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MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 401k Plan overview

Plan NameMILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN
Plan identification number 001

MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • 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

MILLCREEK ANESTHESIA, P.C. has sponsored the creation of one or more 401k plans.

Company Name:MILLCREEK ANESTHESIA, P.C.
Employer identification number (EIN):870482642
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01THOMAS W ENGAR2023-09-12
0012021-01-01RANDY F THURGOOD2022-10-09
0012020-01-01RANDY F THURGOOD2021-09-12
0012019-01-01RANDY F THURGOOD2020-09-11
0012018-01-01RANDY F THURGOOD2019-09-18
0012017-01-01
0012017-01-01RANDY F THURGOOD2019-10-13
0012016-01-01RANDY F THURGOOD
0012015-01-01RANDY F THURGOOD
0012014-01-01RANDY F THURGOOD
0012013-01-01RANDY F THURGOOD
0012012-01-01RANDY F THURGOOD
0012011-01-01MARK W RALLISON, PRESIDENT RANDY F THURGOOD, TRUSTEE2012-06-06
0012010-01-01MARK W RALLISON, PRESIDENT RANDY F THURGOOD, TRUSTEE2011-10-03
0012009-01-01MARK W RALLISON, PRESIDENT RANDY F THURGOOD, TRUSTEE2010-07-09

Plan Statistics for MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN

401k plan membership statisitcs for MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN

Measure Date Value
2022: MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0135
Total number of active participants reported on line 7a of the Form 55002022-01-0136
Number of retired or separated participants receiving benefits2022-01-011
Number of other retired or separated participants entitled to future benefits2022-01-011
Total of all active and inactive participants2022-01-0138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-0138
Number of participants with account balances2022-01-0138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0134
Total number of active participants reported on line 7a of the Form 55002021-01-0133
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-011
Total of all active and inactive participants2021-01-0134
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-0134
Number of participants with account balances2021-01-0134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0132
Total number of active participants reported on line 7a of the Form 55002020-01-0132
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-011
Total of all active and inactive participants2020-01-0133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-0133
Number of participants with account balances2020-01-0133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0132
Total number of active participants reported on line 7a of the Form 55002019-01-0130
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-011
Total of all active and inactive participants2019-01-0131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0131
Number of participants with account balances2019-01-0131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0131
Total number of active participants reported on line 7a of the Form 55002018-01-0128
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-012
Total of all active and inactive participants2018-01-0130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0130
Number of participants with account balances2018-01-0130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0131
Total number of active participants reported on line 7a of the Form 55002017-01-0128
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-011
Total of all active and inactive participants2017-01-0129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0129
Number of participants with account balances2017-01-0129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0127
Total number of active participants reported on line 7a of the Form 55002016-01-0125
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-013
Total of all active and inactive participants2016-01-0128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0128
Number of participants with account balances2016-01-0128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0128
Total number of active participants reported on line 7a of the Form 55002015-01-0125
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-012
Total of all active and inactive participants2015-01-0127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0127
Number of participants with account balances2015-01-0127
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0126
Total number of active participants reported on line 7a of the Form 55002014-01-0126
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-0126
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0126
Number of participants with account balances2014-01-0126
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0125
Total number of active participants reported on line 7a of the Form 55002013-01-0126
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-0126
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0126
Number of participants with account balances2013-01-0126
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0125
Total number of active participants reported on line 7a of the Form 55002012-01-0125
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-0125
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0125
Number of participants with account balances2012-01-0125
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0126
Total number of active participants reported on line 7a of the Form 55002011-01-0125
Number of retired or separated participants receiving benefits2011-01-012
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-0127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0127
Number of participants with account balances2011-01-0125
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0127
Total number of active participants reported on line 7a of the Form 55002010-01-0125
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-011
Total of all active and inactive participants2010-01-0126
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0126
Number of participants with account balances2010-01-0126
2009: MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0130
Total number of active participants reported on line 7a of the Form 55002009-01-0124
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-013
Total of all active and inactive participants2009-01-0127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0127
Number of participants with account balances2009-01-0127

Financial Data on MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN

Measure Date Value
2022 : MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2022 401k financial data
Transfers to/from the plan2022-12-31$0
Total income from all sources2022-12-31$-5,911,589
Expenses. Total of all expenses incurred2022-12-31$11,917,180
Benefits paid (including direct rollovers)2022-12-31$11,770,917
Total plan assets at end of year2022-12-31$29,919,314
Total plan assets at beginning of year2022-12-31$47,748,083
Value of fidelity bond covering the plan2022-12-31$500,000
Total contributions received or receivable from participants2022-12-31$647,875
Contributions received from other sources (not participants or employers)2022-12-31$336,477
Other income received2022-12-31$-8,233,628
Net income (gross income less expenses)2022-12-31$-17,828,769
Net plan assets at end of year (total assets less liabilities)2022-12-31$29,919,314
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$47,748,083
Assets. Value of assets in partnership/joint-venture interests2022-12-31$26,220
Total contributions received or receivable from employer(s)2022-12-31$1,337,687
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$146,263
2021 : MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2021 401k financial data
Transfers to/from the plan2021-12-31$0
Total income from all sources2021-12-31$9,440,595
Expenses. Total of all expenses incurred2021-12-31$2,369,727
Benefits paid (including direct rollovers)2021-12-31$2,228,361
Total plan assets at end of year2021-12-31$47,748,083
Total plan assets at beginning of year2021-12-31$40,677,215
Value of fidelity bond covering the plan2021-12-31$500,000
Total contributions received or receivable from participants2021-12-31$625,864
Other income received2021-12-31$7,607,724
Net income (gross income less expenses)2021-12-31$7,070,868
Net plan assets at end of year (total assets less liabilities)2021-12-31$47,748,083
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$40,677,215
Assets. Value of assets in partnership/joint-venture interests2021-12-31$26,061
Total contributions received or receivable from employer(s)2021-12-31$1,207,007
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$141,366
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
2020 : MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2020 401k financial data
Transfers to/from the plan2020-12-31$0
Total income from all sources2020-12-31$7,981,541
Expenses. Total of all expenses incurred2020-12-31$4,609,098
Benefits paid (including direct rollovers)2020-12-31$4,490,168
Total plan assets at end of year2020-12-31$40,677,215
Total plan assets at beginning of year2020-12-31$37,304,772
Value of fidelity bond covering the plan2020-12-31$500,000
Total contributions received or receivable from participants2020-12-31$574,550
Contributions received from other sources (not participants or employers)2020-12-31$39,370
Other income received2020-12-31$6,288,761
Net income (gross income less expenses)2020-12-31$3,372,443
Net plan assets at end of year (total assets less liabilities)2020-12-31$40,677,215
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$37,304,772
Assets. Value of assets in partnership/joint-venture interests2020-12-31$26,588
Total contributions received or receivable from employer(s)2020-12-31$1,078,860
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$118,930
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
2019 : MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2019 401k financial data
Transfers to/from the plan2019-12-31$0
Total income from all sources2019-12-31$8,709,642
Expenses. Total of all expenses incurred2019-12-31$5,368,919
Benefits paid (including direct rollovers)2019-12-31$5,236,990
Total plan assets at end of year2019-12-31$37,304,772
Total plan assets at beginning of year2019-12-31$33,964,049
Value of fidelity bond covering the plan2019-12-31$500,000
Total contributions received or receivable from participants2019-12-31$443,600
Other income received2019-12-31$7,295,827
Net income (gross income less expenses)2019-12-31$3,340,723
Net plan assets at end of year (total assets less liabilities)2019-12-31$37,304,772
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$33,964,049
Assets. Value of assets in partnership/joint-venture interests2019-12-31$26,671
Total contributions received or receivable from employer(s)2019-12-31$970,215
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$131,929
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
2018 : MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2018 401k financial data
Transfers to/from the plan2018-12-31$0
Total income from all sources2018-12-31$-699,047
Expenses. Total of all expenses incurred2018-12-31$2,819,703
Benefits paid (including direct rollovers)2018-12-31$2,710,234
Total plan assets at end of year2018-12-31$33,964,049
Total plan assets at beginning of year2018-12-31$37,482,799
Value of fidelity bond covering the plan2018-12-31$500,000
Total contributions received or receivable from participants2018-12-31$440,849
Other income received2018-12-31$-2,063,620
Net income (gross income less expenses)2018-12-31$-3,518,750
Net plan assets at end of year (total assets less liabilities)2018-12-31$33,964,049
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$37,482,799
Assets. Value of assets in partnership/joint-venture interests2018-12-31$274,102
Total contributions received or receivable from employer(s)2018-12-31$923,724
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$109,469
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
2017 : MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2017 401k financial data
Transfers to/from the plan2017-12-31$0
Total income from all sources2017-12-31$6,402,151
Expenses. Total of all expenses incurred2017-12-31$146,664
Benefits paid (including direct rollovers)2017-12-31$15,309
Total plan assets at end of year2017-12-31$37,465,838
Total plan assets at beginning of year2017-12-31$31,210,351
Value of fidelity bond covering the plan2017-12-31$500,000
Total contributions received or receivable from participants2017-12-31$444,000
Contributions received from other sources (not participants or employers)2017-12-31$21,366
Other income received2017-12-31$5,035,822
Net income (gross income less expenses)2017-12-31$6,255,487
Net plan assets at end of year (total assets less liabilities)2017-12-31$37,465,838
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$31,210,351
Assets. Value of assets in partnership/joint-venture interests2017-12-31$297,205
Total contributions received or receivable from employer(s)2017-12-31$900,963
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$131,355
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2016 401k financial data
Transfers to/from the plan2016-12-31$0
Total income from all sources2016-12-31$3,437,169
Expenses. Total of all expenses incurred2016-12-31$124,369
Total plan assets at end of year2016-12-31$31,210,351
Total plan assets at beginning of year2016-12-31$27,897,551
Value of fidelity bond covering the plan2016-12-31$500,000
Total contributions received or receivable from participants2016-12-31$426,000
Other income received2016-12-31$2,198,092
Net income (gross income less expenses)2016-12-31$3,312,800
Net plan assets at end of year (total assets less liabilities)2016-12-31$31,210,351
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$27,897,551
Assets. Value of assets in partnership/joint-venture interests2016-12-31$337,966
Total contributions received or receivable from employer(s)2016-12-31$813,077
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$124,369
2015 : MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2015 401k financial data
Transfers to/from the plan2015-12-31$0
Total income from all sources2015-12-31$1,095,288
Expenses. Total of all expenses incurred2015-12-31$6,215,288
Benefits paid (including direct rollovers)2015-12-31$6,090,389
Total plan assets at end of year2015-12-31$27,897,551
Total plan assets at beginning of year2015-12-31$33,017,551
Value of fidelity bond covering the plan2015-12-31$500,000
Total contributions received or receivable from participants2015-12-31$449,351
Other income received2015-12-31$-199,073
Net income (gross income less expenses)2015-12-31$-5,120,000
Net plan assets at end of year (total assets less liabilities)2015-12-31$27,897,551
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$33,017,551
Assets. Value of assets in partnership/joint-venture interests2015-12-31$205,085
Total contributions received or receivable from employer(s)2015-12-31$845,010
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$124,899
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2014 401k financial data
Transfers to/from the plan2014-12-31$0
Total income from all sources2014-12-31$3,386,922
Expenses. Total of all expenses incurred2014-12-31$85,238
Total plan assets at end of year2014-12-31$33,017,551
Total plan assets at beginning of year2014-12-31$29,715,867
Value of fidelity bond covering the plan2014-12-31$500,000
Total contributions received or receivable from participants2014-12-31$400,965
Other income received2014-12-31$2,170,615
Net income (gross income less expenses)2014-12-31$3,301,684
Net plan assets at end of year (total assets less liabilities)2014-12-31$33,017,551
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$29,715,867
Assets. Value of assets in partnership/joint-venture interests2014-12-31$147,830
Total contributions received or receivable from employer(s)2014-12-31$815,342
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$85,238
2013 : MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2013 401k financial data
Transfers to/from the plan2013-12-31$0
Total income from all sources2013-12-31$5,174,973
Expenses. Total of all expenses incurred2013-12-31$101,882
Total plan assets at end of year2013-12-31$29,715,867
Total plan assets at beginning of year2013-12-31$24,642,776
Value of fidelity bond covering the plan2013-12-31$500,000
Total contributions received or receivable from participants2013-12-31$418,000
Other income received2013-12-31$3,970,377
Net income (gross income less expenses)2013-12-31$5,073,091
Net plan assets at end of year (total assets less liabilities)2013-12-31$29,715,867
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$24,642,776
Assets. Value of assets in partnership/joint-venture interests2013-12-31$22,560
Total contributions received or receivable from employer(s)2013-12-31$786,596
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$101,882
2012 : MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2012 401k financial data
Transfers to/from the plan2012-12-31$0
Total income from all sources2012-12-31$3,421,516
Expenses. Total of all expenses incurred2012-12-31$77,847
Total plan assets at end of year2012-12-31$24,642,776
Total plan assets at beginning of year2012-12-31$21,299,107
Value of fidelity bond covering the plan2012-12-31$500,000
Total contributions received or receivable from participants2012-12-31$386,887
Other income received2012-12-31$2,260,909
Net income (gross income less expenses)2012-12-31$3,343,669
Net plan assets at end of year (total assets less liabilities)2012-12-31$24,642,776
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$21,299,107
Assets. Value of assets in partnership/joint-venture interests2012-12-31$122,800
Total contributions received or receivable from employer(s)2012-12-31$773,720
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$77,847
2011 : MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2011 401k financial data
Total plan liabilities at beginning of year2011-12-31$61
Total income from all sources2011-12-31$1,171,391
Expenses. Total of all expenses incurred2011-12-31$568,174
Benefits paid (including direct rollovers)2011-12-31$479,203
Total plan assets at end of year2011-12-31$21,299,107
Total plan assets at beginning of year2011-12-31$20,695,951
Value of fidelity bond covering the plan2011-12-31$500,000
Total contributions received or receivable from participants2011-12-31$368,302
Other income received2011-12-31$46,530
Net income (gross income less expenses)2011-12-31$603,217
Net plan assets at end of year (total assets less liabilities)2011-12-31$21,299,107
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$20,695,890
Assets. Value of assets in partnership/joint-venture interests2011-12-31$84,419
Total contributions received or receivable from employer(s)2011-12-31$756,559
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$88,971
2010 : MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2010 401k financial data
Total plan liabilities at end of year2010-12-31$61
Total plan liabilities at beginning of year2010-12-31$258
Total income from all sources2010-12-31$3,335,380
Expenses. Total of all expenses incurred2010-12-31$177,084
Benefits paid (including direct rollovers)2010-12-31$123,670
Total plan assets at end of year2010-12-31$20,622,687
Total plan assets at beginning of year2010-12-31$17,464,588
Value of fidelity bond covering the plan2010-12-31$500,000
Total contributions received or receivable from participants2010-12-31$380,515
Other income received2010-12-31$2,186,481
Net income (gross income less expenses)2010-12-31$3,158,296
Net plan assets at end of year (total assets less liabilities)2010-12-31$20,622,626
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$17,464,330
Assets. Value of assets in partnership/joint-venture interests2010-12-31$89,424
Total contributions received or receivable from employer(s)2010-12-31$768,384
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$53,414

Form 5500 Responses for MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN

2022: MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement - TrustYes
2010: MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement - TrustYes
2009: MILLCREEK ANESTHESIA, P.C. PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

PENN MUTUAL LIFE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 67644 )
Policy contract number8922358
Policy instance 2
Insurance contract or identification number8922358
Number of Individuals Covered2
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $4,537
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,537
Insurance broker organization code?3
JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65099 )
Policy contract numberRV02714219
Policy instance 1
Insurance contract or identification numberRV02714219
Number of Individuals Covered1
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PENN MUTUAL LIFE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 67644 )
Policy contract number8922358
Policy instance 2
Insurance contract or identification number8922358
Number of Individuals Covered2
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $4,234
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,234
Insurance broker organization code?3
JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65099 )
Policy contract numberRV02714219
Policy instance 1
Insurance contract or identification numberRV02714219
Number of Individuals Covered1
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PENN MUTUAL LIFE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 67644 )
Policy contract number8922358
Policy instance 2
Insurance contract or identification number8922358
Number of Individuals Covered2
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $3,252
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,252
Insurance broker organization code?3
JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65099 )
Policy contract numberRV02714219
Policy instance 1
Insurance contract or identification numberRV02714219
Number of Individuals Covered1
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PENN MUTUAL LIFE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 67644 )
Policy contract number8922358
Policy instance 2
Insurance contract or identification number8922358
Number of Individuals Covered2
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65099 )
Policy contract numberRV02714219
Policy instance 1
Insurance contract or identification numberRV02714219
Number of Individuals Covered1
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65099 )
Policy contract numberRV02714219
Policy instance 1
Insurance contract or identification numberRV02714219
Number of Individuals Covered1
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PENN MUTUAL LIFE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 67644 )
Policy contract number8922358
Policy instance 2
Insurance contract or identification number8922358
Number of Individuals Covered2
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $4,787
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,787
Insurance broker organization code?3
JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65099 )
Policy contract numberRV02714219
Policy instance 1
Insurance contract or identification numberRV02714219
Number of Individuals Covered1
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PENN MUTUAL LIFE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 67644 )
Policy contract number8922358
Policy instance 2
Insurance contract or identification number8922358
Number of Individuals Covered2
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $3,687
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,687
Insurance broker organization code?3
Insurance broker nameANDRUS-WASHBURN AGENCY
PENN MUTUAL LIFE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 67644 )
Policy contract number8922358
Policy instance 2
Insurance contract or identification number8922358
Number of Individuals Covered2
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $2,962
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,962
Insurance broker organization code?3
Insurance broker nameANDRUS-WASHBURN AGENCY
JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65099 )
Policy contract numberRV02714219
Policy instance 1
Insurance contract or identification numberRV02714219
Number of Individuals Covered1
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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
PENN MUTUAL LIFE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 67644 )
Policy contract number8922358
Policy instance 1
Insurance contract or identification number8922358
Number of Individuals Covered2
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,048
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 $1,048
Insurance broker organization code?3
Insurance broker nameANDRUS-WASHBURN AGENCY
JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65099 )
Policy contract numberRV02714219
Policy instance 2
Insurance contract or identification numberRV02714219
Number of Individuals Covered1
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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
JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65099 )
Policy contract numberRV02714219
Policy instance 2
Insurance contract or identification numberRV02714219
Number of Individuals Covered1
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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
PENN MUTUAL LIFE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 67644 )
Policy contract number8922358
Policy instance 1
Insurance contract or identification number8922358
Number of Individuals Covered2
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,013
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 $1,013
Insurance broker organization code?3
Insurance broker nameANDRUS-WASHBURN AGENCY
JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65099 )
Policy contract numberRV02714219
Policy instance 2
Insurance contract or identification numberRV02714219
Number of Individuals Covered1
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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
PENN MUTUAL LIFE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 67644 )
Policy contract number8922358
Policy instance 1
Insurance contract or identification number8922358
Number of Individuals Covered2
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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

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