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NORTHLAKE CHRISTIAN SCHOOL 401(K) PLAN 401k Plan overview

Plan NameNORTHLAKE CHRISTIAN SCHOOL 401(K) PLAN
Plan identification number 001

NORTHLAKE CHRISTIAN SCHOOL 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.
  • 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

NORTHLAKE CHRISTIAN SCHOOL has sponsored the creation of one or more 401k plans.

Company Name:NORTHLAKE CHRISTIAN SCHOOL
Employer identification number (EIN):720841693
NAIC Classification:611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTHLAKE CHRISTIAN SCHOOL 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-10-01CATHERINE DAVIS2024-01-19
0012021-10-01CATHERINE DAVIS2023-04-05
0012020-10-01CATHERINE DAVIS2022-03-24
0012019-10-01
0012018-10-01
0012017-10-01
0012016-10-01
0012015-10-01MICHELLE STEWART2017-03-13
0012014-10-01MICHELLE STEWART2016-01-07
0012013-10-01MICHELLE STEWART2015-04-20
0012012-10-01MICHELLE STEWART2014-01-09
0012011-10-01MICHELLE STEWART2013-02-12
0012010-10-01MICHELLE STEWART2012-04-16

Plan Statistics for NORTHLAKE CHRISTIAN SCHOOL 401(K) PLAN

401k plan membership statisitcs for NORTHLAKE CHRISTIAN SCHOOL 401(K) PLAN

Measure Date Value
2022: NORTHLAKE CHRISTIAN SCHOOL 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-10-01155
Total number of active participants reported on line 7a of the Form 55002022-10-01122
Number of retired or separated participants receiving benefits2022-10-010
Number of other retired or separated participants entitled to future benefits2022-10-0120
Total of all active and inactive participants2022-10-01142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-10-010
Total participants2022-10-01142
Number of participants with account balances2022-10-0178
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-10-011
2021: NORTHLAKE CHRISTIAN SCHOOL 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-10-01133
Total number of active participants reported on line 7a of the Form 55002021-10-01105
Number of retired or separated participants receiving benefits2021-10-010
Number of other retired or separated participants entitled to future benefits2021-10-0127
Total of all active and inactive participants2021-10-01132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-10-010
Total participants2021-10-01132
Number of participants with account balances2021-10-0172
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-10-018
2020: NORTHLAKE CHRISTIAN SCHOOL 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-10-01122
Total number of active participants reported on line 7a of the Form 55002020-10-0190
Number of retired or separated participants receiving benefits2020-10-010
Number of other retired or separated participants entitled to future benefits2020-10-0120
Total of all active and inactive participants2020-10-01110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-10-010
Total participants2020-10-01110
Number of participants with account balances2020-10-0168
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-10-010

Financial Data on NORTHLAKE CHRISTIAN SCHOOL 401(K) PLAN

Measure Date Value
2023 : NORTHLAKE CHRISTIAN SCHOOL 401(K) PLAN 2023 401k financial data
Total unrealized appreciation/depreciation of assets2023-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-09-30$262
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-09-30$463
Total income from all sources (including contributions)2023-09-30$360,939
Total loss/gain on sale of assets2023-09-30$0
Total of all expenses incurred2023-09-30$420,572
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-09-30$418,784
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-09-30$206,917
Value of total assets at end of year2023-09-30$1,212,331
Value of total assets at beginning of year2023-09-30$1,272,165
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-09-30$1,788
Total interest from all sources2023-09-30$0
Total dividends received (eg from common stock, registered investment company shares)2023-09-30$1,653
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-09-30No
Total dividends received from registered investment company shares (eg mutual funds)2023-09-30$1,653
Was this plan covered by a fidelity bond2023-09-30Yes
Value of fidelity bond cover2023-09-30$250,000
If this is an individual account plan, was there a blackout period2023-09-30No
Were there any nonexempt tranactions with any party-in-interest2023-09-30No
Contributions received from participants2023-09-30$135,981
Participant contributions at end of year2023-09-30$5,356
Participant contributions at beginning of year2023-09-30$47
Income. Received or receivable in cash from other sources (including rollovers)2023-09-30$22,348
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2023-09-30$262
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2023-09-30$463
Other income not declared elsewhere2023-09-30$185
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-09-30No
Value of net income/loss2023-09-30$-59,633
Value of net assets at end of year (total assets less liabilities)2023-09-30$1,212,069
Value of net assets at beginning of year (total assets less liabilities)2023-09-30$1,271,702
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2023-09-30No
Were any leases to which the plan was party in default or uncollectible2023-09-30No
Value of interest in pooled separate accounts at end of year2023-09-30$1,086,652
Value of interest in pooled separate accounts at beginning of year2023-09-30$1,125,820
Value of interest in common/collective trusts at end of year2023-09-30$0
Value of interest in common/collective trusts at beginning of year2023-09-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2023-09-30$118,490
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2023-09-30$146,274
Net investment gain/loss from registered investment companies (e.g. mutual funds)2023-09-30$152,184
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-09-30No
Was there a failure to transmit to the plan any participant contributions2023-09-30Yes
Has the plan failed to provide any benefit when due under the plan2023-09-30No
Contributions received in cash from employer2023-09-30$48,588
Employer contributions (assets) at end of year2023-09-30$1,833
Employer contributions (assets) at beginning of year2023-09-30$24
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-09-30$418,784
Contract administrator fees2023-09-30$1,788
Did the plan have assets held for investment2023-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-09-30No
Opinion of an independent qualified public accountant for this plan2023-09-30Unqualified
Accountancy firm name2023-09-30LAPORTE CPAS & BUSINESS ADVISORS
Accountancy firm EIN2023-09-30721088864
2022 : NORTHLAKE CHRISTIAN SCHOOL 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-09-30$463
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-09-30$506
Total income from all sources (including contributions)2022-09-30$-83,407
Total loss/gain on sale of assets2022-09-30$0
Total of all expenses incurred2022-09-30$32,480
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-09-30$31,700
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-09-30$151,841
Value of total assets at end of year2022-09-30$1,272,165
Value of total assets at beginning of year2022-09-30$1,388,095
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-09-30$780
Total interest from all sources2022-09-30$0
Total dividends received (eg from common stock, registered investment company shares)2022-09-30$1,105
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-09-30No
Total dividends received from registered investment company shares (eg mutual funds)2022-09-30$1,105
Administrative expenses professional fees incurred2022-09-30$780
Was this plan covered by a fidelity bond2022-09-30Yes
Value of fidelity bond cover2022-09-30$250,000
If this is an individual account plan, was there a blackout period2022-09-30Yes
Were there any nonexempt tranactions with any party-in-interest2022-09-30No
Contributions received from participants2022-09-30$108,961
Participant contributions at end of year2022-09-30$47
Participant contributions at beginning of year2022-09-30$4,217
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-09-30$463
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-09-30$506
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-09-30No
Value of net income/loss2022-09-30$-115,887
Value of net assets at end of year (total assets less liabilities)2022-09-30$1,271,702
Value of net assets at beginning of year (total assets less liabilities)2022-09-30$1,387,589
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2022-09-30No
Were any leases to which the plan was party in default or uncollectible2022-09-30No
Value of interest in pooled separate accounts at end of year2022-09-30$1,125,820
Value of interest in pooled separate accounts at beginning of year2022-09-30$1,225,062
Value of interest in common/collective trusts at end of year2022-09-30$0
Value of interest in common/collective trusts at beginning of year2022-09-30$13,430
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-09-30$146,274
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-09-30$143,610
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-09-30$-236,353
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-09-30No
Was there a failure to transmit to the plan any participant contributions2022-09-30Yes
Has the plan failed to provide any benefit when due under the plan2022-09-30No
Contributions received in cash from employer2022-09-30$42,880
Employer contributions (assets) at end of year2022-09-30$24
Employer contributions (assets) at beginning of year2022-09-30$1,776
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-09-30$31,700
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32022-09-30Yes
Did the plan have assets held for investment2022-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-09-30No
Opinion of an independent qualified public accountant for this plan2022-09-30Unqualified
Accountancy firm name2022-09-30LAPORTE CPAS & BUSINESS ADVISORS
Accountancy firm EIN2022-09-30721088864
2021 : NORTHLAKE CHRISTIAN SCHOOL 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-09-30$506
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-09-30$40
Total income from all sources (including contributions)2021-09-30$447,105
Total loss/gain on sale of assets2021-09-30$0
Total of all expenses incurred2021-09-30$402,653
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-09-30$401,853
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-09-30$187,709
Value of total assets at end of year2021-09-30$1,388,095
Value of total assets at beginning of year2021-09-30$1,343,177
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-09-30$800
Total interest from all sources2021-09-30$0
Total dividends received (eg from common stock, registered investment company shares)2021-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-09-30No
Administrative expenses professional fees incurred2021-09-30$800
Was this plan covered by a fidelity bond2021-09-30Yes
Value of fidelity bond cover2021-09-30$250,000
If this is an individual account plan, was there a blackout period2021-09-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-09-30$0
Were there any nonexempt tranactions with any party-in-interest2021-09-30No
Contributions received from participants2021-09-30$118,864
Participant contributions at end of year2021-09-30$4,217
Participant contributions at beginning of year2021-09-30$3,859
Income. Received or receivable in cash from other sources (including rollovers)2021-09-30$22,666
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-09-30$506
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-09-30$40
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-09-30No
Value of net income/loss2021-09-30$44,452
Value of net assets at end of year (total assets less liabilities)2021-09-30$1,387,589
Value of net assets at beginning of year (total assets less liabilities)2021-09-30$1,343,137
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2021-09-30No
Were any leases to which the plan was party in default or uncollectible2021-09-30No
Value of interest in pooled separate accounts at end of year2021-09-30$1,225,062
Value of interest in pooled separate accounts at beginning of year2021-09-30$1,063,534
Value of interest in common/collective trusts at end of year2021-09-30$13,430
Value of interest in common/collective trusts at beginning of year2021-09-30$9,492
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-09-30$143,610
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-09-30$264,824
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-09-30$259,396
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-09-30No
Was there a failure to transmit to the plan any participant contributions2021-09-30No
Has the plan failed to provide any benefit when due under the plan2021-09-30No
Contributions received in cash from employer2021-09-30$46,179
Employer contributions (assets) at end of year2021-09-30$1,776
Employer contributions (assets) at beginning of year2021-09-30$1,468
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-09-30$401,853
Did the plan have assets held for investment2021-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-09-30No
Opinion of an independent qualified public accountant for this plan2021-09-30Disclaimer
Accountancy firm name2021-09-30LAPORTE CPAS & BUSINESS ADVISORS
Accountancy firm EIN2021-09-30721088864
2009 : NORTHLAKE CHRISTIAN SCHOOL 401(K) PLAN 2009 401k financial data
Total income from all sources2009-09-30$113,378
Expenses. Total of all expenses incurred2009-09-30$62,682
Benefits paid (including direct rollovers)2009-09-30$61,767
Total plan assets at end of year2009-09-30$594,668
Total plan assets at beginning of year2009-09-30$543,972
Value of fidelity bond covering the plan2009-09-30$60,000
Total contributions received or receivable from participants2009-09-30$85,101
Expenses. Other expenses not covered elsewhere2009-09-30$915
Other income received2009-09-30$1,782
Net income (gross income less expenses)2009-09-30$50,696
Net plan assets at end of year (total assets less liabilities)2009-09-30$594,668
Net plan assets at beginning of year (total assets less liabilities)2009-09-30$543,972
Total contributions received or receivable from employer(s)2009-09-30$26,495
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-09-30$0

Form 5500 Responses for NORTHLAKE CHRISTIAN SCHOOL 401(K) PLAN

2022: NORTHLAKE CHRISTIAN SCHOOL 401(K) PLAN 2022 form 5500 responses
2022-10-01Type of plan entitySingle employer plan
2022-10-01Submission has been amendedNo
2022-10-01This submission is the final filingNo
2022-10-01This return/report is a short plan year return/report (less than 12 months)No
2022-10-01Plan is a collectively bargained planNo
2022-10-01Plan funding arrangement – InsuranceYes
2022-10-01Plan funding arrangement – TrustYes
2022-10-01Plan benefit arrangement – InsuranceYes
2022-10-01Plan benefit arrangement - TrustYes
2021: NORTHLAKE CHRISTIAN SCHOOL 401(K) PLAN 2021 form 5500 responses
2021-10-01Type of plan entitySingle employer plan
2021-10-01Submission has been amendedNo
2021-10-01This submission is the final filingNo
2021-10-01This return/report is a short plan year return/report (less than 12 months)No
2021-10-01Plan is a collectively bargained planNo
2021-10-01Plan funding arrangement – InsuranceYes
2021-10-01Plan funding arrangement – TrustYes
2021-10-01Plan benefit arrangement – InsuranceYes
2021-10-01Plan benefit arrangement - TrustYes
2020: NORTHLAKE CHRISTIAN SCHOOL 401(K) PLAN 2020 form 5500 responses
2020-10-01Type of plan entitySingle employer plan
2020-10-01Submission has been amendedNo
2020-10-01This submission is the final filingNo
2020-10-01This return/report is a short plan year return/report (less than 12 months)No
2020-10-01Plan is a collectively bargained planNo
2020-10-01Plan funding arrangement – InsuranceYes
2020-10-01Plan funding arrangement – TrustYes
2020-10-01Plan benefit arrangement – InsuranceYes
2020-10-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number747411-01
Policy instance 1
Insurance contract or identification number747411-01
Number of Individuals Covered78
Insurance policy start date2023-02-19
Insurance policy end date2023-09-30
Total amount of commissions paid to insurance brokerUSD $2,515
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?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 $1,710
Amount paid for insurance broker fees0
Insurance broker organization code?3
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number747411-01
Policy instance 1
Insurance contract or identification number747411-01
Number of Individuals Covered72
Insurance policy start date2022-02-19
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $673
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?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 $458
Insurance broker organization code?3
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number839655
Policy instance 2
Insurance contract or identification number839655
Number of Individuals Covered0
Insurance policy start date2021-10-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $2,967
Total amount of fees paid to insurance companyUSD $742
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
Commission paid to Insurance BrokerUSD $2,967
Insurance broker organization code?3
Amount paid for insurance broker fees742
Additional information about fees paid to insurance brokerADMIN EXPENSES
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number839655
Policy instance 1
Insurance contract or identification number839655
Number of Individuals Covered68
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $2,853
Total amount of fees paid to insurance companyUSD $713
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 $2,853
Insurance broker organization code?3
Amount paid for insurance broker fees713
Additional information about fees paid to insurance brokerADMIN EXPENSES
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number801387
Policy instance 1
Insurance contract or identification number801387
Number of Individuals Covered44
Insurance policy start date2008-10-01
Insurance policy end date2009-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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