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LOCHMOOR CLUB, INC. RETIREMENT INCOME PLAN 401k Plan overview

Plan NameLOCHMOOR CLUB, INC. RETIREMENT INCOME PLAN
Plan identification number 002

LOCHMOOR CLUB, INC. RETIREMENT INCOME PLAN Benefits

401k Plan TypeDefined Benefit Pension
Plan Features/Benefits
  • Frozen Plan - As of the last day of the plan year, the plan provides that no participant will get any new benefit accrual (whether because of service or compensation).
  • 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.
  • 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.
  • 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

LOCHMOOR CLUB, INC. has sponsored the creation of one or more 401k plans.

Company Name:LOCHMOOR CLUB, INC.
Employer identification number (EIN):380768670
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LOCHMOOR CLUB, INC. RETIREMENT INCOME PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022022-01-01SCOTT ORHAN2023-10-11
0022021-01-01SCOTT ORHAN2022-10-06
0022020-01-01PATRICIA SOKOLNICKI2021-10-11
0022019-01-01PATRICIA SOKOLNICKI2020-10-12
0022018-01-01PATRICIA SOKOLNICKI2019-10-11
0022015-01-01
0022014-01-01
0022013-01-01MARCIA ERICKSON MARCIA ERICKSON2014-10-14
0022012-01-01MARCIA ERICKSON MARCIA ERICKSON2013-10-15
0022011-01-01MARCIA ERICKSON
0022010-01-01MARCIA ERICKSON

Plan Statistics for LOCHMOOR CLUB, INC. RETIREMENT INCOME PLAN

401k plan membership statisitcs for LOCHMOOR CLUB, INC. RETIREMENT INCOME PLAN

Measure Date Value
2022: LOCHMOOR CLUB, INC. RETIREMENT INCOME PLAN 2022 401k membership
Market value of plan assets2022-12-31151,761
Acturial value of plan assets2022-12-31151,761
Funding target for retired participants and beneficiaries receiving payment2022-12-31102,298
Number of terminated vested participants2022-12-3110
Fundng target for terminated vested participants2022-12-31208,192
Active participant vested funding target2022-12-310
Number of active participants2022-12-310
Total funding liabilities for active participants2022-12-310
Total participant count2022-12-3112
Total funding target for all participants2022-12-31310,490
Balance at beginning of prior year after applicable adjustments2022-12-310
Prefunding balance at beginning of prior year after applicable adjustments2022-12-310
Carryover balanced portion elected for use to offset prior years funding requirement2022-12-310
Prefunding balanced used to offset prior years funding requirement2022-12-310
Amount remaining of carryover balance2022-12-310
Amount remaining of prefunding balance2022-12-310
Present value of excess contributions2022-12-31550
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2022-12-31550
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2022-12-310
Reductions in caryover balances due to elections or deemed elections2022-12-310
Reductions in prefunding balances due to elections or deemed elections2022-12-310
Balance of carryovers at beginning of current year2022-12-310
Balance of prefunding at beginning of current year2022-12-310
Total employer contributions2022-12-3115,822
Total employee contributions2022-12-310
Contributions allocated toward unpaid minimum require contributions from prior years2022-12-310
Contributions made to avoid restrictions adjusted to valuation date2022-12-310
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2022-12-3115,550
Unpaid minimum required contributions for all prior years2022-12-310
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2022-12-310
Remaining amount of unpaid minimum required contributions2022-12-310
Minimum required contributions for current year target normal cost2022-12-310
Net shortfall amortization installment of oustanding balance2022-12-31158,729
Waiver amortization installment2022-12-310
Total funding amount beforereflecting carryover/prefunding balances2022-12-3114,668
Additional cash requirement2022-12-3114,668
Contributions allocatedtoward minimum required contributions for current year2022-12-3115,550
Unpaid minimum required contributions for current year2022-12-310
Unpaid minimum required contributions for all years2022-12-310
2021: LOCHMOOR CLUB, INC. RETIREMENT INCOME PLAN 2021 401k membership
Market value of plan assets2021-12-31147,721
Acturial value of plan assets2021-12-31147,721
Funding target for retired participants and beneficiaries receiving payment2021-12-3124,244
Number of terminated vested participants2021-12-3111
Fundng target for terminated vested participants2021-12-31268,099
Active participant vested funding target2021-12-310
Number of active participants2021-12-310
Total funding liabilities for active participants2021-12-310
Total participant count2021-12-3112
Total funding target for all participants2021-12-31292,343
Balance at beginning of prior year after applicable adjustments2021-12-310
Prefunding balance at beginning of prior year after applicable adjustments2021-12-310
Carryover balanced portion elected for use to offset prior years funding requirement2021-12-310
Prefunding balanced used to offset prior years funding requirement2021-12-310
Amount remaining of carryover balance2021-12-310
Amount remaining of prefunding balance2021-12-310
Present value of excess contributions2021-12-310
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2021-12-310
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2021-12-310
Reductions in caryover balances due to elections or deemed elections2021-12-310
Reductions in prefunding balances due to elections or deemed elections2021-12-310
Balance of carryovers at beginning of current year2021-12-310
Balance of prefunding at beginning of current year2021-12-310
Total employer contributions2021-12-3139,018
Total employee contributions2021-12-310
Contributions allocated toward unpaid minimum require contributions from prior years2021-12-310
Contributions made to avoid restrictions adjusted to valuation date2021-12-310
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2021-12-3136,627
Liquidity shortfalls end of Q12021-12-310
Liquidity shortfalls end of Q22021-12-310
Liquidity shortfalls end of Q32021-12-310
Liquidity shortfalls end of Q42021-12-310
Unpaid minimum required contributions for all prior years2021-12-310
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2021-12-310
Remaining amount of unpaid minimum required contributions2021-12-310
Minimum required contributions for current year target normal cost2021-12-310
Net shortfall amortization installment of oustanding balance2021-12-31144,622
Waiver amortization installment2021-12-310
Total funding amount beforereflecting carryover/prefunding balances2021-12-3136,077
Additional cash requirement2021-12-3136,077
Contributions allocatedtoward minimum required contributions for current year2021-12-3136,627
Unpaid minimum required contributions for current year2021-12-310
Unpaid minimum required contributions for all years2021-12-310
2020: LOCHMOOR CLUB, INC. RETIREMENT INCOME PLAN 2020 401k membership
Market value of plan assets2020-12-31361,800
Acturial value of plan assets2020-12-31361,800
Funding target for retired participants and beneficiaries receiving payment2020-12-31131,563
Number of terminated vested participants2020-12-3112
Fundng target for terminated vested participants2020-12-31310,372
Active participant vested funding target2020-12-3142,820
Number of active participants2020-12-311
Total funding liabilities for active participants2020-12-3142,820
Total participant count2020-12-3115
Total funding target for all participants2020-12-31484,755
Balance at beginning of prior year after applicable adjustments2020-12-310
Prefunding balance at beginning of prior year after applicable adjustments2020-12-310
Carryover balanced portion elected for use to offset prior years funding requirement2020-12-310
Prefunding balanced used to offset prior years funding requirement2020-12-310
Amount remaining of carryover balance2020-12-310
Amount remaining of prefunding balance2020-12-310
Present value of excess contributions2020-12-3166
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2020-12-3166
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2020-12-310
Reductions in caryover balances due to elections or deemed elections2020-12-310
Reductions in prefunding balances due to elections or deemed elections2020-12-310
Balance of carryovers at beginning of current year2020-12-310
Balance of prefunding at beginning of current year2020-12-310
Total employer contributions2020-12-3134,125
Total employee contributions2020-12-310
Contributions allocated toward unpaid minimum require contributions from prior years2020-12-310
Contributions made to avoid restrictions adjusted to valuation date2020-12-310
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2020-12-3131,534
Liquidity shortfalls end of Q12020-12-310
Liquidity shortfalls end of Q22020-12-310
Liquidity shortfalls end of Q32020-12-310
Liquidity shortfalls end of Q42020-12-310
Unpaid minimum required contributions for all prior years2020-12-310
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2020-12-310
Remaining amount of unpaid minimum required contributions2020-12-310
Minimum required contributions for current year target normal cost2020-12-310
Net shortfall amortization installment of oustanding balance2020-12-31122,955
Waiver amortization installment2020-12-310
Total funding amount beforereflecting carryover/prefunding balances2020-12-3131,534
Additional cash requirement2020-12-3131,534
Contributions allocatedtoward minimum required contributions for current year2020-12-3131,534
Unpaid minimum required contributions for current year2020-12-310
Unpaid minimum required contributions for all years2020-12-310
2019: LOCHMOOR CLUB, INC. RETIREMENT INCOME PLAN 2019 401k membership
Market value of plan assets2019-12-31253,556
Acturial value of plan assets2019-12-31253,556
Funding target for retired participants and beneficiaries receiving payment2019-12-3125,723
Number of terminated vested participants2019-12-3112
Fundng target for terminated vested participants2019-12-31332,973
Active participant vested funding target2019-12-31108,333
Number of active participants2019-12-312
Total funding liabilities for active participants2019-12-31108,333
Total participant count2019-12-3115
Total funding target for all participants2019-12-31467,029
Balance at beginning of prior year after applicable adjustments2019-12-310
Prefunding balance at beginning of prior year after applicable adjustments2019-12-310
Carryover balanced portion elected for use to offset prior years funding requirement2019-12-310
Prefunding balanced used to offset prior years funding requirement2019-12-310
Amount remaining of carryover balance2019-12-310
Amount remaining of prefunding balance2019-12-310
Present value of excess contributions2019-12-310
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2019-12-310
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2019-12-310
Reductions in caryover balances due to elections or deemed elections2019-12-310
Reductions in prefunding balances due to elections or deemed elections2019-12-310
Balance of carryovers at beginning of current year2019-12-310
Balance of prefunding at beginning of current year2019-12-310
Total employer contributions2019-12-3186,069
Total employee contributions2019-12-310
Contributions allocated toward unpaid minimum require contributions from prior years2019-12-3137,006
Contributions made to avoid restrictions adjusted to valuation date2019-12-310
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2019-12-3140,742
Unpaid minimum required contributions for all prior years2019-12-3137,006
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2019-12-3137,006
Remaining amount of unpaid minimum required contributions2019-12-310
Minimum required contributions for current year target normal cost2019-12-310
Net shortfall amortization installment of oustanding balance2019-12-31213,473
Waiver amortization installment2019-12-310
Total funding amount beforereflecting carryover/prefunding balances2019-12-3140,676
Additional cash requirement2019-12-3140,676
Contributions allocatedtoward minimum required contributions for current year2019-12-3140,742
Unpaid minimum required contributions for current year2019-12-310
Unpaid minimum required contributions for all years2019-12-310
2018: LOCHMOOR CLUB, INC. RETIREMENT INCOME PLAN 2018 401k membership
Market value of plan assets2018-12-31217,081
Acturial value of plan assets2018-12-31217,081
Funding target for retired participants and beneficiaries receiving payment2018-12-3126,020
Number of terminated vested participants2018-12-3111
Fundng target for terminated vested participants2018-12-31217,295
Active participant vested funding target2018-12-31100,757
Number of active participants2018-12-312
Total funding liabilities for active participants2018-12-31100,757
Total participant count2018-12-3114
Total funding target for all participants2018-12-31344,072
Balance at beginning of prior year after applicable adjustments2018-12-310
Prefunding balance at beginning of prior year after applicable adjustments2018-12-310
Carryover balanced portion elected for use to offset prior years funding requirement2018-12-310
Prefunding balanced used to offset prior years funding requirement2018-12-310
Amount remaining of carryover balance2018-12-310
Amount remaining of prefunding balance2018-12-310
Present value of excess contributions2018-12-310
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance2018-12-310
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance2018-12-310
Reductions in caryover balances due to elections or deemed elections2018-12-310
Reductions in prefunding balances due to elections or deemed elections2018-12-310
Balance of carryovers at beginning of current year2018-12-310
Balance of prefunding at beginning of current year2018-12-310
Total employer contributions2018-12-310
Total employee contributions2018-12-310
Contributions allocated toward unpaid minimum require contributions from prior years2018-12-310
Contributions made to avoid restrictions adjusted to valuation date2018-12-310
Contributions allocated toward minimum required contributions for current year adjusted to valuation date2018-12-310
Unpaid minimum required contributions for all prior years2018-12-3113,335
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years2018-12-310
Remaining amount of unpaid minimum required contributions2018-12-3113,335
Minimum required contributions for current year target normal cost2018-12-310
Net shortfall amortization installment of oustanding balance2018-12-31126,991
Waiver amortization installment2018-12-310
Total funding amount beforereflecting carryover/prefunding balances2018-12-3123,671
Additional cash requirement2018-12-3123,671
Contributions allocatedtoward minimum required contributions for current year2018-12-310
Unpaid minimum required contributions for current year2018-12-3123,671
Unpaid minimum required contributions for all years2018-12-3137,006
2013: LOCHMOOR CLUB, INC. RETIREMENT INCOME PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-018
Total number of active participants reported on line 7a of the Form 55002013-01-017
Total of all active and inactive participants2013-01-017
Total participants2013-01-017
Number of participants with account balances2013-01-017
2012: LOCHMOOR CLUB, INC. RETIREMENT INCOME PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-019
Total number of active participants reported on line 7a of the Form 55002012-01-018
Total of all active and inactive participants2012-01-018
Total participants2012-01-018
Number of participants with account balances2012-01-018
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: LOCHMOOR CLUB, INC. RETIREMENT INCOME PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0113
Total number of active participants reported on line 7a of the Form 55002011-01-019
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-019
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-019
Number of participants with account balances2011-01-019
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: LOCHMOOR CLUB, INC. RETIREMENT INCOME PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0115
Total number of active participants reported on line 7a of the Form 55002010-01-0113
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-0113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0113
Number of participants with account balances2010-01-0113

Financial Data on LOCHMOOR CLUB, INC. RETIREMENT INCOME PLAN

Measure Date Value
2013 : LOCHMOOR CLUB, INC. RETIREMENT INCOME PLAN 2013 401k financial data
Total income from all sources2013-12-31$51,122
Expenses. Total of all expenses incurred2013-12-31$27,017
Benefits paid (including direct rollovers)2013-12-31$27,017
Total plan assets at end of year2013-12-31$197,492
Total plan assets at beginning of year2013-12-31$173,387
Value of fidelity bond covering the plan2013-12-31$1,000,000
Total contributions received or receivable from participants2013-12-31$11,010
Other income received2013-12-31$34,607
Net income (gross income less expenses)2013-12-31$24,105
Net plan assets at end of year (total assets less liabilities)2013-12-31$197,492
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$173,387
Total contributions received or receivable from employer(s)2013-12-31$5,505
2012 : LOCHMOOR CLUB, INC. RETIREMENT INCOME PLAN 2012 401k financial data
Total income from all sources2012-12-31$44,756
Expenses. Total of all expenses incurred2012-12-31$94,630
Benefits paid (including direct rollovers)2012-12-31$94,630
Total plan assets at end of year2012-12-31$173,387
Total plan assets at beginning of year2012-12-31$223,261
Value of fidelity bond covering the plan2012-12-31$1,000,000
Total contributions received or receivable from participants2012-12-31$13,505
Other income received2012-12-31$24,498
Net income (gross income less expenses)2012-12-31$-49,874
Net plan assets at end of year (total assets less liabilities)2012-12-31$173,387
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$223,261
Total contributions received or receivable from employer(s)2012-12-31$6,753
2011 : LOCHMOOR CLUB, INC. RETIREMENT INCOME PLAN 2011 401k financial data
Total income from all sources2011-12-31$28,020
Expenses. Total of all expenses incurred2011-12-31$290,046
Benefits paid (including direct rollovers)2011-12-31$290,046
Total plan assets at end of year2011-12-31$223,261
Total plan assets at beginning of year2011-12-31$485,287
Value of fidelity bond covering the plan2011-12-31$1,000,000
Total contributions received or receivable from participants2011-12-31$16,885
Other income received2011-12-31$2,729
Net income (gross income less expenses)2011-12-31$-262,026
Net plan assets at end of year (total assets less liabilities)2011-12-31$223,261
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$485,287
Total contributions received or receivable from employer(s)2011-12-31$8,406
2010 : LOCHMOOR CLUB, INC. RETIREMENT INCOME PLAN 2010 401k financial data
Total plan liabilities at end of year2010-12-31$0
Total plan liabilities at beginning of year2010-12-31$0
Total income from all sources2010-12-31$127,702
Expenses. Total of all expenses incurred2010-12-31$178,539
Benefits paid (including direct rollovers)2010-12-31$178,539
Total plan assets at end of year2010-12-31$485,287
Total plan assets at beginning of year2010-12-31$536,124
Value of fidelity bond covering the plan2010-12-31$1,000,000
Total contributions received or receivable from participants2010-12-31$45,844
Other income received2010-12-31$58,936
Net income (gross income less expenses)2010-12-31$-50,837
Net plan assets at end of year (total assets less liabilities)2010-12-31$485,287
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$536,124
Total contributions received or receivable from employer(s)2010-12-31$22,922

Form 5500 Responses for LOCHMOOR CLUB, INC. RETIREMENT INCOME PLAN

2013: LOCHMOOR CLUB, INC. RETIREMENT INCOME PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: LOCHMOOR CLUB, INC. RETIREMENT INCOME PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: LOCHMOOR CLUB, INC. RETIREMENT INCOME PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: LOCHMOOR CLUB, INC. RETIREMENT INCOME PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan 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 number15867
Policy instance 1
Insurance contract or identification number15867
Number of Individuals Covered7
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,853
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?Yes
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,853
Insurance broker organization code?3
Insurance broker nameMORGAN STANLEY
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number15867
Policy instance 1
Insurance contract or identification number15867
Number of Individuals Covered8
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,992
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,992
Insurance broker organization code?3
Insurance broker nameMORGAN STANLEY INSURANCE SERVICES
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number15867
Policy instance 1
Insurance contract or identification number15867
Number of Individuals Covered9
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $3,528
Are there contracts with allocated funds for group deferred annuity?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number15867
Policy instance 1
Insurance contract or identification number15867
Number of Individuals Covered13
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $4,822
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?Yes
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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