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REILLY FAMILY DENTAL LLC 401(K) PLAN 401k Plan overview

Plan NameREILLY FAMILY DENTAL LLC 401(K) PLAN
Plan identification number 001

REILLY FAMILY DENTAL LLC 401(K) PLAN Benefits

401k Plan Type
Plan Features/Benefits

    401k Sponsoring company profile

    REILLY FAMILY DENTAL LLC has sponsored the creation of one or more 401k plans.

    Company Name:REILLY FAMILY DENTAL LLC
    Employer identification number (EIN):391186273
    NAIC Classification:621210
    NAIC Description:Offices of Dentists

    Form 5500 Filing Information

    Submission information for form 5500 for 401k plan REILLY FAMILY DENTAL LLC 401(K) PLAN

    Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
    0012021-01-01MICHAEL P. REILLY2022-04-14
    0012020-01-01MICHAEL P. REILLY2021-06-22
    0012019-01-01
    0012018-01-01MICHAEL P. REILLY
    0012017-01-01MICHAEL P. REILLY
    0012016-01-01MICHAEL P. REILLY
    0012015-01-01MICHAEL P. REILLY
    0012014-01-01MICHAEL P. REILLY
    0012013-01-01MICHAEL P. REILLY
    0012012-01-01MICHAEL P. REILLY
    0012011-01-01MICHAEL P. REILLY
    0012010-01-01MICHAEL REILLY2011-03-07 MICHAEL REILLY2011-03-07

    Plan Statistics for REILLY FAMILY DENTAL LLC 401(K) PLAN

    401k plan membership statisitcs for REILLY FAMILY DENTAL LLC 401(K) PLAN

    Measure Date Value
    2019
    Total participants, beginning-of-year2019-01-019
    Total number of active participants reported on line 7a of the Form 55002019-01-017
    Number of retired or separated participants receiving benefits2019-01-010
    Number of other retired or separated participants entitled to future benefits2019-01-011
    Total of all active and inactive participants2019-01-018
    Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
    Total participants2019-01-018
    Number of participants with account balances2019-01-018
    Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
    2018
    Total participants, beginning-of-year2018-01-019
    Total number of active participants reported on line 7a of the Form 55002018-01-017
    Number of retired or separated participants receiving benefits2018-01-010
    Number of other retired or separated participants entitled to future benefits2018-01-012
    Total of all active and inactive participants2018-01-019
    Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
    Total participants2018-01-019
    Number of participants with account balances2018-01-019
    Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
    2017
    Total participants, beginning-of-year2017-01-019
    Total number of active participants reported on line 7a of the Form 55002017-01-019
    Number of retired or separated participants receiving benefits2017-01-010
    Number of other retired or separated participants entitled to future benefits2017-01-010
    Total of all active and inactive participants2017-01-019
    Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
    Total participants2017-01-019
    Number of participants with account balances2017-01-019
    Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
    2016
    Total participants, beginning-of-year2016-01-019
    Total number of active participants reported on line 7a of the Form 55002016-01-019
    Number of retired or separated participants receiving benefits2016-01-010
    Number of other retired or separated participants entitled to future benefits2016-01-010
    Total of all active and inactive participants2016-01-019
    Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
    Total participants2016-01-019
    Number of participants with account balances2016-01-019
    Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
    2015
    Total participants, beginning-of-year2015-01-019
    Total number of active participants reported on line 7a of the Form 55002015-01-019
    Number of retired or separated participants receiving benefits2015-01-010
    Number of other retired or separated participants entitled to future benefits2015-01-010
    Total of all active and inactive participants2015-01-019
    Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
    Total participants2015-01-019
    Number of participants with account balances2015-01-019
    Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
    2014
    Total participants, beginning-of-year2014-01-019
    Total number of active participants reported on line 7a of the Form 55002014-01-019
    Number of retired or separated participants receiving benefits2014-01-010
    Number of other retired or separated participants entitled to future benefits2014-01-010
    Total of all active and inactive participants2014-01-019
    Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
    Total participants2014-01-019
    Number of participants with account balances2014-01-010
    Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
    2013
    Total participants, beginning-of-year2013-01-0110
    Total number of active participants reported on line 7a of the Form 55002013-01-019
    Number of retired or separated participants receiving benefits2013-01-010
    Number of other retired or separated participants entitled to future benefits2013-01-010
    Total of all active and inactive participants2013-01-019
    Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
    Total participants2013-01-019
    Number of participants with account balances2013-01-019
    Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
    2012
    Total participants, beginning-of-year2012-01-0110
    Total number of active participants reported on line 7a of the Form 55002012-01-019
    Number of retired or separated participants receiving benefits2012-01-010
    Number of other retired or separated participants entitled to future benefits2012-01-011
    Total of all active and inactive participants2012-01-0110
    Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
    Total participants2012-01-0110
    Number of participants with account balances2012-01-0110
    Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
    2011
    Total participants, beginning-of-year2011-01-019
    Total number of active participants reported on line 7a of the Form 55002011-01-0110
    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 participants2011-01-0110
    Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
    Total participants2011-01-0110
    Number of participants with account balances2011-01-0110
    Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010

    Financial Data on REILLY FAMILY DENTAL LLC 401(K) PLAN

    Measure Date Value
    2019
    Total income from all sources2019-12-31$303,473
    Expenses. Total of all expenses incurred2019-12-31$36,323
    Benefits paid (including direct rollovers)2019-12-31$35,896
    Total plan assets at end of year2019-12-31$1,271,745
    Total plan assets at beginning of year2019-12-31$1,004,595
    Value of fidelity bond covering the plan2019-12-31$100,460
    Total contributions received or receivable from participants2019-12-31$50,111
    Other income received2019-12-31$236,073
    Net income (gross income less expenses)2019-12-31$267,150
    Net plan assets at end of year (total assets less liabilities)2019-12-31$1,271,745
    Net plan assets at beginning of year (total assets less liabilities)2019-12-31$1,004,595
    Total contributions received or receivable from employer(s)2019-12-31$17,289
    Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$427
    Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
    2018
    Total income from all sources2018-12-31$433
    Expenses. Total of all expenses incurred2018-12-31$335
    Total plan assets at end of year2018-12-31$1,004,595
    Total plan assets at beginning of year2018-12-31$1,004,497
    Value of fidelity bond covering the plan2018-12-31$100,500
    Total contributions received or receivable from participants2018-12-31$52,097
    Other income received2018-12-31$-70,158
    Net income (gross income less expenses)2018-12-31$98
    Net plan assets at end of year (total assets less liabilities)2018-12-31$1,004,595
    Net plan assets at beginning of year (total assets less liabilities)2018-12-31$1,004,497
    Total contributions received or receivable from employer(s)2018-12-31$18,494
    Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$335
    Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
    2017
    Total income from all sources2017-12-31$216,261
    Expenses. Total of all expenses incurred2017-12-31$3,545
    Total plan assets at end of year2017-12-31$1,004,497
    Total plan assets at beginning of year2017-12-31$791,781
    Value of fidelity bond covering the plan2017-12-31$100,500
    Total contributions received or receivable from participants2017-12-31$57,704
    Other income received2017-12-31$139,282
    Net income (gross income less expenses)2017-12-31$212,716
    Net plan assets at end of year (total assets less liabilities)2017-12-31$1,004,497
    Net plan assets at beginning of year (total assets less liabilities)2017-12-31$791,781
    Total contributions received or receivable from employer(s)2017-12-31$19,275
    Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$3,545
    Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
    2016
    Total income from all sources2016-12-31$135,678
    Expenses. Total of all expenses incurred2016-12-31$2,987
    Total plan assets at end of year2016-12-31$791,781
    Total plan assets at beginning of year2016-12-31$659,090
    Value of fidelity bond covering the plan2016-12-31$80,000
    Total contributions received or receivable from participants2016-12-31$57,144
    Other income received2016-12-31$56,526
    Net income (gross income less expenses)2016-12-31$132,691
    Net plan assets at end of year (total assets less liabilities)2016-12-31$791,781
    Net plan assets at beginning of year (total assets less liabilities)2016-12-31$659,090
    Total contributions received or receivable from employer(s)2016-12-31$22,008
    Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$2,987
    Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
    2015
    Total income from all sources2015-12-31$64,211
    Expenses. Total of all expenses incurred2015-12-31$2,727
    Total plan assets at end of year2015-12-31$659,090
    Total plan assets at beginning of year2015-12-31$597,606
    Value of fidelity bond covering the plan2015-12-31$60,000
    Total contributions received or receivable from participants2015-12-31$57,575
    Other income received2015-12-31$-15,808
    Net income (gross income less expenses)2015-12-31$61,484
    Net plan assets at end of year (total assets less liabilities)2015-12-31$659,090
    Net plan assets at beginning of year (total assets less liabilities)2015-12-31$597,606
    Total contributions received or receivable from employer(s)2015-12-31$22,444
    Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$2,727
    Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
    2014
    Total income from all sources2014-12-31$105,087
    Expenses. Total of all expenses incurred2014-12-31$3,372
    Total plan assets at end of year2014-12-31$597,606
    Total plan assets at beginning of year2014-12-31$495,891
    Value of fidelity bond covering the plan2014-12-31$58,000
    Total contributions received or receivable from participants2014-12-31$56,778
    Other income received2014-12-31$27,175
    Net income (gross income less expenses)2014-12-31$101,715
    Net plan assets at end of year (total assets less liabilities)2014-12-31$597,606
    Net plan assets at beginning of year (total assets less liabilities)2014-12-31$495,891
    Total contributions received or receivable from employer(s)2014-12-31$21,134
    Value of corrective distributions2014-12-31$789
    Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$2,583
    Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
    2013
    Total income from all sources2013-12-31$146,620
    Expenses. Total of all expenses incurred2013-12-31$67,117
    Benefits paid (including direct rollovers)2013-12-31$65,069
    Total plan assets at end of year2013-12-31$495,891
    Total plan assets at beginning of year2013-12-31$416,388
    Value of fidelity bond covering the plan2013-12-31$25,000
    Total contributions received or receivable from participants2013-12-31$56,274
    Other income received2013-12-31$64,380
    Net income (gross income less expenses)2013-12-31$79,503
    Net plan assets at end of year (total assets less liabilities)2013-12-31$495,891
    Net plan assets at beginning of year (total assets less liabilities)2013-12-31$416,388
    Total contributions received or receivable from employer(s)2013-12-31$25,966
    Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$2,048
    Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
    2012
    Total income from all sources2012-12-31$116,919
    Expenses. Total of all expenses incurred2012-12-31$1,683
    Total plan assets at end of year2012-12-31$416,388
    Total plan assets at beginning of year2012-12-31$301,152
    Value of fidelity bond covering the plan2012-12-31$25,000
    Total contributions received or receivable from participants2012-12-31$52,878
    Other income received2012-12-31$35,753
    Net income (gross income less expenses)2012-12-31$115,236
    Net plan assets at end of year (total assets less liabilities)2012-12-31$416,388
    Net plan assets at beginning of year (total assets less liabilities)2012-12-31$301,152
    Total contributions received or receivable from employer(s)2012-12-31$28,288
    Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$1,683
    2011
    Total income from all sources2011-12-31$109,125
    Expenses. Total of all expenses incurred2011-12-31$4,460
    Benefits paid (including direct rollovers)2011-12-31$3,850
    Total plan assets at end of year2011-12-31$301,152
    Total plan assets at beginning of year2011-12-31$196,487
    Value of fidelity bond covering the plan2011-12-31$25,000
    Total contributions received or receivable from participants2011-12-31$51,181
    Contributions received from other sources (not participants or employers)2011-12-31$10,040
    Other income received2011-12-31$21,238
    Net income (gross income less expenses)2011-12-31$104,665
    Net plan assets at end of year (total assets less liabilities)2011-12-31$301,152
    Net plan assets at beginning of year (total assets less liabilities)2011-12-31$196,487
    Total contributions received or receivable from employer(s)2011-12-31$26,666
    Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$610
    Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0

    Form 5500 Responses

    2019
    2019-01-01Type of plan entitySingle employer plan
    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 – InsuranceYes
    2019-01-01Plan benefit arrangement - TrustYes
    2018
    2018-01-01Type of plan entitySingle employer plan
    2018-01-01Submission has been amendedNo
    2018-01-01This submission is the final filingNo
    2018-01-01This return/report is a short plan year return/report (less than 12 months)No
    2018-01-01Plan is a collectively bargained planNo
    2018-01-01Plan funding arrangement – InsuranceYes
    2018-01-01Plan funding arrangement – TrustYes
    2018-01-01Plan benefit arrangement – InsuranceYes
    2018-01-01Plan benefit arrangement - TrustYes
    2017
    2017-01-01Type of plan entitySingle employer plan
    2017-01-01Submission has been amendedNo
    2017-01-01This submission is the final filingNo
    2017-01-01This return/report is a short plan year return/report (less than 12 months)No
    2017-01-01Plan is a collectively bargained planNo
    2017-01-01Plan funding arrangement – InsuranceYes
    2017-01-01Plan funding arrangement – TrustYes
    2017-01-01Plan benefit arrangement – InsuranceYes
    2017-01-01Plan benefit arrangement - TrustYes
    2016
    2016-01-01Type of plan entitySingle employer plan
    2016-01-01Submission has been amendedNo
    2016-01-01This submission is the final filingNo
    2016-01-01This return/report is a short plan year return/report (less than 12 months)No
    2016-01-01Plan is a collectively bargained planNo
    2016-01-01Plan funding arrangement – InsuranceYes
    2016-01-01Plan funding arrangement – TrustYes
    2016-01-01Plan benefit arrangement – InsuranceYes
    2016-01-01Plan benefit arrangement - TrustYes
    2015
    2015-01-01Type of plan entitySingle employer plan
    2015-01-01Submission has been amendedNo
    2015-01-01This submission is the final filingNo
    2015-01-01This return/report is a short plan year return/report (less than 12 months)No
    2015-01-01Plan is a collectively bargained planNo
    2015-01-01Plan funding arrangement – InsuranceYes
    2015-01-01Plan funding arrangement – TrustYes
    2015-01-01Plan benefit arrangement – InsuranceYes
    2015-01-01Plan benefit arrangement - TrustYes
    2014
    2014-01-01Type of plan entitySingle employer plan
    2014-01-01Submission has been amendedNo
    2014-01-01This submission is the final filingNo
    2014-01-01This return/report is a short plan year return/report (less than 12 months)No
    2014-01-01Plan is a collectively bargained planNo
    2014-01-01Plan funding arrangement – InsuranceYes
    2014-01-01Plan funding arrangement – TrustYes
    2014-01-01Plan benefit arrangement – InsuranceYes
    2014-01-01Plan benefit arrangement - TrustYes
    2013
    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
    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
    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

    Insurance Providers Used on plan

    JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
    Policy contract number101916
    Policy instance 1
    Insurance contract or identification number101916
    Number of Individuals Covered7
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $3,910
    Total amount of fees paid to insurance companyUSD $619
    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
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $3,910
    Amount paid for insurance broker fees0
    Additional information about fees paid to insurance brokerCOMMISSIONS
    Insurance broker organization code?7
    JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
    Policy contract number101916
    Policy instance 1
    Insurance contract or identification number101916
    Number of Individuals Covered9
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $3,657
    Total amount of fees paid to insurance companyUSD $523
    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
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $3,657
    Insurance broker organization code?7
    Amount paid for insurance broker fees523
    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 number101916
    Policy instance 1
    Insurance contract or identification number101916
    Number of Individuals Covered9
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $3,141
    Total amount of fees paid to insurance companyUSD $435
    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
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $3,141
    Insurance broker organization code?7
    Amount paid for insurance broker fees435
    Additional information about fees paid to insurance brokerTPA COMPENSATION
    Insurance broker namePPG RETIREMENT PLAN SERVICES
    JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
    Policy contract number101916
    Policy instance 1
    Insurance contract or identification number101916
    Number of Individuals Covered9
    Insurance policy start date2016-01-01
    Insurance policy end date2016-12-31
    Total amount of commissions paid to insurance brokerUSD $2,784
    Total amount of fees paid to insurance companyUSD $347
    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 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 $2,784
    Insurance broker organization code?7
    Amount paid for insurance broker fees347
    Additional information about fees paid to insurance brokerTPA COMPENSATION
    Insurance broker namePPG RETIREMENT PLAN SERVICES
    JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
    Policy contract number101916
    Policy instance 1
    Insurance contract or identification number101916
    Number of Individuals Covered9
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $2,471
    Total amount of fees paid to insurance companyUSD $310
    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 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 $2,471
    Insurance broker organization code?7
    Amount paid for insurance broker fees310
    Additional information about fees paid to insurance brokerTPA COMPENSATION
    Insurance broker namePPG RETIREMENT PLAN SERVICES
    JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
    Policy contract number101916
    Policy instance 1
    Insurance contract or identification number101916
    Number of Individuals Covered9
    Insurance policy start date2014-01-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $2,105
    Total amount of fees paid to insurance companyUSD $396
    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 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 $2,105
    Insurance broker organization code?7
    Amount paid for insurance broker fees396
    Additional information about fees paid to insurance brokerTPA COMPENSATION
    Insurance broker namePPG RETIREMENT PLAN SERVICES
    JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
    Policy contract number101916
    Policy instance 1
    Insurance contract or identification number101916
    Number of Individuals Covered9
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $1,603
    Total amount of fees paid to insurance companyUSD $261
    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 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 $1,603
    Insurance broker organization code?7
    Amount paid for insurance broker fees261
    Additional information about fees paid to insurance brokerTPA COMPENSATION
    Insurance broker namePPG RETIREMENT PLAN SERVICES
    JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
    Policy contract number101916
    Policy instance 1
    Insurance contract or identification number101916
    Number of Individuals Covered10
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $937
    Total amount of fees paid to insurance companyUSD $1,261
    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 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 $937
    Insurance broker organization code?7
    Amount paid for insurance broker fees1261
    Additional information about fees paid to insurance brokerTPA COMPENSATION
    Insurance broker namePPG RETIREMENT PLAN SERVICES
    PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
    Policy contract number709854
    Policy instance 2
    Insurance contract or identification number709854
    Number of Individuals Covered0
    Insurance policy start date2011-01-01
    Insurance policy end date2011-07-21
    Total amount of commissions paid to insurance brokerUSD $416
    Total amount of fees paid to insurance companyUSD $296
    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 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
    JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
    Policy contract number101916
    Policy instance 1
    Insurance contract or identification number101916
    Number of Individuals Covered10
    Insurance policy start date2011-07-20
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $2,856
    Total amount of fees paid to insurance companyUSD $520
    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 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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