LAKEWAY DERMATOLOGY ASSOCIATES, PC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan LAKEWAY DERMATOLOGY ASSOCIATES, PC
| Measure | Date | Value |
|---|
| 2022: LAKEWAY DERMATOLOGY ASSOCIATES, PC 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 38 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 30 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 4 |
| Total of all active and inactive participants | 2022-01-01 | 34 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2022-01-01 | 0 |
| Total participants | 2022-01-01 | 34 |
| Number of participants with account balances | 2022-01-01 | 34 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2022-01-01 | 0 |
| 2021: LAKEWAY DERMATOLOGY ASSOCIATES, PC 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 36 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 26 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 8 |
| Total of all active and inactive participants | 2021-01-01 | 35 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2021-01-01 | 2 |
| Total participants | 2021-01-01 | 37 |
| Number of participants with account balances | 2021-01-01 | 37 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2021-01-01 | 1 |
| 2020: LAKEWAY DERMATOLOGY ASSOCIATES, PC 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 40 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 27 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 7 |
| Total of all active and inactive participants | 2020-01-01 | 34 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2020-01-01 | 0 |
| Total participants | 2020-01-01 | 34 |
| Number of participants with account balances | 2020-01-01 | 34 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2020-01-01 | 2 |
| 2019: LAKEWAY DERMATOLOGY ASSOCIATES, PC 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 37 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 29 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 9 |
| Total of all active and inactive participants | 2019-01-01 | 40 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2019-01-01 | 0 |
| Total participants | 2019-01-01 | 40 |
| Number of participants with account balances | 2019-01-01 | 40 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2019-01-01 | 1 |
| 2018: LAKEWAY DERMATOLOGY ASSOCIATES, PC 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 37 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 28 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 6 |
| Total of all active and inactive participants | 2018-01-01 | 36 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2018-01-01 | 0 |
| Total participants | 2018-01-01 | 36 |
| Number of participants with account balances | 2018-01-01 | 36 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2018-01-01 | 0 |
| 2017: LAKEWAY DERMATOLOGY ASSOCIATES, PC 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 34 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 31 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 4 |
| Total of all active and inactive participants | 2017-01-01 | 37 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2017-01-01 | 0 |
| Total participants | 2017-01-01 | 37 |
| Number of participants with account balances | 2017-01-01 | 37 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2017-01-01 | 0 |
| 2016: LAKEWAY DERMATOLOGY ASSOCIATES, PC 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 34 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 28 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 4 |
| Total of all active and inactive participants | 2016-01-01 | 32 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2016-01-01 | 0 |
| Total participants | 2016-01-01 | 32 |
| Number of participants with account balances | 2016-01-01 | 32 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2016-01-01 | 0 |
| 2015: LAKEWAY DERMATOLOGY ASSOCIATES, PC 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 32 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 27 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 6 |
| Total of all active and inactive participants | 2015-01-01 | 34 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2015-01-01 | 0 |
| Total participants | 2015-01-01 | 34 |
| Number of participants with account balances | 2015-01-01 | 34 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2015-01-01 | 0 |
| Measure | Date | Value |
|---|
| 2022 : LAKEWAY DERMATOLOGY ASSOCIATES, PC 2022 401k financial data |
|---|
| Total income from all sources | 2022-12-31 | $-188,628 |
| Expenses. Total of all expenses incurred | 2022-12-31 | $702,475 |
| Benefits paid (including direct rollovers) | 2022-12-31 | $686,891 |
| Total plan assets at end of year | 2022-12-31 | $2,571,981 |
| Total plan assets at beginning of year | 2022-12-31 | $3,463,084 |
| Value of fidelity bond covering the plan | 2022-12-31 | $1,400,000 |
| Total contributions received or receivable from participants | 2022-12-31 | $150,534 |
| Other income received | 2022-12-31 | $-415,767 |
| Net income (gross income less expenses) | 2022-12-31 | $-891,103 |
| Net plan assets at end of year (total assets less liabilities) | 2022-12-31 | $2,571,981 |
| Net plan assets at beginning of year (total assets less liabilities) | 2022-12-31 | $3,463,084 |
| Assets. Value of participant loans | 2022-12-31 | $0 |
| Assets. Value of real-estate (other than employer real property) | 2022-12-31 | $764,953 |
| Total contributions received or receivable from employer(s) | 2022-12-31 | $76,605 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2022-12-31 | $15,584 |
| 2021 : LAKEWAY DERMATOLOGY ASSOCIATES, PC 2021 401k financial data |
|---|
| Total income from all sources | 2021-12-31 | $535,852 |
| Expenses. Total of all expenses incurred | 2021-12-31 | $197,947 |
| Benefits paid (including direct rollovers) | 2021-12-31 | $193,188 |
| Total plan assets at end of year | 2021-12-31 | $3,463,084 |
| Total plan assets at beginning of year | 2021-12-31 | $3,125,179 |
| Value of fidelity bond covering the plan | 2021-12-31 | $1,400,000 |
| Total contributions received or receivable from participants | 2021-12-31 | $145,803 |
| Other income received | 2021-12-31 | $316,042 |
| Net income (gross income less expenses) | 2021-12-31 | $337,905 |
| Net plan assets at end of year (total assets less liabilities) | 2021-12-31 | $3,463,084 |
| Net plan assets at beginning of year (total assets less liabilities) | 2021-12-31 | $3,125,179 |
| Assets. Value of participant loans | 2021-12-31 | $3,143 |
| Assets. Value of real-estate (other than employer real property) | 2021-12-31 | $742,672 |
| Total contributions received or receivable from employer(s) | 2021-12-31 | $74,007 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2021-12-31 | $4,759 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2021-12-31 | $0 |
| 2020 : LAKEWAY DERMATOLOGY ASSOCIATES, PC 2020 401k financial data |
|---|
| Total income from all sources | 2020-12-31 | $495,619 |
| Expenses. Total of all expenses incurred | 2020-12-31 | $78,737 |
| Benefits paid (including direct rollovers) | 2020-12-31 | $78,737 |
| Total plan assets at end of year | 2020-12-31 | $3,125,179 |
| Total plan assets at beginning of year | 2020-12-31 | $2,708,297 |
| Value of fidelity bond covering the plan | 2020-12-31 | $1,400,000 |
| Total contributions received or receivable from participants | 2020-12-31 | $131,886 |
| Other income received | 2020-12-31 | $291,428 |
| Net income (gross income less expenses) | 2020-12-31 | $416,882 |
| Net plan assets at end of year (total assets less liabilities) | 2020-12-31 | $3,125,179 |
| Net plan assets at beginning of year (total assets less liabilities) | 2020-12-31 | $2,708,297 |
| Assets. Value of participant loans | 2020-12-31 | $0 |
| Assets. Value of real-estate (other than employer real property) | 2020-12-31 | $721,041 |
| Total contributions received or receivable from employer(s) | 2020-12-31 | $72,305 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2020-12-31 | $0 |
| 2019 : LAKEWAY DERMATOLOGY ASSOCIATES, PC 2019 401k financial data |
|---|
| Total income from all sources | 2019-12-31 | $500,114 |
| Expenses. Total of all expenses incurred | 2019-12-31 | $68,887 |
| Benefits paid (including direct rollovers) | 2019-12-31 | $64,835 |
| Total plan assets at end of year | 2019-12-31 | $2,708,297 |
| Total plan assets at beginning of year | 2019-12-31 | $2,277,070 |
| Value of fidelity bond covering the plan | 2019-12-31 | $1,400,000 |
| Total contributions received or receivable from participants | 2019-12-31 | $123,835 |
| Expenses. Other expenses not covered elsewhere | 2019-12-31 | $4,052 |
| Contributions received from other sources (not participants or employers) | 2019-12-31 | $8,202 |
| Other income received | 2019-12-31 | $299,038 |
| Net income (gross income less expenses) | 2019-12-31 | $431,227 |
| Net plan assets at end of year (total assets less liabilities) | 2019-12-31 | $2,708,297 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-12-31 | $2,277,070 |
| Assets. Value of participant loans | 2019-12-31 | $27,715 |
| Assets. Value of real-estate (other than employer real property) | 2019-12-31 | $700,040 |
| Total contributions received or receivable from employer(s) | 2019-12-31 | $69,039 |
| 2018 : LAKEWAY DERMATOLOGY ASSOCIATES, PC 2018 401k financial data |
|---|
| Total income from all sources | 2018-12-31 | $52,396 |
| Expenses. Total of all expenses incurred | 2018-12-31 | $127,475 |
| Benefits paid (including direct rollovers) | 2018-12-31 | $119,975 |
| Total plan assets at end of year | 2018-12-31 | $2,905,414 |
| Total plan assets at beginning of year | 2018-12-31 | $2,980,493 |
| Value of fidelity bond covering the plan | 2018-12-31 | $1,400,000 |
| Total contributions received or receivable from participants | 2018-12-31 | $93,835 |
| Contributions received from other sources (not participants or employers) | 2018-12-31 | $4,502 |
| Other income received | 2018-12-31 | $-113,308 |
| Net income (gross income less expenses) | 2018-12-31 | $-75,079 |
| Net plan assets at end of year (total assets less liabilities) | 2018-12-31 | $2,905,414 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-12-31 | $2,980,493 |
| Assets. Value of participant loans | 2018-12-31 | $43,538 |
| Assets. Value of real-estate (other than employer real property) | 2018-12-31 | $1,328,384 |
| Total contributions received or receivable from employer(s) | 2018-12-31 | $67,367 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2018-12-31 | $7,500 |
| 2017 : LAKEWAY DERMATOLOGY ASSOCIATES, PC 2017 401k financial data |
|---|
| Total income from all sources | 2017-12-31 | $365,358 |
| Expenses. Total of all expenses incurred | 2017-12-31 | $290,998 |
| Benefits paid (including direct rollovers) | 2017-12-31 | $284,293 |
| Total plan assets at end of year | 2017-12-31 | $2,980,493 |
| Total plan assets at beginning of year | 2017-12-31 | $2,906,133 |
| Value of fidelity bond covering the plan | 2017-12-31 | $1,400,000 |
| Total contributions received or receivable from participants | 2017-12-31 | $96,889 |
| Other income received | 2017-12-31 | $200,777 |
| Net income (gross income less expenses) | 2017-12-31 | $74,360 |
| Net plan assets at end of year (total assets less liabilities) | 2017-12-31 | $2,980,493 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-12-31 | $2,906,133 |
| Assets. Value of participant loans | 2017-12-31 | $62,779 |
| Assets. Value of real-estate (other than employer real property) | 2017-12-31 | $1,328,384 |
| Total contributions received or receivable from employer(s) | 2017-12-31 | $67,692 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-12-31 | $6,705 |
| 2016 : LAKEWAY DERMATOLOGY ASSOCIATES, PC 2016 401k financial data |
|---|
| Total income from all sources | 2016-12-31 | $296,522 |
| Expenses. Total of all expenses incurred | 2016-12-31 | $77,428 |
| Benefits paid (including direct rollovers) | 2016-12-31 | $76,243 |
| Total plan assets at end of year | 2016-12-31 | $2,906,133 |
| Total plan assets at beginning of year | 2016-12-31 | $2,687,039 |
| Value of fidelity bond covering the plan | 2016-12-31 | $1,400,000 |
| Total contributions received or receivable from participants | 2016-12-31 | $111,401 |
| Other income received | 2016-12-31 | $95,551 |
| Net income (gross income less expenses) | 2016-12-31 | $219,094 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-31 | $2,906,133 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-31 | $2,687,039 |
| Assets. Value of participant loans | 2016-12-31 | $61,577 |
| Assets. Value of real-estate (other than employer real property) | 2016-12-31 | $1,315,231 |
| Total contributions received or receivable from employer(s) | 2016-12-31 | $89,570 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-12-31 | $1,185 |
| 2015 : LAKEWAY DERMATOLOGY ASSOCIATES, PC 2015 401k financial data |
|---|
| Total income from all sources | 2015-12-31 | $165,204 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $581,212 |
| Benefits paid (including direct rollovers) | 2015-12-31 | $581,212 |
| Total plan assets at end of year | 2015-12-31 | $2,687,039 |
| Total plan assets at beginning of year | 2015-12-31 | $3,103,047 |
| Value of fidelity bond covering the plan | 2015-12-31 | $1,300,000 |
| Total contributions received or receivable from participants | 2015-12-31 | $115,678 |
| Other income received | 2015-12-31 | $-32,974 |
| Net income (gross income less expenses) | 2015-12-31 | $-416,008 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $2,687,039 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $3,103,047 |
| Assets. Value of participant loans | 2015-12-31 | $79,259 |
| Assets. Value of real-estate (other than employer real property) | 2015-12-31 | $1,302,209 |
| Total contributions received or receivable from employer(s) | 2015-12-31 | $82,500 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2015-12-31 | $0 |
| 2022: LAKEWAY DERMATOLOGY ASSOCIATES, PC 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Submission has been amended | No |
| 2022-01-01 | This submission is the final filing | No |
| 2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-01-01 | Plan is a collectively bargained plan | No |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – Trust | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement - Trust | Yes |
| 2021: LAKEWAY DERMATOLOGY ASSOCIATES, PC 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Submission has been amended | No |
| 2021-01-01 | This submission is the final filing | No |
| 2021-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-01-01 | Plan is a collectively bargained plan | No |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – Trust | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement - Trust | Yes |
| 2020: LAKEWAY DERMATOLOGY ASSOCIATES, PC 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Submission has been amended | No |
| 2020-01-01 | This submission is the final filing | No |
| 2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-01-01 | Plan is a collectively bargained plan | No |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – Trust | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement - Trust | Yes |
| 2019: LAKEWAY DERMATOLOGY ASSOCIATES, PC 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Submission has been amended | No |
| 2019-01-01 | This submission is the final filing | No |
| 2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-01-01 | Plan is a collectively bargained plan | No |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – Trust | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement - Trust | Yes |
| 2018: LAKEWAY DERMATOLOGY ASSOCIATES, PC 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Submission has been amended | No |
| 2018-01-01 | This submission is the final filing | No |
| 2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-01-01 | Plan is a collectively bargained plan | No |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – Trust | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement - Trust | Yes |
| 2017: LAKEWAY DERMATOLOGY ASSOCIATES, PC 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | No |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – Trust | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement - Trust | Yes |
| 2016: LAKEWAY DERMATOLOGY ASSOCIATES, PC 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – Trust | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement - Trust | Yes |
| 2015: LAKEWAY DERMATOLOGY ASSOCIATES, PC 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – Trust | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement - Trust | Yes |
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 115999 |
| Policy instance | 1 |
| Insurance contract or identification number | 115999 | | Number of Individuals Covered | 28 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $11,902 | | Total amount of fees paid to insurance company | USD $1,018 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Broker | USD $11,902 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1018 | | Additional information about fees paid to insurance broker | PARTICIPANT FEES |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 115999 |
| Policy instance | 1 |
| Insurance contract or identification number | 115999 | | Number of Individuals Covered | 34 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $12,185 | | Total amount of fees paid to insurance company | USD $400 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Broker | USD $12,185 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 400 | | Additional information about fees paid to insurance broker | PARTICIPANT FEES |
|
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 115999 |
| Policy instance | 1 |
| Insurance contract or identification number | 115999 | | Number of Individuals Covered | 31 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $9,311 | | Total amount of fees paid to insurance company | USD $640 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Broker | USD $9,311 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 640 | | Additional information about fees paid to insurance broker | PARTICIPANT FEES |
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| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 115999 |
| Policy instance | 1 |
| Insurance contract or identification number | 115999 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $8,065 | | Total amount of fees paid to insurance company | USD $300 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Broker | USD $8,065 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 300 | | Additional information about fees paid to insurance broker | PARTICIPANT FEES |
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| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 115999 |
| Policy instance | 1 |
| Insurance contract or identification number | 115999 | | Number of Individuals Covered | 34 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $7,300 | | Total amount of fees paid to insurance company | USD $200 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Broker | USD $7,300 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 200 | | Additional information about fees paid to insurance broker | PARTICIPANT FEES |
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| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 115999 |
| Policy instance | 1 |
| Insurance contract or identification number | 115999 | | Number of Individuals Covered | 30 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $6,270 | | Total amount of fees paid to insurance company | USD $435 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Broker | USD $6,270 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 435 | | Additional information about fees paid to insurance broker | PARTICIPANT FEES | | Insurance broker name | TENNESSEE PENSION ADMINISTRATORS |
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| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) |
| Policy contract number | 115999 |
| Policy instance | 1 |
| Insurance contract or identification number | 115999 | | Number of Individuals Covered | 29 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $6,714 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Broker | USD $6,150 | | Insurance broker organization code? | 3 | | Insurance broker name | TENNESSEE PENSION ADMINISTRATORS |
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