GREENE, ROBERTS & RASMUSSEN, PLLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GREENE, ROBERTS & RASMUSSEN, PLLC 401K PROFIT SHARING PLAN AND TRUST
401k plan membership statisitcs for GREENE, ROBERTS & RASMUSSEN, PLLC 401K PROFIT SHARING PLAN AND TRUST
| Measure | Date | Value |
|---|
| 2015: GREENE, ROBERTS & RASMUSSEN, PLLC 401K PROFIT SHARING PLAN AND TRUST 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 12 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 9 |
| Total of all active and inactive participants | 2015-01-01 | 9 |
| Total participants | 2015-01-01 | 9 |
| Number of participants with account balances | 2015-01-01 | 9 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2015-01-01 | 0 |
| 2014: GREENE, ROBERTS & RASMUSSEN, PLLC 401K PROFIT SHARING PLAN AND TRUST 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 14 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 12 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 0 |
| Total of all active and inactive participants | 2014-01-01 | 12 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-01-01 | 0 |
| Total participants | 2014-01-01 | 12 |
| Number of participants with account balances | 2014-01-01 | 12 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2014-01-01 | 0 |
| 2013: GREENE, ROBERTS & RASMUSSEN, PLLC 401K PROFIT SHARING PLAN AND TRUST 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 11 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 14 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 3 |
| Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 0 |
| Total of all active and inactive participants | 2013-01-01 | 17 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-01-01 | 0 |
| Total participants | 2013-01-01 | 17 |
| Number of participants with account balances | 2013-01-01 | 14 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-01-01 | 0 |
| 2012: GREENE, ROBERTS & RASMUSSEN, PLLC 401K PROFIT SHARING PLAN AND TRUST 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 13 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 11 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 2 |
| Total of all active and inactive participants | 2012-01-01 | 13 |
| Total participants | 2012-01-01 | 13 |
| Number of participants with account balances | 2012-01-01 | 11 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-01-01 | 0 |
| 2011: GREENE, ROBERTS & RASMUSSEN, PLLC 401K PROFIT SHARING PLAN AND TRUST 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 11 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 13 |
| Total of all active and inactive participants | 2011-01-01 | 13 |
| Total participants | 2011-01-01 | 13 |
| Number of participants with account balances | 2011-01-01 | 13 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2011-01-01 | 0 |
| 2009: GREENE, ROBERTS & RASMUSSEN, PLLC 401K PROFIT SHARING PLAN AND TRUST 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 8 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 10 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 0 |
| Total of all active and inactive participants | 2009-01-01 | 10 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-01-01 | 0 |
| Total participants | 2009-01-01 | 10 |
| Number of participants with account balances | 2009-01-01 | 10 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-01-01 | 0 |
| Measure | Date | Value |
|---|
| 2015 : GREENE, ROBERTS & RASMUSSEN, PLLC 401K PROFIT SHARING PLAN AND TRUST 2015 401k financial data |
|---|
| Total income from all sources | 2015-12-31 | $73,000 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $69,820 |
| Benefits paid (including direct rollovers) | 2015-12-31 | $62,100 |
| Total plan assets at end of year | 2015-12-31 | $1,909,259 |
| Total plan assets at beginning of year | 2015-12-31 | $1,906,079 |
| Value of fidelity bond covering the plan | 2015-12-31 | $800,000 |
| Total contributions received or receivable from participants | 2015-12-31 | $57,219 |
| Other income received | 2015-12-31 | $1,419 |
| Net income (gross income less expenses) | 2015-12-31 | $3,180 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $1,909,259 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $1,906,079 |
| Assets. Value of real-estate (other than employer real property) | 2015-12-31 | $75,996 |
| Total contributions received or receivable from employer(s) | 2015-12-31 | $14,362 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-12-31 | $7,720 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2015-12-31 | $0 |
| 2014 : GREENE, ROBERTS & RASMUSSEN, PLLC 401K PROFIT SHARING PLAN AND TRUST 2014 401k financial data |
|---|
| Total income from all sources | 2014-12-31 | $104,530 |
| Expenses. Total of all expenses incurred | 2014-12-31 | $145,009 |
| Benefits paid (including direct rollovers) | 2014-12-31 | $132,214 |
| Total plan assets at end of year | 2014-12-31 | $1,906,079 |
| Total plan assets at beginning of year | 2014-12-31 | $1,946,558 |
| Value of fidelity bond covering the plan | 2014-12-31 | $800,000 |
| Total contributions received or receivable from participants | 2014-12-31 | $55,560 |
| Other income received | 2014-12-31 | $32,085 |
| Net income (gross income less expenses) | 2014-12-31 | $-40,479 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $1,906,079 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $1,946,558 |
| Assets. Value of real-estate (other than employer real property) | 2014-12-31 | $52,441 |
| Total contributions received or receivable from employer(s) | 2014-12-31 | $16,885 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2014-12-31 | $12,795 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2014-12-31 | $0 |
| 2013 : GREENE, ROBERTS & RASMUSSEN, PLLC 401K PROFIT SHARING PLAN AND TRUST 2013 401k financial data |
|---|
| Total income from all sources | 2013-12-31 | $371,190 |
| Expenses. Total of all expenses incurred | 2013-12-31 | $94,919 |
| Benefits paid (including direct rollovers) | 2013-12-31 | $87,577 |
| Total plan assets at end of year | 2013-12-31 | $1,946,558 |
| Total plan assets at beginning of year | 2013-12-31 | $1,670,287 |
| Value of fidelity bond covering the plan | 2013-12-31 | $800,000 |
| Total contributions received or receivable from participants | 2013-12-31 | $57,049 |
| Other income received | 2013-12-31 | $295,525 |
| Net income (gross income less expenses) | 2013-12-31 | $276,271 |
| Net plan assets at end of year (total assets less liabilities) | 2013-12-31 | $1,946,558 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-12-31 | $1,670,287 |
| Assets. Value of real-estate (other than employer real property) | 2013-12-31 | $66,833 |
| Total contributions received or receivable from employer(s) | 2013-12-31 | $18,616 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2013-12-31 | $7,342 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2013-12-31 | $0 |
| 2012 : GREENE, ROBERTS & RASMUSSEN, PLLC 401K PROFIT SHARING PLAN AND TRUST 2012 401k financial data |
|---|
| Total income from all sources | 2012-12-31 | $220,277 |
| Expenses. Total of all expenses incurred | 2012-12-31 | $94,821 |
| Benefits paid (including direct rollovers) | 2012-12-31 | $88,179 |
| Total plan assets at end of year | 2012-12-31 | $1,670,287 |
| Total plan assets at beginning of year | 2012-12-31 | $1,544,831 |
| Value of fidelity bond covering the plan | 2012-12-31 | $800,000 |
| Total contributions received or receivable from participants | 2012-12-31 | $48,785 |
| Other income received | 2012-12-31 | $155,846 |
| Net income (gross income less expenses) | 2012-12-31 | $125,456 |
| Net plan assets at end of year (total assets less liabilities) | 2012-12-31 | $1,670,287 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-12-31 | $1,544,831 |
| Assets. Value of real-estate (other than employer real property) | 2012-12-31 | $52,411 |
| Total contributions received or receivable from employer(s) | 2012-12-31 | $15,646 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2012-12-31 | $6,642 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2012-12-31 | $0 |
| 2011 : GREENE, ROBERTS & RASMUSSEN, PLLC 401K PROFIT SHARING PLAN AND TRUST 2011 401k financial data |
|---|
| Total income from all sources | 2011-12-31 | $16,315 |
| Expenses. Total of all expenses incurred | 2011-12-31 | $2,783 |
| Benefits paid (including direct rollovers) | 2011-12-31 | $2,783 |
| Total plan assets at end of year | 2011-12-31 | $1,544,831 |
| Total plan assets at beginning of year | 2011-12-31 | $1,531,298 |
| Value of fidelity bond covering the plan | 2011-12-31 | $800,000 |
| Total contributions received or receivable from participants | 2011-12-31 | $47,295 |
| Other income received | 2011-12-31 | $-48,269 |
| Net income (gross income less expenses) | 2011-12-31 | $13,532 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-31 | $1,544,831 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-31 | $1,531,298 |
| Assets. Value of real-estate (other than employer real property) | 2011-12-31 | $100,972 |
| Total contributions received or receivable from employer(s) | 2011-12-31 | $17,289 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2011-12-31 | $0 |
| 2010 : GREENE, ROBERTS & RASMUSSEN, PLLC 401K PROFIT SHARING PLAN AND TRUST 2010 401k financial data |
|---|
| Total income from all sources | 2010-12-31 | $11,031 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $0 |
| Benefits paid (including direct rollovers) | 2010-12-31 | $0 |
| Total plan assets at end of year | 2010-12-31 | $1,531,298 |
| Total plan assets at beginning of year | 2010-12-31 | $1,520,267 |
| Value of fidelity bond covering the plan | 2010-12-31 | $800,000 |
| Total contributions received or receivable from participants | 2010-12-31 | $48,849 |
| Expenses. Other expenses not covered elsewhere | 2010-12-31 | $0 |
| Other income received | 2010-12-31 | $-57,995 |
| Net income (gross income less expenses) | 2010-12-31 | $11,031 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $1,531,298 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $1,520,267 |
| Assets. Value of real-estate (other than employer real property) | 2010-12-31 | $122,986 |
| Total contributions received or receivable from employer(s) | 2010-12-31 | $20,177 |
| Value of certain deemed distributions of participant loans | 2010-12-31 | $0 |
| Value of corrective distributions | 2010-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2010-12-31 | $0 |
| 2009 : GREENE, ROBERTS & RASMUSSEN, PLLC 401K PROFIT SHARING PLAN AND TRUST 2009 401k financial data |
|---|
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2009-12-31 | $0 |
| 2015: GREENE, ROBERTS & RASMUSSEN, PLLC 401K PROFIT SHARING PLAN AND TRUST 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – Trust | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement - Trust | Yes |
| 2014: GREENE, ROBERTS & RASMUSSEN, PLLC 401K PROFIT SHARING PLAN AND TRUST 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Submission has been amended | No |
| 2014-01-01 | This submission is the final filing | No |
| 2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-01-01 | Plan is a collectively bargained plan | No |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – Trust | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement - Trust | Yes |
| 2013: GREENE, ROBERTS & RASMUSSEN, PLLC 401K PROFIT SHARING PLAN AND TRUST 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Submission has been amended | No |
| 2013-01-01 | This submission is the final filing | No |
| 2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-01-01 | Plan is a collectively bargained plan | No |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – Trust | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement - Trust | Yes |
| 2012: GREENE, ROBERTS & RASMUSSEN, PLLC 401K PROFIT SHARING PLAN AND TRUST 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Submission has been amended | No |
| 2012-01-01 | This submission is the final filing | No |
| 2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-01-01 | Plan is a collectively bargained plan | No |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – Trust | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement - Trust | Yes |
| 2011: GREENE, ROBERTS & RASMUSSEN, PLLC 401K PROFIT SHARING PLAN AND TRUST 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Submission has been amended | No |
| 2011-01-01 | This submission is the final filing | No |
| 2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-01-01 | Plan is a collectively bargained plan | No |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan funding arrangement – Trust | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement - Trust | Yes |
| 2009: GREENE, ROBERTS & RASMUSSEN, PLLC 401K PROFIT SHARING PLAN AND TRUST 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Submission has been amended | No |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan funding arrangement – Trust | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement - Trust | Yes |
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 13245 |
| Policy instance | 1 |
| Insurance contract or identification number | 13245 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $4,864 | | Total amount of fees paid to insurance company | USD $7,720 | | 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? | Yes | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | Yes | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Other information about contract | GROUP ANNUITY CONTRACT | | Commission paid to Insurance Broker | USD $4,864 | | Insurance broker name | UBS FINANCIAL SERVICES |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 5420799 |
| Policy instance | 2 |
| Insurance contract or identification number | 5420799 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $172 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Commission paid to Insurance Broker | USD $172 | | Insurance broker name | JEFFREY PINK |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 13245 |
| Policy instance | 1 |
| Insurance contract or identification number | 13245 | | Number of Individuals Covered | 12 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $4,864 | | Total amount of fees paid to insurance company | USD $7,779 | | 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? | Yes | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | Yes | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Other information about contract | GROUP ANNUITY CONTRACT | | Commission paid to Insurance Broker | USD $4,864 | | Insurance broker name | UBS FINANCIAL SERVICES |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 5420799 |
| Policy instance | 2 |
| Insurance contract or identification number | 5420799 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $172 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $86 | | Insurance broker name | PHILLIP RICHARDS |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 13245 |
| Policy instance | 1 |
| Insurance contract or identification number | 13245 | | Number of Individuals Covered | 14 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $4,418 | | 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? | Yes | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | Yes | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Other information about contract | GROUP ANNUITY CONTRACT | | Commission paid to Insurance Broker | USD $4,418 | | Insurance broker name | UBS FINANCIAL SERVICES |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 5420799 |
| Policy instance | 2 |
| Insurance contract or identification number | 5420799 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $172 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Commission paid to Insurance Broker | USD $86 | | Insurance broker name | JEFFREY PINK |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 5420799 |
| Policy instance | 2 |
| Insurance contract or identification number | 5420799 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $172 | | Total amount of fees paid to insurance company | USD $0 | | Commission paid to Insurance Broker | USD $86 | | Insurance broker name | JEFFREY PINK |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 13245 |
| Policy instance | 1 |
| Insurance contract or identification number | 13245 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $3,924 | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | Yes | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | Yes | | Other information about contract | GROUP ANNUITY CONTRACT | | Commission paid to Insurance Broker | USD $3,924 | | Insurance broker name | UBS FINANCIAL SERVICES |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 13245 |
| Policy instance | 1 |
| Insurance contract or identification number | 13245 | | Number of Individuals Covered | 13 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $3,743 | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | Yes | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | Yes | | Other information about contract | GROUP ANNUITY CONTRACT |
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| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 5420799 |
| Policy instance | 2 |
| Insurance contract or identification number | 5420799 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $848 | | Total amount of fees paid to insurance company | USD $0 |
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| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 13245 |
| Policy instance | 1 |
| Insurance contract or identification number | 13245 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $2,988 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | Yes | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Other information about contract | GROUP ANNUITY CONTRACT | | Commission paid to Insurance Broker | USD $458 | | Insurance broker name | UBS FINANCIAL SERVICES |
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| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 5420799 |
| Policy instance | 2 |
| Insurance contract or identification number | 5420799 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $565 | | Total amount of fees paid to insurance company | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $283 | | Insurance broker name | JEFFREY PINK |
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