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OLYMPIC SPORTS & SPINE PLLC 401(K) PLAN 401k Plan overview

Plan NameOLYMPIC SPORTS & SPINE PLLC 401(K) PLAN
Plan identification number 002

OLYMPIC SPORTS & SPINE PLLC 401(K) PLAN Benefits

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

401k Sponsoring company profile

OLYMPIC SPORTS & SPINE PLLC has sponsored the creation of one or more 401k plans.

Company Name:OLYMPIC SPORTS & SPINE PLLC
Employer identification number (EIN):822950138
NAIC Classification:621340
NAIC Description:Offices of Physical, Occupational and Speech Therapists, and Audiologists

Additional information about OLYMPIC SPORTS & SPINE PLLC

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division
Incorporation Date: 2017-09-22
Company Identification Number: 604171643
Legal Registered Office Address: 6625 WAGNER WAY STE 203

GIG HARBOR
United States of America (USA)
983358392

More information about OLYMPIC SPORTS & SPINE PLLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan OLYMPIC SPORTS & SPINE PLLC 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022022-01-01BRIAN THACKER2023-05-09
0022021-01-01BRIAN THACKER2022-06-15
0022020-01-01BRIAN THACKER2021-07-26
0022019-01-01BRIAN THACKER2020-03-10
0022018-01-01

Plan Statistics for OLYMPIC SPORTS & SPINE PLLC 401(K) PLAN

401k plan membership statisitcs for OLYMPIC SPORTS & SPINE PLLC 401(K) PLAN

Measure Date Value
2022: OLYMPIC SPORTS & SPINE PLLC 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01474
Total number of active participants reported on line 7a of the Form 55002022-01-01331
Number of retired or separated participants receiving benefits2022-01-011
Number of other retired or separated participants entitled to future benefits2022-01-01203
Total of all active and inactive participants2022-01-01535
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-012
Total participants2022-01-01537
Number of participants with account balances2022-01-01492
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-0148
2021: OLYMPIC SPORTS & SPINE PLLC 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01385
Total number of active participants reported on line 7a of the Form 55002021-01-01307
Number of retired or separated participants receiving benefits2021-01-011
Number of other retired or separated participants entitled to future benefits2021-01-01166
Total of all active and inactive participants2021-01-01474
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01474
Number of participants with account balances2021-01-01433
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-0144
2020: OLYMPIC SPORTS & SPINE PLLC 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01300
Total number of active participants reported on line 7a of the Form 55002020-01-01261
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-01105
Total of all active and inactive participants2020-01-01366
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01366
Number of participants with account balances2020-01-01333
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-0123
2019: OLYMPIC SPORTS & SPINE PLLC 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01261
Total number of active participants reported on line 7a of the Form 55002019-01-01220
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0180
Total of all active and inactive participants2019-01-01300
Total participants2019-01-01300
Number of participants with account balances2019-01-01274
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-0121

Financial Data on OLYMPIC SPORTS & SPINE PLLC 401(K) PLAN

Measure Date Value
2022 : OLYMPIC SPORTS & SPINE PLLC 401(K) PLAN 2022 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$14,003
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$2,474
Total income from all sources (including contributions)2022-12-31$-317,185
Total of all expenses incurred2022-12-31$1,477,801
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$1,391,132
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$1,975,375
Value of total assets at end of year2022-12-31$11,423,823
Value of total assets at beginning of year2022-12-31$13,207,280
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$86,669
Total interest from all sources2022-12-31$3,396
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Administrative expenses professional fees incurred2022-12-31$20,525
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$1,395,215
Participant contributions at end of year2022-12-31$73,993
Participant contributions at beginning of year2022-12-31$70,847
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$57,863
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$14,003
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$2,474
Total non interest bearing cash at end of year2022-12-31$66,933
Total non interest bearing cash at beginning of year2022-12-31$9,674
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-1,794,986
Value of net assets at end of year (total assets less liabilities)2022-12-31$11,409,820
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$13,204,806
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Investment advisory and management fees2022-12-31$32,360
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$10,760,600
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$12,660,281
Interest on participant loans2022-12-31$3,396
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-2,295,956
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$522,297
Employer contributions (assets) at end of year2022-12-31$522,297
Employer contributions (assets) at beginning of year2022-12-31$466,478
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$1,391,132
Contract administrator fees2022-12-31$33,784
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31DWYER, PEMBERTON & COULSON, P.C.
Accountancy firm EIN2022-12-31911503183
2021 : OLYMPIC SPORTS & SPINE PLLC 401(K) PLAN 2021 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$2,474
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$89
Total income from all sources (including contributions)2021-12-31$3,717,154
Total of all expenses incurred2021-12-31$429,353
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$324,235
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$2,289,790
Value of total assets at end of year2021-12-31$13,207,280
Value of total assets at beginning of year2021-12-31$9,917,094
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$105,118
Total interest from all sources2021-12-31$3,864
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Administrative expenses professional fees incurred2021-12-31$35,830
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$1,330,745
Participant contributions at end of year2021-12-31$70,847
Participant contributions at beginning of year2021-12-31$92,503
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$492,567
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$2,474
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$89
Total non interest bearing cash at end of year2021-12-31$9,674
Total non interest bearing cash at beginning of year2021-12-31$15,805
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$3,287,801
Value of net assets at end of year (total assets less liabilities)2021-12-31$13,204,806
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$9,917,005
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Investment advisory and management fees2021-12-31$34,107
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$12,660,281
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$9,458,747
Interest on participant loans2021-12-31$3,864
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$1,423,500
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$466,478
Employer contributions (assets) at end of year2021-12-31$466,478
Employer contributions (assets) at beginning of year2021-12-31$350,039
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$324,235
Contract administrator fees2021-12-31$35,181
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31DWYER, PEMBERTON & COULSON, P.C.
Accountancy firm EIN2021-12-31911503183
2020 : OLYMPIC SPORTS & SPINE PLLC 401(K) PLAN 2020 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$89
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$2,749,368
Total of all expenses incurred2020-12-31$332,978
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$276,499
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$1,433,608
Value of total assets at end of year2020-12-31$9,917,094
Value of total assets at beginning of year2020-12-31$7,500,615
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$56,479
Total interest from all sources2020-12-31$2,006
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$968,454
Participant contributions at end of year2020-12-31$92,503
Participant contributions at beginning of year2020-12-31$28,705
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$114,457
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$89
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$0
Administrative expenses (other) incurred2020-12-31$56,479
Total non interest bearing cash at end of year2020-12-31$15,805
Total non interest bearing cash at beginning of year2020-12-31$4,555
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$2,416,390
Value of net assets at end of year (total assets less liabilities)2020-12-31$9,917,005
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$7,500,615
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$9,458,747
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$7,153,039
Interest on participant loans2020-12-31$2,006
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$1,313,754
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$350,697
Employer contributions (assets) at end of year2020-12-31$350,039
Employer contributions (assets) at beginning of year2020-12-31$314,316
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$276,499
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31DWYER, PEMBERTON & COULSON, P.C.
Accountancy firm EIN2020-12-31911503183
2019 : OLYMPIC SPORTS & SPINE PLLC 401(K) PLAN 2019 401k financial data
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$1,706
Total income from all sources (including contributions)2019-12-31$2,553,434
Total of all expenses incurred2019-12-31$244,227
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$218,016
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$1,328,539
Value of total assets at end of year2019-12-31$7,500,615
Value of total assets at beginning of year2019-12-31$5,193,114
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$26,211
Total interest from all sources2019-12-31$2,060
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Administrative expenses professional fees incurred2019-12-31$5,646
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$874,424
Participant contributions at end of year2019-12-31$28,705
Participant contributions at beginning of year2019-12-31$39,296
Participant contributions at end of year2019-12-31$0
Participant contributions at beginning of year2019-12-31$35,835
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$139,799
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$51
Total non interest bearing cash at end of year2019-12-31$4,555
Total non interest bearing cash at beginning of year2019-12-31$3,433
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$2,309,207
Value of net assets at end of year (total assets less liabilities)2019-12-31$7,500,615
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$5,191,408
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$7,153,039
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$4,933,145
Interest on participant loans2019-12-31$2,060
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$1,222,835
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$314,316
Employer contributions (assets) at end of year2019-12-31$314,316
Employer contributions (assets) at beginning of year2019-12-31$181,405
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$218,016
Contract administrator fees2019-12-31$20,565
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$1,655
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31DWYER, PEMBERTON & COULSON, P.C.
Accountancy firm EIN2019-12-31911503183

Form 5500 Responses for OLYMPIC SPORTS & SPINE PLLC 401(K) PLAN

2022: OLYMPIC SPORTS & SPINE PLLC 401(K) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: OLYMPIC SPORTS & SPINE PLLC 401(K) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: OLYMPIC SPORTS & SPINE PLLC 401(K) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: OLYMPIC SPORTS & SPINE PLLC 401(K) PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number49556
Policy instance 1
Insurance contract or identification number49556
Number of Individuals Covered510
Total amount of commissions paid to insurance brokerUSD $5,860
Total amount of fees paid to insurance companyUSD $20,525
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Commission paid to Insurance BrokerUSD $5,860
Amount paid for insurance broker fees20525
Additional information about fees paid to insurance brokerTHIRD PARTY ADMINISTRATION
Insurance broker organization code?5
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number
Policy instance 1
Total amount of commissions paid to insurance brokerUSD $5,573
Total amount of fees paid to insurance companyUSD $30,725
Are there contracts with allocated funds for group deferred annuity?Yes
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Commission paid to Insurance BrokerUSD $5,573
Amount paid for insurance broker fees30725
Additional information about fees paid to insurance brokerTPA SERVICES
Insurance broker organization code?5
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number
Policy instance 1
Total amount of commissions paid to insurance brokerUSD $1,452
Total amount of fees paid to insurance companyUSD $6,524
Are there contracts with allocated funds for group deferred annuity?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Commission paid to Insurance BrokerUSD $726
Amount paid for insurance broker fees5864
Additional information about fees paid to insurance brokerADMINISTRATIVE ALLOWANCE
Insurance broker organization code?5
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number
Policy instance 1
Number of Individuals Covered277
Total amount of fees paid to insurance companyUSD $3,032
Amount paid for insurance broker fees3032
Additional information about fees paid to insurance brokerTHIRD PARTY ADMINISTRATION
Insurance broker organization code?5

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