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DAVINCI PAYMENTS 401(K) PROFIT SHARING PLAN AND TRUST 401k Plan overview

Plan NameDAVINCI PAYMENTS 401(K) PROFIT SHARING PLAN AND TRUST
Plan identification number 001

DAVINCI PAYMENTS 401(K) PROFIT SHARING PLAN AND 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.
  • 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.
  • 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

DAVINCI PAYMENTS DBA SWIFT PREPAID SOLUTIONS has sponsored the creation of one or more 401k plans.

Company Name:DAVINCI PAYMENTS DBA SWIFT PREPAID SOLUTIONS
Employer identification number (EIN):364104850
NAIC Classification:522300
NAIC Description: Activities Related to Credit Intermediation

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DAVINCI PAYMENTS 401(K) PROFIT SHARING PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012019-01-01

Plan Statistics for DAVINCI PAYMENTS 401(K) PROFIT SHARING PLAN AND TRUST

401k plan membership statisitcs for DAVINCI PAYMENTS 401(K) PROFIT SHARING PLAN AND TRUST

Measure Date Value
2022: DAVINCI PAYMENTS 401(K) PROFIT SHARING PLAN AND TRUST 2022 401k membership
Total participants, beginning-of-year2022-01-01193
Total number of active participants reported on line 7a of the Form 55002022-01-010
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-010
Number of participants with account balances2022-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: DAVINCI PAYMENTS 401(K) PROFIT SHARING PLAN AND TRUST 2021 401k membership
Total participants, beginning-of-year2021-01-01155
Total number of active participants reported on line 7a of the Form 55002021-01-01143
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0150
Total of all active and inactive participants2021-01-01193
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01193
Number of participants with account balances2021-01-01193
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: DAVINCI PAYMENTS 401(K) PROFIT SHARING PLAN AND TRUST 2020 401k membership
Total participants, beginning-of-year2020-01-01135
Total number of active participants reported on line 7a of the Form 55002020-01-01134
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0121
Total of all active and inactive participants2020-01-01155
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01155
Number of participants with account balances2020-01-01155
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: DAVINCI PAYMENTS 401(K) PROFIT SHARING PLAN AND TRUST 2019 401k membership
Total participants, beginning-of-year2019-01-01100
Total number of active participants reported on line 7a of the Form 55002019-01-01119
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0116
Total of all active and inactive participants2019-01-01135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01135
Number of participants with account balances2019-01-01135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010

Financial Data on DAVINCI PAYMENTS 401(K) PROFIT SHARING PLAN AND TRUST

Measure Date Value
2022 : DAVINCI PAYMENTS 401(K) PROFIT SHARING PLAN AND TRUST 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-01-31$0
Total transfer of assets from this plan2022-01-31$6,867,689
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-31$0
Total income from all sources (including contributions)2022-01-31$-436,881
Total loss/gain on sale of assets2022-01-31$0
Total of all expenses incurred2022-01-31$141,950
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-01-31$141,650
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-01-31$0
Value of total assets at end of year2022-01-31$0
Value of total assets at beginning of year2022-01-31$7,446,520
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-01-31$300
Total interest from all sources2022-01-31$105
Total dividends received (eg from common stock, registered investment company shares)2022-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-01-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2022-01-31$0
Administrative expenses professional fees incurred2022-01-31$300
Was this plan covered by a fidelity bond2022-01-31Yes
Value of fidelity bond cover2022-01-31$500,000
If this is an individual account plan, was there a blackout period2022-01-31No
Were there any nonexempt tranactions with any party-in-interest2022-01-31No
Participant contributions at beginning of year2022-01-31$36,736
Other income not declared elsewhere2022-01-31$-436,986
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-01-31No
Value of net income/loss2022-01-31$-578,831
Value of net assets at end of year (total assets less liabilities)2022-01-31$0
Value of net assets at beginning of year (total assets less liabilities)2022-01-31$7,446,520
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-01-31No
Were any leases to which the plan was party in default or uncollectible2022-01-31No
Income. Interest from loans (other than to participants)2022-01-31$105
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-01-31$7,385,337
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-01-31No
Was there a failure to transmit to the plan any participant contributions2022-01-31No
Has the plan failed to provide any benefit when due under the plan2022-01-31No
Employer contributions (assets) at beginning of year2022-01-31$24,447
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-01-31$141,650
Did the plan have assets held for investment2022-01-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-01-31Yes
Opinion of an independent qualified public accountant for this plan2022-01-31Unqualified
Accountancy firm name2022-01-31WARADY & DAVIS LLP
Accountancy firm EIN2022-01-31362170602
2021 : DAVINCI PAYMENTS 401(K) PROFIT SHARING PLAN AND TRUST 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$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$3,015,626
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$1,602,238
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$1,601,101
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$1,913,509
Value of total assets at end of year2021-12-31$7,446,520
Value of total assets at beginning of year2021-12-31$6,033,132
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$1,137
Total interest from all sources2021-12-31$2,060
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 year2021-12-31No
Administrative expenses professional fees incurred2021-12-31$1,137
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$972,494
Participant contributions at end of year2021-12-31$36,736
Participant contributions at beginning of year2021-12-31$59,202
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$484,324
Other income not declared elsewhere2021-12-31$1,100,057
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$1,413,388
Value of net assets at end of year (total assets less liabilities)2021-12-31$7,446,520
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$6,033,132
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Interest on participant loans2021-12-31$2,060
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$7,385,337
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$5,966,484
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$456,691
Employer contributions (assets) at end of year2021-12-31$24,447
Employer contributions (assets) at beginning of year2021-12-31$7,446
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$1,601,101
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31WARADY & DAVIS LLP
Accountancy firm EIN2021-12-31362170602
2020 : DAVINCI PAYMENTS 401(K) PROFIT SHARING PLAN AND TRUST 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$2,496,225
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$39,987
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$38,509
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$1,543,835
Value of total assets at end of year2020-12-31$6,033,132
Value of total assets at beginning of year2020-12-31$3,576,894
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$1,478
Total interest from all sources2020-12-31$1,294
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 year2020-12-31No
Administrative expenses professional fees incurred2020-12-31$1,478
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$360,000
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$909,440
Participant contributions at end of year2020-12-31$59,202
Participant contributions at beginning of year2020-12-31$11,696
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$135,674
Other income not declared elsewhere2020-12-31$951,096
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$2,456,238
Value of net assets at end of year (total assets less liabilities)2020-12-31$6,033,132
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$3,576,894
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Interest on participant loans2020-12-31$1,294
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$5,966,484
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$3,512,857
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$498,721
Employer contributions (assets) at end of year2020-12-31$7,446
Employer contributions (assets) at beginning of year2020-12-31$52,341
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$38,509
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31WARADY & DAVIS LLP
Accountancy firm EIN2020-12-31362170602
2019 : DAVINCI PAYMENTS 401(K) PROFIT SHARING PLAN AND TRUST 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$3,596,692
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$19,798
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$8,236
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$3,167,104
Value of total assets at end of year2019-12-31$3,576,894
Value of total assets at beginning of year2019-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$11,562
Total interest from all sources2019-12-31$227
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 year2019-12-31No
Administrative expenses professional fees incurred2019-12-31$11,562
Was this plan covered by a fidelity bond2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$664,353
Participant contributions at end of year2019-12-31$11,696
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$2,096,947
Other income not declared elsewhere2019-12-31$429,361
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$3,576,894
Value of net assets at end of year (total assets less liabilities)2019-12-31$3,576,894
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Interest on participant loans2019-12-31$227
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$3,512,857
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$405,804
Employer contributions (assets) at end of year2019-12-31$52,341
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$8,236
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31WARADY & DAVIS LLP
Accountancy firm EIN2019-12-31362170602

Form 5500 Responses for DAVINCI PAYMENTS 401(K) PROFIT SHARING PLAN AND TRUST

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

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number137764
Policy instance 1
Insurance contract or identification number137764
Number of Individuals Covered0
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $534
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Amount paid for insurance broker fees309
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker organization code?3
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number137764
Policy instance 1
Insurance contract or identification number137764
Number of Individuals Covered195
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $18,532
Total amount of fees paid to insurance companyUSD $4,013
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $18,532
Insurance broker organization code?3
Amount paid for insurance broker fees3338
Additional information about fees paid to insurance brokerTPA COMPENSATION
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number137764
Policy instance 1
Insurance contract or identification number137764
Number of Individuals Covered155
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $11,801
Total amount of fees paid to insurance companyUSD $4,330
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $11,801
Insurance broker organization code?3
Amount paid for insurance broker fees3355
Additional information about fees paid to insurance brokerTPA COMPENSATION
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number137764
Policy instance 1
Insurance contract or identification number137764
Number of Individuals Covered140
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $5,806
Total amount of fees paid to insurance companyUSD $14,624
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $5,806
Insurance broker organization code?3
Amount paid for insurance broker fees13874
Additional information about fees paid to insurance brokerTPA COMPENSATION

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