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INGHAM NEPHROLOGY & HYPERTENSION, P.C. 401(K) PLAN 401k Plan overview

Plan NameINGHAM NEPHROLOGY & HYPERTENSION, P.C. 401(K) PLAN
Plan identification number 001

INGHAM NEPHROLOGY & HYPERTENSION, P.C. 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • 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.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • 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

INGHAM NEPHROLOGY & HYPERTENSION, P.C. has sponsored the creation of one or more 401k plans.

Company Name:INGHAM NEPHROLOGY & HYPERTENSION, P.C.
Employer identification number (EIN):465597091
NAIC Classification:621399
NAIC Description:Offices of All Other Miscellaneous Health Practitioners

Form 5500 Filing Information

Submission information for form 5500 for 401k plan INGHAM NEPHROLOGY & HYPERTENSION, P.C. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01DR. CARLA DUDASH-MION2023-06-13 DR. CARLA DUDASH-MION2023-06-13
0012021-01-01DR. CARLA DUDASH-MION2022-09-01
0012020-01-01DR. CARLA DUDASH-MION2021-04-27
0012019-01-01
0012018-01-01CARLA DUDASH MION CARLA DUDASH MION2019-02-21
0012017-01-01CARLA DUDASH MION CARLA DUDASH MION2018-02-06
0012016-01-01CARLA DUDASH MION CARLA DUDASH MION2017-03-14
0012015-07-01CARLA DUDASH MION CARLA DUDASH MION2016-06-09

Plan Statistics for INGHAM NEPHROLOGY & HYPERTENSION, P.C. 401(K) PLAN

401k plan membership statisitcs for INGHAM NEPHROLOGY & HYPERTENSION, P.C. 401(K) PLAN

Measure Date Value
2022: INGHAM NEPHROLOGY & HYPERTENSION, P.C. 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0117
Total number of active participants reported on line 7a of the Form 55002022-01-0114
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 participants2022-01-0117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-0117
Number of participants with account balances2022-01-0117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-011
2021: INGHAM NEPHROLOGY & HYPERTENSION, P.C. 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0117
Total number of active participants reported on line 7a of the Form 55002021-01-0114
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-012
Total of all active and inactive participants2021-01-0116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-0116
Number of participants with account balances2021-01-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: INGHAM NEPHROLOGY & HYPERTENSION, P.C. 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0117
Total number of active participants reported on line 7a of the Form 55002020-01-0113
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-013
Total of all active and inactive participants2020-01-0116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-0116
Number of participants with account balances2020-01-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: INGHAM NEPHROLOGY & HYPERTENSION, P.C. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0117
Total number of active participants reported on line 7a of the Form 55002019-01-019
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-018
Total of all active and inactive participants2019-01-0117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0117
Number of participants with account balances2019-01-0117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-011
2018: INGHAM NEPHROLOGY & HYPERTENSION, P.C. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0115
Total number of active participants reported on line 7a of the Form 55002018-01-0110
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-015
Total of all active and inactive participants2018-01-0115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0115
Number of participants with account balances2018-01-0115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: INGHAM NEPHROLOGY & HYPERTENSION, P.C. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0114
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 benefits2017-01-016
Total of all active and inactive participants2017-01-0115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0115
Number of participants with account balances2017-01-0115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: INGHAM NEPHROLOGY & HYPERTENSION, P.C. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0113
Total number of active participants reported on line 7a of the Form 55002016-01-0112
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-011
Total of all active and inactive participants2016-01-0113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0113
Number of participants with account balances2016-01-0113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: INGHAM NEPHROLOGY & HYPERTENSION, P.C. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-0113
Total number of active participants reported on line 7a of the Form 55002015-07-0112
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-011
Total of all active and inactive participants2015-07-0113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-07-010
Total participants2015-07-0113
Number of participants with account balances2015-07-0113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-07-010

Financial Data on INGHAM NEPHROLOGY & HYPERTENSION, P.C. 401(K) PLAN

Measure Date Value
2022 : INGHAM NEPHROLOGY & HYPERTENSION, P.C. 401(K) PLAN 2022 401k financial data
Transfers to/from the plan2022-12-31$0
Total plan liabilities at end of year2022-12-31$0
Total plan liabilities at beginning of year2022-12-31$0
Total income from all sources2022-12-31$-116,091
Expenses. Total of all expenses incurred2022-12-31$9,714
Benefits paid (including direct rollovers)2022-12-31$0
Total plan assets at end of year2022-12-31$2,002,406
Total plan assets at beginning of year2022-12-31$2,128,211
Value of fidelity bond covering the plan2022-12-31$180,000
Total contributions received or receivable from participants2022-12-31$137,880
Expenses. Other expenses not covered elsewhere2022-12-31$0
Contributions received from other sources (not participants or employers)2022-12-31$0
Other income received2022-12-31$-350,149
Noncash contributions received2022-12-31$0
Net income (gross income less expenses)2022-12-31$-125,805
Net plan assets at end of year (total assets less liabilities)2022-12-31$2,002,406
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$2,128,211
Assets. Value of participant loans2022-12-31$39,663
Total contributions received or receivable from employer(s)2022-12-31$96,178
Value of certain deemed distributions of participant loans2022-12-31$0
Value of corrective distributions2022-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$9,714
2021 : INGHAM NEPHROLOGY & HYPERTENSION, P.C. 401(K) PLAN 2021 401k financial data
Transfers to/from the plan2021-12-31$0
Total plan liabilities at end of year2021-12-31$0
Total plan liabilities at beginning of year2021-12-31$0
Total income from all sources2021-12-31$430,989
Expenses. Total of all expenses incurred2021-12-31$9,962
Benefits paid (including direct rollovers)2021-12-31$609
Total plan assets at end of year2021-12-31$2,128,211
Total plan assets at beginning of year2021-12-31$1,707,184
Value of fidelity bond covering the plan2021-12-31$180,000
Total contributions received or receivable from participants2021-12-31$134,973
Expenses. Other expenses not covered elsewhere2021-12-31$0
Contributions received from other sources (not participants or employers)2021-12-31$0
Other income received2021-12-31$196,016
Noncash contributions received2021-12-31$0
Net income (gross income less expenses)2021-12-31$421,027
Net plan assets at end of year (total assets less liabilities)2021-12-31$2,128,211
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$1,707,184
Total contributions received or receivable from employer(s)2021-12-31$100,000
Value of certain deemed distributions of participant loans2021-12-31$9,353
Value of corrective distributions2021-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
2020 : INGHAM NEPHROLOGY & HYPERTENSION, P.C. 401(K) PLAN 2020 401k financial data
Transfers to/from the plan2020-12-31$0
Total plan liabilities at end of year2020-12-31$0
Total plan liabilities at beginning of year2020-12-31$0
Total income from all sources2020-12-31$367,651
Expenses. Total of all expenses incurred2020-12-31$244,549
Benefits paid (including direct rollovers)2020-12-31$237,368
Total plan assets at end of year2020-12-31$1,707,184
Total plan assets at beginning of year2020-12-31$1,584,082
Total contributions received or receivable from participants2020-12-31$122,247
Expenses. Other expenses not covered elsewhere2020-12-31$0
Contributions received from other sources (not participants or employers)2020-12-31$0
Other income received2020-12-31$145,404
Noncash contributions received2020-12-31$0
Net income (gross income less expenses)2020-12-31$123,102
Net plan assets at end of year (total assets less liabilities)2020-12-31$1,707,184
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$1,584,082
Total contributions received or receivable from employer(s)2020-12-31$100,000
Value of certain deemed distributions of participant loans2020-12-31$0
Value of corrective distributions2020-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$7,181
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
2019 : INGHAM NEPHROLOGY & HYPERTENSION, P.C. 401(K) PLAN 2019 401k financial data
Transfers to/from the plan2019-12-31$0
Total plan liabilities at end of year2019-12-31$0
Total plan liabilities at beginning of year2019-12-31$0
Total income from all sources2019-12-31$424,078
Expenses. Total of all expenses incurred2019-12-31$9,902
Benefits paid (including direct rollovers)2019-12-31$3,400
Total plan assets at end of year2019-12-31$1,584,082
Total plan assets at beginning of year2019-12-31$1,169,906
Total contributions received or receivable from participants2019-12-31$108,900
Expenses. Other expenses not covered elsewhere2019-12-31$0
Contributions received from other sources (not participants or employers)2019-12-31$0
Other income received2019-12-31$215,178
Noncash contributions received2019-12-31$0
Net income (gross income less expenses)2019-12-31$414,176
Net plan assets at end of year (total assets less liabilities)2019-12-31$1,584,082
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$1,169,906
Total contributions received or receivable from employer(s)2019-12-31$100,000
Value of certain deemed distributions of participant loans2019-12-31$0
Value of corrective distributions2019-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$6,502
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
2018 : INGHAM NEPHROLOGY & HYPERTENSION, P.C. 401(K) PLAN 2018 401k financial data
Transfers to/from the plan2018-12-31$0
Total plan liabilities at end of year2018-12-31$0
Total plan liabilities at beginning of year2018-12-31$0
Total income from all sources2018-12-31$158,224
Expenses. Total of all expenses incurred2018-12-31$8,348
Benefits paid (including direct rollovers)2018-12-31$3,055
Total plan assets at end of year2018-12-31$1,169,906
Total plan assets at beginning of year2018-12-31$1,020,030
Total contributions received or receivable from participants2018-12-31$130,753
Expenses. Other expenses not covered elsewhere2018-12-31$0
Contributions received from other sources (not participants or employers)2018-12-31$0
Other income received2018-12-31$-72,529
Noncash contributions received2018-12-31$0
Net income (gross income less expenses)2018-12-31$149,876
Net plan assets at end of year (total assets less liabilities)2018-12-31$1,169,906
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$1,020,030
Total contributions received or receivable from employer(s)2018-12-31$100,000
Value of certain deemed distributions of participant loans2018-12-31$0
Value of corrective distributions2018-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$5,293
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
2017 : INGHAM NEPHROLOGY & HYPERTENSION, P.C. 401(K) PLAN 2017 401k financial data
Transfers to/from the plan2017-12-31$0
Total plan liabilities at end of year2017-12-31$0
Total plan liabilities at beginning of year2017-12-31$0
Total income from all sources2017-12-31$293,857
Expenses. Total of all expenses incurred2017-12-31$8,208
Benefits paid (including direct rollovers)2017-12-31$5,933
Total plan assets at end of year2017-12-31$1,020,030
Total plan assets at beginning of year2017-12-31$734,381
Total contributions received or receivable from participants2017-12-31$135,768
Expenses. Other expenses not covered elsewhere2017-12-31$0
Contributions received from other sources (not participants or employers)2017-12-31$0
Other income received2017-12-31$98,089
Noncash contributions received2017-12-31$0
Net income (gross income less expenses)2017-12-31$285,649
Net plan assets at end of year (total assets less liabilities)2017-12-31$1,020,030
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$734,381
Total contributions received or receivable from employer(s)2017-12-31$60,000
Value of certain deemed distributions of participant loans2017-12-31$2,275
Value of corrective distributions2017-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : INGHAM NEPHROLOGY & HYPERTENSION, P.C. 401(K) PLAN 2016 401k financial data
Transfers to/from the plan2016-12-31$0
Total plan liabilities at end of year2016-12-31$0
Total plan liabilities at beginning of year2016-12-31$0
Total income from all sources2016-12-31$337,999
Expenses. Total of all expenses incurred2016-12-31$2,275
Benefits paid (including direct rollovers)2016-12-31$0
Total plan assets at end of year2016-12-31$734,381
Total plan assets at beginning of year2016-12-31$398,657
Total contributions received or receivable from participants2016-12-31$131,412
Expenses. Other expenses not covered elsewhere2016-12-31$0
Contributions received from other sources (not participants or employers)2016-12-31$44,582
Other income received2016-12-31$22,005
Noncash contributions received2016-12-31$0
Net income (gross income less expenses)2016-12-31$335,724
Net plan assets at end of year (total assets less liabilities)2016-12-31$734,381
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$398,657
Total contributions received or receivable from employer(s)2016-12-31$140,000
Value of certain deemed distributions of participant loans2016-12-31$0
Value of corrective distributions2016-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$2,275
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : INGHAM NEPHROLOGY & HYPERTENSION, P.C. 401(K) PLAN 2015 401k financial data
Transfers to/from the plan2015-12-31$0
Total plan liabilities at end of year2015-12-31$0
Total plan liabilities at beginning of year2015-12-31$0
Total income from all sources2015-12-31$399,233
Expenses. Total of all expenses incurred2015-12-31$576
Benefits paid (including direct rollovers)2015-12-31$0
Total plan assets at end of year2015-12-31$398,657
Total plan assets at beginning of year2015-12-31$0
Total contributions received or receivable from participants2015-12-31$85,495
Expenses. Other expenses not covered elsewhere2015-12-31$0
Contributions received from other sources (not participants or employers)2015-12-31$299,470
Other income received2015-12-31$-15,732
Noncash contributions received2015-12-31$0
Net income (gross income less expenses)2015-12-31$398,657
Net plan assets at end of year (total assets less liabilities)2015-12-31$398,657
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$0
Total contributions received or receivable from employer(s)2015-12-31$30,000
Value of certain deemed distributions of participant loans2015-12-31$0
Value of corrective distributions2015-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$576
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0

Form 5500 Responses for INGHAM NEPHROLOGY & HYPERTENSION, P.C. 401(K) PLAN

2022: INGHAM NEPHROLOGY & HYPERTENSION, P.C. 401(K) 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 – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: INGHAM NEPHROLOGY & HYPERTENSION, P.C. 401(K) 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: INGHAM NEPHROLOGY & HYPERTENSION, P.C. 401(K) 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: INGHAM NEPHROLOGY & HYPERTENSION, P.C. 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: INGHAM NEPHROLOGY & HYPERTENSION, P.C. 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: INGHAM NEPHROLOGY & HYPERTENSION, P.C. 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: INGHAM NEPHROLOGY & HYPERTENSION, P.C. 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: INGHAM NEPHROLOGY & HYPERTENSION, P.C. 401(K) PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01First time form 5500 has been submittedYes
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan funding arrangement – TrustYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-07-01Plan 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 number119087
Policy instance 1
Insurance contract or identification number119087
Number of Individuals Covered18
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $9,714
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?Yes
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,714
Insurance broker organization code?3
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number119087
Policy instance 1
Insurance contract or identification number119087
Number of Individuals Covered16
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $9,353
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?Yes
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,353
Insurance broker organization code?3
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number119087
Policy instance 1
Insurance contract or identification number119087
Number of Individuals Covered17
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $7,096
Total amount of fees paid to insurance companyUSD $85
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?Yes
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,096
Amount paid for insurance broker fees0
Insurance broker organization code?3
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number119087
Policy instance 1
Insurance contract or identification number119087
Number of Individuals Covered16
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $6,502
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?Yes
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,769
Amount paid for insurance broker fees0
Insurance broker organization code?3
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number119087
Policy instance 1
Insurance contract or identification number119087
Number of Individuals Covered15
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $5,293
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for group deferred annuity?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,293
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameLPL FINANCIAL CORPORATION
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number119087
Policy instance 1
Insurance contract or identification number119087
Number of Individuals Covered14
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $2,275
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for group deferred annuity?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $805
Insurance broker organization code?3
Insurance broker nameLPL FINANCIAL
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number119087
Policy instance 1
Insurance contract or identification number119087
Number of Individuals Covered14
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
Total amount of commissions paid to insurance brokerUSD $2,275
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for group deferred annuity?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $805
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameLPL FINANCIAL
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number119087
Policy instance 1
Insurance contract or identification number119087
Number of Individuals Covered10
Insurance policy start date2015-07-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $548
Total amount of fees paid to insurance companyUSD $28
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees548
Insurance broker organization code?3
Insurance broker nameWILSHIRE ASSOCIATES, INC.

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