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NORTHEAST FLORIDA SAFETY COUNCIL 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan NameNORTHEAST FLORIDA SAFETY COUNCIL 401(K) PROFIT SHARING PLAN
Plan identification number 001

NORTHEAST FLORIDA SAFETY COUNCIL 401(K) PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

NORTHEAST FLORIDA SAFETY COUNCIL, INC. has sponsored the creation of one or more 401k plans.

Company Name:NORTHEAST FLORIDA SAFETY COUNCIL, INC.
Employer identification number (EIN):590536003
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Additional information about NORTHEAST FLORIDA SAFETY COUNCIL, INC.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations
Incorporation Date: 1963-03-25
Company Identification Number: 705382
Legal Registered Office Address: 1725 ART MUSEUM DRIVE

JACKSONVILLE

32207

More information about NORTHEAST FLORIDA SAFETY COUNCIL, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTHEAST FLORIDA SAFETY COUNCIL 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012021-01-01CATHERINE SUTTON2021-07-15
0012020-01-01CATHERINE SUTTON2021-07-06
0012019-01-01CATHERINE SUTTON2020-06-23
0012018-01-01ULIANA FROELICH2019-07-10
0012017-01-01PATTY LOYD2018-06-05
0012016-01-01SUE HOLLEY2017-06-15
0012015-01-01SUE HOLLEY2016-06-08
0012014-01-01LISA S. CROSS
0012013-01-01JOEL HOLLEY, JR.
0012012-01-01WALLACE E. KIRBY
0012011-01-01WALLACE E. KIRBY
0012010-01-01WALLACE E. KIRBY
0012009-01-01WALLACE E. KIRBY

Plan Statistics for NORTHEAST FLORIDA SAFETY COUNCIL 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for NORTHEAST FLORIDA SAFETY COUNCIL 401(K) PROFIT SHARING PLAN

Measure Date Value
2014: NORTHEAST FLORIDA SAFETY COUNCIL 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0153
Total number of active participants reported on line 7a of the Form 55002014-01-0126
Number of retired or separated participants receiving benefits2014-01-013
Number of other retired or separated participants entitled to future benefits2014-01-0111
Total of all active and inactive participants2014-01-0140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-011
Total participants2014-01-0141
Number of participants with account balances2014-01-0139
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: NORTHEAST FLORIDA SAFETY COUNCIL 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0153
Total number of active participants reported on line 7a of the Form 55002013-01-0126
Number of retired or separated participants receiving benefits2013-01-018
Number of other retired or separated participants entitled to future benefits2013-01-0118
Total of all active and inactive participants2013-01-0152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-011
Total participants2013-01-0153
Number of participants with account balances2013-01-0153
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: NORTHEAST FLORIDA SAFETY COUNCIL 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0151
Total number of active participants reported on line 7a of the Form 55002012-01-0125
Number of retired or separated participants receiving benefits2012-01-019
Number of other retired or separated participants entitled to future benefits2012-01-0117
Total of all active and inactive participants2012-01-0151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-011
Total participants2012-01-0152
Number of participants with account balances2012-01-0152
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: NORTHEAST FLORIDA SAFETY COUNCIL 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0151
Total number of active participants reported on line 7a of the Form 55002011-01-0124
Number of retired or separated participants receiving benefits2011-01-018
Number of other retired or separated participants entitled to future benefits2011-01-0118
Total of all active and inactive participants2011-01-0150
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-011
Total participants2011-01-0151
Number of participants with account balances2011-01-0151
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: NORTHEAST FLORIDA SAFETY COUNCIL 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0150
Total number of active participants reported on line 7a of the Form 55002010-01-0123
Number of retired or separated participants receiving benefits2010-01-017
Number of other retired or separated participants entitled to future benefits2010-01-0118
Total of all active and inactive participants2010-01-0148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-011
Total participants2010-01-0149
Number of participants with account balances2010-01-0149
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: NORTHEAST FLORIDA SAFETY COUNCIL 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0147
Total number of active participants reported on line 7a of the Form 55002009-01-0123
Number of retired or separated participants receiving benefits2009-01-017
Number of other retired or separated participants entitled to future benefits2009-01-0117
Total of all active and inactive participants2009-01-0147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-011
Total participants2009-01-0148
Number of participants with account balances2009-01-0148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-011

Financial Data on NORTHEAST FLORIDA SAFETY COUNCIL 401(K) PROFIT SHARING PLAN

Measure Date Value
2014 : NORTHEAST FLORIDA SAFETY COUNCIL 401(K) PROFIT SHARING PLAN 2014 401k financial data
Total plan liabilities at beginning of year2014-12-31$1,818
Total income from all sources2014-12-31$67,424
Expenses. Total of all expenses incurred2014-12-31$484,513
Benefits paid (including direct rollovers)2014-12-31$478,288
Total plan assets at end of year2014-12-31$431,533
Total plan assets at beginning of year2014-12-31$850,440
Value of fidelity bond covering the plan2014-12-31$500,000
Total contributions received or receivable from participants2014-12-31$24,933
Expenses. Other expenses not covered elsewhere2014-12-31$441
Other income received2014-12-31$19,709
Net income (gross income less expenses)2014-12-31$-417,089
Net plan assets at end of year (total assets less liabilities)2014-12-31$431,533
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$848,622
Total contributions received or receivable from employer(s)2014-12-31$22,782
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$5,784
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : NORTHEAST FLORIDA SAFETY COUNCIL 401(K) PROFIT SHARING PLAN 2013 401k financial data
Total plan liabilities at end of year2013-12-31$1,818
Total plan liabilities at beginning of year2013-12-31$1,818
Total income from all sources2013-12-31$137,045
Expenses. Total of all expenses incurred2013-12-31$8,907
Benefits paid (including direct rollovers)2013-12-31$1,682
Total plan assets at end of year2013-12-31$850,440
Total plan assets at beginning of year2013-12-31$722,302
Value of fidelity bond covering the plan2013-12-31$500,000
Total contributions received or receivable from participants2013-12-31$39,480
Expenses. Other expenses not covered elsewhere2013-12-31$7,225
Other income received2013-12-31$73,592
Net income (gross income less expenses)2013-12-31$128,138
Net plan assets at end of year (total assets less liabilities)2013-12-31$848,622
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$720,484
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-1022013-12-31$35,907
Total contributions received or receivable from employer(s)2013-12-31$23,973
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : NORTHEAST FLORIDA SAFETY COUNCIL 401(K) PROFIT SHARING PLAN 2012 401k financial data
Total plan liabilities at end of year2012-12-31$1,818
Total plan liabilities at beginning of year2012-12-31$3,191
Total income from all sources2012-12-31$124,618
Expenses. Total of all expenses incurred2012-12-31$113,862
Benefits paid (including direct rollovers)2012-12-31$107,306
Total plan assets at end of year2012-12-31$722,302
Total plan assets at beginning of year2012-12-31$712,919
Value of fidelity bond covering the plan2012-12-31$500,000
Total contributions received or receivable from participants2012-12-31$34,081
Expenses. Other expenses not covered elsewhere2012-12-31$112
Other income received2012-12-31$62,654
Net income (gross income less expenses)2012-12-31$10,756
Net plan assets at end of year (total assets less liabilities)2012-12-31$720,484
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$709,728
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-1022012-12-31$33,342
Total contributions received or receivable from employer(s)2012-12-31$27,883
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$6,444
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : NORTHEAST FLORIDA SAFETY COUNCIL 401(K) PROFIT SHARING PLAN 2011 401k financial data
Total plan liabilities at end of year2011-12-31$3,191
Total plan liabilities at beginning of year2011-12-31$1,349
Total income from all sources2011-12-31$60,111
Expenses. Total of all expenses incurred2011-12-31$164,961
Benefits paid (including direct rollovers)2011-12-31$157,908
Total plan assets at end of year2011-12-31$712,919
Total plan assets at beginning of year2011-12-31$815,927
Value of fidelity bond covering the plan2011-12-31$500,000
Total contributions received or receivable from participants2011-12-31$35,145
Expenses. Other expenses not covered elsewhere2011-12-31$7,053
Other income received2011-12-31$-2,941
Net income (gross income less expenses)2011-12-31$-104,850
Net plan assets at end of year (total assets less liabilities)2011-12-31$709,728
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$814,578
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-1022011-12-31$42,809
Total contributions received or receivable from employer(s)2011-12-31$27,907
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : NORTHEAST FLORIDA SAFETY COUNCIL 401(K) PROFIT SHARING PLAN 2010 401k financial data
Total plan liabilities at end of year2010-12-31$1,349
Total plan liabilities at beginning of year2010-12-31$1,349
Total income from all sources2010-12-31$125,982
Expenses. Total of all expenses incurred2010-12-31$10,397
Benefits paid (including direct rollovers)2010-12-31$3,178
Total plan assets at end of year2010-12-31$815,927
Total plan assets at beginning of year2010-12-31$700,342
Value of fidelity bond covering the plan2010-12-31$500,000
Total contributions received or receivable from participants2010-12-31$25,499
Expenses. Other expenses not covered elsewhere2010-12-31$7,219
Other income received2010-12-31$73,509
Net income (gross income less expenses)2010-12-31$115,585
Net plan assets at end of year (total assets less liabilities)2010-12-31$814,578
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$698,993
Total contributions received or receivable from employer(s)2010-12-31$26,974
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0

Form 5500 Responses for NORTHEAST FLORIDA SAFETY COUNCIL 401(K) PROFIT SHARING PLAN

2014: NORTHEAST FLORIDA SAFETY COUNCIL 401(K) PROFIT SHARING 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 – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: NORTHEAST FLORIDA SAFETY COUNCIL 401(K) PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: NORTHEAST FLORIDA SAFETY COUNCIL 401(K) PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: NORTHEAST FLORIDA SAFETY COUNCIL 401(K) PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: NORTHEAST FLORIDA SAFETY COUNCIL 401(K) PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: NORTHEAST FLORIDA SAFETY COUNCIL 401(K) PROFIT SHARING 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 – InsuranceYes
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 number20011
Policy instance 1
Insurance contract or identification number20011
Number of Individuals Covered0
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $2,775
Total amount of fees paid to insurance companyUSD $472
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,775
Insurance broker organization code?3
Amount paid for insurance broker fees472
Additional information about fees paid to insurance brokerTPA FEES AND COMPENSATION
Insurance broker nameR. BRUCE TANNER & ASSOCIATES, INC.
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number20011
Policy instance 1
Insurance contract or identification number20011
Number of Individuals Covered42
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $3,361
Total amount of fees paid to insurance companyUSD $474
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,361
Insurance broker organization code?3
Amount paid for insurance broker fees474
Additional information about fees paid to insurance brokerTPA FEES AND TPA COMPENSATION
Insurance broker nameR. BRUCE TANNER & ASSOCIATES, INC.
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number20011
Policy instance 1
Insurance contract or identification number20011
Number of Individuals Covered40
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $3,063
Total amount of fees paid to insurance companyUSD $418
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,063
Insurance broker organization code?3
Amount paid for insurance broker fees343
Additional information about fees paid to insurance brokerTPA FEES AND TPA COMPENSATION
Insurance broker nameVANGUARD GROUP, INC.
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number20011
Policy instance 1
Insurance contract or identification number20011
Number of Individuals Covered41
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $3,347
Total amount of fees paid to insurance companyUSD $867
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number20011
Policy instance 1
Insurance contract or identification number20011
Number of Individuals Covered39
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $3,425
Total amount of fees paid to insurance companyUSD $38
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,425
Insurance broker organization code?3
Amount paid for insurance broker fees38
Additional information about fees paid to insurance brokerREDEMPTION FEES
Insurance broker nameVANGUARD GROUP, INC.

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