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INSURANCE MANAGEMENT COMPANY PROFIT SHARING PLAN 401k Plan overview

Plan NameINSURANCE MANAGEMENT COMPANY PROFIT SHARING PLAN
Plan identification number 001

INSURANCE MANAGEMENT COMPANY PROFIT SHARING 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.
  • 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

INSURANCE MANAGEMENT COMPANY has sponsored the creation of one or more 401k plans.

Company Name:INSURANCE MANAGEMENT COMPANY
Employer identification number (EIN):251142710
NAIC Classification:524210
NAIC Description:Insurance Agencies and Brokerages

Additional information about INSURANCE MANAGEMENT COMPANY

Jurisdiction of Incorporation: Vermont Secretary of State Corporations Division
Incorporation Date: 2005-09-09
Company Identification Number: 80990
Legal Registered Office Address: 17 G W Tatro Dr

Jeffersonville
United States of America (USA)
05464

More information about INSURANCE MANAGEMENT COMPANY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan INSURANCE MANAGEMENT COMPANY PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-07-01JOHN C. BLOOMSTINE2023-10-10
0012021-07-01JOHN C. BLOOMSTINE2022-08-31
0012020-07-01JOHN BLOOMSTINE2021-10-28
0012019-07-01JOHN BLOOMSTINE2020-12-08
0012018-07-01JOHN C BLOOMSTINE2019-12-23
0012017-07-01JOHN C BLOOMSTINE
0012016-07-01BDUBIK
0012015-07-01BDUBIK
0012014-07-01BDUBIK
0012013-07-01BDUBIK
0012012-07-01BDUBIK
0012011-07-01BETH DUBIK2012-08-31
0012010-07-01BETH DUBIK2011-08-17
0012007-07-01

Plan Statistics for INSURANCE MANAGEMENT COMPANY PROFIT SHARING PLAN

401k plan membership statisitcs for INSURANCE MANAGEMENT COMPANY PROFIT SHARING PLAN

Measure Date Value
2017: INSURANCE MANAGEMENT COMPANY PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-0130
Total number of active participants reported on line 7a of the Form 55002017-07-0127
Number of retired or separated participants receiving benefits2017-07-011
Number of other retired or separated participants entitled to future benefits2017-07-011
Total of all active and inactive participants2017-07-0129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-07-010
Total participants2017-07-0129
Number of participants with account balances2017-07-0129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-07-010
2016: INSURANCE MANAGEMENT COMPANY PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-0129
Total number of active participants reported on line 7a of the Form 55002016-07-0126
Number of retired or separated participants receiving benefits2016-07-012
Number of other retired or separated participants entitled to future benefits2016-07-010
Total of all active and inactive participants2016-07-0128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-07-010
Total participants2016-07-0128
Number of participants with account balances2016-07-0128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-07-010
2015: INSURANCE MANAGEMENT COMPANY PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-0129
Total number of active participants reported on line 7a of the Form 55002015-07-0127
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-012
Total of all active and inactive participants2015-07-0129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-07-010
Total participants2015-07-0129
Number of participants with account balances2015-07-0129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-07-010
2014: INSURANCE MANAGEMENT COMPANY PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-0127
Total number of active participants reported on line 7a of the Form 55002014-07-0127
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-010
Total of all active and inactive participants2014-07-0127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-07-010
Total participants2014-07-0127
Number of participants with account balances2014-07-0126
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-07-010
2013: INSURANCE MANAGEMENT COMPANY PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-0124
Total number of active participants reported on line 7a of the Form 55002013-07-0122
Number of retired or separated participants receiving benefits2013-07-012
Number of other retired or separated participants entitled to future benefits2013-07-010
Total of all active and inactive participants2013-07-0124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-07-010
Total participants2013-07-0124
Number of participants with account balances2013-07-0124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-07-010
2012: INSURANCE MANAGEMENT COMPANY PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-07-0127
Total number of active participants reported on line 7a of the Form 55002012-07-0123
Number of retired or separated participants receiving benefits2012-07-010
Number of other retired or separated participants entitled to future benefits2012-07-010
Total of all active and inactive participants2012-07-0123
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-07-010
Total participants2012-07-0123
Number of participants with account balances2012-07-0123
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-07-010

Financial Data on INSURANCE MANAGEMENT COMPANY PROFIT SHARING PLAN

Measure Date Value
2018 : INSURANCE MANAGEMENT COMPANY PROFIT SHARING PLAN 2018 401k financial data
Total income from all sources2018-06-30$1,788,798
Expenses. Total of all expenses incurred2018-06-30$35,105
Benefits paid (including direct rollovers)2018-06-30$14,087
Total plan assets at end of year2018-06-30$11,390,625
Total plan assets at beginning of year2018-06-30$9,636,932
Value of fidelity bond covering the plan2018-06-30$500,000
Total contributions received or receivable from participants2018-06-30$229,142
Other income received2018-06-30$1,408,550
Net income (gross income less expenses)2018-06-30$1,753,693
Net plan assets at end of year (total assets less liabilities)2018-06-30$11,390,625
Net plan assets at beginning of year (total assets less liabilities)2018-06-30$9,636,932
Assets. Value of participant loans2018-06-30$20,293
Total contributions received or receivable from employer(s)2018-06-30$151,106
Expenses. Administrative service providers (salaries,fees and commissions)2018-06-30$21,018
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-06-30$0
2017 : INSURANCE MANAGEMENT COMPANY PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources2017-06-30$1,907,949
Expenses. Total of all expenses incurred2017-06-30$99,659
Benefits paid (including direct rollovers)2017-06-30$81,682
Total plan assets at end of year2017-06-30$9,636,932
Total plan assets at beginning of year2017-06-30$7,828,642
Value of fidelity bond covering the plan2017-06-30$500,000
Total contributions received or receivable from participants2017-06-30$202,921
Contributions received from other sources (not participants or employers)2017-06-30$1,703
Other income received2017-06-30$1,558,648
Net income (gross income less expenses)2017-06-30$1,808,290
Net plan assets at end of year (total assets less liabilities)2017-06-30$9,636,932
Net plan assets at beginning of year (total assets less liabilities)2017-06-30$7,828,642
Assets. Value of participant loans2017-06-30$26,758
Total contributions received or receivable from employer(s)2017-06-30$144,677
Expenses. Administrative service providers (salaries,fees and commissions)2017-06-30$17,977
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-06-30$0
2016 : INSURANCE MANAGEMENT COMPANY PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources2016-06-30$6,402
Expenses. Total of all expenses incurred2016-06-30$23,900
Benefits paid (including direct rollovers)2016-06-30$7,074
Total plan assets at end of year2016-06-30$7,828,642
Total plan assets at beginning of year2016-06-30$7,846,140
Value of fidelity bond covering the plan2016-06-30$500,000
Total contributions received or receivable from participants2016-06-30$244,477
Other income received2016-06-30$-383,252
Net income (gross income less expenses)2016-06-30$-17,498
Net plan assets at end of year (total assets less liabilities)2016-06-30$7,828,642
Net plan assets at beginning of year (total assets less liabilities)2016-06-30$7,846,140
Assets. Value of participant loans2016-06-30$25,020
Total contributions received or receivable from employer(s)2016-06-30$145,177
Expenses. Administrative service providers (salaries,fees and commissions)2016-06-30$16,826
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-06-30$0
2015 : INSURANCE MANAGEMENT COMPANY PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources2015-06-30$443,031
Expenses. Total of all expenses incurred2015-06-30$23,422
Benefits paid (including direct rollovers)2015-06-30$2,207
Total plan assets at end of year2015-06-30$7,846,140
Total plan assets at beginning of year2015-06-30$7,426,531
Value of fidelity bond covering the plan2015-06-30$500,000
Total contributions received or receivable from participants2015-06-30$174,524
Contributions received from other sources (not participants or employers)2015-06-30$3,367
Other income received2015-06-30$160,229
Net income (gross income less expenses)2015-06-30$419,609
Net plan assets at end of year (total assets less liabilities)2015-06-30$7,846,140
Net plan assets at beginning of year (total assets less liabilities)2015-06-30$7,426,531
Assets. Value of participant loans2015-06-30$13,399
Total contributions received or receivable from employer(s)2015-06-30$104,911
Expenses. Administrative service providers (salaries,fees and commissions)2015-06-30$21,215
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-06-30$0
2014 : INSURANCE MANAGEMENT COMPANY PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources2014-06-30$1,239,676
Expenses. Total of all expenses incurred2014-06-30$104,763
Benefits paid (including direct rollovers)2014-06-30$88,929
Total plan assets at end of year2014-06-30$7,426,531
Total plan assets at beginning of year2014-06-30$6,291,618
Value of fidelity bond covering the plan2014-06-30$500,000
Total contributions received or receivable from participants2014-06-30$151,565
Other income received2014-06-30$995,533
Net income (gross income less expenses)2014-06-30$1,134,913
Net plan assets at end of year (total assets less liabilities)2014-06-30$7,426,531
Net plan assets at beginning of year (total assets less liabilities)2014-06-30$6,291,618
Assets. Value of participant loans2014-06-30$20,713
Total contributions received or receivable from employer(s)2014-06-30$92,578
Expenses. Administrative service providers (salaries,fees and commissions)2014-06-30$15,834
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-06-30$0
2013 : INSURANCE MANAGEMENT COMPANY PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources2013-06-30$1,100,549
Expenses. Total of all expenses incurred2013-06-30$28,985
Benefits paid (including direct rollovers)2013-06-30$10,641
Total plan assets at end of year2013-06-30$6,291,618
Total plan assets at beginning of year2013-06-30$5,220,054
Value of fidelity bond covering the plan2013-06-30$500,000
Total contributions received or receivable from participants2013-06-30$150,904
Other income received2013-06-30$855,081
Net income (gross income less expenses)2013-06-30$1,071,564
Net plan assets at end of year (total assets less liabilities)2013-06-30$6,291,618
Net plan assets at beginning of year (total assets less liabilities)2013-06-30$5,220,054
Assets. Value of participant loans2013-06-30$27,952
Total contributions received or receivable from employer(s)2013-06-30$94,564
Expenses. Administrative service providers (salaries,fees and commissions)2013-06-30$18,344
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-06-30$0

Form 5500 Responses for INSURANCE MANAGEMENT COMPANY PROFIT SHARING PLAN

2017: INSURANCE MANAGEMENT COMPANY PROFIT SHARING PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Submission has been amendedNo
2017-07-01This submission is the final filingNo
2017-07-01This return/report is a short plan year return/report (less than 12 months)No
2017-07-01Plan is a collectively bargained planNo
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan funding arrangement – TrustYes
2017-07-01Plan benefit arrangement – InsuranceYes
2017-07-01Plan benefit arrangement - TrustYes
2016: INSURANCE MANAGEMENT COMPANY PROFIT SHARING PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Submission has been amendedNo
2016-07-01This submission is the final filingNo
2016-07-01This return/report is a short plan year return/report (less than 12 months)No
2016-07-01Plan is a collectively bargained planNo
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan funding arrangement – TrustYes
2016-07-01Plan benefit arrangement – InsuranceYes
2016-07-01Plan benefit arrangement - TrustYes
2015: INSURANCE MANAGEMENT COMPANY PROFIT SHARING PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan funding arrangement – TrustYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-07-01Plan benefit arrangement - TrustYes
2014: INSURANCE MANAGEMENT COMPANY PROFIT SHARING PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan funding arrangement – TrustYes
2014-07-01Plan benefit arrangement – InsuranceYes
2014-07-01Plan benefit arrangement - TrustYes
2013: INSURANCE MANAGEMENT COMPANY PROFIT SHARING PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan funding arrangement – TrustYes
2013-07-01Plan benefit arrangement – InsuranceYes
2013-07-01Plan benefit arrangement - TrustYes
2012: INSURANCE MANAGEMENT COMPANY PROFIT SHARING PLAN 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan funding arrangement – TrustYes
2012-07-01Plan benefit arrangement – InsuranceYes
2012-07-01Plan benefit arrangement - TrustYes
2007: INSURANCE MANAGEMENT COMPANY PROFIT SHARING PLAN 2007 form 5500 responses
2007-07-01Type of plan entitySingle employer plan
2007-07-01Submission has been amendedNo
2007-07-01This submission is the final filingNo
2007-07-01This return/report is a short plan year return/report (less than 12 months)No
2007-07-01Plan is a collectively bargained planNo

Insurance Providers Used on plan

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number41521
Policy instance 2
Insurance contract or identification number41521
Number of Individuals Covered3
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $2
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?1
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 BenefitYes
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 $2
Insurance broker organization code?3
Insurance broker nameRICHARD R O'NEILL
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number54135
Policy instance 1
Insurance contract or identification number54135
Number of Individuals Covered29
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $4,322
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 BenefitYes
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
Amount paid for insurance broker fees4322
Additional information about fees paid to insurance brokerTPA FEE & COMPENSATION
Insurance broker organization code?5
Insurance broker nameGF PENSION CORP
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number41521
Policy instance 2
Insurance contract or identification number41521
Number of Individuals Covered3
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $5
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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 BenefitYes
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
Insurance broker organization code?3
Insurance broker nameRICHARD R O'NEILL
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number54135
Policy instance 1
Insurance contract or identification number54135
Number of Individuals Covered29
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $19,628
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 BenefitYes
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
Amount paid for insurance broker fees16607
Additional information about fees paid to insurance brokerINVESTMENT ADVISORY
Insurance broker organization code?4
Insurance broker nameGF PENSION CORP
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number41521
Policy instance 2
Insurance contract or identification number41521
Number of Individuals Covered3
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $5
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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 BenefitYes
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
Insurance broker organization code?3
Insurance broker nameRICHARD R O'NEILL
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number54135
Policy instance 1
Insurance contract or identification number54135
Number of Individuals Covered27
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $21,093
Total amount of fees paid to insurance companyUSD $3,013
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 BenefitYes
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 $21,093
Insurance broker organization code?4
Amount paid for insurance broker fees3013
Additional information about fees paid to insurance brokerTPA FEE & COMPENSATION
Insurance broker nameGF PENSION CORP
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number41521
Policy instance 2
Insurance contract or identification number41521
Number of Individuals Covered3
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $5
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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 BenefitYes
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
Insurance broker organization code?3
Insurance broker nameRICHARD R O'NEILL
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number54135
Policy instance 1
Insurance contract or identification number54135
Number of Individuals Covered24
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $19,355
Total amount of fees paid to insurance companyUSD $2,599
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 BenefitYes
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 $19,355
Insurance broker organization code?4
Amount paid for insurance broker fees2599
Additional information about fees paid to insurance brokerTPA FEE & COMPENSATION
Insurance broker nameGF PENSION CORP
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number41521
Policy instance 2
Insurance contract or identification number41521
Number of Individuals Covered2
Insurance policy start date2009-07-01
Insurance policy end date2010-06-30
Total amount of commissions paid to insurance brokerUSD $5
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
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 BenefitYes
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
Insurance broker organization code?3
Insurance broker nameRICHARD R O'NEILL
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number54135
Policy instance 1
Insurance contract or identification number54135
Number of Individuals Covered23
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $17,980
Total amount of fees paid to insurance companyUSD $2,717
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 BenefitYes
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 $17,980
Insurance broker organization code?4
Amount paid for insurance broker fees2717
Additional information about fees paid to insurance brokerTPA FEE & COMPENSATION
Insurance broker nameGF PENSION CORP

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