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CMMS, IN 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan NameCMMS, IN 401(K) PROFIT SHARING PLAN
Plan identification number 001

CMMS, IN 401(K) PROFIT SHARING 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.
  • 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

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

Company Name:CMMS, INC
Employer identification number (EIN):465069411
NAIC Classification:511210
NAIC Description:Software Publishers

Additional information about CMMS, INC

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division
Incorporation Date: 2014-11-18
Company Identification Number: 603453007
Legal Registered Office Address: 9086 S MARCH POINT RD # 140

ANACORTES
United States of America (USA)
982218693

More information about CMMS, INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CMMS, IN 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01STEPHANIE L. MEYERS2023-09-07
0012021-01-01STEPHANIE L. MEYERS2022-08-15
0012020-01-01STEPHANIE L. MEYERS2021-08-23
0012019-01-01STEPHANIE L. MEYERS2020-06-07
0012018-01-01
0012017-01-01
0012016-01-01STEPHANIE L. MEYERS
0012015-01-01STEPHANIE L. MEYERS
0012014-07-01STEPHANIE L. MEYERS

Plan Statistics for CMMS, IN 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for CMMS, IN 401(K) PROFIT SHARING PLAN

Measure Date Value
2022: CMMS, IN 401(K) PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0139
Total number of active participants reported on line 7a of the Form 55002022-01-0133
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-013
Total of all active and inactive participants2022-01-0136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-0136
Number of participants with account balances2022-01-0120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: CMMS, IN 401(K) PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0136
Total number of active participants reported on line 7a of the Form 55002021-01-0131
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-017
Total of all active and inactive participants2021-01-0138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-0138
Number of participants with account balances2021-01-0121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: CMMS, IN 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0131
Total number of active participants reported on line 7a of the Form 55002020-01-0132
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-015
Total of all active and inactive participants2020-01-0137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-0137
Number of participants with account balances2020-01-0122
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-011
2019: CMMS, IN 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0129
Total number of active participants reported on line 7a of the Form 55002019-01-0130
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-013
Total of all active and inactive participants2019-01-0133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0133
Number of participants with account balances2019-01-0119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: CMMS, IN 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0116
Total number of active participants reported on line 7a of the Form 55002018-01-0126
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-011
Total of all active and inactive participants2018-01-0127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0127
Number of participants with account balances2018-01-0118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: CMMS, IN 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0116
Total number of active participants reported on line 7a of the Form 55002017-01-0115
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-014
Total of all active and inactive participants2017-01-0119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0119
Number of participants with account balances2017-01-0115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-012
2016: CMMS, IN 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0120
Total number of active participants reported on line 7a of the Form 55002016-01-0118
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 participants2016-01-0118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0118
Number of participants with account balances2016-01-0113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-012
2015: CMMS, IN 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0114
Total number of active participants reported on line 7a of the Form 55002015-01-0116
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-012
Total of all active and inactive participants2015-01-0118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0118
Number of participants with account balances2015-01-0113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-012
2014: CMMS, IN 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-0111
Total number of active participants reported on line 7a of the Form 55002014-07-0113
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-010
Total of all active and inactive participants2014-07-0113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-07-010
Total participants2014-07-0113
Number of participants with account balances2014-07-014
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-07-010

Financial Data on CMMS, IN 401(K) PROFIT SHARING PLAN

Measure Date Value
2022 : CMMS, IN 401(K) PROFIT SHARING PLAN 2022 401k financial data
Total income from all sources2022-12-31$118,630
Expenses. Total of all expenses incurred2022-12-31$123,994
Benefits paid (including direct rollovers)2022-12-31$114,330
Total plan assets at end of year2022-12-31$1,112,219
Total plan assets at beginning of year2022-12-31$1,117,583
Value of fidelity bond covering the plan2022-12-31$125,000
Total contributions received or receivable from participants2022-12-31$17,219
Expenses. Other expenses not covered elsewhere2022-12-31$9,664
Other income received2022-12-31$101,411
Net income (gross income less expenses)2022-12-31$-5,364
Net plan assets at end of year (total assets less liabilities)2022-12-31$1,112,219
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$1,117,583
Assets. Value of participant loans2022-12-31$41,868
Assets. Value of employer securities2022-12-31$522,180
Total contributions received or receivable from employer(s)2022-12-31$0
2021 : CMMS, IN 401(K) PROFIT SHARING PLAN 2021 401k financial data
Total income from all sources2021-12-31$101,899
Expenses. Total of all expenses incurred2021-12-31$72,178
Benefits paid (including direct rollovers)2021-12-31$61,870
Total plan assets at end of year2021-12-31$1,117,583
Total plan assets at beginning of year2021-12-31$1,087,862
Value of fidelity bond covering the plan2021-12-31$125,000
Total contributions received or receivable from participants2021-12-31$17,573
Expenses. Other expenses not covered elsewhere2021-12-31$10,308
Other income received2021-12-31$84,326
Net income (gross income less expenses)2021-12-31$29,721
Net plan assets at end of year (total assets less liabilities)2021-12-31$1,117,583
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$1,087,862
Assets. Value of participant loans2021-12-31$68,093
Assets. Value of employer securities2021-12-31$409,738
Total contributions received or receivable from employer(s)2021-12-31$0
2020 : CMMS, IN 401(K) PROFIT SHARING PLAN 2020 401k financial data
Total income from all sources2020-12-31$225,111
Expenses. Total of all expenses incurred2020-12-31$70,445
Benefits paid (including direct rollovers)2020-12-31$59,906
Total plan assets at end of year2020-12-31$1,087,862
Total plan assets at beginning of year2020-12-31$933,196
Value of fidelity bond covering the plan2020-12-31$125,000
Total contributions received or receivable from participants2020-12-31$22,012
Other income received2020-12-31$203,099
Net income (gross income less expenses)2020-12-31$154,666
Net plan assets at end of year (total assets less liabilities)2020-12-31$1,087,862
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$933,196
Assets. Value of employer securities2020-12-31$473,817
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$10,539
2019 : CMMS, IN 401(K) PROFIT SHARING PLAN 2019 401k financial data
Total income from all sources2019-12-31$47,672
Expenses. Total of all expenses incurred2019-12-31$59,622
Benefits paid (including direct rollovers)2019-12-31$52,019
Total plan assets at end of year2019-12-31$933,196
Total plan assets at beginning of year2019-12-31$945,146
Value of fidelity bond covering the plan2019-12-31$125,000
Total contributions received or receivable from participants2019-12-31$24,541
Expenses. Other expenses not covered elsewhere2019-12-31$7,603
Contributions received from other sources (not participants or employers)2019-12-31$4,347
Other income received2019-12-31$18,784
Net income (gross income less expenses)2019-12-31$-11,950
Net plan assets at end of year (total assets less liabilities)2019-12-31$933,196
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$945,146
Assets. Value of employer real property2019-12-31$415,338
2018 : CMMS, IN 401(K) PROFIT SHARING PLAN 2018 401k financial data
Total income from all sources2018-12-31$185,012
Expenses. Total of all expenses incurred2018-12-31$164,376
Benefits paid (including direct rollovers)2018-12-31$157,867
Total plan assets at end of year2018-12-31$945,146
Total plan assets at beginning of year2018-12-31$924,510
Value of fidelity bond covering the plan2018-12-31$100,000
Total contributions received or receivable from participants2018-12-31$17,966
Expenses. Other expenses not covered elsewhere2018-12-31$6,509
Contributions received from other sources (not participants or employers)2018-12-31$147,185
Other income received2018-12-31$19,861
Net income (gross income less expenses)2018-12-31$20,636
Net plan assets at end of year (total assets less liabilities)2018-12-31$945,146
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$924,510
Assets. Value of employer real property2018-12-31$527,357
2017 : CMMS, IN 401(K) PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources2017-12-31$314,128
Expenses. Total of all expenses incurred2017-12-31$4,594
Benefits paid (including direct rollovers)2017-12-31$1,538
Total plan assets at end of year2017-12-31$924,510
Total plan assets at beginning of year2017-12-31$614,976
Value of fidelity bond covering the plan2017-12-31$55,000
Total contributions received or receivable from participants2017-12-31$6,295
Expenses. Other expenses not covered elsewhere2017-12-31$3,056
Other income received2017-12-31$307,833
Net income (gross income less expenses)2017-12-31$309,534
Net plan assets at end of year (total assets less liabilities)2017-12-31$924,510
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$614,976
Assets. Value of employer real property2017-12-31$528,355
Total contributions received or receivable from employer(s)2017-12-31$0
2016 : CMMS, IN 401(K) PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources2016-12-31$100,942
Expenses. Total of all expenses incurred2016-12-31$2,021
Benefits paid (including direct rollovers)2016-12-31$1,522
Total plan assets at end of year2016-12-31$614,976
Total plan assets at beginning of year2016-12-31$516,055
Value of fidelity bond covering the plan2016-12-31$55,000
Total contributions received or receivable from participants2016-12-31$15,119
Expenses. Other expenses not covered elsewhere2016-12-31$499
Contributions received from other sources (not participants or employers)2016-12-31$25,000
Other income received2016-12-31$51,702
Net income (gross income less expenses)2016-12-31$98,921
Net plan assets at end of year (total assets less liabilities)2016-12-31$614,976
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$516,055
Assets. Value of employer real property2016-12-31$282,375
Total contributions received or receivable from employer(s)2016-12-31$9,121
2015 : CMMS, IN 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources2015-12-31$212,257
Expenses. Total of all expenses incurred2015-12-31$50,052
Benefits paid (including direct rollovers)2015-12-31$49,975
Total plan assets at end of year2015-12-31$516,055
Total plan assets at beginning of year2015-12-31$353,850
Value of fidelity bond covering the plan2015-12-31$50,000
Total contributions received or receivable from participants2015-12-31$12,496
Expenses. Other expenses not covered elsewhere2015-12-31$77
Contributions received from other sources (not participants or employers)2015-12-31$195,627
Other income received2015-12-31$-4,180
Net income (gross income less expenses)2015-12-31$162,205
Net plan assets at end of year (total assets less liabilities)2015-12-31$516,055
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$353,850
Assets. Value of employer real property2015-12-31$226,000
Total contributions received or receivable from employer(s)2015-12-31$8,314
2014 : CMMS, IN 401(K) PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources2014-12-31$353,898
Expenses. Total of all expenses incurred2014-12-31$48
Total plan assets at end of year2014-12-31$353,850
Total plan assets at beginning of year2014-12-31$0
Value of fidelity bond covering the plan2014-12-31$25,000
Total contributions received or receivable from participants2014-12-31$5,396
Expenses. Other expenses not covered elsewhere2014-12-31$48
Contributions received from other sources (not participants or employers)2014-12-31$342,187
Other income received2014-12-31$1,662
Net income (gross income less expenses)2014-12-31$353,850
Net plan assets at end of year (total assets less liabilities)2014-12-31$353,850
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$0
Assets. Value of employer real property2014-12-31$128,590
Total contributions received or receivable from employer(s)2014-12-31$4,653

Form 5500 Responses for CMMS, IN 401(K) PROFIT SHARING PLAN

2022: CMMS, IN 401(K) PROFIT SHARING PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement - TrustYes
2021: CMMS, IN 401(K) PROFIT SHARING PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: CMMS, IN 401(K) PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: CMMS, IN 401(K) PROFIT SHARING 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: CMMS, IN 401(K) PROFIT SHARING 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: CMMS, IN 401(K) PROFIT SHARING 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: CMMS, IN 401(K) PROFIT SHARING 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 – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: CMMS, IN 401(K) PROFIT SHARING 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 – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2014: CMMS, IN 401(K) PROFIT SHARING PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01First time form 5500 has been submittedYes
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – TrustYes
2014-07-01Plan 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 number130274
Policy instance 1
Insurance contract or identification number130274
Number of Individuals Covered25
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $69,000
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Amount paid for insurance broker fees69000
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker organization code?5
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number130274
Policy instance 1
Insurance contract or identification number130274
Number of Individuals Covered26
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $567
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Amount paid for insurance broker fees567
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker organization code?5
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number130274
Policy instance 1
Insurance contract or identification number130274
Number of Individuals Covered27
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Amount paid for insurance broker fees1562
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker organization code?5
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number130274
Policy instance 1
Insurance contract or identification number130274
Number of Individuals Covered24
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1,735
Total amount of fees paid to insurance companyUSD $1,248
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $1,735
Amount paid for insurance broker fees0
Insurance broker organization code?3
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 number130274
Policy instance 1
Insurance contract or identification number130274
Number of Individuals Covered22
Insurance policy start date2018-07-25
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $1,027
Total amount of fees paid to insurance companyUSD $616
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $1,027
Insurance broker organization code?3
Amount paid for insurance broker fees616
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 number130274
Policy instance 1
Insurance contract or identification number130274
Number of Individuals Covered21
Insurance policy start date2017-07-25
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,914
Total amount of fees paid to insurance companyUSD $950
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $1,914
Insurance broker organization code?3
Amount paid for insurance broker fees950
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker nameSHEAKLEY PENSION

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