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BROOKS STEVENS, INC. 401(K) PLAN 401k Plan overview

Plan NameBROOKS STEVENS, INC. 401(K) PLAN
Plan identification number 001

BROOKS STEVENS, INC. 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.
  • Plan sponsor(s) received services of leased employees, as defined in Code section 414(n), during the plan year.

401k Sponsoring company profile

BROOKS STEVENS, INC. has sponsored the creation of one or more 401k plans.

Company Name:BROOKS STEVENS, INC.
Employer identification number (EIN):391892931
NAIC Classification:333900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BROOKS STEVENS, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012021-10-01MICHAEL HOPKINS2023-07-13
0012020-10-01MICHAEL HOPKINS2022-07-11
0012019-10-01
0012018-10-01
0012017-10-01DAN RILEY
0012016-10-01GEORGE KONSTANTAKIS
0012015-10-01GEORGE KONSTANTAKIS
0012014-10-01GEORGE KONSTANTAKIS
0012013-10-01GEORGE KONSTANTAKIS
0012012-10-01GEORGE KONSTANTAKIS
0012011-10-01GEORGE KONSTANTAKIS2012-12-07 GEORGE KONSTANTAKIS2012-12-07
0012010-10-01GEORGE KONSTANTAKIS2012-01-13 GEORGE KONSTANTAKIS2012-01-13

Plan Statistics for BROOKS STEVENS, INC. 401(K) PLAN

401k plan membership statisitcs for BROOKS STEVENS, INC. 401(K) PLAN

Measure Date Value
2019: BROOKS STEVENS, INC. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-10-0110
Total number of active participants reported on line 7a of the Form 55002019-10-018
Number of retired or separated participants receiving benefits2019-10-010
Number of other retired or separated participants entitled to future benefits2019-10-0114
Total of all active and inactive participants2019-10-0122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-10-010
Total participants2019-10-0122
Number of participants with account balances2019-10-0120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-10-010
2018: BROOKS STEVENS, INC. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-10-0126
Total number of active participants reported on line 7a of the Form 55002018-10-0110
Number of retired or separated participants receiving benefits2018-10-010
Number of other retired or separated participants entitled to future benefits2018-10-0113
Total of all active and inactive participants2018-10-0123
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-10-010
Total participants2018-10-0123
Number of participants with account balances2018-10-0121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-10-010
2017: BROOKS STEVENS, INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-10-0131
Total number of active participants reported on line 7a of the Form 55002017-10-0111
Number of retired or separated participants receiving benefits2017-10-010
Number of other retired or separated participants entitled to future benefits2017-10-0115
Total of all active and inactive participants2017-10-0126
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-10-010
Total participants2017-10-0126
Number of participants with account balances2017-10-0125
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-10-010
2016: BROOKS STEVENS, INC. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-0111
Total number of active participants reported on line 7a of the Form 55002016-10-019
Number of retired or separated participants receiving benefits2016-10-010
Number of other retired or separated participants entitled to future benefits2016-10-0122
Total of all active and inactive participants2016-10-0131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-10-010
Total participants2016-10-0131
Number of participants with account balances2016-10-0130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-10-011
2015: BROOKS STEVENS, INC. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-0131
Total number of active participants reported on line 7a of the Form 55002015-10-0111
Number of retired or separated participants receiving benefits2015-10-010
Number of other retired or separated participants entitled to future benefits2015-10-0121
Total of all active and inactive participants2015-10-0132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-10-010
Total participants2015-10-0132
Number of participants with account balances2015-10-0132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-10-010
2014: BROOKS STEVENS, INC. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-10-0118
Total number of active participants reported on line 7a of the Form 55002014-10-0113
Number of retired or separated participants receiving benefits2014-10-010
Number of other retired or separated participants entitled to future benefits2014-10-0118
Total of all active and inactive participants2014-10-0131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-10-010
Total participants2014-10-0131
Number of participants with account balances2014-10-0130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-10-010
2013: BROOKS STEVENS, INC. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-10-0135
Total number of active participants reported on line 7a of the Form 55002013-10-0116
Number of retired or separated participants receiving benefits2013-10-010
Number of other retired or separated participants entitled to future benefits2013-10-0119
Total of all active and inactive participants2013-10-0135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-10-010
Total participants2013-10-0135
Number of participants with account balances2013-10-0132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-10-010
2012: BROOKS STEVENS, INC. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year2012-10-0125
Total number of active participants reported on line 7a of the Form 55002012-10-0115
Number of retired or separated participants receiving benefits2012-10-010
Number of other retired or separated participants entitled to future benefits2012-10-0120
Total of all active and inactive participants2012-10-0135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-10-010
Total participants2012-10-0135
Number of participants with account balances2012-10-0133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-10-010

Financial Data on BROOKS STEVENS, INC. 401(K) PLAN

Measure Date Value
2020 : BROOKS STEVENS, INC. 401(K) PLAN 2020 401k financial data
Total income from all sources2020-09-30$236,117
Expenses. Total of all expenses incurred2020-09-30$22,077
Benefits paid (including direct rollovers)2020-09-30$9,153
Total plan assets at end of year2020-09-30$1,761,637
Total plan assets at beginning of year2020-09-30$1,547,597
Total contributions received or receivable from participants2020-09-30$58,759
Other income received2020-09-30$164,771
Net income (gross income less expenses)2020-09-30$214,040
Net plan assets at end of year (total assets less liabilities)2020-09-30$1,761,637
Net plan assets at beginning of year (total assets less liabilities)2020-09-30$1,547,597
Total contributions received or receivable from employer(s)2020-09-30$12,587
Expenses. Administrative service providers (salaries,fees and commissions)2020-09-30$12,924
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-09-30$0
2019 : BROOKS STEVENS, INC. 401(K) PLAN 2019 401k financial data
Total income from all sources2019-09-30$125,586
Expenses. Total of all expenses incurred2019-09-30$203,180
Benefits paid (including direct rollovers)2019-09-30$190,834
Total plan assets at end of year2019-09-30$1,547,597
Total plan assets at beginning of year2019-09-30$1,625,191
Value of fidelity bond covering the plan2019-09-30$200,000
Total contributions received or receivable from participants2019-09-30$61,993
Contributions received from other sources (not participants or employers)2019-09-30$4,609
Other income received2019-09-30$58,464
Net income (gross income less expenses)2019-09-30$-77,594
Net plan assets at end of year (total assets less liabilities)2019-09-30$1,547,597
Net plan assets at beginning of year (total assets less liabilities)2019-09-30$1,625,191
Total contributions received or receivable from employer(s)2019-09-30$520
Expenses. Administrative service providers (salaries,fees and commissions)2019-09-30$12,346
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-09-30$0
2018 : BROOKS STEVENS, INC. 401(K) PLAN 2018 401k financial data
Total income from all sources2018-09-30$207,768
Expenses. Total of all expenses incurred2018-09-30$529,542
Benefits paid (including direct rollovers)2018-09-30$523,316
Total plan assets at end of year2018-09-30$1,625,191
Total plan assets at beginning of year2018-09-30$1,946,965
Value of fidelity bond covering the plan2018-09-30$200,000
Total contributions received or receivable from participants2018-09-30$69,421
Other income received2018-09-30$138,347
Net income (gross income less expenses)2018-09-30$-321,774
Net plan assets at end of year (total assets less liabilities)2018-09-30$1,625,191
Net plan assets at beginning of year (total assets less liabilities)2018-09-30$1,946,965
Total contributions received or receivable from employer(s)2018-09-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2018-09-30$6,226
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-09-30$0
2017 : BROOKS STEVENS, INC. 401(K) PLAN 2017 401k financial data
Total income from all sources2017-09-30$288,878
Expenses. Total of all expenses incurred2017-09-30$275,099
Benefits paid (including direct rollovers)2017-09-30$274,659
Total plan assets at end of year2017-09-30$1,946,965
Total plan assets at beginning of year2017-09-30$1,933,186
Value of fidelity bond covering the plan2017-09-30$200,000
Total contributions received or receivable from participants2017-09-30$64,458
Other income received2017-09-30$224,420
Net income (gross income less expenses)2017-09-30$13,779
Net plan assets at end of year (total assets less liabilities)2017-09-30$1,946,965
Net plan assets at beginning of year (total assets less liabilities)2017-09-30$1,933,186
Expenses. Administrative service providers (salaries,fees and commissions)2017-09-30$440
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-09-30$0
2016 : BROOKS STEVENS, INC. 401(K) PLAN 2016 401k financial data
Total income from all sources2016-09-30$258,322
Expenses. Total of all expenses incurred2016-09-30$220,096
Benefits paid (including direct rollovers)2016-09-30$219,356
Total plan assets at end of year2016-09-30$1,933,186
Total plan assets at beginning of year2016-09-30$1,894,960
Value of fidelity bond covering the plan2016-09-30$175,000
Total contributions received or receivable from participants2016-09-30$81,291
Other income received2016-09-30$177,031
Net income (gross income less expenses)2016-09-30$38,226
Net plan assets at end of year (total assets less liabilities)2016-09-30$1,933,186
Net plan assets at beginning of year (total assets less liabilities)2016-09-30$1,894,960
Expenses. Administrative service providers (salaries,fees and commissions)2016-09-30$740
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-09-30$0
2015 : BROOKS STEVENS, INC. 401(K) PLAN 2015 401k financial data
Total income from all sources2015-09-30$38,291
Expenses. Total of all expenses incurred2015-09-30$271,779
Benefits paid (including direct rollovers)2015-09-30$271,229
Total plan assets at end of year2015-09-30$1,894,960
Total plan assets at beginning of year2015-09-30$2,128,448
Value of fidelity bond covering the plan2015-09-30$200,000
Total contributions received or receivable from participants2015-09-30$63,047
Expenses. Other expenses not covered elsewhere2015-09-30$0
Contributions received from other sources (not participants or employers)2015-09-30$0
Other income received2015-09-30$-24,756
Noncash contributions received2015-09-30$0
Net income (gross income less expenses)2015-09-30$-233,488
Net plan assets at end of year (total assets less liabilities)2015-09-30$1,894,960
Net plan assets at beginning of year (total assets less liabilities)2015-09-30$2,128,448
Total contributions received or receivable from employer(s)2015-09-30$0
Value of certain deemed distributions of participant loans2015-09-30$0
Value of corrective distributions2015-09-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2015-09-30$550
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-09-30$0
2014 : BROOKS STEVENS, INC. 401(K) PLAN 2014 401k financial data
Total income from all sources2014-09-30$257,408
Expenses. Total of all expenses incurred2014-09-30$77,023
Benefits paid (including direct rollovers)2014-09-30$75,531
Total plan assets at end of year2014-09-30$2,128,448
Total plan assets at beginning of year2014-09-30$1,948,063
Value of fidelity bond covering the plan2014-09-30$200,000
Total contributions received or receivable from participants2014-09-30$52,530
Expenses. Other expenses not covered elsewhere2014-09-30$0
Contributions received from other sources (not participants or employers)2014-09-30$0
Other income received2014-09-30$204,878
Noncash contributions received2014-09-30$0
Net income (gross income less expenses)2014-09-30$180,385
Net plan assets at end of year (total assets less liabilities)2014-09-30$2,128,448
Net plan assets at beginning of year (total assets less liabilities)2014-09-30$1,948,063
Assets. Value of participant loans2014-09-30$45,846
Total contributions received or receivable from employer(s)2014-09-30$0
Value of corrective distributions2014-09-30$937
Expenses. Administrative service providers (salaries,fees and commissions)2014-09-30$555
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-09-30$0
2013 : BROOKS STEVENS, INC. 401(K) PLAN 2013 401k financial data
Total income from all sources2013-09-30$266,184
Expenses. Total of all expenses incurred2013-09-30$248,104
Benefits paid (including direct rollovers)2013-09-30$229,799
Total plan assets at end of year2013-09-30$1,948,063
Total plan assets at beginning of year2013-09-30$1,929,983
Value of fidelity bond covering the plan2013-09-30$200,000
Total contributions received or receivable from participants2013-09-30$59,270
Expenses. Other expenses not covered elsewhere2013-09-30$0
Contributions received from other sources (not participants or employers)2013-09-30$0
Other income received2013-09-30$206,914
Noncash contributions received2013-09-30$0
Net income (gross income less expenses)2013-09-30$18,080
Net plan assets at end of year (total assets less liabilities)2013-09-30$1,948,063
Net plan assets at beginning of year (total assets less liabilities)2013-09-30$1,929,983
Total contributions received or receivable from employer(s)2013-09-30$0
Value of certain deemed distributions of participant loans2013-09-30$13,394
Value of corrective distributions2013-09-30$4,606
Expenses. Administrative service providers (salaries,fees and commissions)2013-09-30$305
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-09-30$0

Form 5500 Responses for BROOKS STEVENS, INC. 401(K) PLAN

2019: BROOKS STEVENS, INC. 401(K) PLAN 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01Submission has been amendedNo
2019-10-01This submission is the final filingNo
2019-10-01This return/report is a short plan year return/report (less than 12 months)No
2019-10-01Plan is a collectively bargained planNo
2019-10-01Plan funding arrangement – InsuranceYes
2019-10-01Plan funding arrangement – TrustYes
2019-10-01Plan benefit arrangement – InsuranceYes
2019-10-01Plan benefit arrangement - TrustYes
2018: BROOKS STEVENS, INC. 401(K) PLAN 2018 form 5500 responses
2018-10-01Type of plan entitySingle employer plan
2018-10-01Submission has been amendedNo
2018-10-01This submission is the final filingNo
2018-10-01This return/report is a short plan year return/report (less than 12 months)No
2018-10-01Plan is a collectively bargained planNo
2018-10-01Plan funding arrangement – InsuranceYes
2018-10-01Plan funding arrangement – TrustYes
2018-10-01Plan benefit arrangement – InsuranceYes
2018-10-01Plan benefit arrangement - TrustYes
2017: BROOKS STEVENS, INC. 401(K) PLAN 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01Submission has been amendedNo
2017-10-01This submission is the final filingNo
2017-10-01This return/report is a short plan year return/report (less than 12 months)No
2017-10-01Plan is a collectively bargained planNo
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan funding arrangement – TrustYes
2017-10-01Plan benefit arrangement – InsuranceYes
2017-10-01Plan benefit arrangement - TrustYes
2016: BROOKS STEVENS, INC. 401(K) PLAN 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Submission has been amendedNo
2016-10-01This submission is the final filingNo
2016-10-01This return/report is a short plan year return/report (less than 12 months)No
2016-10-01Plan is a collectively bargained planNo
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan funding arrangement – TrustYes
2016-10-01Plan benefit arrangement – InsuranceYes
2016-10-01Plan benefit arrangement - TrustYes
2015: BROOKS STEVENS, INC. 401(K) PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Submission has been amendedNo
2015-10-01This submission is the final filingNo
2015-10-01This return/report is a short plan year return/report (less than 12 months)No
2015-10-01Plan is a collectively bargained planNo
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan funding arrangement – TrustYes
2015-10-01Plan benefit arrangement – InsuranceYes
2015-10-01Plan benefit arrangement - TrustYes
2014: BROOKS STEVENS, INC. 401(K) PLAN 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Submission has been amendedNo
2014-10-01This submission is the final filingNo
2014-10-01This return/report is a short plan year return/report (less than 12 months)No
2014-10-01Plan is a collectively bargained planNo
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan funding arrangement – TrustYes
2014-10-01Plan benefit arrangement – InsuranceYes
2014-10-01Plan benefit arrangement - TrustYes
2013: BROOKS STEVENS, INC. 401(K) PLAN 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Submission has been amendedNo
2013-10-01This submission is the final filingNo
2013-10-01This return/report is a short plan year return/report (less than 12 months)No
2013-10-01Plan is a collectively bargained planNo
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan funding arrangement – TrustYes
2013-10-01Plan benefit arrangement – InsuranceYes
2013-10-01Plan benefit arrangement - TrustYes
2012: BROOKS STEVENS, INC. 401(K) PLAN 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Submission has been amendedNo
2012-10-01This submission is the final filingNo
2012-10-01This return/report is a short plan year return/report (less than 12 months)No
2012-10-01Plan is a collectively bargained planNo
2012-10-01Plan funding arrangement – InsuranceYes
2012-10-01Plan funding arrangement – TrustYes
2012-10-01Plan benefit arrangement – InsuranceYes
2012-10-01Plan 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 number134075
Policy instance 1
Insurance contract or identification number134075
Number of Individuals Covered20
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $4,024
Total amount of fees paid to insurance companyUSD $2,492
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 $4,024
Insurance broker organization code?7
Amount paid for insurance broker fees2492
Additional information about fees paid to insurance brokerTPA FEES
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number134075
Policy instance 1
Insurance contract or identification number134075
Number of Individuals Covered21
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $3,450
Total amount of fees paid to insurance companyUSD $2,991
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 $0
Amount paid for insurance broker fees2991
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker organization code?5
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number873562
Policy instance 1
Insurance contract or identification number873562
Number of Individuals Covered33
Insurance policy start date2017-10-01
Insurance policy end date2018-05-08
Total amount of commissions paid to insurance brokerUSD $2,515
Total amount of fees paid to insurance companyUSD $798
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?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 number134075
Policy instance 2
Insurance contract or identification number134075
Number of Individuals Covered25
Insurance policy start date2018-04-27
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $1,664
Total amount of fees paid to insurance companyUSD $4,397
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
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number873562
Policy instance 1
Insurance contract or identification number873562
Number of Individuals Covered33
Insurance policy start date2015-10-01
Insurance policy end date2016-09-30
Total amount of commissions paid to insurance brokerUSD $3,848
Total amount of fees paid to insurance companyUSD $1,085
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
Commission paid to Insurance BrokerUSD $3,848
Amount paid for insurance broker fees118
Additional information about fees paid to insurance brokerSUPPLEMENTAL CASH PAID
Insurance broker organization code?7
Insurance broker namePPG RETIREMENT PLAN SERVICES, LTD.
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number873562
Policy instance 1
Insurance contract or identification number873562
Number of Individuals Covered30
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $4,185
Total amount of fees paid to insurance companyUSD $1,239
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
Commission paid to Insurance BrokerUSD $4,185
Amount paid for insurance broker fees183
Additional information about fees paid to insurance brokerSUPPLEMENTAL CASH PAID
Insurance broker organization code?7
Insurance broker namePPG RETIREMENT PLAN SERVICES, LTD.
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number873562
Policy instance 1
Insurance contract or identification number873562
Number of Individuals Covered32
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Total amount of commissions paid to insurance brokerUSD $3,493
Total amount of fees paid to insurance companyUSD $1,172
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
Commission paid to Insurance BrokerUSD $3,493
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerADVISOR FEES
Insurance broker organization code?7
Insurance broker namePPG RETIREMENT PLAN SERVICES, LTD.
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number873562
Policy instance 1
Insurance contract or identification number873562
Number of Individuals Covered33
Insurance policy start date2012-11-16
Insurance policy end date2013-09-30
Total amount of commissions paid to insurance brokerUSD $17,370
Total amount of fees paid to insurance companyUSD $6,263
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?Yes
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
Other information about contractGUARANTEED INTEREST
Commission paid to Insurance BrokerUSD $17,370
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerADVISOR FEES
Insurance broker organization code?7
Insurance broker namePPG RETIREMENT PLAN SERVICES, LTD.

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