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DMS RETIREMENT PLAN 401k Plan overview

Plan NameDMS RETIREMENT PLAN
Plan identification number 001

DMS RETIREMENT 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

DATA MANAGEMENT SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name:DATA MANAGEMENT SERVICES, INC.
Employer identification number (EIN):521888039
NAIC Classification:541600

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DMS RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01J. PALADINO2023-09-28
0012021-01-01J. PALADINO2022-10-14
0012020-01-01J. PALADINO2021-09-24
0012019-01-01
0012018-01-01
0012017-01-01
0012016-01-01MAGDALAH SILVA2017-10-10 MAGDALAH SILVA2017-10-10
0012015-01-01MAGDALAH SILVA2016-10-04 MAGDALAH SILVA2016-10-04
0012015-01-01MAGDALAH SILVA2016-10-04
0012014-01-01MAGDALAH SILVA2015-05-05
0012013-01-01MAGDALAH SILVA
0012012-01-01OLYMPIA TISDALE
0012011-01-01JENNIFER LYNNE SCRITCHFIELD
0012010-01-01SUZANNE E. MISCIK

Plan Statistics for DMS RETIREMENT PLAN

401k plan membership statisitcs for DMS RETIREMENT PLAN

Measure Date Value
2013: DMS RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01104
Total number of active participants reported on line 7a of the Form 55002013-01-0164
Number of retired or separated participants receiving benefits2013-01-011
Number of other retired or separated participants entitled to future benefits2013-01-0122
Total of all active and inactive participants2013-01-0187
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0187
Number of participants with account balances2013-01-0152
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-014
2012: DMS RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01114
Total number of active participants reported on line 7a of the Form 55002012-01-0174
Number of retired or separated participants receiving benefits2012-01-012
Number of other retired or separated participants entitled to future benefits2012-01-0128
Total of all active and inactive participants2012-01-01104
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01104
Number of participants with account balances2012-01-0168
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-012
2011: DMS RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01138
Total number of active participants reported on line 7a of the Form 55002011-01-0187
Number of retired or separated participants receiving benefits2011-01-011
Number of other retired or separated participants entitled to future benefits2011-01-0126
Total of all active and inactive participants2011-01-01114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01114
Number of participants with account balances2011-01-0181
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-011
2010: DMS RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01148
Total number of active participants reported on line 7a of the Form 55002010-01-0190
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-0148
Total of all active and inactive participants2010-01-01138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-01138
Number of participants with account balances2010-01-01125
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-0129

Financial Data on DMS RETIREMENT PLAN

Measure Date Value
2013 : DMS RETIREMENT PLAN 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2013-12-31$303,330
Total unrealized appreciation/depreciation of assets2013-12-31$303,330
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total income from all sources (including contributions)2013-12-31$459,734
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$829,197
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$822,507
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$151,527
Value of total assets at end of year2013-12-31$1,817,432
Value of total assets at beginning of year2013-12-31$2,186,895
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$6,690
Total interest from all sources2013-12-31$4,877
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$500,000
If this is an individual account plan, was there a blackout period2013-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$130,935
Participant contributions at end of year2013-12-31$100,615
Participant contributions at beginning of year2013-12-31$42,374
Assets. Other investments not covered elsewhere at end of year2013-12-31$75
Assets. Other investments not covered elsewhere at beginning of year2013-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$12,293
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$-369,463
Value of net assets at end of year (total assets less liabilities)2013-12-31$1,817,432
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$2,186,895
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Investment advisory and management fees2013-12-31$6,690
Value of interest in pooled separate accounts at end of year2013-12-31$1,716,742
Value of interest in pooled separate accounts at beginning of year2013-12-31$2,115,761
Income. Interest from loans (other than to participants)2013-12-31$4,877
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$28,760
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$8,299
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$822,507
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31SALTER & COMPANY, LLC
Accountancy firm EIN2013-12-31208078757
2012 : DMS RETIREMENT PLAN 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2012-12-31$232,582
Total unrealized appreciation/depreciation of assets2012-12-31$232,582
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total income from all sources (including contributions)2012-12-31$582,001
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$210,452
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$197,732
Value of total corrective distributions2012-12-31$6,115
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$347,730
Value of total assets at end of year2012-12-31$2,186,895
Value of total assets at beginning of year2012-12-31$1,815,346
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$6,605
Total interest from all sources2012-12-31$1,689
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$500,000
If this is an individual account plan, was there a blackout period2012-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$210,809
Participant contributions at end of year2012-12-31$42,374
Participant contributions at beginning of year2012-12-31$43,170
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$39,868
Administrative expenses (other) incurred2012-12-31$1,616
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$371,549
Value of net assets at end of year (total assets less liabilities)2012-12-31$2,186,895
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$1,815,346
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Investment advisory and management fees2012-12-31$4,989
Value of interest in pooled separate accounts at end of year2012-12-31$2,115,761
Value of interest in pooled separate accounts at beginning of year2012-12-31$1,765,443
Interest on participant loans2012-12-31$1,689
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$28,760
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$6,733
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31Yes
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$97,053
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$197,732
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31SALTER & COMPANY, LLC
Accountancy firm EIN2012-12-31208078757
2011 : DMS RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total income from all sources (including contributions)2011-12-31$873,361
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$771,158
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$739,279
Value of total corrective distributions2011-12-31$17,310
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$921,077
Value of total assets at end of year2011-12-31$1,815,346
Value of total assets at beginning of year2011-12-31$1,713,143
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$14,569
Total interest from all sources2011-12-31$1,198
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$230,000
If this is an individual account plan, was there a blackout period2011-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$296,827
Participant contributions at end of year2011-12-31$43,170
Participant contributions at beginning of year2011-12-31$16,216
Participant contributions at end of year2011-12-31$0
Participant contributions at beginning of year2011-12-31$1,964
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$485,739
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Income. Non cash contributions2011-12-31$1,315
Value of net income/loss2011-12-31$102,203
Value of net assets at end of year (total assets less liabilities)2011-12-31$1,815,346
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$1,713,143
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in pooled separate accounts at end of year2011-12-31$1,765,443
Value of interest in pooled separate accounts at beginning of year2011-12-31$1,687,821
Income. Interest from loans (other than to participants)2011-12-31$1,198
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$6,733
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$7,142
Net investment gain/loss from pooled separate accounts2011-12-31$-48,914
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31Yes
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$137,196
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$739,279
Contract administrator fees2011-12-31$14,569
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-12-31Yes
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31SALTER & COMPANY, LLC
Accountancy firm EIN2011-12-31208078757
2010 : DMS RETIREMENT PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total income from all sources (including contributions)2010-12-31$766,636
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$52,103
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$48,270
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$538,583
Value of total assets at end of year2010-12-31$1,713,143
Value of total assets at beginning of year2010-12-31$998,610
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$3,833
Total interest from all sources2010-12-31$371
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$230,000
If this is an individual account plan, was there a blackout period2010-12-31Yes
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$327,681
Participant contributions at end of year2010-12-31$16,216
Participant contributions at beginning of year2010-12-31$375
Participant contributions at end of year2010-12-31$1,964
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$43,978
Other income not declared elsewhere2010-12-31$3,922
Administrative expenses (other) incurred2010-12-31$1,925
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$714,533
Value of net assets at end of year (total assets less liabilities)2010-12-31$1,713,143
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$998,610
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$998,235
Value of interest in pooled separate accounts at end of year2010-12-31$1,687,821
Interest on participant loans2010-12-31$371
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$7,142
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$17,657
Net investment gain/loss from pooled separate accounts2010-12-31$206,103
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$166,924
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$48,270
Contract administrator fees2010-12-31$1,908
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31Yes
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31SALTER & COMPANY, LLC
Accountancy firm EIN2010-12-31208078757

Form 5500 Responses for DMS RETIREMENT PLAN

2013: DMS RETIREMENT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: DMS RETIREMENT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: DMS RETIREMENT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: DMS RETIREMENT PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number94932
Policy instance 1
Insurance contract or identification number94932
Number of Individuals Covered60
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,982
Total amount of fees paid to insurance companyUSD $5,845
Are there contracts with allocated funds for individual policies?No
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 Administration1
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?Yes
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees5845
Additional information about fees paid to insurance brokerADMINISTRATIVE FEES
Insurance broker organization code?5
Insurance broker nameMORGAN STANLEY INSURANCE SERVICES
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number94932
Policy instance 1
Insurance contract or identification number94932
Number of Individuals Covered75
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $4,989
Total amount of fees paid to insurance companyUSD $3,015
Are there contracts with allocated funds for individual policies?No
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 Administration1
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?Yes
Commission paid to Insurance BrokerUSD $4,989
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerBROKER COMMISSIONS
Insurance broker organization code?3
Insurance broker nameFELDMAN BENEFIT SERVICE, INC.
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number94932
Policy instance 1
Insurance contract or identification number94932
Number of Individuals Covered197393
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $19,740
Total amount of fees paid to insurance companyUSD $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 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
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number94932
Policy instance 1
Insurance contract or identification number94932
Number of Individuals Covered125
Insurance policy start date2010-01-25
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $15,369
Total amount of fees paid to insurance companyUSD $1,925
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No

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