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PROGRESSIVE REHABILITATION ASSOCIATES 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan NamePROGRESSIVE REHABILITATION ASSOCIATES 401(K) PROFIT SHARING PLAN
Plan identification number 001

PROGRESSIVE REHABILITATION ASSOCIATES 401(K) PROFIT SHARING PLAN Benefits

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

PROGRESSIVE REHABILITATION ASSOCIATES, LLC has sponsored the creation of one or more 401k plans.

Company Name:PROGRESSIVE REHABILITATION ASSOCIATES, LLC
Employer identification number (EIN):930793656
NAIC Classification:621112
NAIC Description:Offices of Physicians, Mental Health Specialists

Additional information about PROGRESSIVE REHABILITATION ASSOCIATES, LLC

Jurisdiction of Incorporation: Oregon Secretary of State Corporations Division
Incorporation Date: 1981-07-13
Company Identification Number: 15433816
Legal Registered Office Address: 1030 SW MORRISON ST

PORTLAND
United States of America (USA)
97205

More information about PROGRESSIVE REHABILITATION ASSOCIATES, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PROGRESSIVE REHABILITATION ASSOCIATES 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-08-01SHANNON ERNST2024-02-01
0012021-08-01JACKIE STOUT2022-12-07
0012020-08-01JACKIE STOUT2022-01-17
0012018-08-01REBBEKKAH LISS2020-04-20
0012017-08-01REBBEKKAH LISS2018-11-07
0012016-08-01REBBEKKAH LISS
0012015-08-01REBBEKKAH LISS
0012014-08-01REBBEKKAH LISS
0012013-08-01REBBEKKAH LISS
0012012-08-01REBBEKKAH LISS
0012011-08-01REBBEKKAH LISS
0012010-08-01JOANNE BEASLEY2011-10-25

Plan Statistics for PROGRESSIVE REHABILITATION ASSOCIATES 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for PROGRESSIVE REHABILITATION ASSOCIATES 401(K) PROFIT SHARING PLAN

Measure Date Value
2016: PROGRESSIVE REHABILITATION ASSOCIATES 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-08-0137
Total number of active participants reported on line 7a of the Form 55002016-08-0123
Number of retired or separated participants receiving benefits2016-08-010
Number of other retired or separated participants entitled to future benefits2016-08-018
Total of all active and inactive participants2016-08-0131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-08-010
Total participants2016-08-0131
Number of participants with account balances2016-08-0130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-08-010
2015: PROGRESSIVE REHABILITATION ASSOCIATES 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-08-0137
Total number of active participants reported on line 7a of the Form 55002015-08-0128
Number of retired or separated participants receiving benefits2015-08-010
Number of other retired or separated participants entitled to future benefits2015-08-019
Total of all active and inactive participants2015-08-0137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-08-010
Total participants2015-08-0137
Number of participants with account balances2015-08-0134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-08-010
2014: PROGRESSIVE REHABILITATION ASSOCIATES 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-08-0137
Total number of active participants reported on line 7a of the Form 55002014-08-0127
Number of retired or separated participants receiving benefits2014-08-010
Number of other retired or separated participants entitled to future benefits2014-08-0110
Total of all active and inactive participants2014-08-0137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-08-010
Total participants2014-08-0137
Number of participants with account balances2014-08-0136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-08-010
2013: PROGRESSIVE REHABILITATION ASSOCIATES 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-08-0146
Total number of active participants reported on line 7a of the Form 55002013-08-0129
Number of retired or separated participants receiving benefits2013-08-010
Number of other retired or separated participants entitled to future benefits2013-08-018
Total of all active and inactive participants2013-08-0137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-08-010
Total participants2013-08-0137
Number of participants with account balances2013-08-0136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-08-010
2012: PROGRESSIVE REHABILITATION ASSOCIATES 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-08-0143
Total number of active participants reported on line 7a of the Form 55002012-08-0140
Number of retired or separated participants receiving benefits2012-08-010
Number of other retired or separated participants entitled to future benefits2012-08-016
Total of all active and inactive participants2012-08-0146
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-08-010
Total participants2012-08-0146
Number of participants with account balances2012-08-0139
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-08-010
2011: PROGRESSIVE REHABILITATION ASSOCIATES 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-08-0143
Total number of active participants reported on line 7a of the Form 55002011-08-0134
Number of retired or separated participants receiving benefits2011-08-010
Number of other retired or separated participants entitled to future benefits2011-08-019
Total of all active and inactive participants2011-08-0143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-08-010
Total participants2011-08-0143
Number of participants with account balances2011-08-0142
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-08-010

Financial Data on PROGRESSIVE REHABILITATION ASSOCIATES 401(K) PROFIT SHARING PLAN

Measure Date Value
2017 : PROGRESSIVE REHABILITATION ASSOCIATES 401(K) PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources2017-07-31$570,755
Expenses. Total of all expenses incurred2017-07-31$848,343
Benefits paid (including direct rollovers)2017-07-31$830,147
Total plan assets at end of year2017-07-31$3,012,247
Total plan assets at beginning of year2017-07-31$3,289,835
Value of fidelity bond covering the plan2017-07-31$328,984
Total contributions received or receivable from participants2017-07-31$129,098
Assets. Value of loans (other than to participants)2017-07-31$0
Other income received2017-07-31$394,617
Net income (gross income less expenses)2017-07-31$-277,588
Net plan assets at end of year (total assets less liabilities)2017-07-31$3,012,247
Net plan assets at beginning of year (total assets less liabilities)2017-07-31$3,289,835
Assets. Value of participant loans2017-07-31$37,088
Total contributions received or receivable from employer(s)2017-07-31$47,040
Value of certain deemed distributions of participant loans2017-07-31$5,623
Expenses. Administrative service providers (salaries,fees and commissions)2017-07-31$12,573
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-07-31$0
2016 : PROGRESSIVE REHABILITATION ASSOCIATES 401(K) PROFIT SHARING PLAN 2016 401k financial data
Total plan liabilities at beginning of year2016-07-31$49
Total income from all sources2016-07-31$177,447
Expenses. Total of all expenses incurred2016-07-31$683,368
Benefits paid (including direct rollovers)2016-07-31$652,873
Total plan assets at end of year2016-07-31$3,289,835
Total plan assets at beginning of year2016-07-31$3,795,805
Value of fidelity bond covering the plan2016-07-31$379,581
Total contributions received or receivable from participants2016-07-31$145,851
Assets. Value of loans (other than to participants)2016-07-31$25,000
Other income received2016-07-31$-23,140
Net income (gross income less expenses)2016-07-31$-505,921
Net plan assets at end of year (total assets less liabilities)2016-07-31$3,289,835
Net plan assets at beginning of year (total assets less liabilities)2016-07-31$3,795,756
Assets. Value of participant loans2016-07-31$64,044
Total contributions received or receivable from employer(s)2016-07-31$54,736
Value of corrective distributions2016-07-31$13,493
Expenses. Administrative service providers (salaries,fees and commissions)2016-07-31$17,002
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-07-31$0
2015 : PROGRESSIVE REHABILITATION ASSOCIATES 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total plan liabilities at end of year2015-07-31$49
Total plan liabilities at beginning of year2015-07-31$504
Total income from all sources2015-07-31$422,423
Expenses. Total of all expenses incurred2015-07-31$348,513
Benefits paid (including direct rollovers)2015-07-31$333,339
Total plan assets at end of year2015-07-31$3,795,805
Total plan assets at beginning of year2015-07-31$3,722,350
Value of fidelity bond covering the plan2015-07-31$372,235
Total contributions received or receivable from participants2015-07-31$196,213
Assets. Value of loans (other than to participants)2015-07-31$25,000
Other income received2015-07-31$163,488
Net income (gross income less expenses)2015-07-31$73,910
Net plan assets at end of year (total assets less liabilities)2015-07-31$3,795,756
Net plan assets at beginning of year (total assets less liabilities)2015-07-31$3,721,846
Total contributions received or receivable from employer(s)2015-07-31$62,722
Expenses. Administrative service providers (salaries,fees and commissions)2015-07-31$15,174
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-07-31$0
2014 : PROGRESSIVE REHABILITATION ASSOCIATES 401(K) PROFIT SHARING PLAN 2014 401k financial data
Total plan liabilities at end of year2014-07-31$504
Total plan liabilities at beginning of year2014-07-31$1,042
Total income from all sources2014-07-31$645,383
Expenses. Total of all expenses incurred2014-07-31$410,983
Benefits paid (including direct rollovers)2014-07-31$381,044
Total plan assets at end of year2014-07-31$3,722,350
Total plan assets at beginning of year2014-07-31$3,488,488
Value of fidelity bond covering the plan2014-07-31$348,849
Total contributions received or receivable from participants2014-07-31$202,137
Assets. Value of loans (other than to participants)2014-07-31$25,000
Other income received2014-07-31$374,123
Net income (gross income less expenses)2014-07-31$234,400
Net plan assets at end of year (total assets less liabilities)2014-07-31$3,721,846
Net plan assets at beginning of year (total assets less liabilities)2014-07-31$3,487,446
Total contributions received or receivable from employer(s)2014-07-31$69,123
Expenses. Administrative service providers (salaries,fees and commissions)2014-07-31$29,939
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-07-31$0
2013 : PROGRESSIVE REHABILITATION ASSOCIATES 401(K) PROFIT SHARING PLAN 2013 401k financial data
Total plan liabilities at end of year2013-07-31$1,042
Total plan liabilities at beginning of year2013-07-31$1,813
Total income from all sources2013-07-31$877,713
Expenses. Total of all expenses incurred2013-07-31$391,421
Benefits paid (including direct rollovers)2013-07-31$370,999
Total plan assets at end of year2013-07-31$3,488,488
Total plan assets at beginning of year2013-07-31$3,002,967
Value of fidelity bond covering the plan2013-07-31$500,000
Total contributions received or receivable from participants2013-07-31$210,255
Assets. Value of loans (other than to participants)2013-07-31$55,268
Expenses. Other expenses not covered elsewhere2013-07-31$0
Contributions received from other sources (not participants or employers)2013-07-31$106,843
Other income received2013-07-31$483,258
Noncash contributions received2013-07-31$0
Net income (gross income less expenses)2013-07-31$486,292
Net plan assets at end of year (total assets less liabilities)2013-07-31$3,487,446
Net plan assets at beginning of year (total assets less liabilities)2013-07-31$3,001,154
Total contributions received or receivable from employer(s)2013-07-31$77,357
Value of certain deemed distributions of participant loans2013-07-31$0
Value of corrective distributions2013-07-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2013-07-31$20,422
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-07-31$0
2012 : PROGRESSIVE REHABILITATION ASSOCIATES 401(K) PROFIT SHARING PLAN 2012 401k financial data
Total plan liabilities at end of year2012-07-31$1,813
Total plan liabilities at beginning of year2012-07-31$2,243
Total income from all sources2012-07-31$396,157
Expenses. Total of all expenses incurred2012-07-31$104,290
Benefits paid (including direct rollovers)2012-07-31$85,870
Total plan assets at end of year2012-07-31$3,002,967
Total plan assets at beginning of year2012-07-31$2,711,530
Value of fidelity bond covering the plan2012-07-31$500,000
Total contributions received or receivable from participants2012-07-31$231,322
Assets. Value of loans (other than to participants)2012-07-31$55,268
Contributions received from other sources (not participants or employers)2012-07-31$45,267
Other income received2012-07-31$34,903
Net income (gross income less expenses)2012-07-31$291,867
Net plan assets at end of year (total assets less liabilities)2012-07-31$3,001,154
Net plan assets at beginning of year (total assets less liabilities)2012-07-31$2,709,287
Total contributions received or receivable from employer(s)2012-07-31$84,665
Expenses. Administrative service providers (salaries,fees and commissions)2012-07-31$18,420
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-07-31$0

Form 5500 Responses for PROGRESSIVE REHABILITATION ASSOCIATES 401(K) PROFIT SHARING PLAN

2016: PROGRESSIVE REHABILITATION ASSOCIATES 401(K) PROFIT SHARING PLAN 2016 form 5500 responses
2016-08-01Type of plan entitySingle employer plan
2016-08-01Submission has been amendedNo
2016-08-01This submission is the final filingNo
2016-08-01This return/report is a short plan year return/report (less than 12 months)No
2016-08-01Plan is a collectively bargained planNo
2016-08-01Plan funding arrangement – InsuranceYes
2016-08-01Plan funding arrangement – TrustYes
2016-08-01Plan benefit arrangement – InsuranceYes
2016-08-01Plan benefit arrangement - TrustYes
2015: PROGRESSIVE REHABILITATION ASSOCIATES 401(K) PROFIT SHARING PLAN 2015 form 5500 responses
2015-08-01Type of plan entitySingle employer plan
2015-08-01Submission has been amendedNo
2015-08-01This submission is the final filingNo
2015-08-01This return/report is a short plan year return/report (less than 12 months)No
2015-08-01Plan is a collectively bargained planNo
2015-08-01Plan funding arrangement – InsuranceYes
2015-08-01Plan funding arrangement – TrustYes
2015-08-01Plan benefit arrangement – InsuranceYes
2015-08-01Plan benefit arrangement - TrustYes
2014: PROGRESSIVE REHABILITATION ASSOCIATES 401(K) PROFIT SHARING PLAN 2014 form 5500 responses
2014-08-01Type of plan entitySingle employer plan
2014-08-01Submission has been amendedNo
2014-08-01This submission is the final filingNo
2014-08-01This return/report is a short plan year return/report (less than 12 months)No
2014-08-01Plan is a collectively bargained planNo
2014-08-01Plan funding arrangement – InsuranceYes
2014-08-01Plan funding arrangement – TrustYes
2014-08-01Plan benefit arrangement – InsuranceYes
2014-08-01Plan benefit arrangement - TrustYes
2013: PROGRESSIVE REHABILITATION ASSOCIATES 401(K) PROFIT SHARING PLAN 2013 form 5500 responses
2013-08-01Type of plan entitySingle employer plan
2013-08-01Submission has been amendedNo
2013-08-01This submission is the final filingNo
2013-08-01This return/report is a short plan year return/report (less than 12 months)No
2013-08-01Plan is a collectively bargained planNo
2013-08-01Plan funding arrangement – InsuranceYes
2013-08-01Plan funding arrangement – TrustYes
2013-08-01Plan benefit arrangement – InsuranceYes
2013-08-01Plan benefit arrangement - TrustYes
2012: PROGRESSIVE REHABILITATION ASSOCIATES 401(K) PROFIT SHARING PLAN 2012 form 5500 responses
2012-08-01Type of plan entitySingle employer plan
2012-08-01Submission has been amendedNo
2012-08-01This submission is the final filingNo
2012-08-01This return/report is a short plan year return/report (less than 12 months)No
2012-08-01Plan is a collectively bargained planNo
2012-08-01Plan funding arrangement – InsuranceYes
2012-08-01Plan funding arrangement – TrustYes
2012-08-01Plan benefit arrangement – InsuranceYes
2012-08-01Plan benefit arrangement - TrustYes
2011: PROGRESSIVE REHABILITATION ASSOCIATES 401(K) PROFIT SHARING PLAN 2011 form 5500 responses
2011-08-01Type of plan entitySingle employer plan
2011-08-01Submission has been amendedYes
2011-08-01This submission is the final filingNo
2011-08-01This return/report is a short plan year return/report (less than 12 months)No
2011-08-01Plan is a collectively bargained planNo
2011-08-01Plan funding arrangement – InsuranceYes
2011-08-01Plan funding arrangement – TrustYes
2011-08-01Plan benefit arrangement – InsuranceYes
2011-08-01Plan 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 number18904
Policy instance 1
Insurance contract or identification number18904
Number of Individuals Covered39
Insurance policy start date2015-08-01
Insurance policy end date2016-07-31
Total amount of commissions paid to insurance brokerUSD $10,212
Total amount of fees paid to insurance companyUSD $1,491
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 $10,212
Insurance broker organization code?3
Amount paid for insurance broker fees1491
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker namePENSION PLAN SPECIALISTS, PC
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number18904
Policy instance 1
Insurance contract or identification number18904
Number of Individuals Covered39
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $13,019
Total amount of fees paid to insurance companyUSD $1,747
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 $13,019
Insurance broker organization code?3
Amount paid for insurance broker fees1747
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker namePENSION PLAN SPECIALISTS, PC
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number18904
Policy instance 1
Insurance contract or identification number18904
Number of Individuals Covered29
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Total amount of commissions paid to insurance brokerUSD $11,009
Total amount of fees paid to insurance companyUSD $2,260
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 $11,009
Insurance broker organization code?3
Amount paid for insurance broker fees2260
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker namePENSION PLAN SPECIALISTS, PC
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number18904
Policy instance 1
Insurance contract or identification number18904
Number of Individuals Covered39
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Total amount of commissions paid to insurance brokerUSD $10,359
Total amount of fees paid to insurance companyUSD $1,894
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 $10,359
Insurance broker organization code?3
Amount paid for insurance broker fees1894
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker namePENSION PLAN SPECIALISTS, PC
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number18904
Policy instance 1
Insurance contract or identification number18904
Number of Individuals Covered43
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Total amount of commissions paid to insurance brokerUSD $7,872
Total amount of fees paid to insurance companyUSD $1,944
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

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