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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 TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

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
0012022-01-01MICHAEL P. REILLY2023-05-30
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: REILLY FAMILY DENTAL LLC 401(K) PLAN 2019 401k membership
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: REILLY FAMILY DENTAL LLC 401(K) PLAN 2018 401k membership
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: REILLY FAMILY DENTAL LLC 401(K) PLAN 2017 401k membership
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: REILLY FAMILY DENTAL LLC 401(K) PLAN 2016 401k membership
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: REILLY FAMILY DENTAL LLC 401(K) PLAN 2015 401k membership
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: REILLY FAMILY DENTAL LLC 401(K) PLAN 2014 401k membership
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: REILLY FAMILY DENTAL LLC 401(K) PLAN 2013 401k membership
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: REILLY FAMILY DENTAL LLC 401(K) PLAN 2012 401k membership
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: REILLY FAMILY DENTAL LLC 401(K) PLAN 2011 401k membership
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 : REILLY FAMILY DENTAL LLC 401(K) PLAN 2019 401k financial data
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 : REILLY FAMILY DENTAL LLC 401(K) PLAN 2018 401k financial data
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 : REILLY FAMILY DENTAL LLC 401(K) PLAN 2017 401k financial data
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 : REILLY FAMILY DENTAL LLC 401(K) PLAN 2016 401k financial data
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 : REILLY FAMILY DENTAL LLC 401(K) PLAN 2015 401k financial data
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 : REILLY FAMILY DENTAL LLC 401(K) PLAN 2014 401k financial data
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 : REILLY FAMILY DENTAL LLC 401(K) PLAN 2013 401k financial data
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 : REILLY FAMILY DENTAL LLC 401(K) PLAN 2012 401k financial data
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 : REILLY FAMILY DENTAL LLC 401(K) PLAN 2011 401k financial data
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 for REILLY FAMILY DENTAL LLC 401(K) PLAN

2019: REILLY FAMILY DENTAL LLC 401(K) PLAN 2019 form 5500 responses
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: REILLY FAMILY DENTAL LLC 401(K) PLAN 2018 form 5500 responses
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: REILLY FAMILY DENTAL LLC 401(K) PLAN 2017 form 5500 responses
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: REILLY FAMILY DENTAL LLC 401(K) PLAN 2016 form 5500 responses
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: REILLY FAMILY DENTAL LLC 401(K) PLAN 2015 form 5500 responses
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: REILLY FAMILY DENTAL LLC 401(K) PLAN 2014 form 5500 responses
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: REILLY FAMILY DENTAL LLC 401(K) 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: REILLY FAMILY DENTAL LLC 401(K) 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: REILLY FAMILY DENTAL LLC 401(K) 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

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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