401k Plan data: COOPEREIN 401(K) PLAN plan

COOPEREIN 401(K) PLAN 401k Plan overview

Plan Name	COOPEREIN 401(K) PLAN
Plan identification number	001

COOPEREIN 401(K) PLAN Benefits

401k Plan Type

Defined 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

HUEMAN PEOPLE SOLUTIONS, LLC has sponsored the creation of one or more 401k plans.

Company Name: HUEMAN PEOPLE SOLUTIONS, LLC

Employer identification number (EIN): 813395754

NAIC Classification: 621610
NAIC Description: Home Health Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COOPEREIN 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 ANDREA BLAIR 2023-10-24
001 2021-01-01 ANDREA BLAIR 2022-11-28
001 2020-01-01 ANDREA BLAIR 2021-10-13
001 2019-01-01 ANDREA BLAIR 2020-10-12
001 2018-01-01 ANDREA BLAIR 2019-10-07
001 2017-01-01
001 2016-10-24

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01	ANDREA BLAIR	2023-10-24
001	2021-01-01	ANDREA BLAIR	2022-11-28
001	2020-01-01	ANDREA BLAIR	2021-10-13
001	2019-01-01	ANDREA BLAIR	2020-10-12
001	2018-01-01	ANDREA BLAIR	2019-10-07
001	2017-01-01
001	2016-10-24

Plan Statistics for COOPEREIN 401(K) PLAN

401k plan membership statisitcs for COOPEREIN 401(K) PLAN

Measure Date Value
2022: COOPEREIN 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 375
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 410
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 90
Total of all active and inactive participants 2022-01-01 500
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 500
Number of participants with account balances 2022-01-01 346
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: COOPEREIN 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 224
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 308
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 66
Total of all active and inactive participants 2021-01-01 374
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 374
Number of participants with account balances 2021-01-01 256
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: COOPEREIN 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 189
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 191
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 32
Total of all active and inactive participants 2020-01-01 223
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 223
Number of participants with account balances 2020-01-01 172
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: COOPEREIN 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 183
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 161
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 29
Total of all active and inactive participants 2019-01-01 190
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 190
Number of participants with account balances 2019-01-01 144
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: COOPEREIN 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 116
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 162
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 21
Total of all active and inactive participants 2018-01-01 183
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 183
Number of participants with account balances 2018-01-01 110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: COOPEREIN 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 109
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 93
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 13
Total of all active and inactive participants 2017-01-01 106
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 106
Number of participants with account balances 2017-01-01 69
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: COOPEREIN 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-10-24 110
Total number of active participants reported on line 7a of the Form 5500 2016-10-24 107
Number of retired or separated participants receiving benefits 2016-10-24 0
Number of other retired or separated participants entitled to future benefits 2016-10-24 2
Total of all active and inactive participants 2016-10-24 109
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-10-24 0
Total participants 2016-10-24 109
Number of participants with account balances 2016-10-24 50
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-10-24 0

Measure	Date	Value
2022: COOPEREIN 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	375
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	410
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	90
Total of all active and inactive participants	2022-01-01	500
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	500
Number of participants with account balances	2022-01-01	346
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: COOPEREIN 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	224
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	308
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	66
Total of all active and inactive participants	2021-01-01	374
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	374
Number of participants with account balances	2021-01-01	256
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: COOPEREIN 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	189
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	191
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	32
Total of all active and inactive participants	2020-01-01	223
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	223
Number of participants with account balances	2020-01-01	172
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: COOPEREIN 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	183
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	161
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	29
Total of all active and inactive participants	2019-01-01	190
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	190
Number of participants with account balances	2019-01-01	144
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: COOPEREIN 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	116
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	162
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	21
Total of all active and inactive participants	2018-01-01	183
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	183
Number of participants with account balances	2018-01-01	110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: COOPEREIN 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	109
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	93
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	13
Total of all active and inactive participants	2017-01-01	106
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	106
Number of participants with account balances	2017-01-01	69
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: COOPEREIN 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-10-24	110
Total number of active participants reported on line 7a of the Form 5500	2016-10-24	107
Number of retired or separated participants receiving benefits	2016-10-24	0
Number of other retired or separated participants entitled to future benefits	2016-10-24	2
Total of all active and inactive participants	2016-10-24	109
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-10-24	0
Total participants	2016-10-24	109
Number of participants with account balances	2016-10-24	50
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-10-24	0

Financial Data on COOPEREIN 401(K) PLAN

Measure	Date	Value
2022 : COOPEREIN 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$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	$676,035
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$338,614
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$335,613
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$1,805,608
Value of total assets at end of year	2022-12-31	$6,324,264
Value of total assets at beginning of year	2022-12-31	$5,986,843
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$3,001
Total interest from all sources	2022-12-31	$1,651
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 year	2022-12-31	No
Administrative expenses professional fees incurred	2022-12-31	$2,125
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$1,118,430
Participant contributions at end of year	2022-12-31	$32,990
Participant contributions at beginning of year	2022-12-31	$32,200
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$32,885
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$281,070
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$337,421
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$6,324,264
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$5,986,843
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$6,291,274
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$5,909,574
Interest on participant loans	2022-12-31	$1,651
Net investment gain/loss from pooled separate accounts	2022-12-31	$-1,131,224
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$406,108
Employer contributions (assets) at end of year	2022-12-31	$0
Employer contributions (assets) at beginning of year	2022-12-31	$12,184
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$335,613
Contract administrator fees	2022-12-31	$876
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	ENNIS PELLUM & ASSOCIATES, CPAS
Accountancy firm EIN	2022-12-31	591843700
2021 : COOPEREIN 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$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	$2,071,168
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$520,302
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$514,866
Value of total corrective distributions	2021-12-31	$3,282
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$1,310,810
Value of total assets at end of year	2021-12-31	$5,986,843
Value of total assets at beginning of year	2021-12-31	$4,435,977
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$2,154
Total interest from all sources	2021-12-31	$1,225
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 year	2021-12-31	No
Administrative expenses professional fees incurred	2021-12-31	$1,575
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$791,230
Participant contributions at end of year	2021-12-31	$32,200
Participant contributions at beginning of year	2021-12-31	$7,772
Participant contributions at end of year	2021-12-31	$32,885
Participant contributions at beginning of year	2021-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$234,093
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$1,550,866
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$5,986,843
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$4,435,977
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$5,909,574
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$4,428,205
Interest on participant loans	2021-12-31	$1,225
Net investment gain/loss from pooled separate accounts	2021-12-31	$759,133
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$285,487
Employer contributions (assets) at end of year	2021-12-31	$12,184
Employer contributions (assets) at beginning of year	2021-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$514,866
Contract administrator fees	2021-12-31	$579
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	ENNIS PELLUM & ASSOCIATES, CPAS
Accountancy firm EIN	2021-12-31	591843700
2020 : COOPEREIN 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$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	$1,775,431
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$96,848
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$95,055
Value of total corrective distributions	2020-12-31	$556
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$1,144,422
Value of total assets at end of year	2020-12-31	$4,435,977
Value of total assets at beginning of year	2020-12-31	$2,757,394
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$1,237
Total interest from all sources	2020-12-31	$377
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 year	2020-12-31	No
Administrative expenses professional fees incurred	2020-12-31	$850
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$595,119
Participant contributions at end of year	2020-12-31	$7,772
Participant contributions at beginning of year	2020-12-31	$2,620
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$330,274
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$1,678,583
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$4,435,977
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$2,757,394
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$4,428,205
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$2,754,774
Interest on participant loans	2020-12-31	$377
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$0
Net investment gain/loss from pooled separate accounts	2020-12-31	$630,632
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$219,029
Employer contributions (assets) at end of year	2020-12-31	$0
Employer contributions (assets) at beginning of year	2020-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$95,055
Contract administrator fees	2020-12-31	$387
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Unqualified
Accountancy firm name	2020-12-31	ENNIS PELLUM & ASSOCIATES, CPAS
Accountancy firm EIN	2020-12-31	591843700
2019 : COOPEREIN 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$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	$1,325,191
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$117,507
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$116,218
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$869,961
Value of total assets at end of year	2019-12-31	$2,757,394
Value of total assets at beginning of year	2019-12-31	$1,549,710
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$1,289
Total interest from all sources	2019-12-31	$101
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 year	2019-12-31	No
Administrative expenses professional fees incurred	2019-12-31	$965
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$492,485
Participant contributions at end of year	2019-12-31	$2,620
Participant contributions at beginning of year	2019-12-31	$1,634
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$209,468
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$1,207,684
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$2,757,394
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,549,710
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$2,754,774
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$1,547,521
Interest earned on other investments	2019-12-31	$101
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$552
Net investment gain/loss from pooled separate accounts	2019-12-31	$455,129
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$168,008
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at beginning of year	2019-12-31	$3
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$116,218
Contract administrator fees	2019-12-31	$324
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	ENNIS PELLUM & ASSOCIATES, CPAS
Accountancy firm EIN	2019-12-31	591843700
2018 : COOPEREIN 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$702,867
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$92,952
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$88,315
Value of total corrective distributions	2018-12-31	$3,853
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$834,738
Value of total assets at end of year	2018-12-31	$1,549,710
Value of total assets at beginning of year	2018-12-31	$939,795
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$784
Total interest from all sources	2018-12-31	$4
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Administrative expenses professional fees incurred	2018-12-31	$605
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$100,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$401,837
Participant contributions at end of year	2018-12-31	$1,634
Participant contributions at beginning of year	2018-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$308,481
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$609,915
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$1,549,710
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$939,795
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$1,547,521
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$939,243
Interest on participant loans	2018-12-31	$4
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$552
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$552
Net investment gain/loss from pooled separate accounts	2018-12-31	$-131,875
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$124,420
Employer contributions (assets) at end of year	2018-12-31	$3
Employer contributions (assets) at beginning of year	2018-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$88,315
Contract administrator fees	2018-12-31	$179
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	ENNIS PELLUM & ASSOCIATES, CPAS
Accountancy firm EIN	2018-12-31	591843700
2017 : COOPEREIN 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$856,396
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$36,714
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$32,941
Value of total corrective distributions	2017-12-31	$3,518
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$750,014
Value of total assets at end of year	2017-12-31	$939,795
Value of total assets at beginning of year	2017-12-31	$120,113
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$255
Total interest from all sources	2017-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Administrative expenses professional fees incurred	2017-12-31	$255
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$100,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$288,993
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$376,351
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$819,682
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$939,795
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$120,113
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$939,243
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$120,113
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$552
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$0
Net investment gain/loss from pooled separate accounts	2017-12-31	$106,382
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$84,670
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$32,941
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	ENNIS PELLUM & ASSOCIATES, CPAS
Accountancy firm EIN	2017-12-31	591843700
2016 : COOPEREIN 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$120,113
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$0
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$119,948
Value of total assets at end of year	2016-12-31	$120,113
Value of total assets at beginning of year	2016-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$0
Total interest from all sources	2016-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	No
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$31,481
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$78,999
Total non interest bearing cash at end of year	2016-12-31	$0
Total non interest bearing cash at beginning of year	2016-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$120,113
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$120,113
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$120,113
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$0
Net investment gain/loss from pooled separate accounts	2016-12-31	$165
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$9,468
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No

Form 5500 Responses for COOPEREIN 401(K) PLAN

2022: COOPEREIN 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: COOPEREIN 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: COOPEREIN 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: COOPEREIN 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: COOPEREIN 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: COOPEREIN 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: COOPEREIN 401(K) PLAN 2016 form 5500 responses
2016-10-24	Type of plan entity	Single employer plan
2016-10-24	First time form 5500 has been submitted	Yes
2016-10-24	Submission has been amended	No
2016-10-24	This submission is the final filing	No
2016-10-24	This return/report is a short plan year return/report (less than 12 months)	Yes
2016-10-24	Plan is a collectively bargained plan	No
2016-10-24	Plan funding arrangement – Insurance	Yes
2016-10-24	Plan funding arrangement – Trust	Yes
2016-10-24	Plan benefit arrangement – Insurance	Yes
2016-10-24	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

126605

Policy instance

Insurance contract or identification number	126605
Number of Individuals Covered	349
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $29,126
Total amount of fees paid to insurance company	USD $5,059
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $29,126
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	BROKER COMMISSION
Insurance broker organization code?	3

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

126605

Policy instance

Insurance contract or identification number	126605
Number of Individuals Covered	262
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $26,279
Total amount of fees paid to insurance company	USD $4,258
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $26,279
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	BROKER COMMISSION
Insurance broker organization code?	3

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

126605

Policy instance

Insurance contract or identification number	126605
Number of Individuals Covered	180
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $15,339
Total amount of fees paid to insurance company	USD $2,390
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $15,339
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	BROKER COMMISSION
Insurance broker organization code?	3

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

126605

Policy instance

Insurance contract or identification number	126605
Number of Individuals Covered	146
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $10,645
Total amount of fees paid to insurance company	USD $2,032
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $10,645
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	BROKER COMMISSION
Insurance broker organization code?	3

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

126605

Policy instance

Insurance contract or identification number	126605
Number of Individuals Covered	112
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $6,817
Total amount of fees paid to insurance company	USD $743
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	Yes
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $6,817
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	BROKER COMMISSION
Insurance broker organization code?	3

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

126605

Policy instance

Insurance contract or identification number	126605
Number of Individuals Covered	69
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $7,452
Total amount of fees paid to insurance company	USD $38
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $4,531
Amount paid for insurance broker fees	38
Additional information about fees paid to insurance broker	TPA COMPENSATION
Insurance broker organization code?	5
Insurance broker name	AMERIPRISE FINANCIAL SERVICES, INC

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Company Name:	HUEMAN PEOPLE SOLUTIONS, LLC
Employer identification number (EIN):	813395754
NAIC Classification:	621610
NAIC Description:	Home Health Care Services