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CLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS PLAN 401k Plan overview

Plan NameCLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS PLAN
Plan identification number 001

CLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS 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.
  • 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.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

CLEMSON SPORTS MEDICINE & REHABILITATION has sponsored the creation of one or more 401k plans.

Company Name:CLEMSON SPORTS MEDICINE & REHABILITATION
Employer identification number (EIN):571001418
NAIC Classification:621340
NAIC Description:Offices of Physical, Occupational and Speech Therapists, and Audiologists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012016-01-01MELISSA KELLEY
0012015-01-01MELISSA KELLEY
0012014-01-01MELISSA KELLEY
0012013-01-01MELISSA KELLEY
0012012-01-01MELISSA KELLEY
0012011-01-01MELISSA KELLEY
0012009-01-01JULIA KAY

Plan Statistics for CLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS PLAN

401k plan membership statisitcs for CLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS PLAN

Measure Date Value
2016: CLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01202
Total number of active participants reported on line 7a of the Form 55002016-01-010
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-010
Number of participants with account balances2016-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: CLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01213
Total number of active participants reported on line 7a of the Form 55002015-01-01130
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0162
Total of all active and inactive participants2015-01-01192
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01192
Number of participants with account balances2015-01-01149
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: CLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01212
Total number of active participants reported on line 7a of the Form 55002014-01-01131
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0167
Total of all active and inactive participants2014-01-01198
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01198
Number of participants with account balances2014-01-01159
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: CLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01203
Total number of active participants reported on line 7a of the Form 55002013-01-01142
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0163
Total of all active and inactive participants2013-01-01205
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01205
Number of participants with account balances2013-01-01159
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: CLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01203
Total number of active participants reported on line 7a of the Form 55002012-01-01136
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0160
Total of all active and inactive participants2012-01-01196
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01196
Number of participants with account balances2012-01-01152
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: CLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01231
Total number of active participants reported on line 7a of the Form 55002011-01-01143
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-0146
Total of all active and inactive participants2011-01-01189
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01189
Number of participants with account balances2011-01-01142
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: CLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01187
Total number of active participants reported on line 7a of the Form 55002009-01-01158
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0159
Total of all active and inactive participants2009-01-01217
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01217
Number of participants with account balances2009-01-01149
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-013

Financial Data on CLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS PLAN

Measure Date Value
2016 : CLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-11-09$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-11-09$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-11-09$15
Total income from all sources (including contributions)2016-11-09$565,263
Total loss/gain on sale of assets2016-11-09$0
Total of all expenses incurred2016-11-09$5,915,089
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-11-09$5,910,349
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-11-09$294,413
Value of total assets at end of year2016-11-09$0
Value of total assets at beginning of year2016-11-09$5,349,841
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-11-09$4,740
Total interest from all sources2016-11-09$0
Total dividends received (eg from common stock, registered investment company shares)2016-11-09$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-11-09Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2016-11-09$0
Administrative expenses professional fees incurred2016-11-09$4,740
Was this plan covered by a fidelity bond2016-11-09Yes
Value of fidelity bond cover2016-11-09$600,000
If this is an individual account plan, was there a blackout period2016-11-09No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-11-09$0
Were there any nonexempt tranactions with any party-in-interest2016-11-09No
Contributions received from participants2016-11-09$185,260
Assets. Other investments not covered elsewhere at end of year2016-11-09$0
Assets. Other investments not covered elsewhere at beginning of year2016-11-09$331,063
Income. Received or receivable in cash from other sources (including rollovers)2016-11-09$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-11-09$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-11-09$15
Total non interest bearing cash at end of year2016-11-09$0
Total non interest bearing cash at beginning of year2016-11-09$546
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-11-09No
Value of net income/loss2016-11-09$-5,349,826
Value of net assets at end of year (total assets less liabilities)2016-11-09$0
Value of net assets at beginning of year (total assets less liabilities)2016-11-09$5,349,826
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-11-09No
Were any loans by the plan or fixed income obligations due to the plan in default2016-11-09No
Were any leases to which the plan was party in default or uncollectible2016-11-09No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-11-09$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-11-09$5,016,140
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-11-09$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-11-09$2,092
Net investment gain/loss from pooled separate accounts2016-11-09$270,850
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-11-09No
Was there a failure to transmit to the plan any participant contributions2016-11-09Yes
Has the plan failed to provide any benefit when due under the plan2016-11-09No
Contributions received in cash from employer2016-11-09$109,153
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-11-09$5,910,349
Did the plan have assets held for investment2016-11-09No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-11-09No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-11-09Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-11-09Yes
Opinion of an independent qualified public accountant for this plan2016-11-09Disclaimer
Accountancy firm name2016-11-09ELLIOTT DAVIS DECOSIMO, LLC
Accountancy firm EIN2016-11-09570381582
2015 : CLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$15
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$138
Total income from all sources (including contributions)2015-12-31$479,576
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$333,603
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$332,843
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$554,764
Value of total assets at end of year2015-12-31$5,349,841
Value of total assets at beginning of year2015-12-31$5,203,991
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$760
Total interest from all sources2015-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Administrative expenses professional fees incurred2015-12-31$760
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$600,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$322,887
Assets. Other investments not covered elsewhere at end of year2015-12-31$331,063
Assets. Other investments not covered elsewhere at beginning of year2015-12-31$316,390
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$50,264
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$15
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$138
Total non interest bearing cash at end of year2015-12-31$546
Total non interest bearing cash at beginning of year2015-12-31$412
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$145,973
Value of net assets at end of year (total assets less liabilities)2015-12-31$5,349,826
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$5,203,853
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$5,016,140
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$4,886,841
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$2,092
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$348
Net investment gain/loss from pooled separate accounts2015-12-31$-75,188
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31Yes
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$181,613
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$332,843
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31ELLIOTT DAVIS DECOSIMO, LLC
Accountancy firm EIN2015-12-31570381582
2014 : CLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$138
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$806,340
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$683,161
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$682,201
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$601,963
Value of total assets at end of year2014-12-31$5,203,991
Value of total assets at beginning of year2014-12-31$5,080,674
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$960
Total interest from all sources2014-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Administrative expenses professional fees incurred2014-12-31$960
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
If this is an individual account plan, was there a blackout period2014-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$350,778
Assets. Other investments not covered elsewhere at end of year2014-12-31$316,390
Assets. Other investments not covered elsewhere at beginning of year2014-12-31$366,108
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$138
Total non interest bearing cash at end of year2014-12-31$412
Total non interest bearing cash at beginning of year2014-12-31$338
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Income. Non cash contributions2014-12-31$63,870
Value of net income/loss2014-12-31$123,179
Value of net assets at end of year (total assets less liabilities)2014-12-31$5,203,853
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$5,080,674
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$4,886,841
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$4,714,228
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$348
Net investment gain/loss from pooled separate accounts2014-12-31$204,377
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$187,315
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$682,201
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31ELLIOTT DAVIS DECOSIMO, LLC
Accountancy firm EIN2014-12-31570381582
2013 : CLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
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$41
Total income from all sources (including contributions)2013-12-31$1,336,833
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$642,252
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$641,692
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$545,896
Value of total assets at end of year2013-12-31$5,080,674
Value of total assets at beginning of year2013-12-31$4,386,134
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$560
Total interest from all sources2013-12-31$0
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
Administrative expenses professional fees incurred2013-12-31$560
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$341,985
Assets. Other investments not covered elsewhere at end of year2013-12-31$366,108
Assets. Other investments not covered elsewhere at beginning of year2013-12-31$358,365
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$41
Total non interest bearing cash at end of year2013-12-31$338
Total non interest bearing cash at beginning of year2013-12-31$1,090
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
Income. Non cash contributions2013-12-31$24,231
Value of net income/loss2013-12-31$694,581
Value of net assets at end of year (total assets less liabilities)2013-12-31$5,080,674
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$4,386,093
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
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$4,714,228
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$4,026,679
Net investment gain/loss from pooled separate accounts2013-12-31$790,937
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$179,680
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$641,692
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 name2013-12-31ELLIOTT DAVIS, LLC
Accountancy firm EIN2013-12-31570381582
2012 : CLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$41
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$838
Total income from all sources (including contributions)2012-12-31$1,047,784
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$638,698
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$634,288
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$509,074
Value of total assets at end of year2012-12-31$4,386,134
Value of total assets at beginning of year2012-12-31$3,977,845
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$4,410
Total interest from all sources2012-12-31$0
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
Administrative expenses professional fees incurred2012-12-31$840
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$329,585
Assets. Other investments not covered elsewhere at end of year2012-12-31$358,365
Assets. Other investments not covered elsewhere at beginning of year2012-12-31$365,934
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$6,164
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-12-31$41
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$838
Total non interest bearing cash at end of year2012-12-31$1,090
Total non interest bearing cash at beginning of year2012-12-31$1,090
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$409,086
Value of net assets at end of year (total assets less liabilities)2012-12-31$4,386,093
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$3,977,007
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$3,570
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$4,026,679
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$3,610,821
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$0
Net investment gain/loss from pooled separate accounts2012-12-31$538,710
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
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$173,325
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$634,288
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 name2012-12-31ELLIOTT DAVIS, LLC
Accountancy firm EIN2012-12-31570381582
2011 : CLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS 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$838
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$349,594
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$457,766
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$419,490
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$484,974
Value of total assets at end of year2011-12-31$3,977,845
Value of total assets at beginning of year2011-12-31$4,085,179
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$38,276
Total interest from all sources2011-12-31$0
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
Assets. Real estate other than employer real property at beginning of year2011-12-31$0
Administrative expenses professional fees incurred2011-12-31$865
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2011-12-31$0
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$400,000
If this is an individual account plan, was there a blackout period2011-12-31No
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$311,731
Participant contributions at beginning of year2011-12-31$0
Participant contributions at beginning of year2011-12-31$0
Assets. Other investments not covered elsewhere at end of year2011-12-31$365,934
Assets. Other investments not covered elsewhere at beginning of year2011-12-31$392,452
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$0
Assets. Loans (other than to participants) at beginning of year2011-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-12-31$838
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-12-31$0
Liabilities. Value of operating payables at beginning of year2011-12-31$0
Total non interest bearing cash at end of year2011-12-31$1,090
Total non interest bearing cash at beginning of year2011-12-31$7
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-108,172
Value of net assets at end of year (total assets less liabilities)2011-12-31$3,977,007
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$4,085,179
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
Assets. partnership/joint venture interests at beginning of year2011-12-31$0
Investment advisory and management fees2011-12-31$37,411
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$3,610,821
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$3,692,720
Value of interest in pooled separate accounts at beginning of year2011-12-31$0
Value of interest in master investment trust accounts at beginning of year2011-12-31$0
Value of interest in common/collective trusts at beginning of year2011-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2011-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$0
Asset value of US Government securities at beginning of year2011-12-31$0
Net investment gain/loss from pooled separate accounts2011-12-31$-135,380
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
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
Assets. Invements in employer securities at beginning of year2011-12-31$0
Assets. Value of employer real property at beginning of year2011-12-31$0
Contributions received in cash from employer2011-12-31$173,243
Employer contributions (assets) at beginning of year2011-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$419,490
Asset. Corporate debt instrument preferred debt at beginning of year2011-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2011-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2011-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2011-12-31$0
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
Liabilities. Value of acquisition indebtedness at beginning of year2011-12-31$0
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 name2011-12-31ELLIOTT DAVIS, LLC
Accountancy firm EIN2011-12-31570381582
2010 : CLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS PLAN 2010 401k financial data
Unrealized appreciation/depreciation of real estate assets2010-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$0
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total transfer of assets to this plan2010-12-31$0
Total transfer of assets from this plan2010-12-31$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
Expenses. Interest paid2010-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022010-12-31$0
Total income from all sources (including contributions)2010-12-31$979,012
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$137,805
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$100,402
Expenses. Certain deemed distributions of participant loans2010-12-31$0
Value of total corrective distributions2010-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$516,445
Value of total assets at end of year2010-12-31$4,085,179
Value of total assets at beginning of year2010-12-31$3,243,972
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$37,403
Total income from rents2010-12-31$0
Total interest from all sources2010-12-31$0
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
Total dividends received from registered investment company shares (eg mutual funds)2010-12-31$0
Assets. Real estate other than employer real property at end of year2010-12-31$0
Assets. Real estate other than employer real property at beginning of year2010-12-31$0
Administrative expenses professional fees incurred2010-12-31$410
Assets. Corporate prefeered stocks other than exployer securities at end of year2010-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2010-12-31$0
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$350,000
If this is an individual account plan, was there a blackout period2010-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$300,441
Participant contributions at end of year2010-12-31$0
Participant contributions at beginning of year2010-12-31$0
Participant contributions at end of year2010-12-31$0
Participant contributions at beginning of year2010-12-31$0
Assets. Other investments not covered elsewhere at end of year2010-12-31$392,452
Assets. Other investments not covered elsewhere at beginning of year2010-12-31$382,435
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$42,572
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2010-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$0
Assets. Loans (other than to participants) at end of year2010-12-31$0
Assets. Loans (other than to participants) at beginning of year2010-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2010-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$0
Administrative expenses (other) incurred2010-12-31$36,993
Liabilities. Value of operating payables at end of year2010-12-31$0
Liabilities. Value of operating payables at beginning of year2010-12-31$0
Total non interest bearing cash at end of year2010-12-31$7
Total non interest bearing cash at beginning of year2010-12-31$7
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
Income. Non cash contributions2010-12-31$0
Value of net income/loss2010-12-31$841,207
Value of net assets at end of year (total assets less liabilities)2010-12-31$4,085,179
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$3,243,972
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
Assets. partnership/joint venture interests at end of year2010-12-31$0
Assets. partnership/joint venture interests at beginning of year2010-12-31$0
Investment advisory and management fees2010-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$3,692,720
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$2,861,530
Value of interest in pooled separate accounts at end of year2010-12-31$0
Value of interest in pooled separate accounts at beginning of year2010-12-31$0
Interest on participant loans2010-12-31$0
Income. Interest from loans (other than to participants)2010-12-31$0
Interest earned on other investments2010-12-31$0
Income. Interest from US Government securities2010-12-31$0
Income. Interest from corporate debt instruments2010-12-31$0
Value of interest in master investment trust accounts at end of year2010-12-31$0
Value of interest in master investment trust accounts at beginning of year2010-12-31$0
Value of interest in common/collective trusts at end of year2010-12-31$0
Value of interest in common/collective trusts at beginning of year2010-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2010-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2010-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$0
Asset value of US Government securities at end of year2010-12-31$0
Asset value of US Government securities at beginning of year2010-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$0
Net investment gain/loss from pooled separate accounts2010-12-31$462,567
Net investment gain or loss from common/collective trusts2010-12-31$0
Net gain/loss from 103.12 investment entities2010-12-31$0
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
Assets. Invements in employer securities at end of year2010-12-31$0
Assets. Invements in employer securities at beginning of year2010-12-31$0
Assets. Value of employer real property at end of year2010-12-31$0
Assets. Value of employer real property at beginning of year2010-12-31$0
Contributions received in cash from employer2010-12-31$173,432
Employer contributions (assets) at end of year2010-12-31$0
Employer contributions (assets) at beginning of year2010-12-31$0
Income. Dividends from preferred stock2010-12-31$0
Income. Dividends from common stock2010-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$100,402
Asset. Corporate debt instrument preferred debt at end of year2010-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2010-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2010-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2010-12-31$0
Contract administrator fees2010-12-31$0
Assets. Corporate common stocks other than exployer securities at end of year2010-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2010-12-31$0
Liabilities. Value of benefit claims payable at end of year2010-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2010-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2010-12-31$0
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
Aggregate proceeds on sale of assets2010-12-31$0
Aggregate carrying amount (costs) on sale of assets2010-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2010-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2010-12-31$0
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 name2010-12-31ELLIOTT DAVIS, LLC
Accountancy firm EIN2010-12-31570381582
2009 : CLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for CLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS PLAN

2016: CLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingYes
2016-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: CLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2014: CLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement - TrustYes
2013: CLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS 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 - TrustYes
2012: CLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS 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 - TrustYes
2011: CLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS 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 - TrustYes
2009: CLEMSON SPORTS MEDICINE AND REHAB, INC. 401(K) AND PS PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan 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 number57462
Policy instance 1
Insurance contract or identification number57462
Number of Individuals Covered156
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $13,322
Total amount of fees paid to insurance companyUSD $3,435
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?Yes
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 $13,322
Insurance broker organization code?3
Amount paid for insurance broker fees2675
Additional information about fees paid to insurance brokerTPA COMPENSATION PAID
Insurance broker nameTHE RETIREMENT PLAN COMPANY, LLC
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number57462
Policy instance 1
Insurance contract or identification number57462
Number of Individuals Covered161
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $12,669
Total amount of fees paid to insurance companyUSD $3,498
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?Yes
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 $12,669
Insurance broker organization code?3
Amount paid for insurance broker fees2538
Additional information about fees paid to insurance brokerTPA COMPENSATION PAID
Insurance broker nameTHE RETIREMENT PLAN COMPANY, LLC
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number57462
Policy instance 1
Insurance contract or identification number57462
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $11,797
Total amount of fees paid to insurance companyUSD $2,742
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?Yes
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 $11,797
Insurance broker organization code?3
Amount paid for insurance broker fees2742
Additional information about fees paid to insurance brokerTPA COMPENSATION PAID
Insurance broker nameTHE RETIREMENT PLAN COMPANY, LLC
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number57462
Policy instance 1
Insurance contract or identification number57462
Number of Individuals Covered152
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $13,293
Total amount of fees paid to insurance companyUSD $489
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?Yes
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 $13,293
Insurance broker organization code?3
Amount paid for insurance broker fees489
Additional information about fees paid to insurance brokerTPA COMPENSATION PAID
Insurance broker nameVAUGHAN & ASSOCIATES, INC.
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number57462
Policy instance 1
Insurance contract or identification number57462
Number of Individuals Covered142
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $20,584
Total amount of fees paid to insurance companyUSD $2,922
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?Yes
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
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number57462
Policy instance 1
Insurance contract or identification number57462
Number of Individuals Covered168
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $17,425
Total amount of fees paid to insurance companyUSD $1,855
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?Yes
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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