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CALL4HEALTH 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan NameCALL4HEALTH 401(K) PROFIT SHARING PLAN
Plan identification number 001

CALL4HEALTH 401(K) PROFIT SHARING 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

CALL 4 HEALTH, INC. has sponsored the creation of one or more 401k plans.

Company Name:CALL 4 HEALTH, INC.
Employer identification number (EIN):650711998
NAIC Classification:561420

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CALL4HEALTH 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012021-01-01
0012020-01-01
0012019-01-01

Plan Statistics for CALL4HEALTH 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for CALL4HEALTH 401(K) PROFIT SHARING PLAN

Measure Date Value
2022: CALL4HEALTH 401(K) PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01507
Total number of active participants reported on line 7a of the Form 55002022-01-01445
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01445
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01445
Number of participants with account balances2022-01-0155
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-019
2021: CALL4HEALTH 401(K) PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01473
Total number of active participants reported on line 7a of the Form 55002021-01-01413
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01413
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01413
Number of participants with account balances2021-01-0151
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-0114
2020: CALL4HEALTH 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01425
Total number of active participants reported on line 7a of the Form 55002020-01-01430
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0119
Total of all active and inactive participants2020-01-01449
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01449
Number of participants with account balances2020-01-0182
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-0141
2019: CALL4HEALTH 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01307
Total number of active participants reported on line 7a of the Form 55002019-01-01331
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0127
Total of all active and inactive participants2019-01-01358
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01358
Number of participants with account balances2019-01-01142
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-0137

Financial Data on CALL4HEALTH 401(K) PROFIT SHARING PLAN

Measure Date Value
2022 : CALL4HEALTH 401(K) PROFIT SHARING PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$498,684
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$62,026
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$43,222
Expenses. Certain deemed distributions of participant loans2022-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$600,291
Value of total assets at end of year2022-12-31$837,447
Value of total assets at beginning of year2022-12-31$400,789
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$18,804
Total interest from all sources2022-12-31$132
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Administrative expenses professional fees incurred2022-12-31$10,223
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$83,041
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$174,669
Participant contributions at end of year2022-12-31$3,012
Participant contributions at beginning of year2022-12-31$1,777
Participant contributions at end of year2022-12-31$0
Participant contributions at beginning of year2022-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$406,093
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$0
Total non interest bearing cash at end of year2022-12-31$0
Total non interest bearing cash at beginning of year2022-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$436,658
Value of net assets at end of year (total assets less liabilities)2022-12-31$837,447
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$400,789
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$0
Value of interest in pooled separate accounts at end of year2022-12-31$830,414
Value of interest in pooled separate accounts at beginning of year2022-12-31$396,769
Interest on participant loans2022-12-31$132
Income. Interest from loans (other than to participants)2022-12-31$0
Income. Interest from US Government securities2022-12-31$0
Income. Interest from corporate debt instruments2022-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$4,021
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$2,243
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$2,243
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-101,739
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$19,529
Employer contributions (assets) at end of year2022-12-31$0
Employer contributions (assets) at beginning of year2022-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$43,222
Contract administrator fees2022-12-31$8,581
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Disclaimer
Accountancy firm name2022-12-31JM CPA GROUP LLC
Accountancy firm EIN2022-12-31815471282
2021 : CALL4HEALTH 401(K) PROFIT SHARING PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$188,351
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$75,813
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$65,584
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$139,311
Value of total assets at end of year2021-12-31$400,789
Value of total assets at beginning of year2021-12-31$288,251
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$10,229
Total interest from all sources2021-12-31$254
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$41,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$125,916
Participant contributions at end of year2021-12-31$1,777
Participant contributions at beginning of year2021-12-31$8,260
Participant contributions at end of year2021-12-31$0
Participant contributions at beginning of year2021-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$0
Other income not declared elsewhere2021-12-31$48,786
Total non interest bearing cash at end of year2021-12-31$0
Total non interest bearing cash at beginning of year2021-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$112,538
Value of net assets at end of year (total assets less liabilities)2021-12-31$400,789
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$288,251
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Investment advisory and management fees2021-12-31$3,764
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$0
Value of interest in pooled separate accounts at end of year2021-12-31$396,769
Value of interest in pooled separate accounts at beginning of year2021-12-31$278,332
Interest on participant loans2021-12-31$254
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$2,243
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$1,659
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$1,659
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$13,395
Employer contributions (assets) at end of year2021-12-31$0
Employer contributions (assets) at beginning of year2021-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$65,584
Contract administrator fees2021-12-31$6,465
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Disclaimer
Accountancy firm name2021-12-31JM CPA GROUP LLC
Accountancy firm EIN2021-12-31815471282
2020 : CALL4HEALTH 401(K) PROFIT SHARING PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$223,206
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$39,944
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$22,005
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$180,109
Value of total assets at end of year2020-12-31$288,251
Value of total assets at beginning of year2020-12-31$104,989
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$17,939
Total interest from all sources2020-12-31$86
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$45,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$142,575
Participant contributions at end of year2020-12-31$8,260
Participant contributions at beginning of year2020-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$23,276
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$183,262
Value of net assets at end of year (total assets less liabilities)2020-12-31$288,251
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$104,989
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Investment advisory and management fees2020-12-31$17,939
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$0
Value of interest in pooled separate accounts at end of year2020-12-31$278,332
Value of interest in pooled separate accounts at beginning of year2020-12-31$104,529
Interest on participant loans2020-12-31$86
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$1,659
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$460
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$460
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$43,011
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$14,258
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$22,005
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31DASZKAL BOLTON, LLP
Accountancy firm EIN2020-12-31650406502
2019 : CALL4HEALTH 401(K) PROFIT SHARING PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$109,135
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$4,146
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$1,897
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$102,803
Value of total assets at end of year2019-12-31$104,989
Value of total assets at beginning of year2019-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$2,249
Total interest from all sources2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$45,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$89,866
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$3,572
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$104,989
Value of net assets at end of year (total assets less liabilities)2019-12-31$104,989
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Investment advisory and management fees2019-12-31$2,249
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$0
Value of interest in pooled separate accounts at end of year2019-12-31$104,529
Value of interest in pooled separate accounts at beginning of year2019-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$460
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$6,332
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$9,365
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$1,897
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31DASZKAL BOLTON, LLP
Accountancy firm EIN2019-12-31650406502

Form 5500 Responses for CALL4HEALTH 401(K) PROFIT SHARING PLAN

2022: CALL4HEALTH 401(K) PROFIT SHARING PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: CALL4HEALTH 401(K) PROFIT SHARING PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: CALL4HEALTH 401(K) PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: CALL4HEALTH 401(K) PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01First time form 5500 has been submittedYes
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan 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 number139341
Policy instance 1
Insurance contract or identification number139341
Number of Individuals Covered245
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $5,281
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?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
Amount paid for insurance broker fees4931
Additional information about fees paid to insurance brokerTPA FEES PAID
Insurance broker organization code?5
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number139341
Policy instance 1
Insurance contract or identification number139341
Number of Individuals Covered232
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $2,153
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?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
Amount paid for insurance broker fees1975
Additional information about fees paid to insurance brokerTPA FEES PAID
Insurance broker organization code?5
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number139341
Policy instance 1
Insurance contract or identification number139341
Number of Individuals Covered215
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $10,492
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?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
Amount paid for insurance broker fees9298
Additional information about fees paid to insurance brokerTPA FEES PAID
Insurance broker organization code?5
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number139341
Policy instance 1
Insurance contract or identification number139341
Number of Individuals Covered191
Insurance policy start date2019-07-15
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1,344
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $791
Insurance broker organization code?5

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