401k Plan data: D'ARCY 401(K) PLAN plan

D'ARCY 401(K) PLAN 401k Plan overview

Plan Name	D'ARCY 401(K) PLAN
Plan identification number	002

D'ARCY 401(K) 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

D ARCY BUICK, PONTIAC, GMC INC. has sponsored the creation of one or more 401k plans.

Company Name: D ARCY BUICK, PONTIAC, GMC INC.

Employer identification number (EIN): 363781265

NAIC Classification: 441110
NAIC Description: New Car Dealers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan D'ARCY 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01
002 2021-01-01
002 2020-01-01 CAROLE REH 2021-09-14 CAROLE REH 2021-09-14
002 2019-01-01 DEBRA WOLFE 2020-09-24 DEBRA WOLFE 2020-09-24
002 2018-01-01 DEBBIE WOLFE 2019-10-14 DEBBIE WOLFE 2019-10-14
002 2017-01-01 DEBRA WOLFE 2018-09-28 DEBRA WOLFE 2018-09-28
002 2016-01-01 JEFFREY THEOBALD 2017-06-30 JEFFREY THEOBALD 2017-06-30
002 2015-01-01 ELLEN CRUM 2016-10-07 ELLEN CRUM 2016-10-07
002 2014-01-01 ELLEN CRUM 2015-10-13
002 2013-01-01 ELLEN CRUM
002 2012-01-01 ELLEN CRUM 2013-10-11
002 2011-01-01 ELLEN CRUM 2012-10-15
002 2009-01-01 ELLEN CRUM
002 2009-01-01 ELLEN CRUM

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2022-01-01
002	2021-01-01
002	2020-01-01	CAROLE REH	2021-09-14	CAROLE REH	2021-09-14
002	2019-01-01	DEBRA WOLFE	2020-09-24	DEBRA WOLFE	2020-09-24
002	2018-01-01	DEBBIE WOLFE	2019-10-14	DEBBIE WOLFE	2019-10-14
002	2017-01-01	DEBRA WOLFE	2018-09-28	DEBRA WOLFE	2018-09-28
002	2016-01-01	JEFFREY THEOBALD	2017-06-30	JEFFREY THEOBALD	2017-06-30
002	2015-01-01	ELLEN CRUM	2016-10-07	ELLEN CRUM	2016-10-07
002	2014-01-01	ELLEN CRUM	2015-10-13
002	2013-01-01	ELLEN CRUM
002	2012-01-01	ELLEN CRUM	2013-10-11
002	2011-01-01	ELLEN CRUM	2012-10-15
002	2009-01-01	ELLEN CRUM
002	2009-01-01	ELLEN CRUM

Plan Statistics for D'ARCY 401(K) PLAN

401k plan membership statisitcs for D'ARCY 401(K) PLAN

Measure Date Value
2022: D'ARCY 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 221
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 179
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 35
Total of all active and inactive participants 2022-01-01 214
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 214
Number of participants with account balances 2022-01-01 149
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 2
2021: D'ARCY 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 211
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 174
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 34
Total of all active and inactive participants 2021-01-01 208
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 208
Number of participants with account balances 2021-01-01 137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 6
2013: D'ARCY 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 73
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 63
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 12
Total of all active and inactive participants 2013-01-01 75
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 75
Number of participants with account balances 2013-01-01 48
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2009: D'ARCY 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 76
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 50
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 14
Total of all active and inactive participants 2009-01-01 64
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 64
Number of participants with account balances 2009-01-01 39
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 2

Measure	Date	Value
2022: D'ARCY 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	221
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	179
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	35
Total of all active and inactive participants	2022-01-01	214
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	214
Number of participants with account balances	2022-01-01	149
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	2
2021: D'ARCY 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	211
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	174
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	34
Total of all active and inactive participants	2021-01-01	208
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	208
Number of participants with account balances	2021-01-01	137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	6
2013: D'ARCY 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	73
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	63
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	12
Total of all active and inactive participants	2013-01-01	75
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	75
Number of participants with account balances	2013-01-01	48
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2009: D'ARCY 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	76
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	50
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	14
Total of all active and inactive participants	2009-01-01	64
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	64
Number of participants with account balances	2009-01-01	39
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	2

Financial Data on D'ARCY 401(K) PLAN

Measure	Date	Value
2022 : D'ARCY 401(K) PLAN 2022 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$8,911
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$6,853
Total income from all sources (including contributions)	2022-12-31	$104,881
Total of all expenses incurred	2022-12-31	$426,294
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$367,388
Value of total corrective distributions	2022-12-31	$23,490
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$1,144,843
Value of total assets at end of year	2022-12-31	$6,140,745
Value of total assets at beginning of year	2022-12-31	$6,460,100
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$35,416
Total interest from all sources	2022-12-31	$8,097
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
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	$724,167
Participant contributions at end of year	2022-12-31	$152,494
Participant contributions at beginning of year	2022-12-31	$197,057
Assets. Other investments not covered elsewhere at end of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-12-31	$8,911
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-12-31	$6,853
Administrative expenses (other) incurred	2022-12-31	$2,502
Total non interest bearing cash at end of year	2022-12-31	$6,324
Total non interest bearing cash at beginning of year	2022-12-31	$2,868
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	$-321,413
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$6,131,834
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$6,453,247
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 pooled separate accounts at end of year	2022-12-31	$5,509,082
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$6,061,850
Interest on participant loans	2022-12-31	$7,633
Interest earned on other investments	2022-12-31	$464
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$52,169
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$45,841
Net investment gain/loss from pooled separate accounts	2022-12-31	$-1,048,059
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	No
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	$420,676
Employer contributions (assets) at end of year	2022-12-31	$420,676
Employer contributions (assets) at beginning of year	2022-12-31	$152,484
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$367,388
Contract administrator fees	2022-12-31	$32,914
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	Unqualified
Accountancy firm name	2022-12-31	WERMER, ROGERS, DORAN & RUZON, LLC
Accountancy firm EIN	2022-12-31	362416552
2021 : D'ARCY 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total transfer of assets to this plan	2021-12-31	$1,935,479
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$6,853
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$5,739
Total income from all sources (including contributions)	2021-12-31	$1,577,526
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$640,545
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$488,823
Expenses. Certain deemed distributions of participant loans	2021-12-31	$71,822
Value of total corrective distributions	2021-12-31	$36,891
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$869,003
Value of total assets at end of year	2021-12-31	$6,460,100
Value of total assets at beginning of year	2021-12-31	$3,586,526
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$43,009
Total interest from all sources	2021-12-31	$8,938
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
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$450,000
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	$587,178
Participant contributions at end of year	2021-12-31	$197,057
Participant contributions at beginning of year	2021-12-31	$180,799
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$129,341
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$6,853
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-12-31	$5,739
Administrative expenses (other) incurred	2021-12-31	$8,601
Total non interest bearing cash at end of year	2021-12-31	$2,868
Total non interest bearing cash at beginning of year	2021-12-31	$2,746
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	$936,981
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$6,453,247
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$3,580,787
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 pooled separate accounts at end of year	2021-12-31	$6,061,850
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$3,225,766
Interest on participant loans	2021-12-31	$8,300
Interest earned on other investments	2021-12-31	$638
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$45,841
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$117,326
Net investment gain/loss from pooled separate accounts	2021-12-31	$699,585
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	No
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	$152,484
Employer contributions (assets) at end of year	2021-12-31	$152,484
Employer contributions (assets) at beginning of year	2021-12-31	$59,889
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$488,823
Contract administrator fees	2021-12-31	$34,408
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	Unqualified
Accountancy firm name	2021-12-31	WERMER, ROGERS, DORAN & RUZON, LLC
Accountancy firm EIN	2021-12-31	362416552
2013 : D'ARCY 401(K) PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$484,461
Expenses. Total of all expenses incurred	2013-12-31	$194,735
Benefits paid (including direct rollovers)	2013-12-31	$194,735
Total plan assets at end of year	2013-12-31	$1,906,885
Total plan assets at beginning of year	2013-12-31	$1,617,159
Value of fidelity bond covering the plan	2013-12-31	$200,000
Total contributions received or receivable from participants	2013-12-31	$219,822
Contributions received from other sources (not participants or employers)	2013-12-31	$3,914
Other income received	2013-12-31	$234,419
Net income (gross income less expenses)	2013-12-31	$289,726
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$1,906,885
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$1,617,159
Assets. Value of participant loans	2013-12-31	$68,048
Total contributions received or receivable from employer(s)	2013-12-31	$26,306
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2010 : D'ARCY 401(K) PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$242,906
Expenses. Total of all expenses incurred	2010-12-31	$73,581
Benefits paid (including direct rollovers)	2010-12-31	$65,126
Total plan assets at end of year	2010-12-31	$1,103,525
Total plan assets at beginning of year	2010-12-31	$934,200
Value of fidelity bond covering the plan	2010-12-31	$200,000
Total contributions received or receivable from participants	2010-12-31	$119,934
Other income received	2010-12-31	$107,341
Net income (gross income less expenses)	2010-12-31	$169,325
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,103,525
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$934,200
Assets. Value of participant loans	2010-12-31	$66,044
Total contributions received or receivable from employer(s)	2010-12-31	$15,631
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$8,455
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : D'ARCY 401(K) PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for D'ARCY 401(K) PLAN

2022: D'ARCY 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Mulitple 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: D'ARCY 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Mulitple 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
2013: D'ARCY 401(K) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2009: D'ARCY 401(K) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - 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

22085

Policy instance

Insurance contract or identification number	22085
Number of Individuals Covered	164
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $4,148
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	4148
Additional information about fees paid to insurance broker	TPA FEES TPA 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 number

22085

Policy instance

Insurance contract or identification number	22085
Number of Individuals Covered	149
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $7,262
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	7262
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker organization code?	5

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

Policy contract number

22085

Policy instance

Insurance contract or identification number	22085
Number of Individuals Covered	48
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $7,766
Total amount of fees paid to insurance company	USD $854
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,766
Insurance broker organization code?	3
Amount paid for insurance broker fees	854
Additional information about fees paid to insurance broker	THIRD PARTY ADMINISTRATION FEES
Insurance broker name	HUNTER BENEFITS CONSULTING GROUP

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

Policy contract number

22085

Policy instance

Insurance contract or identification number	22085
Number of Individuals Covered	39
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $4,862
Total amount of fees paid to insurance company	USD $474
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,862
Insurance broker organization code?	3
Amount paid for insurance broker fees	474
Additional information about fees paid to insurance broker	THIRD PARTY ADMINISTRATION FEES
Insurance broker name	HUNTER BENEFITS CONSULTING GROUP

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Company Name:	D ARCY BUICK, PONTIAC, GMC INC.
Employer identification number (EIN):	363781265
NAIC Classification:	441110
NAIC Description:	New Car Dealers