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AAC 401(K) PLAN 401k Plan overview

Plan NameAAC 401(K) PLAN
Plan identification number 001

AAC 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.
  • 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

ADVANCED AIRFOIL COMPONENTS, LLC has sponsored the creation of one or more 401k plans.

Company Name:ADVANCED AIRFOIL COMPONENTS, LLC
Employer identification number (EIN):820621262
NAIC Classification:333610

Form 5500 Filing Information

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

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-10-01
0012021-10-01
0012020-10-01
0012019-10-01
0012018-10-01KELVIN OXENDINE2020-04-23
0012018-01-01

Plan Statistics for AAC 401(K) PLAN

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

Measure Date Value
2022: AAC 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-10-01382
Total number of active participants reported on line 7a of the Form 55002022-10-010
Number of retired or separated participants receiving benefits2022-10-010
Number of other retired or separated participants entitled to future benefits2022-10-010
Total of all active and inactive participants2022-10-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-10-010
Total participants2022-10-010
Number of participants with account balances2022-10-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-10-010
2021: AAC 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-10-01252
Total number of active participants reported on line 7a of the Form 55002021-10-01343
Number of retired or separated participants receiving benefits2021-10-010
Number of other retired or separated participants entitled to future benefits2021-10-0139
Total of all active and inactive participants2021-10-01382
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-10-010
Total participants2021-10-01382
Number of participants with account balances2021-10-01152
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-10-010
2020: AAC 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-10-01217
Total number of active participants reported on line 7a of the Form 55002020-10-01224
Number of retired or separated participants receiving benefits2020-10-010
Number of other retired or separated participants entitled to future benefits2020-10-0124
Total of all active and inactive participants2020-10-01248
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-10-010
Total participants2020-10-01248
Number of participants with account balances2020-10-01111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-10-010
2019: AAC 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-10-01147
Total number of active participants reported on line 7a of the Form 55002019-10-01197
Number of retired or separated participants receiving benefits2019-10-010
Number of other retired or separated participants entitled to future benefits2019-10-0111
Total of all active and inactive participants2019-10-01208
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-10-010
Total participants2019-10-01208
Number of participants with account balances2019-10-0188
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-10-010

Financial Data on AAC 401(K) PLAN

Measure Date Value
2023 : AAC 401(K) PLAN 2023 401k financial data
Total unrealized appreciation/depreciation of assets2023-02-28$0
Total transfer of assets from this plan2023-02-28$3,165,266
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-02-28$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-02-28$0
Total income from all sources (including contributions)2023-02-28$909,775
Total loss/gain on sale of assets2023-02-28$0
Total of all expenses incurred2023-02-28$196,867
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-02-28$195,203
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-02-28$568,976
Value of total assets at end of year2023-02-28$0
Value of total assets at beginning of year2023-02-28$2,452,358
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-02-28$1,664
Total interest from all sources2023-02-28$1,804
Total dividends received (eg from common stock, registered investment company shares)2023-02-28$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-02-28No
Was this plan covered by a fidelity bond2023-02-28Yes
Value of fidelity bond cover2023-02-28$500,000
If this is an individual account plan, was there a blackout period2023-02-28No
Were there any nonexempt tranactions with any party-in-interest2023-02-28No
Contributions received from participants2023-02-28$162,387
Participant contributions at end of year2023-02-28$0
Participant contributions at beginning of year2023-02-28$113,868
Participant contributions at end of year2023-02-28$0
Participant contributions at beginning of year2023-02-28$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-02-28No
Value of net income/loss2023-02-28$712,908
Value of net assets at end of year (total assets less liabilities)2023-02-28$0
Value of net assets at beginning of year (total assets less liabilities)2023-02-28$2,452,358
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2023-02-28No
Were any leases to which the plan was party in default or uncollectible2023-02-28No
Value of interest in registered invesment companies (eg mutual funds) at end of year2023-02-28$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2023-02-28$2,338,490
Interest on participant loans2023-02-28$1,804
Net investment gain/loss from registered investment companies (e.g. mutual funds)2023-02-28$338,995
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-02-28No
Was there a failure to transmit to the plan any participant contributions2023-02-28Yes
Has the plan failed to provide any benefit when due under the plan2023-02-28No
Contributions received in cash from employer2023-02-28$406,589
Employer contributions (assets) at end of year2023-02-28$0
Employer contributions (assets) at beginning of year2023-02-28$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-02-28$195,203
Contract administrator fees2023-02-28$1,664
Did the plan have assets held for investment2023-02-28No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-02-28Yes
Opinion of an independent qualified public accountant for this plan2023-02-28Unqualified
Accountancy firm name2023-02-28FRSCPA, PLLC
Accountancy firm EIN2023-02-28592482214
2022 : AAC 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$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-09-30$0
Total income from all sources (including contributions)2022-09-30$387,086
Total loss/gain on sale of assets2022-09-30$0
Total of all expenses incurred2022-09-30$336,320
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-09-30$333,318
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-09-30$905,008
Value of total assets at end of year2022-09-30$2,452,358
Value of total assets at beginning of year2022-09-30$2,401,592
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-09-30$3,002
Total interest from all sources2022-09-30$4,641
Total dividends received (eg from common stock, registered investment company shares)2022-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-09-30No
Was this plan covered by a fidelity bond2022-09-30Yes
Value of fidelity bond cover2022-09-30$500,000
If this is an individual account plan, was there a blackout period2022-09-30No
Were there any nonexempt tranactions with any party-in-interest2022-09-30No
Contributions received from participants2022-09-30$582,764
Participant contributions at end of year2022-09-30$113,868
Participant contributions at beginning of year2022-09-30$78,314
Participant contributions at end of year2022-09-30$0
Participant contributions at beginning of year2022-09-30$251
Income. Received or receivable in cash from other sources (including rollovers)2022-09-30$33,093
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$50,766
Value of net assets at end of year (total assets less liabilities)2022-09-30$2,452,358
Value of net assets at beginning of year (total assets less liabilities)2022-09-30$2,401,592
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 registered invesment companies (eg mutual funds) at end of year2022-09-30$2,338,490
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-09-30$2,322,927
Interest on participant loans2022-09-30$4,641
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-09-30$-522,563
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 contributions2022-09-30No
Has the plan failed to provide any benefit when due under the plan2022-09-30No
Contributions received in cash from employer2022-09-30$289,151
Employer contributions (assets) at end of year2022-09-30$0
Employer contributions (assets) at beginning of year2022-09-30$100
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-09-30$333,318
Contract administrator fees2022-09-30$3,002
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
2021 : AAC 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$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-09-30$0
Total income from all sources (including contributions)2021-09-30$1,098,228
Total loss/gain on sale of assets2021-09-30$0
Total of all expenses incurred2021-09-30$108,135
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-09-30$105,646
Value of total corrective distributions2021-09-30$32
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-09-30$778,832
Value of total assets at end of year2021-09-30$2,401,592
Value of total assets at beginning of year2021-09-30$1,411,499
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-09-30$2,457
Total interest from all sources2021-09-30$3,063
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
Was this plan covered by a fidelity bond2021-09-30Yes
Value of fidelity bond cover2021-09-30$500,000
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$499,255
Participant contributions at end of year2021-09-30$78,314
Participant contributions at beginning of year2021-09-30$48,811
Participant contributions at end of year2021-09-30$251
Participant contributions at beginning of year2021-09-30$15,408
Income. Received or receivable in cash from other sources (including rollovers)2021-09-30$32,027
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$990,093
Value of net assets at end of year (total assets less liabilities)2021-09-30$2,401,592
Value of net assets at beginning of year (total assets less liabilities)2021-09-30$1,411,499
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 registered invesment companies (eg mutual funds) at end of year2021-09-30$2,322,927
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-09-30$1,339,144
Interest on participant loans2021-09-30$3,063
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-09-30$316,333
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 contributions2021-09-30Yes
Has the plan failed to provide any benefit when due under the plan2021-09-30No
Contributions received in cash from employer2021-09-30$247,550
Employer contributions (assets) at end of year2021-09-30$100
Employer contributions (assets) at beginning of year2021-09-30$8,136
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-09-30$105,646
Contract administrator fees2021-09-30$2,457
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 plan2021-09-30Unqualified
Accountancy firm name2021-09-30FRSCPA, PLLC
Accountancy firm EIN2021-09-30592482214
2020 : AAC 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-09-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-09-30$0
Total income from all sources (including contributions)2020-09-30$705,393
Total loss/gain on sale of assets2020-09-30$0
Total of all expenses incurred2020-09-30$221,703
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-09-30$219,577
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-09-30$582,974
Value of total assets at end of year2020-09-30$1,411,499
Value of total assets at beginning of year2020-09-30$927,809
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-09-30$2,126
Total interest from all sources2020-09-30$1,729
Total dividends received (eg from common stock, registered investment company shares)2020-09-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-09-30No
Was this plan covered by a fidelity bond2020-09-30Yes
Value of fidelity bond cover2020-09-30$500,000
If this is an individual account plan, was there a blackout period2020-09-30No
Were there any nonexempt tranactions with any party-in-interest2020-09-30No
Contributions received from participants2020-09-30$321,997
Participant contributions at end of year2020-09-30$48,811
Participant contributions at beginning of year2020-09-30$10,460
Participant contributions at end of year2020-09-30$15,408
Participant contributions at beginning of year2020-09-30$0
Income. Received or receivable in cash from other sources (including rollovers)2020-09-30$72,205
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-09-30No
Value of net income/loss2020-09-30$483,690
Value of net assets at end of year (total assets less liabilities)2020-09-30$1,411,499
Value of net assets at beginning of year (total assets less liabilities)2020-09-30$927,809
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2020-09-30No
Were any leases to which the plan was party in default or uncollectible2020-09-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-09-30$1,339,144
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-09-30$917,349
Interest on participant loans2020-09-30$1,729
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-09-30$120,690
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-09-30No
Was there a failure to transmit to the plan any participant contributions2020-09-30Yes
Has the plan failed to provide any benefit when due under the plan2020-09-30No
Contributions received in cash from employer2020-09-30$188,772
Employer contributions (assets) at end of year2020-09-30$8,136
Employer contributions (assets) at beginning of year2020-09-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-09-30$219,577
Contract administrator fees2020-09-30$2,126
Did the plan have assets held for investment2020-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-09-30Yes
Opinion of an independent qualified public accountant for this plan2020-09-30Disclaimer
Accountancy firm name2020-09-30FRSCPA, PLLC
Accountancy firm EIN2020-09-30592482214

Form 5500 Responses for AAC 401(K) PLAN

2022: AAC 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 filingYes
2022-10-01This return/report is a short plan year return/report (less than 12 months)Yes
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 - TrustYes
2021: AAC 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 - TrustYes
2020: AAC 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 - TrustYes
2019: AAC 401(K) PLAN 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01Submission has been amendedNo
2019-10-01This submission is the final filingNo
2019-10-01This return/report is a short plan year return/report (less than 12 months)No
2019-10-01Plan is a collectively bargained planNo
2019-10-01Plan funding arrangement – InsuranceYes
2019-10-01Plan funding arrangement – TrustYes
2019-10-01Plan 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 number133843
Policy instance 1
Insurance contract or identification number133843
Number of Individuals Covered0
Insurance policy start date2022-10-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $444
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 $0
Amount paid for insurance broker fees444
Additional information about fees paid to insurance brokerADMIN FEES
Insurance broker organization code?5
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number133843
Policy instance 1
Insurance contract or identification number133843
Number of Individuals Covered212
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $1,286
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 $0
Amount paid for insurance broker fees1286
Additional information about fees paid to insurance brokerADMIN FEES
Insurance broker organization code?5
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number133843
Policy instance 1
Insurance contract or identification number133843
Number of Individuals Covered176
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $955
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 $0
Amount paid for insurance broker fees955
Additional information about fees paid to insurance brokerADMIN FEES
Insurance broker organization code?5
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number133843
Policy instance 1
Insurance contract or identification number133843
Number of Individuals Covered153
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $559
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 $0
Amount paid for insurance broker fees559
Additional information about fees paid to insurance brokerADMIN FEES
Insurance broker organization code?5

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