covered | 30 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | Yes | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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