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BRAIN INJURY ASSOCIATION OF MINNESOTA 401(K) PROFIT SHARING PLAN & TRUST 401k Plan overview

Plan NameBRAIN INJURY ASSOCIATION OF MINNESOTA 401(K) PROFIT SHARING PLAN & TRUST
Plan identification number 001

BRAIN INJURY ASSOCIATION OF MINNESOTA 401(K) PROFIT SHARING PLAN & TRUST Benefits

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

BRAIN INJURY ASSOCIATION OF MINNESOTA has sponsored the creation of one or more 401k plans.

Company Name:BRAIN INJURY ASSOCIATION OF MINNESOTA
Employer identification number (EIN):363418174
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BRAIN INJURY ASSOCIATION OF MINNESOTA 401(K) PROFIT SHARING PLAN & TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012024-01-01BRAD DONALDSON
0012023-01-01
0012023-01-01BRAD DONALDSON
0012022-01-01
0012022-01-01BRAD DONALDSON
0012021-01-01BRAD DONALDSON2022-05-24
0012020-01-01BRAD DONALDSON2021-08-03
0012019-01-01BRAD DONALDSON2020-08-26
0012018-01-01BRADLEY DONALDSON2019-07-05
0012017-01-01BRADLEY DONALDSON2018-07-02
0012016-01-01BRADLEY DONALDSON2017-06-07
0012015-01-01BRADLEY DONALDSON2016-06-24
0012014-01-01BRADLEY DONALDSON2015-06-29
0012013-01-01BRADLEY DONALDSON2014-07-25
0012012-01-01BRADLEY DONALDSON2013-06-14
0012011-01-01BRADLEY DONALDSON2012-06-19
0012010-01-01BRADLEY DONALDSON2011-06-16
0012009-01-01BRADLEY DONALDSON
0012009-01-01BRADLEY DONALDSON BRADLEY DONALDSON2010-07-30
0012009-01-01BRADLEY DONALDSON BRADLEY DONALDSON2010-07-27
0012009-01-01BRADLEY DONALDSON
0012009-01-01BRADLEY DONALDSON
0012009-01-01BRADLEY DONALDSON DAVID KING2010-08-12

Plan Statistics for BRAIN INJURY ASSOCIATION OF MINNESOTA 401(K) PROFIT SHARING PLAN & TRUST

401k plan membership statisitcs for BRAIN INJURY ASSOCIATION OF MINNESOTA 401(K) PROFIT SHARING PLAN & TRUST

Measure Date Value
2023: BRAIN INJURY ASSOCIATION OF MINNESOTA 401(K) PROFIT SHARING PLAN & TRUST 2023 401k membership
Total participants, beginning-of-year2023-01-01120
Total number of active participants reported on line 7a of the Form 55002023-01-0169
Number of retired or separated participants receiving benefits2023-01-011
Number of other retired or separated participants entitled to future benefits2023-01-0159
Total of all active and inactive participants2023-01-01129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2023-01-010
Total participants2023-01-01129
Number of participants with account balances2023-01-01112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2023-01-010
2022: BRAIN INJURY ASSOCIATION OF MINNESOTA 401(K) PROFIT SHARING PLAN & TRUST 2022 401k membership
Total number of particpants at beginning of year2022-05-24117
Total number of particpants at end of year2022-05-24129
Number of Participants With Account Balances2022-05-24104
Total participants, beginning-of-year2022-01-01125
Total number of active participants reported on line 7a of the Form 55002022-01-0167
Number of retired or separated participants receiving benefits2022-01-016
Number of other retired or separated participants entitled to future benefits2022-01-0150
Total of all active and inactive participants2022-01-01123
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01123
Number of participants with account balances2022-01-01106
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2009: BRAIN INJURY ASSOCIATION OF MINNESOTA 401(K) PROFIT SHARING PLAN & TRUST 2009 401k membership
Total participants, beginning-of-year2009-01-0167
Total number of active participants reported on line 7a of the Form 55002009-01-0159
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0118
Total of all active and inactive participants2009-01-0177
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0177
Number of participants with account balances2009-01-0175
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-011

Financial Data on BRAIN INJURY ASSOCIATION OF MINNESOTA 401(K) PROFIT SHARING PLAN & TRUST

Measure Date Value
2023 : BRAIN INJURY ASSOCIATION OF MINNESOTA 401(K) PROFIT SHARING PLAN & TRUST 2023 401k financial data
Total unrealized appreciation/depreciation of assets2023-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$0
Total income from all sources (including contributions)2023-12-31$991,519
Total loss/gain on sale of assets2023-12-31$0
Total of all expenses incurred2023-12-31$143,068
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-12-31$142,870
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-12-31$402,697
Value of total assets at end of year2023-12-31$4,601,981
Value of total assets at beginning of year2023-12-31$3,753,530
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-12-31$198
Total interest from all sources2023-12-31$2,224
Total dividends received (eg from common stock, registered investment company shares)2023-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-12-31No
Was this plan covered by a fidelity bond2023-12-31Yes
Value of fidelity bond cover2023-12-31$500,000
If this is an individual account plan, was there a blackout period2023-12-31No
Were there any nonexempt tranactions with any party-in-interest2023-12-31No
Contributions received from participants2023-12-31$258,051
Participant contributions at end of year2023-12-31$39,540
Participant contributions at beginning of year2023-12-31$24,989
Income. Received or receivable in cash from other sources (including rollovers)2023-12-31$19,011
Other income not declared elsewhere2023-12-31$4,986
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Value of net income/loss2023-12-31$848,451
Value of net assets at end of year (total assets less liabilities)2023-12-31$4,601,981
Value of net assets at beginning of year (total assets less liabilities)2023-12-31$3,753,530
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-12-31No
Were any leases to which the plan was party in default or uncollectible2023-12-31No
Value of interest in pooled separate accounts at end of year2023-12-31$4,172,080
Value of interest in pooled separate accounts at beginning of year2023-12-31$3,376,619
Interest on participant loans2023-12-31$2,224
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2023-12-31$390,361
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2023-12-31$351,922
Net investment gain/loss from pooled separate accounts2023-12-31$581,612
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-12-31No
Was there a failure to transmit to the plan any participant contributions2023-12-31No
Has the plan failed to provide any benefit when due under the plan2023-12-31No
Contributions received in cash from employer2023-12-31$125,635
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-12-31$142,870
Contract administrator fees2023-12-31$198
Did the plan have assets held for investment2023-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-12-31No
Opinion of an independent qualified public accountant for this plan2023-12-31Unqualified
Accountancy firm name2023-12-31BAKER TILLY US, LLP
Accountancy firm EIN2023-12-31301413443
Total unrealized appreciation/depreciation of assets2023-01-01$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-01-01$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-01-01$0
Total income from all sources (including contributions)2023-01-01$991,519
Total loss/gain on sale of assets2023-01-01$0
Total of all expenses incurred2023-01-01$143,068
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-01-01$142,870
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-01-01$402,697
Value of total assets at end of year2023-01-01$4,601,981
Value of total assets at beginning of year2023-01-01$3,753,530
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-01-01$198
Total interest from all sources2023-01-01$2,224
Total dividends received (eg from common stock, registered investment company shares)2023-01-01$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-01-01No
Was this plan covered by a fidelity bond2023-01-01Yes
Value of fidelity bond cover2023-01-01$500,000
If this is an individual account plan, was there a blackout period2023-01-01No
Were there any nonexempt tranactions with any party-in-interest2023-01-01No
Contributions received from participants2023-01-01$258,051
Participant contributions at end of year2023-01-01$39,540
Participant contributions at beginning of year2023-01-01$24,989
Income. Received or receivable in cash from other sources (including rollovers)2023-01-01$19,011
Other income not declared elsewhere2023-01-01$4,986
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-01-01No
Value of net income/loss2023-01-01$848,451
Value of net assets at end of year (total assets less liabilities)2023-01-01$4,601,981
Value of net assets at beginning of year (total assets less liabilities)2023-01-01$3,753,530
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-01-01No
Were any loans by the plan or fixed income obligations due to the plan in default2023-01-01No
Were any leases to which the plan was party in default or uncollectible2023-01-01No
Value of interest in pooled separate accounts at end of year2023-01-01$4,172,080
Value of interest in pooled separate accounts at beginning of year2023-01-01$3,376,619
Interest on participant loans2023-01-01$2,224
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2023-01-01$390,361
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2023-01-01$351,922
Net investment gain/loss from pooled separate accounts2023-01-01$581,612
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-01-01No
Was there a failure to transmit to the plan any participant contributions2023-01-01No
Has the plan failed to provide any benefit when due under the plan2023-01-01No
Contributions received in cash from employer2023-01-01$125,635
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-01-01$142,870
Contract administrator fees2023-01-01$198
Did the plan have assets held for investment2023-01-01Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-01-01No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-01-01No
Opinion of an independent qualified public accountant for this plan2023-01-011
Accountancy firm name2023-01-01BAKER TILLY US, LLP
Accountancy firm EIN2023-01-01301413443
2022 : BRAIN INJURY ASSOCIATION OF MINNESOTA 401(K) PROFIT SHARING PLAN & TRUST 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$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$0
Total income from all sources (including contributions)2022-12-31$-415,628
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$333,926
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$332,962
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$351,305
Value of total assets at end of year2022-12-31$3,753,530
Value of total assets at beginning of year2022-12-31$4,503,084
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$964
Total interest from all sources2022-12-31$1,107
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 year2022-12-31No
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$236,354
Participant contributions at end of year2022-12-31$24,989
Participant contributions at beginning of year2022-12-31$21,424
Other income not declared elsewhere2022-12-31$2,952
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-749,554
Value of net assets at end of year (total assets less liabilities)2022-12-31$3,753,530
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$4,503,084
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 pooled separate accounts at end of year2022-12-31$3,376,619
Value of interest in pooled separate accounts at beginning of year2022-12-31$4,160,252
Interest on participant loans2022-12-31$1,107
Interest earned on other investments2022-12-31$0
Value of interest in common/collective trusts at end of year2022-12-31$0
Value of interest in common/collective trusts at beginning of year2022-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$351,922
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$321,408
Net investment gain/loss from pooled separate accounts2022-12-31$-770,992
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$114,951
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$332,962
Contract administrator fees2022-12-31$964
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 name2022-12-31BAKER TILLY US, LLP
Accountancy firm EIN2022-12-31390859910
Total transfers to/from plan in this plan year2022-05-240
Total liabilities as of the end of the plan year2022-05-240
Total liabilities as of the beginning of the plan year2022-05-240
Total expenses incurred by plan in this plan year2022-05-24237069
Net assets as of the end of the plan year2022-05-244503085
Total assets as of the beginning of the plan year2022-05-243825546
Participant contributions to plan in this plan year2022-05-24233099
Value of participant loans at end of plan year2022-05-2421424
Other expenses paid from plan in this plan year2022-05-240
Other contributions to plan in this plan year2022-05-240
Other income to plan in this plan year2022-05-24566115
Plan net income in this plan year2022-05-24677539
Net assets as of the end of the plan year2022-05-244503085
Net assets as of the beginning of the plan year2022-05-243825546
Employer contributions to plan in this plan year2022-05-24115394
Expensese paid to adminstrative service provicers from plan in this plan year2022-05-241837
Total unrealized appreciation/depreciation of assets2022-01-01$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-01$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-01$0
Total income from all sources (including contributions)2022-01-01$-415,628
Total loss/gain on sale of assets2022-01-01$0
Total of all expenses incurred2022-01-01$333,955
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-01-01$332,111
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-01-01$351,161
Value of total assets at end of year2022-01-01$3,753,501
Value of total assets at beginning of year2022-01-01$4,503,084
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-01-01$1,844
Total interest from all sources2022-01-01$1,108
Total dividends received (eg from common stock, registered investment company shares)2022-01-01$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-01-01No
Was this plan covered by a fidelity bond2022-01-01Yes
Value of fidelity bond cover2022-01-01$500,000
If this is an individual account plan, was there a blackout period2022-01-01No
Were there any nonexempt tranactions with any party-in-interest2022-01-01No
Contributions received from participants2022-01-01$236,354
Participant contributions at end of year2022-01-01$24,960
Participant contributions at beginning of year2022-01-01$21,424
Other income not declared elsewhere2022-01-01$2,955
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-01-01No
Value of net income/loss2022-01-01$-749,583
Value of net assets at end of year (total assets less liabilities)2022-01-01$3,753,501
Value of net assets at beginning of year (total assets less liabilities)2022-01-01$4,503,084
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-01-01No
Were any loans by the plan or fixed income obligations due to the plan in default2022-01-01No
Were any leases to which the plan was party in default or uncollectible2022-01-01No
Value of interest in pooled separate accounts at end of year2022-01-01$3,376,619
Value of interest in pooled separate accounts at beginning of year2022-01-01$4,160,252
Interest on participant loans2022-01-01$1,107
Interest earned on other investments2022-01-01$1
Value of interest in common/collective trusts at end of year2022-01-01$0
Value of interest in common/collective trusts at beginning of year2022-01-01$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-01-01$351,922
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-01-01$321,408
Net investment gain/loss from pooled separate accounts2022-01-01$-770,852
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-01-01No
Was there a failure to transmit to the plan any participant contributions2022-01-01No
Has the plan failed to provide any benefit when due under the plan2022-01-01No
Contributions received in cash from employer2022-01-01$114,807
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-01-01$332,111
Contract administrator fees2022-01-01$1,844
Did the plan have assets held for investment2022-01-01Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-01-01No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-01-01No
Opinion of an independent qualified public accountant for this plan2022-01-011
Accountancy firm name2022-01-01BAKER TILLY
Accountancy firm EIN2022-01-01390859910
2009 : BRAIN INJURY ASSOCIATION OF MINNESOTA 401(K) PROFIT SHARING PLAN & TRUST 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for BRAIN INJURY ASSOCIATION OF MINNESOTA 401(K) PROFIT SHARING PLAN & TRUST

2023: BRAIN INJURY ASSOCIATION OF MINNESOTA 401(K) PROFIT SHARING PLAN & TRUST 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement - TrustYes
2022: BRAIN INJURY ASSOCIATION OF MINNESOTA 401(K) PROFIT SHARING PLAN & TRUST 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedYes
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 – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2009: BRAIN INJURY ASSOCIATION OF MINNESOTA 401(K) PROFIT SHARING PLAN & TRUST 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedYes
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number756933-01
Policy instance 1
Insurance contract or identification number756933-01
Number of Individuals Covered112
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $4,678
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number756933-01
Policy instance 1

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