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LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING 401k Plan overview

Plan NameLEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING
Plan identification number 001

LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING 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.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

LEACH JOHNSON SONG & GRUCHOW has sponsored the creation of one or more 401k plans.

Company Name:LEACH JOHNSON SONG & GRUCHOW
Employer identification number (EIN):260150627
NAIC Classification:541110
NAIC Description:Offices of Lawyers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01KIRBY GRUCHOW2023-07-10
0012021-01-01KIRBY GRUCHOW2022-07-21
0012020-01-01KIRBY GRUCHOW2021-10-11
0012019-01-01KIRBY GRUCHOW2020-10-05
0012018-01-01
0012017-01-01KIRBY GRUCHOW, JR.
0012016-01-01KIRBY GRUCHOW, JR.
0012015-01-01KIRBY GRUCHOW, JR.
0012014-01-01KIRBY GRUCHOW, JR.
0012013-01-01KIRBY GRUCHOW, JR.
0012012-01-01KIRBY GRUCHOW, JR.
0012011-01-01KIRBY GRUCHOW, JR.
0012010-01-01KIRBY GRUCHOW JR2011-06-07

Plan Statistics for LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING

401k plan membership statisitcs for LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING

Measure Date Value
2018: LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING 2018 401k membership
Total participants, beginning-of-year2018-01-0127
Total number of active participants reported on line 7a of the Form 55002018-01-0122
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-012
Total of all active and inactive participants2018-01-0124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0124
Number of participants with account balances2018-01-0123
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-011
2017: LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING 2017 401k membership
Total participants, beginning-of-year2017-01-0132
Total number of active participants reported on line 7a of the Form 55002017-01-0121
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-016
Total of all active and inactive participants2017-01-0127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0127
Number of participants with account balances2017-01-0127
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-012
2016: LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING 2016 401k membership
Total participants, beginning-of-year2016-01-0129
Total number of active participants reported on line 7a of the Form 55002016-01-0123
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-017
Total of all active and inactive participants2016-01-0130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0130
Number of participants with account balances2016-01-0130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-012
2015: LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING 2015 401k membership
Total participants, beginning-of-year2015-01-0127
Total number of active participants reported on line 7a of the Form 55002015-01-0121
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-017
Total of all active and inactive participants2015-01-0128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0128
Number of participants with account balances2015-01-0128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-015
2014: LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING 2014 401k membership
Total participants, beginning-of-year2014-01-0126
Total number of active participants reported on line 7a of the Form 55002014-01-0122
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-018
Total of all active and inactive participants2014-01-0130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0130
Number of participants with account balances2014-01-0130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING 2013 401k membership
Total participants, beginning-of-year2013-01-0119
Total number of active participants reported on line 7a of the Form 55002013-01-0118
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-017
Total of all active and inactive participants2013-01-0125
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0125
Number of participants with account balances2013-01-0123
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-013
2012: LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING 2012 401k membership
Total participants, beginning-of-year2012-01-0118
Total number of active participants reported on line 7a of the Form 55002012-01-0119
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-013
Total of all active and inactive participants2012-01-0122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0122
Number of participants with account balances2012-01-0118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-011
2011: LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING 2011 401k membership
Total participants, beginning-of-year2011-01-0115
Total number of active participants reported on line 7a of the Form 55002011-01-0116
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-012
Total of all active and inactive participants2011-01-0118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0118
Number of participants with account balances2011-01-0118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-012

Financial Data on LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING

Measure Date Value
2018 : LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING 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$0
Total income from all sources2018-12-31$77,955
Expenses. Total of all expenses incurred2018-12-31$29,277
Benefits paid (including direct rollovers)2018-12-31$28,923
Total plan assets at end of year2018-12-31$3,229,531
Total plan assets at beginning of year2018-12-31$3,180,853
Value of fidelity bond covering the plan2018-12-31$500,000
Total contributions received or receivable from participants2018-12-31$179,881
Expenses. Other expenses not covered elsewhere2018-12-31$0
Contributions received from other sources (not participants or employers)2018-12-31$0
Other income received2018-12-31$-227,335
Noncash contributions received2018-12-31$0
Net income (gross income less expenses)2018-12-31$48,678
Net plan assets at end of year (total assets less liabilities)2018-12-31$3,229,531
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$3,180,853
Assets. Value of participant loans2018-12-31$29,138
Total contributions received or receivable from employer(s)2018-12-31$125,409
Value of certain deemed distributions of participant loans2018-12-31$0
Value of corrective distributions2018-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$354
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
2017 : LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING 2017 401k financial data
Total plan liabilities at end of year2017-12-31$0
Total plan liabilities at beginning of year2017-12-31$0
Total income from all sources2017-12-31$739,244
Expenses. Total of all expenses incurred2017-12-31$42,541
Benefits paid (including direct rollovers)2017-12-31$42,233
Total plan assets at end of year2017-12-31$3,180,853
Total plan assets at beginning of year2017-12-31$2,484,150
Value of fidelity bond covering the plan2017-12-31$500,000
Total contributions received or receivable from participants2017-12-31$151,008
Other income received2017-12-31$451,669
Net income (gross income less expenses)2017-12-31$696,703
Net plan assets at end of year (total assets less liabilities)2017-12-31$3,180,853
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$2,484,150
Assets. Value of participant loans2017-12-31$30,119
Total contributions received or receivable from employer(s)2017-12-31$136,567
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$308
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING 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$391,406
Expenses. Total of all expenses incurred2016-12-31$658
Benefits paid (including direct rollovers)2016-12-31$438
Total plan assets at end of year2016-12-31$2,484,150
Total plan assets at beginning of year2016-12-31$2,093,402
Value of fidelity bond covering the plan2016-12-31$180,000
Total contributions received or receivable from participants2016-12-31$126,589
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$110,245
Noncash contributions received2016-12-31$0
Net income (gross income less expenses)2016-12-31$390,748
Net plan assets at end of year (total assets less liabilities)2016-12-31$2,484,150
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$2,093,402
Assets. Value of participant loans2016-12-31$77,822
Total contributions received or receivable from employer(s)2016-12-31$154,572
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$220
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING 2015 401k financial data
Transfers to/from the plan2015-12-31$0
Total plan liabilities at end of year2015-12-31$0
Total plan liabilities at beginning of year2015-12-31$0
Total income from all sources2015-12-31$323,885
Expenses. Total of all expenses incurred2015-12-31$8,445
Benefits paid (including direct rollovers)2015-12-31$8,303
Total plan assets at end of year2015-12-31$2,093,402
Total plan assets at beginning of year2015-12-31$1,777,962
Value of fidelity bond covering the plan2015-12-31$180,000
Total contributions received or receivable from participants2015-12-31$125,462
Expenses. Other expenses not covered elsewhere2015-12-31$0
Contributions received from other sources (not participants or employers)2015-12-31$0
Other income received2015-12-31$20,077
Noncash contributions received2015-12-31$0
Net income (gross income less expenses)2015-12-31$315,440
Net plan assets at end of year (total assets less liabilities)2015-12-31$2,093,402
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$1,777,962
Assets. Value of participant loans2015-12-31$20,431
Total contributions received or receivable from employer(s)2015-12-31$178,346
Value of certain deemed distributions of participant loans2015-12-31$0
Value of corrective distributions2015-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$142
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING 2014 401k financial data
Transfers to/from the plan2014-12-31$0
Total plan liabilities at end of year2014-12-31$0
Total plan liabilities at beginning of year2014-12-31$0
Total income from all sources2014-12-31$425,343
Expenses. Total of all expenses incurred2014-12-31$22,726
Benefits paid (including direct rollovers)2014-12-31$17,069
Total plan assets at end of year2014-12-31$1,777,962
Total plan assets at beginning of year2014-12-31$1,375,345
Value of fidelity bond covering the plan2014-12-31$90,000
Total contributions received or receivable from participants2014-12-31$110,751
Expenses. Other expenses not covered elsewhere2014-12-31$0
Contributions received from other sources (not participants or employers)2014-12-31$36,799
Other income received2014-12-31$99,772
Noncash contributions received2014-12-31$0
Net income (gross income less expenses)2014-12-31$402,617
Net plan assets at end of year (total assets less liabilities)2014-12-31$1,777,962
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$1,375,345
Assets. Value of participant loans2014-12-31$19,864
Total contributions received or receivable from employer(s)2014-12-31$178,021
Value of certain deemed distributions of participant loans2014-12-31$0
Value of corrective distributions2014-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$5,657
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING 2013 401k financial data
Transfers to/from the plan2013-12-31$0
Total plan liabilities at end of year2013-12-31$0
Total plan liabilities at beginning of year2013-12-31$0
Total income from all sources2013-12-31$312,006
Expenses. Total of all expenses incurred2013-12-31$16,638
Benefits paid (including direct rollovers)2013-12-31$16,059
Total plan assets at end of year2013-12-31$1,375,345
Total plan assets at beginning of year2013-12-31$1,079,977
Value of fidelity bond covering the plan2013-12-31$90,000
Total contributions received or receivable from participants2013-12-31$94,757
Expenses. Other expenses not covered elsewhere2013-12-31$0
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$164,201
Noncash contributions received2013-12-31$0
Net income (gross income less expenses)2013-12-31$295,368
Net plan assets at end of year (total assets less liabilities)2013-12-31$1,375,345
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$1,079,977
Assets. Value of participant loans2013-12-31$4,125
Total contributions received or receivable from employer(s)2013-12-31$53,048
Value of certain deemed distributions of participant loans2013-12-31$0
Value of corrective distributions2013-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$579
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING 2012 401k financial data
Transfers to/from the plan2012-12-31$0
Total plan liabilities at end of year2012-12-31$0
Total plan liabilities at beginning of year2012-12-31$0
Total income from all sources2012-12-31$351,828
Expenses. Total of all expenses incurred2012-12-31$35,187
Benefits paid (including direct rollovers)2012-12-31$24,102
Total plan assets at end of year2012-12-31$1,079,977
Total plan assets at beginning of year2012-12-31$763,336
Value of fidelity bond covering the plan2012-12-31$76,000
Total contributions received or receivable from participants2012-12-31$72,534
Expenses. Other expenses not covered elsewhere2012-12-31$0
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$118,688
Noncash contributions received2012-12-31$0
Net income (gross income less expenses)2012-12-31$316,641
Net plan assets at end of year (total assets less liabilities)2012-12-31$1,079,977
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$763,336
Total contributions received or receivable from employer(s)2012-12-31$160,606
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$11,085
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING 2011 401k financial data
Transfers to/from the plan2011-12-31$0
Total plan liabilities at end of year2011-12-31$0
Total plan liabilities at beginning of year2011-12-31$0
Total income from all sources2011-12-31$156,785
Expenses. Total of all expenses incurred2011-12-31$9,179
Benefits paid (including direct rollovers)2011-12-31$0
Total plan assets at end of year2011-12-31$763,336
Total plan assets at beginning of year2011-12-31$615,730
Value of fidelity bond covering the plan2011-12-31$76,000
Total contributions received or receivable from participants2011-12-31$94,810
Expenses. Other expenses not covered elsewhere2011-12-31$0
Contributions received from other sources (not participants or employers)2011-12-31$18,512
Other income received2011-12-31$-22,371
Noncash contributions received2011-12-31$0
Net income (gross income less expenses)2011-12-31$147,606
Net plan assets at end of year (total assets less liabilities)2011-12-31$763,336
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$615,730
Total contributions received or receivable from employer(s)2011-12-31$65,834
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$9,179
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0

Form 5500 Responses for LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING

2018: LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING 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: LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING 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: LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement - TrustYes
2011: LEACH JOHNSON SONG & GRUCHOW 401(K) PROFIT SHARING 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan 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 number110461
Policy instance 1
Insurance contract or identification number110461
Number of Individuals Covered27
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $10,629
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?Yes
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 $10,629
Insurance broker organization code?7
Insurance broker nameQUESTAR AGENCY, INC.
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number110461
Policy instance 1
Insurance contract or identification number110461
Number of Individuals Covered28
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $7,491
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?Yes
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 $7,491
Insurance broker organization code?7
Insurance broker nameQUESTAR AGENCY, INC.
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number110461
Policy instance 1
Insurance contract or identification number110461
Number of Individuals Covered26
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $5,657
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?Yes
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,657
Amount paid for insurance broker fees0
Insurance broker organization code?7
Insurance broker nameQUESTAR AGENCY, INC.
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number110461
Policy instance 1
Insurance contract or identification number110461
Number of Individuals Covered23
Insurance policy start date2013-03-18
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $11,970
Total amount of fees paid to insurance companyUSD $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 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
Commission paid to Insurance BrokerUSD $11,970
Insurance broker organization code?7
Insurance broker nameQUESTAR AGENCY, INC.

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