401k Plan data: UMCNA EMPLOYEE SAVINGS PLAN plan

UMCNA EMPLOYEE SAVINGS PLAN 401k Plan overview

Plan Name	UMCNA EMPLOYEE SAVINGS PLAN
Plan identification number	001

UMCNA EMPLOYEE SAVINGS PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

UACJ METAL COMPONENTS NORTH AMERICA INC. has sponsored the creation of one or more 401k plans.

Company Name: UACJ METAL COMPONENTS NORTH AMERICA INC.

Employer identification number (EIN): 330483651

NAIC Classification: 336300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UMCNA EMPLOYEE SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 DONNA LAPIKAS 2023-08-08
001 2021-01-01 DONNA LAPIKAS 2022-10-10
001 2020-01-01 DESIREE HASSELL 2021-10-06
001 2019-01-01 BRENDA FISHER 2020-10-05
001 2018-01-01 BRENDA FISHER 2019-10-02
001 2017-01-01
001 2016-01-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01	DONNA LAPIKAS	2023-08-08
001	2021-01-01	DONNA LAPIKAS	2022-10-10
001	2020-01-01	DESIREE HASSELL	2021-10-06
001	2019-01-01	BRENDA FISHER	2020-10-05
001	2018-01-01	BRENDA FISHER	2019-10-02
001	2017-01-01
001	2016-01-01

Plan Statistics for UMCNA EMPLOYEE SAVINGS PLAN

401k plan membership statisitcs for UMCNA EMPLOYEE SAVINGS PLAN

Measure Date Value
2022: UMCNA EMPLOYEE SAVINGS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 219
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 124
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 61
Total of all active and inactive participants 2022-01-01 185
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 185
Number of participants with account balances 2022-01-01 172
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: UMCNA EMPLOYEE SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 223
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 142
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 77
Total of all active and inactive participants 2021-01-01 219
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 219
Number of participants with account balances 2021-01-01 205
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: UMCNA EMPLOYEE SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 185
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 173
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 52
Total of all active and inactive participants 2020-01-01 225
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 225
Number of participants with account balances 2020-01-01 190
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 22
2019: UMCNA EMPLOYEE SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 198
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 153
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 31
Total of all active and inactive participants 2019-01-01 184
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 184
Number of participants with account balances 2019-01-01 184
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 16
2018: UMCNA EMPLOYEE SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 209
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 156
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 41
Total of all active and inactive participants 2018-01-01 197
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 197
Number of participants with account balances 2018-01-01 197
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 40
2017: UMCNA EMPLOYEE SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 194
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 181
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 27
Total of all active and inactive participants 2017-01-01 208
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 208
Number of participants with account balances 2017-01-01 207
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 26
2016: UMCNA EMPLOYEE SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 186
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 169
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 20
Total of all active and inactive participants 2016-01-01 189
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 189
Number of participants with account balances 2016-01-01 189
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 19

Measure	Date	Value
2022: UMCNA EMPLOYEE SAVINGS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	219
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	124
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	61
Total of all active and inactive participants	2022-01-01	185
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	185
Number of participants with account balances	2022-01-01	172
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: UMCNA EMPLOYEE SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	223
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	142
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	77
Total of all active and inactive participants	2021-01-01	219
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	219
Number of participants with account balances	2021-01-01	205
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: UMCNA EMPLOYEE SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	185
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	173
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	52
Total of all active and inactive participants	2020-01-01	225
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	225
Number of participants with account balances	2020-01-01	190
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	22
2019: UMCNA EMPLOYEE SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	198
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	153
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	31
Total of all active and inactive participants	2019-01-01	184
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	184
Number of participants with account balances	2019-01-01	184
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	16
2018: UMCNA EMPLOYEE SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	209
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	156
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	41
Total of all active and inactive participants	2018-01-01	197
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	197
Number of participants with account balances	2018-01-01	197
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	40
2017: UMCNA EMPLOYEE SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	194
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	181
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	27
Total of all active and inactive participants	2017-01-01	208
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	208
Number of participants with account balances	2017-01-01	207
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	26
2016: UMCNA EMPLOYEE SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	186
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	169
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	20
Total of all active and inactive participants	2016-01-01	189
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	189
Number of participants with account balances	2016-01-01	189
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	19

Financial Data on UMCNA EMPLOYEE SAVINGS PLAN

Measure	Date	Value
2022 : UMCNA EMPLOYEE SAVINGS PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$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	$-896,415
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$945,478
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$939,398
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$429,613
Value of total assets at end of year	2022-12-31	$7,761,816
Value of total assets at beginning of year	2022-12-31	$9,603,709
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$6,080
Total interest from all sources	2022-12-31	$11,380
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Administrative expenses professional fees incurred	2022-12-31	$5,390
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$252,672
Participant contributions at end of year	2022-12-31	$174,903
Participant contributions at beginning of year	2022-12-31	$226,879
Participant contributions at end of year	2022-12-31	$2
Participant contributions at beginning of year	2022-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$7,014
Other income not declared elsewhere	2022-12-31	$5
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-1,841,893
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$7,761,816
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$9,603,709
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$7,568,987
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$9,369,660
Interest on participant loans	2022-12-31	$9,770
Interest earned on other investments	2022-12-31	$1,610
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$10,680
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$2,082
Net investment gain/loss from pooled separate accounts	2022-12-31	$-1,337,413
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$169,927
Employer contributions (assets) at end of year	2022-12-31	$7,244
Employer contributions (assets) at beginning of year	2022-12-31	$5,088
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$939,398
Contract administrator fees	2022-12-31	$690
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Disclaimer
Accountancy firm name	2022-12-31	STELMACK, DOBRANSKY & EANNACE, LLC
Accountancy firm EIN	2022-12-31	251900686
2021 : UMCNA EMPLOYEE SAVINGS PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$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	$1,468,903
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$1,071,291
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$1,068,309
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$428,884
Value of total assets at end of year	2021-12-31	$9,603,709
Value of total assets at beginning of year	2021-12-31	$9,206,097
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$2,982
Total interest from all sources	2021-12-31	$13,528
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Administrative expenses professional fees incurred	2021-12-31	$2,250
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$256,177
Participant contributions at end of year	2021-12-31	$226,879
Participant contributions at beginning of year	2021-12-31	$220,480
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$807
Other income not declared elsewhere	2021-12-31	$1
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$397,612
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$9,603,709
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$9,206,097
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$9,369,660
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$8,984,021
Interest on participant loans	2021-12-31	$11,701
Interest earned on other investments	2021-12-31	$1,827
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$2,082
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$11
Net investment gain/loss from pooled separate accounts	2021-12-31	$1,026,490
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$171,900
Employer contributions (assets) at end of year	2021-12-31	$5,088
Employer contributions (assets) at beginning of year	2021-12-31	$1,585
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$1,068,309
Contract administrator fees	2021-12-31	$732
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Disclaimer
Accountancy firm name	2021-12-31	STELMACK, DOBRANSKY & EANNACE, LLC
Accountancy firm EIN	2021-12-31	251900686
2020 : UMCNA EMPLOYEE SAVINGS PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$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	$20
Total income from all sources (including contributions)	2020-12-31	$1,410,904
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$1,086,538
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$1,083,230
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$437,042
Value of total assets at end of year	2020-12-31	$9,206,097
Value of total assets at beginning of year	2020-12-31	$8,881,751
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$3,308
Total interest from all sources	2020-12-31	$15,772
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Administrative expenses professional fees incurred	2020-12-31	$2,450
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$272,986
Participant contributions at end of year	2020-12-31	$220,480
Participant contributions at beginning of year	2020-12-31	$230,731
Participant contributions at end of year	2020-12-31	$0
Participant contributions at beginning of year	2020-12-31	$67
Other income not declared elsewhere	2020-12-31	$19
Liabilities. Value of operating payables at end of year	2020-12-31	$0
Liabilities. Value of operating payables at beginning of year	2020-12-31	$20
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$324,366
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$9,206,097
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$8,881,731
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$8,984,021
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$8,650,682
Interest on participant loans	2020-12-31	$14,118
Interest earned on other investments	2020-12-31	$1,654
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$11
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$0
Net investment gain/loss from pooled separate accounts	2020-12-31	$958,071
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$164,056
Employer contributions (assets) at end of year	2020-12-31	$1,585
Employer contributions (assets) at beginning of year	2020-12-31	$271
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$1,083,230
Contract administrator fees	2020-12-31	$858
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	ARNETT CARBIS TOOTHMAN LLP
Accountancy firm EIN	2020-12-31	550486667
2019 : UMCNA EMPLOYEE SAVINGS PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$20
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	$2,015,055
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$1,201,321
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$1,194,974
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$560,968
Value of total assets at end of year	2019-12-31	$8,881,751
Value of total assets at beginning of year	2019-12-31	$8,067,997
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$6,347
Total interest from all sources	2019-12-31	$11,899
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Administrative expenses professional fees incurred	2019-12-31	$5,537
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$304,768
Participant contributions at end of year	2019-12-31	$230,731
Participant contributions at beginning of year	2019-12-31	$174,778
Participant contributions at end of year	2019-12-31	$67
Participant contributions at beginning of year	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$76,207
Liabilities. Value of operating payables at end of year	2019-12-31	$20
Liabilities. Value of operating payables at beginning of year	2019-12-31	$0
Total non interest bearing cash at end of year	2019-12-31	$0
Total non interest bearing cash at beginning of year	2019-12-31	$17,969
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$813,734
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$8,881,731
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$8,067,997
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$8,650,682
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$7,873,508
Interest on participant loans	2019-12-31	$10,246
Interest earned on other investments	2019-12-31	$1,653
Net investment gain/loss from pooled separate accounts	2019-12-31	$1,442,188
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$179,993
Employer contributions (assets) at end of year	2019-12-31	$271
Employer contributions (assets) at beginning of year	2019-12-31	$1,742
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$1,194,974
Contract administrator fees	2019-12-31	$810
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	ARNETT CARBIS TOOTHMAN LLP
Accountancy firm EIN	2019-12-31	550486667
2018 : UMCNA EMPLOYEE SAVINGS PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$37,769
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$1,188,619
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$1,182,770
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$577,238
Value of total assets at end of year	2018-12-31	$8,067,997
Value of total assets at beginning of year	2018-12-31	$9,218,847
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$5,849
Total interest from all sources	2018-12-31	$11,461
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$345,187
Participant contributions at end of year	2018-12-31	$174,778
Participant contributions at beginning of year	2018-12-31	$230,020
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$1,050
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$36
Other income not declared elsewhere	2018-12-31	$1,732
Total non interest bearing cash at end of year	2018-12-31	$17,969
Total non interest bearing cash at beginning of year	2018-12-31	$1,147
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-1,150,850
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$8,067,997
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$9,218,847
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$7,873,508
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$8,986,594
Interest on participant loans	2018-12-31	$11,461
Net investment gain/loss from pooled separate accounts	2018-12-31	$-552,662
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$232,051
Employer contributions (assets) at end of year	2018-12-31	$1,742
Employer contributions (assets) at beginning of year	2018-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$1,182,770
Contract administrator fees	2018-12-31	$5,849
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	ARNETT CARBIS TOOTHMAN LLP
Accountancy firm EIN	2018-12-31	550486667
2017 : UMCNA EMPLOYEE SAVINGS PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$1,774,651
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$418,255
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$413,483
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$625,377
Value of total assets at end of year	2017-12-31	$9,218,847
Value of total assets at beginning of year	2017-12-31	$7,862,451
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$4,772
Total interest from all sources	2017-12-31	$10,267
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Administrative expenses professional fees incurred	2017-12-31	$3,850
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$363,964
Participant contributions at end of year	2017-12-31	$230,020
Participant contributions at beginning of year	2017-12-31	$197,444
Participant contributions at end of year	2017-12-31	$1,050
Participant contributions at beginning of year	2017-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$39,993
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$36
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$0
Other income not declared elsewhere	2017-12-31	$36
Total non interest bearing cash at end of year	2017-12-31	$1,147
Total non interest bearing cash at beginning of year	2017-12-31	$1,574
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$1,356,396
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$9,218,847
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$7,862,451
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$8,986,594
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$7,663,433
Interest on participant loans	2017-12-31	$10,267
Net investment gain/loss from pooled separate accounts	2017-12-31	$1,138,971
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$221,420
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$413,483
Contract administrator fees	2017-12-31	$922
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	ARNETT CARBIS TOOTHMAN LLP
Accountancy firm EIN	2017-12-31	550486667
2016 : UMCNA EMPLOYEE SAVINGS PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$1,151,271
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$533,671
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$529,045
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$614,705
Value of total assets at end of year	2016-12-31	$7,862,451
Value of total assets at beginning of year	2016-12-31	$7,244,851
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$4,626
Total interest from all sources	2016-12-31	$7,916
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Administrative expenses professional fees incurred	2016-12-31	$3,700
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$350,310
Participant contributions at end of year	2016-12-31	$197,444
Participant contributions at beginning of year	2016-12-31	$151,899
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$26,918
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$3,733
Other income not declared elsewhere	2016-12-31	$3,880
Total non interest bearing cash at end of year	2016-12-31	$1,574
Total non interest bearing cash at beginning of year	2016-12-31	$143
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$617,600
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$7,862,451
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$7,244,851
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$7,663,433
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$7,088,871
Interest on participant loans	2016-12-31	$7,916
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$524,770
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$237,477
Employer contributions (assets) at end of year	2016-12-31	$0
Employer contributions (assets) at beginning of year	2016-12-31	$205
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$529,045
Contract administrator fees	2016-12-31	$926
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	ARNETT CARBIS TOOTHMAN LLP
Accountancy firm EIN	2016-12-31	550486667

Form 5500 Responses for UMCNA EMPLOYEE SAVINGS PLAN

2022: UMCNA EMPLOYEE SAVINGS PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: UMCNA EMPLOYEE SAVINGS PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: UMCNA EMPLOYEE SAVINGS PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: UMCNA EMPLOYEE SAVINGS PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: UMCNA EMPLOYEE SAVINGS PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: UMCNA EMPLOYEE SAVINGS PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: UMCNA EMPLOYEE SAVINGS PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

39872

Policy instance

Insurance contract or identification number	39872
Number of Individuals Covered	173
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $20,473
Total amount of fees paid to insurance company	USD $4,206
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 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 $20,473
Insurance broker organization code?	4
Amount paid for insurance broker fees	4206
Additional information about fees paid to insurance broker	TPA COMPENSATION OFFSETS FEES

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

39872

Policy instance

Insurance contract or identification number	39872
Number of Individuals Covered	209
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $22,757
Total amount of fees paid to insurance company	USD $4,675
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 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 $22,757
Insurance broker organization code?	4
Amount paid for insurance broker fees	4675
Additional information about fees paid to insurance broker	TPA COMPENSATION OFFSETS FEES

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

39872

Policy instance

Insurance contract or identification number	39872
Number of Individuals Covered	192
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $20,608
Total amount of fees paid to insurance company	USD $4,257
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 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 $20,608
Insurance broker organization code?	3
Amount paid for insurance broker fees	4257
Additional information about fees paid to insurance broker	TPA COMPENSATION OFFSETS FEES

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

39872

Policy instance

Insurance contract or identification number	39872
Number of Individuals Covered	186
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $20,478
Total amount of fees paid to insurance company	USD $4,197
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 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 $20,478
Insurance broker organization code?	3
Amount paid for insurance broker fees	4197
Additional information about fees paid to insurance broker	TPA COMPENSATION

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

39872

Policy instance

Insurance contract or identification number	39872
Number of Individuals Covered	204
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $21,865
Total amount of fees paid to insurance company	USD $4,501
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 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 $21,865
Insurance broker organization code?	3
Amount paid for insurance broker fees	4501
Additional information about fees paid to insurance broker	TPA COMPENSATION

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

39872

Policy instance

Insurance contract or identification number	39872
Number of Individuals Covered	216
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $20,541
Total amount of fees paid to insurance company	USD $4,230
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 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 $20,541
Insurance broker organization code?	3
Amount paid for insurance broker fees	4230
Additional information about fees paid to insurance broker	TPA COMPENSATION
Insurance broker name	WALKER BENEFITS, INC.

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Company Name:	UACJ METAL COMPONENTS NORTH AMERICA INC.
Employer identification number (EIN):	330483651
NAIC Classification:	336300