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LAMB 401K PROFIT SHARING PLAN 401k Plan overview

Plan NameLAMB 401K PROFIT SHARING PLAN
Plan identification number 001

LAMB 401K PROFIT SHARING 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.
  • 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

LATIN AMERICAN MONTESSORI BILINGUAL PUBLIC CHARTER SCHOOL has sponsored the creation of one or more 401k plans.

Company Name:LATIN AMERICAN MONTESSORI BILINGUAL PUBLIC CHARTER SCHOOL
Employer identification number (EIN):522356681
NAIC Classification:611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LAMB 401K PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012021-07-01BRIAN NIELSEN2023-04-16
0012020-07-01BRIAN NIELSEN2022-04-14 BRIAN NIELSEN2022-04-14
0012019-07-01BRIAN NIELSEN2021-04-07
0012018-07-01BRIAN NIELSEN2020-07-11
0012017-07-01
0012016-07-01DICK ERTZINGER2018-01-30
0012015-07-01DICK ERTZINGER2017-01-18
0012014-07-01DICK ERTZINGER2016-01-19
0012013-07-01DICK ERTZINGER2015-01-21
0012012-07-01DICK ERTZINGER2014-01-15
0012011-07-01DICK ERTZINGER2012-10-26
0012010-07-01DICK ERTZINGER2012-01-09

Plan Statistics for LAMB 401K PROFIT SHARING PLAN

401k plan membership statisitcs for LAMB 401K PROFIT SHARING PLAN

Measure Date Value
2021: LAMB 401K PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-01157
Total number of active participants reported on line 7a of the Form 55002021-07-01117
Number of retired or separated participants receiving benefits2021-07-010
Number of other retired or separated participants entitled to future benefits2021-07-0159
Total of all active and inactive participants2021-07-01176
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-07-010
Total participants2021-07-01176
Number of participants with account balances2021-07-01145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-07-0111
2020: LAMB 401K PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year2020-07-01158
Total number of active participants reported on line 7a of the Form 55002020-07-01104
Number of retired or separated participants receiving benefits2020-07-010
Number of other retired or separated participants entitled to future benefits2020-07-0153
Total of all active and inactive participants2020-07-01157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-07-010
Total participants2020-07-01157
Number of participants with account balances2020-07-01131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-07-0112
2019: LAMB 401K PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-01139
Total number of active participants reported on line 7a of the Form 55002019-07-01119
Number of retired or separated participants receiving benefits2019-07-010
Number of other retired or separated participants entitled to future benefits2019-07-0139
Total of all active and inactive participants2019-07-01158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-07-010
Total participants2019-07-01158
Number of participants with account balances2019-07-01118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-07-016
2018: LAMB 401K PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year2018-07-01125
Total number of active participants reported on line 7a of the Form 55002018-07-01106
Number of retired or separated participants receiving benefits2018-07-010
Number of other retired or separated participants entitled to future benefits2018-07-0131
Total of all active and inactive participants2018-07-01137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-07-010
Total participants2018-07-01137
Number of participants with account balances2018-07-0194
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-07-019

Financial Data on LAMB 401K PROFIT SHARING PLAN

Measure Date Value
2022 : LAMB 401K PROFIT SHARING PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-06-30$0
Total transfer of assets to this plan2022-06-30$0
Total transfer of assets from this plan2022-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-06-30$0
Total income from all sources (including contributions)2022-06-30$-19,951
Total loss/gain on sale of assets2022-06-30$0
Total of all expenses incurred2022-06-30$231,039
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-06-30$226,066
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-06-30$431,377
Value of total assets at end of year2022-06-30$2,951,103
Value of total assets at beginning of year2022-06-30$3,202,093
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-06-30$4,973
Total interest from all sources2022-06-30$884
Total dividends received (eg from common stock, registered investment company shares)2022-06-30$0
Was this plan covered by a fidelity bond2022-06-30Yes
Value of fidelity bond cover2022-06-30$320,209
If this is an individual account plan, was there a blackout period2022-06-30No
Were there any nonexempt tranactions with any party-in-interest2022-06-30No
Contributions received from participants2022-06-30$166,075
Participant contributions at end of year2022-06-30$19,495
Participant contributions at beginning of year2022-06-30$23,716
Income. Received or receivable in cash from other sources (including rollovers)2022-06-30$16,103
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2022-06-30$0
Total non interest bearing cash at end of year2022-06-30$14,839
Total non interest bearing cash at beginning of year2022-06-30$3,343
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-06-30No
Income. Non cash contributions2022-06-30$0
Value of net income/loss2022-06-30$-250,990
Value of net assets at end of year (total assets less liabilities)2022-06-30$2,951,103
Value of net assets at beginning of year (total assets less liabilities)2022-06-30$3,202,093
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2022-06-30No
Were any leases to which the plan was party in default or uncollectible2022-06-30No
Value of interest in pooled separate accounts at end of year2022-06-30$2,667,569
Value of interest in pooled separate accounts at beginning of year2022-06-30$2,940,583
Interest on participant loans2022-06-30$884
Net investment gain/loss from pooled separate accounts2022-06-30$-452,212
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-06-30No
Was there a failure to transmit to the plan any participant contributions2022-06-30No
Has the plan failed to provide any benefit when due under the plan2022-06-30No
Contributions received in cash from employer2022-06-30$249,199
Employer contributions (assets) at end of year2022-06-30$249,200
Employer contributions (assets) at beginning of year2022-06-30$234,451
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-06-30$226,066
Contract administrator fees2022-06-30$4,973
Did the plan have assets held for investment2022-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-06-30No
Opinion of an independent qualified public accountant for this plan2022-06-30Unqualified
Accountancy firm name2022-06-30BURDETTE SMITH & BISH LLC
Accountancy firm EIN2022-06-30454037800
2021 : LAMB 401K PROFIT SHARING PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-06-30$0
Total income from all sources (including contributions)2021-06-30$961,594
Total loss/gain on sale of assets2021-06-30$0
Total of all expenses incurred2021-06-30$368,724
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-06-30$363,546
Expenses. Certain deemed distributions of participant loans2021-06-30$1,468
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-06-30$405,456
Value of total assets at end of year2021-06-30$3,202,093
Value of total assets at beginning of year2021-06-30$2,609,223
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-06-30$3,710
Total interest from all sources2021-06-30$1,462
Total dividends received (eg from common stock, registered investment company shares)2021-06-30$0
Was this plan covered by a fidelity bond2021-06-30Yes
Value of fidelity bond cover2021-06-30$270,000
If this is an individual account plan, was there a blackout period2021-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-06-30$0
Were there any nonexempt tranactions with any party-in-interest2021-06-30No
Contributions received from participants2021-06-30$169,424
Participant contributions at end of year2021-06-30$23,716
Participant contributions at beginning of year2021-06-30$32,546
Income. Received or receivable in cash from other sources (including rollovers)2021-06-30$1,581
Total non interest bearing cash at end of year2021-06-30$3,343
Total non interest bearing cash at beginning of year2021-06-30$6,734
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-06-30No
Value of net income/loss2021-06-30$592,870
Value of net assets at end of year (total assets less liabilities)2021-06-30$3,202,093
Value of net assets at beginning of year (total assets less liabilities)2021-06-30$2,609,223
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2021-06-30No
Were any leases to which the plan was party in default or uncollectible2021-06-30No
Value of interest in pooled separate accounts at end of year2021-06-30$2,940,583
Value of interest in pooled separate accounts at beginning of year2021-06-30$2,381,760
Interest on participant loans2021-06-30$1,462
Net investment gain/loss from pooled separate accounts2021-06-30$554,676
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-06-30No
Was there a failure to transmit to the plan any participant contributions2021-06-30No
Has the plan failed to provide any benefit when due under the plan2021-06-30No
Contributions received in cash from employer2021-06-30$234,451
Employer contributions (assets) at end of year2021-06-30$234,451
Employer contributions (assets) at beginning of year2021-06-30$188,183
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-06-30$363,546
Contract administrator fees2021-06-30$3,710
Did the plan have assets held for investment2021-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-06-30No
Opinion of an independent qualified public accountant for this plan2021-06-30Disclaimer
Accountancy firm name2021-06-30BURDETTE SMITH & BISH LLC
Accountancy firm EIN2021-06-30454037800
2020 : LAMB 401K PROFIT SHARING PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-06-30$0
Total income from all sources (including contributions)2020-06-30$747,795
Total loss/gain on sale of assets2020-06-30$0
Total of all expenses incurred2020-06-30$149,131
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-06-30$132,138
Expenses. Certain deemed distributions of participant loans2020-06-30$10,445
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-06-30$702,142
Value of total assets at end of year2020-06-30$2,609,223
Value of total assets at beginning of year2020-06-30$2,010,559
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-06-30$6,548
Total interest from all sources2020-06-30$2,398
Total dividends received (eg from common stock, registered investment company shares)2020-06-30$0
Was this plan covered by a fidelity bond2020-06-30Yes
Value of fidelity bond cover2020-06-30$201,056
If this is an individual account plan, was there a blackout period2020-06-30No
Were there any nonexempt tranactions with any party-in-interest2020-06-30No
Contributions received from participants2020-06-30$120,248
Participant contributions at end of year2020-06-30$32,546
Participant contributions at beginning of year2020-06-30$53,682
Income. Received or receivable in cash from other sources (including rollovers)2020-06-30$394,123
Total non interest bearing cash at end of year2020-06-30$6,734
Total non interest bearing cash at beginning of year2020-06-30$2,980
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-06-30No
Value of net income/loss2020-06-30$598,664
Value of net assets at end of year (total assets less liabilities)2020-06-30$2,609,223
Value of net assets at beginning of year (total assets less liabilities)2020-06-30$2,010,559
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2020-06-30No
Were any leases to which the plan was party in default or uncollectible2020-06-30No
Value of interest in pooled separate accounts at end of year2020-06-30$2,381,760
Value of interest in pooled separate accounts at beginning of year2020-06-30$1,753,433
Interest on participant loans2020-06-30$2,398
Net investment gain/loss from pooled separate accounts2020-06-30$43,255
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-06-30No
Was there a failure to transmit to the plan any participant contributions2020-06-30No
Has the plan failed to provide any benefit when due under the plan2020-06-30No
Contributions received in cash from employer2020-06-30$187,771
Employer contributions (assets) at end of year2020-06-30$188,183
Employer contributions (assets) at beginning of year2020-06-30$200,464
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-06-30$132,138
Contract administrator fees2020-06-30$6,548
Did the plan have assets held for investment2020-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-06-30Yes
Opinion of an independent qualified public accountant for this plan2020-06-30Disclaimer
Accountancy firm name2020-06-30BURDETTE SMITH & BISH LLC
Accountancy firm EIN2020-06-30454037800
2019 : LAMB 401K PROFIT SHARING PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-06-30$0
Total income from all sources (including contributions)2019-06-30$379,743
Total loss/gain on sale of assets2019-06-30$0
Total of all expenses incurred2019-06-30$454,245
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-06-30$447,216
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-06-30$296,444
Value of total assets at end of year2019-06-30$2,010,559
Value of total assets at beginning of year2019-06-30$2,085,061
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-06-30$7,029
Total interest from all sources2019-06-30$2,700
Total dividends received (eg from common stock, registered investment company shares)2019-06-30$0
Was this plan covered by a fidelity bond2019-06-30Yes
Value of fidelity bond cover2019-06-30$208,507
If this is an individual account plan, was there a blackout period2019-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-06-30$0
Were there any nonexempt tranactions with any party-in-interest2019-06-30No
Contributions received from participants2019-06-30$98,431
Participant contributions at end of year2019-06-30$53,682
Participant contributions at beginning of year2019-06-30$58,379
Total non interest bearing cash at end of year2019-06-30$2,980
Total non interest bearing cash at beginning of year2019-06-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-06-30No
Value of net income/loss2019-06-30$-74,502
Value of net assets at end of year (total assets less liabilities)2019-06-30$2,010,559
Value of net assets at beginning of year (total assets less liabilities)2019-06-30$2,085,061
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2019-06-30No
Were any leases to which the plan was party in default or uncollectible2019-06-30No
Value of interest in pooled separate accounts at end of year2019-06-30$1,753,433
Value of interest in pooled separate accounts at beginning of year2019-06-30$1,899,132
Interest on participant loans2019-06-30$2,700
Net investment gain/loss from pooled separate accounts2019-06-30$80,599
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-06-30No
Was there a failure to transmit to the plan any participant contributions2019-06-30No
Has the plan failed to provide any benefit when due under the plan2019-06-30No
Contributions received in cash from employer2019-06-30$198,013
Employer contributions (assets) at end of year2019-06-30$200,464
Employer contributions (assets) at beginning of year2019-06-30$127,550
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-06-30$447,216
Contract administrator fees2019-06-30$7,029
Did the plan have assets held for investment2019-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-06-30Yes
Opinion of an independent qualified public accountant for this plan2019-06-30Disclaimer
Accountancy firm name2019-06-30BURDETTE SMITH & BISH LLC
Accountancy firm EIN2019-06-30454037800

Form 5500 Responses for LAMB 401K PROFIT SHARING PLAN

2021: LAMB 401K PROFIT SHARING PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Submission has been amendedNo
2021-07-01This submission is the final filingNo
2021-07-01This return/report is a short plan year return/report (less than 12 months)No
2021-07-01Plan is a collectively bargained planNo
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan funding arrangement – TrustYes
2021-07-01Plan benefit arrangement – InsuranceYes
2021-07-01Plan benefit arrangement - TrustYes
2020: LAMB 401K PROFIT SHARING PLAN 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Submission has been amendedNo
2020-07-01This submission is the final filingNo
2020-07-01This return/report is a short plan year return/report (less than 12 months)No
2020-07-01Plan is a collectively bargained planNo
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – TrustYes
2020-07-01Plan benefit arrangement – InsuranceYes
2020-07-01Plan benefit arrangement - TrustYes
2019: LAMB 401K PROFIT SHARING PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Submission has been amendedNo
2019-07-01This submission is the final filingNo
2019-07-01This return/report is a short plan year return/report (less than 12 months)No
2019-07-01Plan is a collectively bargained planNo
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan funding arrangement – TrustYes
2019-07-01Plan benefit arrangement – InsuranceYes
2019-07-01Plan benefit arrangement - TrustYes
2018: LAMB 401K PROFIT SHARING PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Submission has been amendedNo
2018-07-01This submission is the final filingNo
2018-07-01This return/report is a short plan year return/report (less than 12 months)No
2018-07-01Plan is a collectively bargained planNo
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan funding arrangement – TrustYes
2018-07-01Plan benefit arrangement – InsuranceYes
2018-07-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number98633
Policy instance 1
Insurance contract or identification number98633
Number of Individuals Covered133
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $13,994
Total amount of fees paid to insurance companyUSD $2,552
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $6,997
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerBROKER COMMISSION
Insurance broker organization code?4
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number98633
Policy instance 1
Insurance contract or identification number98633
Number of Individuals Covered131
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $11,978
Total amount of fees paid to insurance companyUSD $1,691
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,989
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerBROKER COMMISSION
Insurance broker organization code?4
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number98633
Policy instance 1
Insurance contract or identification number98633
Number of Individuals Covered112
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $8,124
Total amount of fees paid to insurance companyUSD $1,411
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,062
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerBROKER COMMISSION
Insurance broker organization code?4
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number98633
Policy instance 1
Insurance contract or identification number98633
Number of Individuals Covered97
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $8,586
Total amount of fees paid to insurance companyUSD $1,750
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,293
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerBROKER COMMISSION
Insurance broker organization code?4

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