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JOHNSTONE SUPPLY 401(K) PROFIT SHARING PLAN PLAN 401k Plan overview

Plan NameJOHNSTONE SUPPLY 401(K) PROFIT SHARING PLAN PLAN
Plan identification number 001

JOHNSTONE SUPPLY 401(K) PROFIT SHARING PLAN PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • 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

CONTROLS CENTER, INC DBA JOHNSTONE SUPPLY has sponsored the creation of one or more 401k plans.

Company Name:CONTROLS CENTER, INC DBA JOHNSTONE SUPPLY
Employer identification number (EIN):310514287
NAIC Classification:423700

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JOHNSTONE SUPPLY 401(K) PROFIT SHARING PLAN PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01CAMERON GRIMME2019-07-03
0012017-01-01CAMERON GRIMME2018-10-12
0012016-01-01CAMERON GRIMME2017-08-01 CAMERON GRIMME2017-08-01
0012015-01-01GREG GRIMME2016-05-12 GREG GRIMME2016-05-12
0012014-01-01GREG GRIMME2015-05-06 GREG GRIMME2015-05-06
0012013-01-01GREG GRIMME2014-06-20 GREG GRIMME2014-06-20
0012012-01-01GREG GRIMME2013-06-04 GREG GRIMME2013-06-04
0012011-01-01GREG GRIMME2012-05-04 GREG GRIMME2012-05-04
0012010-01-01GREG GRIMME2011-07-20 GREG GRIMME2011-07-20

Plan Statistics for JOHNSTONE SUPPLY 401(K) PROFIT SHARING PLAN PLAN

401k plan membership statisitcs for JOHNSTONE SUPPLY 401(K) PROFIT SHARING PLAN PLAN

Measure Date Value
2022: JOHNSTONE SUPPLY 401(K) PROFIT SHARING PLAN PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01251
Total number of active participants reported on line 7a of the Form 55002022-01-01215
Number of retired or separated participants receiving benefits2022-01-011
Number of other retired or separated participants entitled to future benefits2022-01-0128
Total of all active and inactive participants2022-01-01244
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01244
Number of participants with account balances2022-01-01226
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-0135
2021: JOHNSTONE SUPPLY 401(K) PROFIT SHARING PLAN PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01197
Total number of active participants reported on line 7a of the Form 55002021-01-01192
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0129
Total of all active and inactive participants2021-01-01221
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01221
Number of participants with account balances2021-01-01201
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-0114
2020: JOHNSTONE SUPPLY 401(K) PROFIT SHARING PLAN PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01137
Total number of active participants reported on line 7a of the Form 55002020-01-01129
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0117
Total of all active and inactive participants2020-01-01146
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-011
Total participants2020-01-01147
Number of participants with account balances2020-01-01107
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-014
2019: JOHNSTONE SUPPLY 401(K) PROFIT SHARING PLAN PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01131
Total number of active participants reported on line 7a of the Form 55002019-01-01116
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0113
Total of all active and inactive participants2019-01-01129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-011
Total participants2019-01-01130
Number of participants with account balances2019-01-01107
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-012

Financial Data on JOHNSTONE SUPPLY 401(K) PROFIT SHARING PLAN PLAN

Measure Date Value
2022 : JOHNSTONE SUPPLY 401(K) PROFIT SHARING PLAN PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total transfer of assets to this plan2022-12-31$0
Total transfer of assets from this plan2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$-197,312
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$800,578
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$689,485
Expenses. Certain deemed distributions of participant loans2022-12-31$5,236
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$1,635,906
Value of total assets at end of year2022-12-31$10,213,565
Value of total assets at beginning of year2022-12-31$11,211,455
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$105,857
Total interest from all sources2022-12-31$222
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$1,328
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$1,328
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$952,504
Participant contributions at beginning of year2022-12-31$5,015
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$226,833
Other income not declared elsewhere2022-12-31$34,863
Administrative expenses (other) incurred2022-12-31$105,857
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-997,890
Value of net assets at end of year (total assets less liabilities)2022-12-31$10,213,565
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$11,211,455
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$86,494
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$82,511
Interest on participant loans2022-12-31$222
Value of interest in common/collective trusts at end of year2022-12-31$10,097,090
Value of interest in common/collective trusts at beginning of year2022-12-31$11,105,911
Net investment gain or loss from common/collective trusts2022-12-31$-1,869,631
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$456,569
Employer contributions (assets) at end of year2022-12-31$29,981
Employer contributions (assets) at beginning of year2022-12-31$18,018
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$689,485
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31BARNES DENNIG & CO., LTD.
Accountancy firm EIN2022-12-31311119890
2021 : JOHNSTONE SUPPLY 401(K) PROFIT SHARING PLAN PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total transfer of assets to this plan2021-12-31$1,214,316
Total transfer of assets from this plan2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$2,341,102
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$529,643
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$471,298
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$1,311,978
Value of total assets at end of year2021-12-31$11,211,455
Value of total assets at beginning of year2021-12-31$8,185,680
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$58,345
Total interest from all sources2021-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$100
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$100
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$602,266
Participant contributions at end of year2021-12-31$5,015
Participant contributions at beginning of year2021-12-31$47
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$417,073
Other income not declared elsewhere2021-12-31$19,166
Administrative expenses (other) incurred2021-12-31$58,345
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$1,811,459
Value of net assets at end of year (total assets less liabilities)2021-12-31$11,211,455
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$8,185,680
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$82,511
Value of interest in pooled separate accounts at beginning of year2021-12-31$8,176,648
Value of interest in common/collective trusts at end of year2021-12-31$11,105,911
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$216,159
Net investment gain or loss from common/collective trusts2021-12-31$793,699
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$292,639
Employer contributions (assets) at end of year2021-12-31$18,018
Employer contributions (assets) at beginning of year2021-12-31$8,985
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$471,298
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32021-12-31Yes
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31BARNES DENNIG & CO., LTD.
Accountancy firm EIN2021-12-31311119890
2020 : JOHNSTONE SUPPLY 401(K) PROFIT SHARING PLAN PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$1,535,498
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$198,465
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$148,793
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$626,298
Value of total assets at end of year2020-12-31$8,185,680
Value of total assets at beginning of year2020-12-31$6,848,647
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$49,672
Total interest from all sources2020-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$414,904
Participant contributions at end of year2020-12-31$47
Participant contributions at beginning of year2020-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$8,113
Administrative expenses (other) incurred2020-12-31$49,672
Total non interest bearing cash at end of year2020-12-31$0
Total non interest bearing cash at beginning of year2020-12-31$9,730
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$1,337,033
Value of net assets at end of year (total assets less liabilities)2020-12-31$8,185,680
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$6,848,647
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in pooled separate accounts at end of year2020-12-31$8,176,648
Value of interest in pooled separate accounts at beginning of year2020-12-31$6,823,764
Net investment gain/loss from pooled separate accounts2020-12-31$909,200
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$203,281
Employer contributions (assets) at end of year2020-12-31$8,985
Employer contributions (assets) at beginning of year2020-12-31$15,153
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$148,793
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31BARNES DENNIG AND CO., LTD.
Accountancy firm EIN2020-12-31311119890
2019 : JOHNSTONE SUPPLY 401(K) PROFIT SHARING PLAN PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$1,887,162
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$130,403
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$85,734
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$697,468
Value of total assets at end of year2019-12-31$6,848,647
Value of total assets at beginning of year2019-12-31$5,091,888
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$44,669
Total interest from all sources2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$374,219
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$130,262
Administrative expenses (other) incurred2019-12-31$44,669
Total non interest bearing cash at end of year2019-12-31$9,730
Total non interest bearing cash at beginning of year2019-12-31$3,177
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$1,756,759
Value of net assets at end of year (total assets less liabilities)2019-12-31$6,848,647
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$5,091,888
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in pooled separate accounts at end of year2019-12-31$6,823,764
Value of interest in pooled separate accounts at beginning of year2019-12-31$5,079,842
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$1,189,694
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$192,987
Employer contributions (assets) at end of year2019-12-31$15,153
Employer contributions (assets) at beginning of year2019-12-31$8,869
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$85,734
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31BARNES DENNIG AND CO., LTD.
Accountancy firm EIN2019-12-31311119890

Form 5500 Responses for JOHNSTONE SUPPLY 401(K) PROFIT SHARING PLAN PLAN

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

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number126924
Policy instance 1
Insurance contract or identification number126924
Number of Individuals Covered114
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $699
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees699
Additional information about fees paid to insurance brokerTPA FEES & COMPENSATION
Insurance broker organization code?5
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number126924
Policy instance 1
Insurance contract or identification number126924
Number of Individuals Covered114
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $19,999
Total amount of fees paid to insurance companyUSD $5,032
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,999
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerBROKER COMMISSION
Insurance broker organization code?3
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number126924
Policy instance 1
Insurance contract or identification number126924
Number of Individuals Covered110
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $19,136
Total amount of fees paid to insurance companyUSD $4,544
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,136
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerBROKER COMMISSION
Insurance broker organization code?3

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