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AMERICAN BLANCHING COMPANY 401(K)PLAN 401k Plan overview

Plan NameAMERICAN BLANCHING COMPANY 401(K)PLAN
Plan identification number 001

AMERICAN BLANCHING COMPANY 401(K)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.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • 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

AMERICAN BLANCHING COMPANY has sponsored the creation of one or more 401k plans.

Company Name:AMERICAN BLANCHING COMPANY
Employer identification number (EIN):581926957
NAIC Classification:311900
NAIC Description: Other Food Manufacturing

Additional information about AMERICAN BLANCHING COMPANY

Jurisdiction of Incorporation: Georgia Department of States Corporations Division
Incorporation Date:
Company Identification Number: 818192

More information about AMERICAN BLANCHING COMPANY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AMERICAN BLANCHING COMPANY 401(K)PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012015-01-01HENRY WARDEN
0012015-01-01HENRY WARDEN
0012014-01-01HENRY WARDEN
0012013-01-01JAMES FREEMAN
0012012-08-01JAMES FREEMAN
0012008-07-01C CONGER

Plan Statistics for AMERICAN BLANCHING COMPANY 401(K)PLAN

401k plan membership statisitcs for AMERICAN BLANCHING COMPANY 401(K)PLAN

Measure Date Value
2015: AMERICAN BLANCHING COMPANY 401(K)PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-010
Total number of active participants reported on line 7a of the Form 55002015-01-010
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-010
Number of participants with account balances2015-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: AMERICAN BLANCHING COMPANY 401(K)PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01381
Total number of active participants reported on line 7a of the Form 55002014-01-01336
Number of retired or separated participants receiving benefits2014-01-013
Number of other retired or separated participants entitled to future benefits2014-01-0146
Total of all active and inactive participants2014-01-01385
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01385
Number of participants with account balances2014-01-01234
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: AMERICAN BLANCHING COMPANY 401(K)PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01323
Total number of active participants reported on line 7a of the Form 55002013-01-01347
Number of retired or separated participants receiving benefits2013-01-012
Number of other retired or separated participants entitled to future benefits2013-01-0122
Total of all active and inactive participants2013-01-01371
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01371
Number of participants with account balances2013-01-01204
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: AMERICAN BLANCHING COMPANY 401(K)PLAN 2012 401k membership
Total participants, beginning-of-year2012-08-01334
Total number of active participants reported on line 7a of the Form 55002012-08-01317
Number of retired or separated participants receiving benefits2012-08-010
Number of other retired or separated participants entitled to future benefits2012-08-014
Total of all active and inactive participants2012-08-01321
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-08-010
Total participants2012-08-01321
Number of participants with account balances2012-08-01107
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-08-010
2008: AMERICAN BLANCHING COMPANY 401(K)PLAN 2008 401k membership
Total number of active participants reported on line 7a of the Form 55002008-07-01102
Number of retired or separated participants receiving benefits2008-07-010
Number of other retired or separated participants entitled to future benefits2008-07-010
Total of all active and inactive participants2008-07-01102
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2008-07-010
Total participants2008-07-01102

Financial Data on AMERICAN BLANCHING COMPANY 401(K)PLAN

Measure Date Value
2015 : AMERICAN BLANCHING COMPANY 401(K)PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-02-02$0
Total transfer of assets from this plan2015-02-02$986,886
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-02-02$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-02-02$0
Total income from all sources (including contributions)2015-02-02$-7,863
Total loss/gain on sale of assets2015-02-02$0
Total of all expenses incurred2015-02-02$58,659
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-02-02$58,359
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-02-02$0
Value of total assets at end of year2015-02-02$0
Value of total assets at beginning of year2015-02-02$1,053,408
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-02-02$300
Total interest from all sources2015-02-02$788
Total dividends received (eg from common stock, registered investment company shares)2015-02-02$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-02-02Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2015-02-02$0
Was this plan covered by a fidelity bond2015-02-02Yes
Value of fidelity bond cover2015-02-02$100,000
If this is an individual account plan, was there a blackout period2015-02-02Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-02-02$0
Were there any nonexempt tranactions with any party-in-interest2015-02-02No
Participant contributions at end of year2015-02-02$0
Participant contributions at beginning of year2015-02-02$22,149
Assets. Loans (other than to participants) at end of year2015-02-02$0
Assets. Loans (other than to participants) at beginning of year2015-02-02$22,149
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-02-02No
Value of net income/loss2015-02-02$-66,522
Value of net assets at end of year (total assets less liabilities)2015-02-02$0
Value of net assets at beginning of year (total assets less liabilities)2015-02-02$1,053,408
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-02-02No
Were any loans by the plan or fixed income obligations due to the plan in default2015-02-02No
Were any leases to which the plan was party in default or uncollectible2015-02-02No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-02-02$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-02-02$1,031,259
Interest on participant loans2015-02-02$788
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-02-02$-8,651
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-02-02No
Was there a failure to transmit to the plan any participant contributions2015-02-02No
Has the plan failed to provide any benefit when due under the plan2015-02-02No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-02-02$58,359
Contract administrator fees2015-02-02$300
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-02-02Yes
Did the plan have assets held for investment2015-02-02No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-02-02No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-02-02Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-02-02Yes
Opinion of an independent qualified public accountant for this plan2015-02-02Disclaimer
Accountancy firm name2015-02-02BROWN SMTIH WALLACE, LLC
Accountancy firm EIN2015-02-02431001367
2014 : AMERICAN BLANCHING COMPANY 401(K)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$0
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$569,037
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$64,310
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$35,257
Expenses. Certain deemed distributions of participant loans2014-12-31$305
Value of total corrective distributions2014-12-31$15,829
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$537,429
Value of total assets at end of year2014-12-31$1,053,408
Value of total assets at beginning of year2014-12-31$548,681
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$12,919
Total interest from all sources2014-12-31$489
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 year2014-12-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2014-12-31$0
Administrative expenses professional fees incurred2014-12-31$3,992
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$100,000
If this is an individual account plan, was there a blackout period2014-12-31Yes
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$456,757
Participant contributions at end of year2014-12-31$22,149
Participant contributions at beginning of year2014-12-31$6,761
Participant contributions at end of year2014-12-31$0
Participant contributions at beginning of year2014-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$54
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
Value of net income/loss2014-12-31$504,727
Value of net assets at end of year (total assets less liabilities)2014-12-31$1,053,408
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$548,681
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$1,031,259
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$523,388
Interest on participant loans2014-12-31$489
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$31,119
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$80,618
Employer contributions (assets) at end of year2014-12-31$0
Employer contributions (assets) at beginning of year2014-12-31$18,532
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$35,257
Contract administrator fees2014-12-31$8,927
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-12-31Yes
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 name2014-12-31BROWN SMITH WALLACE, LLC
Accountancy firm EIN2014-12-31431001367
2013 : AMERICAN BLANCHING COMPANY 401(K)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$0
Total income from all sources (including contributions)2013-12-31$442,824
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$18,572
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$9,653
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$400,593
Value of total assets at end of year2013-12-31$548,681
Value of total assets at beginning of year2013-12-31$124,429
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$8,919
Total interest from all sources2013-12-31$148
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$7,369
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$1,000,000
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$316,046
Participant contributions at end of year2013-12-31$6,761
Participant contributions at beginning of year2013-12-31$0
Participant contributions at end of year2013-12-31$0
Participant contributions at beginning of year2013-12-31$6
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$12,609
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$424,252
Value of net assets at end of year (total assets less liabilities)2013-12-31$548,681
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$124,429
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$523,388
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$120,316
Interest on participant loans2013-12-31$148
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$42,083
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 contributions2013-12-31Yes
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$71,938
Employer contributions (assets) at end of year2013-12-31$18,532
Employer contributions (assets) at beginning of year2013-12-31$4,107
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$9,653
Contract administrator fees2013-12-31$1,550
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 name2013-12-31FRAZIER & DEETER, LLC
Accountancy firm EIN2013-12-31581433845
2012 : AMERICAN BLANCHING COMPANY 401(K)PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total transfer of assets to this plan2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total income from all sources (including contributions)2012-12-31$126,138
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$1,709
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$149
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$124,518
Value of total assets at end of year2012-12-31$124,429
Value of total assets at beginning of year2012-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$1,560
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$95
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$1,000,000
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$86,685
Participant contributions at end of year2012-12-31$6
Participant contributions at beginning of year2012-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$21,891
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$124,429
Value of net assets at end of year (total assets less liabilities)2012-12-31$124,429
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$0
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
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$120,316
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$1,620
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$15,942
Employer contributions (assets) at end of year2012-12-31$4,107
Employer contributions (assets) at beginning of year2012-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$149
Contract administrator fees2012-12-31$1,465
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 name2012-12-31FRAZIER & DEETER, LLC
Accountancy firm EIN2012-12-31581433845

Form 5500 Responses for AMERICAN BLANCHING COMPANY 401(K)PLAN

2015: AMERICAN BLANCHING COMPANY 401(K)PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedYes
2015-01-01This submission is the final filingYes
2015-01-01This return/report is a short plan year return/report (less than 12 months)Yes
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 – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: AMERICAN BLANCHING COMPANY 401(K)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: AMERICAN BLANCHING COMPANY 401(K)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: AMERICAN BLANCHING COMPANY 401(K)PLAN 2012 form 5500 responses
2012-08-01Type of plan entitySingle employer plan
2012-08-01First time form 5500 has been submittedYes
2012-08-01Submission has been amendedNo
2012-08-01This submission is the final filingNo
2012-08-01This return/report is a short plan year return/report (less than 12 months)Yes
2012-08-01Plan is a collectively bargained planNo
2012-08-01Plan funding arrangement – InsuranceYes
2012-08-01Plan funding arrangement – TrustYes
2012-08-01Plan benefit arrangement - TrustYes
2008: AMERICAN BLANCHING COMPANY 401(K)PLAN 2008 form 5500 responses
2008-07-01Type of plan entitySingle employer plan
2008-07-01First time form 5500 has been submittedYes
2008-07-01Submission has been amendedNo
2008-07-01This submission is the final filingNo
2008-07-01This return/report is a short plan year return/report (less than 12 months)No
2008-07-01Plan is a collectively bargained planYes
2008-07-01Plan funding arrangement – InsuranceYes
2008-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number106673
Policy instance 1
Insurance contract or identification number106673
Number of Individuals Covered0
Insurance policy start date2015-01-01
Insurance policy end date2015-02-02
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $434
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees434
Additional information about fees paid to insurance brokerTHIRD PARTY ADMINISTRATION AND TPA COMPENSATION
Insurance broker organization code?5
Insurance broker nameRETIREMENT STRATEGIES, INC
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number106673
Policy instance 1
Insurance contract or identification number106673
Number of Individuals Covered486
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $5,648
Total amount of fees paid to insurance companyUSD $4,420
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?Yes
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
Other information about contractGROUP ANNUITY
Commission paid to Insurance BrokerUSD $5,648
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerBROKER COMMISSION
Insurance broker organization code?3
Insurance broker nameRETIREMENT STRATEGIES, INC.
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number106673
Policy instance 1
Insurance contract or identification number106673
Number of Individuals Covered204
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,383
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,307
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker organization code?5
Insurance broker nameWELLS FARGO ADVISORS INS AGENCY LLC
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number106673
Policy instance 1
Insurance contract or identification number106673
Number of Individuals Covered116
Insurance policy start date2012-09-26
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $66
Total amount of fees paid to insurance companyUSD $630
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees630
Additional information about fees paid to insurance brokerTHIRD PARTY ADMINISTRATION FEES
Insurance broker organization code?5
Commission paid to Insurance BrokerUSD $66
Insurance broker nameWELLS FARGO ADVISORS INS AGENCY LLC

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