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MOUNTAIN GEAR, INC. 401K PROFIT SHARING PLAN 401k Plan overview

Plan NameMOUNTAIN GEAR, INC. 401K PROFIT SHARING PLAN
Plan identification number 001

MOUNTAIN GEAR, INC. 401K 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

MOUNTAIN GEAR, INC. has sponsored the creation of one or more 401k plans.

Company Name:MOUNTAIN GEAR, INC.
Employer identification number (EIN):911313988
NAIC Classification:451110
NAIC Description:Sporting Goods Stores

Additional information about MOUNTAIN GEAR, INC.

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division
Incorporation Date: 1985-11-27
Company Identification Number: 600409945
Legal Registered Office Address: 6021 E MANSFIELD AVE STE 300

SPOKANE VALLEY
United States of America (USA)
992121300

More information about MOUNTAIN GEAR, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MOUNTAIN GEAR, INC. 401K PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012021-01-01DALE STEVENS2022-10-07
0012020-01-01
0012019-01-01
0012018-01-01
0012017-01-01
0012016-01-01
0012015-01-01
0012014-01-01DALE STEVENS
0012013-01-01DALE STEVENS
0012012-01-01DALE STEVENS
0012011-01-01DALE STEVENS
0012009-01-01PAUL FISH

Plan Statistics for MOUNTAIN GEAR, INC. 401K PROFIT SHARING PLAN

401k plan membership statisitcs for MOUNTAIN GEAR, INC. 401K PROFIT SHARING PLAN

Measure Date Value
2015: MOUNTAIN GEAR, INC. 401K PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0187
Total number of active participants reported on line 7a of the Form 55002015-01-0155
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0121
Total of all active and inactive participants2015-01-0176
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0176
Number of participants with account balances2015-01-0147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-011
2014: MOUNTAIN GEAR, INC. 401K PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0196
Total number of active participants reported on line 7a of the Form 55002014-01-0164
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0123
Total of all active and inactive participants2014-01-0187
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0187
Number of participants with account balances2014-01-0150
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-012
2013: MOUNTAIN GEAR, INC. 401K PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01111
Total number of active participants reported on line 7a of the Form 55002013-01-0184
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0112
Total of all active and inactive participants2013-01-0196
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0196
Number of participants with account balances2013-01-0155
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-013
2012: MOUNTAIN GEAR, INC. 401K PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0182
Total number of active participants reported on line 7a of the Form 55002012-01-0184
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0127
Total of all active and inactive participants2012-01-01111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01111
Number of participants with account balances2012-01-0165
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: MOUNTAIN GEAR, INC. 401K PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0195
Total number of active participants reported on line 7a of the Form 55002011-01-0161
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-0120
Total of all active and inactive participants2011-01-0181
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-011
Total participants2011-01-0182
Number of participants with account balances2011-01-0166
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: MOUNTAIN GEAR, INC. 401K PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0185
Total number of active participants reported on line 7a of the Form 55002009-01-0171
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0125
Total of all active and inactive participants2009-01-0196
Total participants2009-01-0196
Number of participants with account balances2009-01-0174
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on MOUNTAIN GEAR, INC. 401K PROFIT SHARING PLAN

Measure Date Value
2015 : MOUNTAIN GEAR, INC. 401K PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources2015-12-31$40,187
Expenses. Total of all expenses incurred2015-12-31$39,565
Benefits paid (including direct rollovers)2015-12-31$39,565
Total plan assets at end of year2015-12-31$1,842,867
Total plan assets at beginning of year2015-12-31$1,842,245
Value of fidelity bond covering the plan2015-12-31$200,000
Total contributions received or receivable from participants2015-12-31$80,622
Other income received2015-12-31$-40,435
Net income (gross income less expenses)2015-12-31$622
Net plan assets at end of year (total assets less liabilities)2015-12-31$1,842,867
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$1,842,245
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : MOUNTAIN GEAR, INC. 401K PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources2014-12-31$166,937
Expenses. Total of all expenses incurred2014-12-31$109,146
Benefits paid (including direct rollovers)2014-12-31$95,936
Total plan assets at end of year2014-12-31$1,842,245
Total plan assets at beginning of year2014-12-31$1,784,454
Value of fidelity bond covering the plan2014-12-31$200,000
Total contributions received or receivable from participants2014-12-31$83,146
Other income received2014-12-31$83,791
Net income (gross income less expenses)2014-12-31$57,791
Net plan assets at end of year (total assets less liabilities)2014-12-31$1,842,245
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$1,784,454
Total contributions received or receivable from employer(s)2014-12-31$0
Value of corrective distributions2014-12-31$13,210
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : MOUNTAIN GEAR, INC. 401K PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources2013-12-31$412,678
Expenses. Total of all expenses incurred2013-12-31$219,728
Benefits paid (including direct rollovers)2013-12-31$219,728
Total plan assets at end of year2013-12-31$1,784,454
Total plan assets at beginning of year2013-12-31$1,591,504
Value of fidelity bond covering the plan2013-12-31$150,000
Total contributions received or receivable from participants2013-12-31$108,631
Contributions received from other sources (not participants or employers)2013-12-31$11,635
Other income received2013-12-31$292,412
Net income (gross income less expenses)2013-12-31$192,950
Net plan assets at end of year (total assets less liabilities)2013-12-31$1,784,454
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$1,591,504
Total contributions received or receivable from employer(s)2013-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : MOUNTAIN GEAR, INC. 401K PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources2012-12-31$331,765
Expenses. Total of all expenses incurred2012-12-31$72,645
Benefits paid (including direct rollovers)2012-12-31$72,645
Total plan assets at end of year2012-12-31$1,591,504
Total plan assets at beginning of year2012-12-31$1,332,384
Value of fidelity bond covering the plan2012-12-31$150,000
Total contributions received or receivable from participants2012-12-31$108,498
Other income received2012-12-31$163,125
Net income (gross income less expenses)2012-12-31$259,120
Net plan assets at end of year (total assets less liabilities)2012-12-31$1,591,504
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$1,332,384
Assets. Value of participant loans2012-12-31$249
Total contributions received or receivable from employer(s)2012-12-31$60,142
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : MOUNTAIN GEAR, INC. 401K PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources2011-12-31$202,118
Expenses. Total of all expenses incurred2011-12-31$115,326
Benefits paid (including direct rollovers)2011-12-31$115,326
Total plan assets at end of year2011-12-31$1,426,167
Total plan assets at beginning of year2011-12-31$1,339,375
Value of fidelity bond covering the plan2011-12-31$150,000
Total contributions received or receivable from participants2011-12-31$200,236
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-55,746
Net income (gross income less expenses)2011-12-31$86,792
Net plan assets at end of year (total assets less liabilities)2011-12-31$1,426,167
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$1,339,375
Assets. Value of participant loans2011-12-31$1,034
Total contributions received or receivable from employer(s)2011-12-31$57,628
Value of corrective distributions2011-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : MOUNTAIN GEAR, INC. 401K PROFIT SHARING PLAN 2010 401k financial data
Total plan liabilities at beginning of year2010-12-31$0
Total income from all sources2010-12-31$232,323
Expenses. Total of all expenses incurred2010-12-31$19,231
Benefits paid (including direct rollovers)2010-12-31$19,231
Total plan assets at end of year2010-12-31$1,339,375
Total plan assets at beginning of year2010-12-31$1,126,283
Value of fidelity bond covering the plan2010-12-31$150,000
Total contributions received or receivable from participants2010-12-31$96,041
Other income received2010-12-31$136,282
Net income (gross income less expenses)2010-12-31$213,092
Net plan assets at end of year (total assets less liabilities)2010-12-31$1,339,375
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$1,126,283
Assets. Value of participant loans2010-12-31$1,800
Total contributions received or receivable from employer(s)2010-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
2009 : MOUNTAIN GEAR, INC. 401K PROFIT SHARING PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for MOUNTAIN GEAR, INC. 401K PROFIT SHARING PLAN

2015: MOUNTAIN GEAR, INC. 401K 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: MOUNTAIN GEAR, INC. 401K 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: MOUNTAIN GEAR, INC. 401K 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: MOUNTAIN GEAR, INC. 401K 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: MOUNTAIN GEAR, INC. 401K PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedYes
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: MOUNTAIN GEAR, INC. 401K PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan 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 number36392
Policy instance 1
Insurance contract or identification number36392
Number of Individuals Covered57
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $5,216
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?Yes
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
Other information about contractGROUP PENSION ACCOUNT
Commission paid to Insurance BrokerUSD $5,216
Insurance broker organization code?7
Insurance broker nameWELLS FARGO INS. SERVICES INC.
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number36392
Policy instance 1
Insurance contract or identification number36392
Number of Individuals Covered60
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $5,506
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?Yes
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
Other information about contractGROUP PENSION ACCOUNT
Commission paid to Insurance BrokerUSD $5,506
Insurance broker organization code?7
Insurance broker nameSMITH BARNEY
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number36392
Policy instance 1
Insurance contract or identification number36392
Number of Individuals Covered55
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $5,983
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?Yes
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
Other information about contractGROUP PENSION ACCOUNT
Commission paid to Insurance BrokerUSD $5,983
Insurance broker organization code?7
Insurance broker nameSMITH BARNEY
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number36392
Policy instance 1
Insurance contract or identification number36392
Number of Individuals Covered74
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $5,039
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?Yes
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
Other information about contractGROUP PENSION ACCOUNT
Commission paid to Insurance BrokerUSD $5,039
Amount paid for insurance broker fees0
Additional information about fees paid to insurance broker0.00
Insurance broker organization code?7
Insurance broker nameSMITH BARNEY
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number36392
Policy instance 1
Insurance contract or identification number36392
Number of Individuals Covered66
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $5,010
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?Yes
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
Other information about contractGROUP PENSION ACCOUNT
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number36392
Policy instance 1
Insurance contract or identification number36392
Number of Individuals Covered81
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $4,074
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?Yes
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
Other information about contractGROUP PENSION ACCOUNT
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?7
Insurance broker nameWELLS FARGO INS. SERVICES INC.

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