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ADVANCED ORTHOPAEDIC CENTERS 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan NameADVANCED ORTHOPAEDIC CENTERS 401(K) PROFIT SHARING PLAN
Plan identification number 004

ADVANCED ORTHOPAEDIC CENTERS 401(K) PROFIT SHARING PLAN Benefits

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

401k Sponsoring company profile

ADVANCED ORTHOPAEDIC CENTERS has sponsored the creation of one or more 401k plans.

Company Name:ADVANCED ORTHOPAEDIC CENTERS
Employer identification number (EIN):221931562
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ADVANCED ORTHOPAEDIC CENTERS 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0042022-01-01THOMAS P. O'BADE2023-10-16
0042021-01-01THOMAS P. OBADE, MD2022-10-10
0042020-01-01THOMAS P. OBADE, MD2021-10-15
0042019-01-01THOMAS P. OBADE, MD2020-10-07
0042018-01-01THOMAS P. OBADE, MD2019-10-01
0042017-01-01
0042016-01-01
0042016-01-01
0042015-01-01
0042014-01-01DARCY MALIN2015-09-30
0042013-01-01DARCY MALIN2015-01-10
0042012-01-01DARCY MALIN2013-07-02
0042011-01-01DARCY MALIN2012-09-28
0042010-01-01DARCY MALIN2011-09-07

Plan Statistics for ADVANCED ORTHOPAEDIC CENTERS 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for ADVANCED ORTHOPAEDIC CENTERS 401(K) PROFIT SHARING PLAN

Measure Date Value
2022: ADVANCED ORTHOPAEDIC CENTERS 401(K) PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0140
Total number of active participants reported on line 7a of the Form 55002022-01-018
Number of retired or separated participants receiving benefits2022-01-015
Number of other retired or separated participants entitled to future benefits2022-01-0123
Total of all active and inactive participants2022-01-0136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-011
Total participants2022-01-0137
Number of participants with account balances2022-01-0136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: ADVANCED ORTHOPAEDIC CENTERS 401(K) PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0142
Total number of active participants reported on line 7a of the Form 55002021-01-018
Number of retired or separated participants receiving benefits2021-01-016
Number of other retired or separated participants entitled to future benefits2021-01-0126
Total of all active and inactive participants2021-01-0140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-0140
Number of participants with account balances2021-01-0140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-012
2020: ADVANCED ORTHOPAEDIC CENTERS 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0140
Total number of active participants reported on line 7a of the Form 55002020-01-0110
Number of retired or separated participants receiving benefits2020-01-016
Number of other retired or separated participants entitled to future benefits2020-01-0123
Total of all active and inactive participants2020-01-0139
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-011
Total participants2020-01-0140
Number of participants with account balances2020-01-0140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-011
2019: ADVANCED ORTHOPAEDIC CENTERS 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0147
Total number of active participants reported on line 7a of the Form 55002019-01-019
Number of retired or separated participants receiving benefits2019-01-017
Number of other retired or separated participants entitled to future benefits2019-01-0124
Total of all active and inactive participants2019-01-0140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0140
Number of participants with account balances2019-01-0140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-014
2018: ADVANCED ORTHOPAEDIC CENTERS 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0149
Total number of active participants reported on line 7a of the Form 55002018-01-0119
Number of retired or separated participants receiving benefits2018-01-016
Number of other retired or separated participants entitled to future benefits2018-01-0122
Total of all active and inactive participants2018-01-0147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0147
Number of participants with account balances2018-01-015
2017: ADVANCED ORTHOPAEDIC CENTERS 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0151
Total number of active participants reported on line 7a of the Form 55002017-01-0131
Number of retired or separated participants receiving benefits2017-01-013
Number of other retired or separated participants entitled to future benefits2017-01-0112
Total of all active and inactive participants2017-01-0146
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0146
Number of participants with account balances2017-01-0145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: ADVANCED ORTHOPAEDIC CENTERS 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0144
Total number of active participants reported on line 7a of the Form 55002016-01-0129
Number of retired or separated participants receiving benefits2016-01-013
Number of other retired or separated participants entitled to future benefits2016-01-0115
Total of all active and inactive participants2016-01-0147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0147
Number of participants with account balances2016-01-0147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-012

Financial Data on ADVANCED ORTHOPAEDIC CENTERS 401(K) PROFIT SHARING PLAN

Measure Date Value
2022 : ADVANCED ORTHOPAEDIC CENTERS 401(K) PROFIT SHARING PLAN 2022 401k financial data
Transfers to/from the plan2022-12-31$0
Total plan liabilities at end of year2022-12-31$0
Total plan liabilities at beginning of year2022-12-31$0
Total income from all sources2022-12-31$-2,010,686
Expenses. Total of all expenses incurred2022-12-31$597,176
Benefits paid (including direct rollovers)2022-12-31$515,311
Total plan assets at end of year2022-12-31$8,946,120
Total plan assets at beginning of year2022-12-31$11,553,982
Value of fidelity bond covering the plan2022-12-31$600,000
Total contributions received or receivable from participants2022-12-31$2,646
Expenses. Other expenses not covered elsewhere2022-12-31$0
Contributions received from other sources (not participants or employers)2022-12-31$0
Other income received2022-12-31$-2,026,751
Noncash contributions received2022-12-31$0
Net income (gross income less expenses)2022-12-31$-2,607,862
Net plan assets at end of year (total assets less liabilities)2022-12-31$8,946,120
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$11,553,982
Assets. Value of assets in partnership/joint-venture interests2022-12-31$510,298
Total contributions received or receivable from employer(s)2022-12-31$13,419
Value of certain deemed distributions of participant loans2022-12-31$0
Value of corrective distributions2022-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$81,865
2021 : ADVANCED ORTHOPAEDIC CENTERS 401(K) PROFIT SHARING PLAN 2021 401k financial data
Transfers to/from the plan2021-12-31$0
Total plan liabilities at end of year2021-12-31$0
Total plan liabilities at beginning of year2021-12-31$0
Total income from all sources2021-12-31$2,080,666
Expenses. Total of all expenses incurred2021-12-31$504,657
Benefits paid (including direct rollovers)2021-12-31$415,513
Total plan assets at end of year2021-12-31$11,553,982
Total plan assets at beginning of year2021-12-31$9,977,973
Value of fidelity bond covering the plan2021-12-31$500,000
Total contributions received or receivable from participants2021-12-31$3,469
Expenses. Other expenses not covered elsewhere2021-12-31$0
Contributions received from other sources (not participants or employers)2021-12-31$0
Other income received2021-12-31$2,077,172
Noncash contributions received2021-12-31$0
Net income (gross income less expenses)2021-12-31$1,576,009
Net plan assets at end of year (total assets less liabilities)2021-12-31$11,553,982
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$9,977,973
Assets. Value of assets in partnership/joint-venture interests2021-12-31$509,963
Total contributions received or receivable from employer(s)2021-12-31$25
Value of certain deemed distributions of participant loans2021-12-31$0
Value of corrective distributions2021-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$89,144
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
2020 : ADVANCED ORTHOPAEDIC CENTERS 401(K) PROFIT SHARING PLAN 2020 401k financial data
Transfers to/from the plan2020-12-31$0
Total plan liabilities at end of year2020-12-31$0
Total plan liabilities at beginning of year2020-12-31$0
Total income from all sources2020-12-31$1,368,971
Expenses. Total of all expenses incurred2020-12-31$1,017,977
Benefits paid (including direct rollovers)2020-12-31$949,136
Total plan assets at end of year2020-12-31$9,977,973
Total plan assets at beginning of year2020-12-31$9,626,979
Value of fidelity bond covering the plan2020-12-31$600,000
Total contributions received or receivable from participants2020-12-31$6,384
Expenses. Other expenses not covered elsewhere2020-12-31$0
Contributions received from other sources (not participants or employers)2020-12-31$0
Noncash contributions received2020-12-31$1,347,758
Net income (gross income less expenses)2020-12-31$350,994
Net plan assets at end of year (total assets less liabilities)2020-12-31$9,977,973
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$9,626,979
Assets. Value of participant loans2020-12-31$17,718
Assets. Value of assets in partnership/joint-venture interests2020-12-31$464,948
Total contributions received or receivable from employer(s)2020-12-31$14,829
Value of certain deemed distributions of participant loans2020-12-31$0
Value of corrective distributions2020-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$68,841
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
2019 : ADVANCED ORTHOPAEDIC CENTERS 401(K) PROFIT SHARING PLAN 2019 401k financial data
Transfers to/from the plan2019-12-31$0
Total plan liabilities at end of year2019-12-31$0
Total plan liabilities at beginning of year2019-12-31$0
Total income from all sources2019-12-31$2,210,319
Expenses. Total of all expenses incurred2019-12-31$775,899
Benefits paid (including direct rollovers)2019-12-31$715,934
Total plan assets at end of year2019-12-31$9,626,979
Total plan assets at beginning of year2019-12-31$8,192,559
Value of fidelity bond covering the plan2019-12-31$600,000
Total contributions received or receivable from participants2019-12-31$47,231
Expenses. Other expenses not covered elsewhere2019-12-31$0
Contributions received from other sources (not participants or employers)2019-12-31$0
Other income received2019-12-31$2,139,303
Noncash contributions received2019-12-31$0
Net income (gross income less expenses)2019-12-31$1,434,420
Net plan assets at end of year (total assets less liabilities)2019-12-31$9,626,979
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$8,192,559
Assets. Value of participant loans2019-12-31$24,007
Assets. Value of assets in partnership/joint-venture interests2019-12-31$504,110
Total contributions received or receivable from employer(s)2019-12-31$23,785
Value of certain deemed distributions of participant loans2019-12-31$0
Value of corrective distributions2019-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$59,965
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
2018 : ADVANCED ORTHOPAEDIC CENTERS 401(K) PROFIT SHARING PLAN 2018 401k financial data
Transfers to/from the plan2018-12-31$0
Total plan liabilities at end of year2018-12-31$0
Total plan liabilities at beginning of year2018-12-31$3,185
Total income from all sources2018-12-31$-289,931
Expenses. Total of all expenses incurred2018-12-31$449,400
Benefits paid (including direct rollovers)2018-12-31$360,132
Total plan assets at end of year2018-12-31$8,192,559
Total plan assets at beginning of year2018-12-31$8,935,075
Value of fidelity bond covering the plan2018-12-31$600,000
Total contributions received or receivable from participants2018-12-31$144,585
Expenses. Other expenses not covered elsewhere2018-12-31$0
Contributions received from other sources (not participants or employers)2018-12-31$0
Other income received2018-12-31$-513,863
Noncash contributions received2018-12-31$0
Net income (gross income less expenses)2018-12-31$-739,331
Net plan assets at end of year (total assets less liabilities)2018-12-31$8,192,559
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$8,931,890
Assets. Value of participant loans2018-12-31$30,376
Assets. Value of assets in partnership/joint-venture interests2018-12-31$462,568
Total contributions received or receivable from employer(s)2018-12-31$79,347
Value of certain deemed distributions of participant loans2018-12-31$0
Value of corrective distributions2018-12-31$33,077
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$56,191
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
2017 : ADVANCED ORTHOPAEDIC CENTERS 401(K) PROFIT SHARING PLAN 2017 401k financial data
Transfers to/from the plan2017-12-31$0
Total plan liabilities at end of year2017-12-31$3,185
Total plan liabilities at beginning of year2017-12-31$0
Total income from all sources2017-12-31$1,791,248
Expenses. Total of all expenses incurred2017-12-31$436,681
Benefits paid (including direct rollovers)2017-12-31$354,451
Total plan assets at end of year2017-12-31$8,935,075
Total plan assets at beginning of year2017-12-31$7,577,323
Value of fidelity bond covering the plan2017-12-31$500,000
Total contributions received or receivable from participants2017-12-31$138,575
Contributions received from other sources (not participants or employers)2017-12-31$37,827
Other income received2017-12-31$1,560,402
Noncash contributions received2017-12-31$0
Net income (gross income less expenses)2017-12-31$1,354,567
Net plan assets at end of year (total assets less liabilities)2017-12-31$8,931,890
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$7,577,323
Assets. Value of participant loans2017-12-31$3,783
Assets. Value of assets in partnership/joint-venture interests2017-12-31$506,667
Total contributions received or receivable from employer(s)2017-12-31$54,444
Value of certain deemed distributions of participant loans2017-12-31$0
Value of corrective distributions2017-12-31$32,538
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$49,692
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : ADVANCED ORTHOPAEDIC CENTERS 401(K) PROFIT SHARING PLAN 2016 401k financial data
Transfers to/from the plan2016-12-31$0
Total plan liabilities at end of year2016-12-31$0
Total plan liabilities at beginning of year2016-12-31$0
Total income from all sources2016-12-31$642,781
Expenses. Total of all expenses incurred2016-12-31$553,142
Benefits paid (including direct rollovers)2016-12-31$509,489
Total plan assets at end of year2016-12-31$7,577,323
Total plan assets at beginning of year2016-12-31$7,487,684
Value of fidelity bond covering the plan2016-12-31$500,000
Total contributions received or receivable from participants2016-12-31$106,683
Expenses. Other expenses not covered elsewhere2016-12-31$0
Contributions received from other sources (not participants or employers)2016-12-31$0
Other income received2016-12-31$474,665
Noncash contributions received2016-12-31$0
Net income (gross income less expenses)2016-12-31$89,639
Net plan assets at end of year (total assets less liabilities)2016-12-31$7,577,323
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$7,487,684
Assets. Value of participant loans2016-12-31$13,246
Assets. Value of assets in partnership/joint-venture interests2016-12-31$470,089
Total contributions received or receivable from employer(s)2016-12-31$61,433
Value of certain deemed distributions of participant loans2016-12-31$0
Value of corrective distributions2016-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$43,653

Form 5500 Responses for ADVANCED ORTHOPAEDIC CENTERS 401(K) PROFIT SHARING PLAN

2022: ADVANCED ORTHOPAEDIC CENTERS 401(K) PROFIT SHARING PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: ADVANCED ORTHOPAEDIC CENTERS 401(K) PROFIT SHARING PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: ADVANCED ORTHOPAEDIC CENTERS 401(K) PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: ADVANCED ORTHOPAEDIC CENTERS 401(K) PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: ADVANCED ORTHOPAEDIC CENTERS 401(K) PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: ADVANCED ORTHOPAEDIC CENTERS 401(K) PROFIT SHARING 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 filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
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: ADVANCED ORTHOPAEDIC CENTERS 401(K) PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedYes
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

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number123391
Policy instance 1
Insurance contract or identification number123391
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $3,563
Total amount of fees paid to insurance companyUSD $1,708
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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,563
Additional information about fees paid to insurance brokerBROKER COMMISSION
Insurance broker organization code?3
Amount paid for insurance broker fees1708
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number123391
Policy instance 1
Insurance contract or identification number123391
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $7,057
Total amount of fees paid to insurance companyUSD $1,545
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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,057
Insurance broker organization code?3
Amount paid for insurance broker fees1545
Additional information about fees paid to insurance brokerTPA FEES
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number123391
Policy instance 1
Insurance contract or identification number123391
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $5,597
Total amount of fees paid to insurance companyUSD $1,281
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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,597
Insurance broker organization code?3
Amount paid for insurance broker fees1281
Additional information about fees paid to insurance brokerTPA FEES
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number123391
Policy instance 1
Insurance contract or identification number123391
Number of Individuals Covered36
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $9,583
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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,329
Insurance broker organization code?3
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number123391
Policy instance 1
Insurance contract or identification number123391
Number of Individuals Covered42
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $9,901
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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,811
Insurance broker organization code?3
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number123391
Policy instance 1
Insurance contract or identification number123391
Number of Individuals Covered44
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $9,650
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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,753
Insurance broker organization code?3
Insurance broker nameTHE MANDMARBLESTONE GROUP LLC

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