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INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN 401k Plan overview

Plan NameINTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN
Plan identification number 001

INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K 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.
  • Plan covering Self-Employed individuals.
  • 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.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

INTERCOMMUNITY EMERGENCY MEDICAL GROUP has sponsored the creation of one or more 401k plans.

Company Name:INTERCOMMUNITY EMERGENCY MEDICAL GROUP
Employer identification number (EIN):953192932
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01RICHARD ZORASTER, MD2023-08-29
0012021-01-01RICHARD ZORASTER, MD2022-10-14
0012021-01-01RICHARD ZORASTER, MD2023-08-29
0012020-01-01RICHARD ZORASTER, MD2021-10-11
0012019-01-01RICHARD ZORASTER, M.D.2020-10-11
0012018-01-01RICHARD M. ZORASTER, MD2019-08-16
0012017-01-01
0012016-01-01GLEN DONALD SHOOK, MD
0012015-01-01IAN M. KRAMER, MD2016-10-14
0012014-01-01IAN M. KRAMER, MD
0012013-01-01IAN M. KRAMER, MD
0012012-01-01IAN M. KRAMER, MD
0012011-01-01IAN M. KRAMER, MD
0012009-01-01IAN KRAMER

Plan Statistics for INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN

401k plan membership statisitcs for INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN

Measure Date Value
2022: INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0170
Total number of active participants reported on line 7a of the Form 55002022-01-0138
Number of retired or separated participants receiving benefits2022-01-0123
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-0161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-0161
Number of participants with account balances2022-01-0158
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-012
2021: INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0162
Total number of active participants reported on line 7a of the Form 55002021-01-0140
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0127
Total of all active and inactive participants2021-01-0167
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-0167
Number of participants with account balances2021-01-0164
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-016
2020: INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0164
Total number of active participants reported on line 7a of the Form 55002020-01-0149
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0116
Total of all active and inactive participants2020-01-0165
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-0165
Number of participants with account balances2020-01-0158
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-015
2019: INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0154
Total number of active participants reported on line 7a of the Form 55002019-01-0149
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0110
Total of all active and inactive participants2019-01-0159
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0159
Number of participants with account balances2019-01-0152
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-014
2018: INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0144
Total number of active participants reported on line 7a of the Form 55002018-01-0139
Number of retired or separated participants receiving benefits2018-01-011
Number of other retired or separated participants entitled to future benefits2018-01-017
Total of all active and inactive participants2018-01-0147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0147
Number of participants with account balances2018-01-0145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-012
2017: INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0149
Total number of active participants reported on line 7a of the Form 55002017-01-0142
Number of retired or separated participants receiving benefits2017-01-011
Number of other retired or separated participants entitled to future benefits2017-01-015
Total of all active and inactive participants2017-01-0148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0148
Number of participants with account balances2017-01-0143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-011
2016: INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0142
Total number of active participants reported on line 7a of the Form 55002016-01-0141
Number of retired or separated participants receiving benefits2016-01-011
Number of other retired or separated participants entitled to future benefits2016-01-017
Total of all active and inactive participants2016-01-0149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0149
Number of participants with account balances2016-01-0146
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-012
2014: INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0138
Total number of active participants reported on line 7a of the Form 55002014-01-0136
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-014
Total of all active and inactive participants2014-01-0140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0140
Number of participants with account balances2014-01-0137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-011
2013: INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0135
Total number of active participants reported on line 7a of the Form 55002013-01-0134
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-014
Total of all active and inactive participants2013-01-0138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0138
Number of participants with account balances2013-01-0135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0134
Total number of active participants reported on line 7a of the Form 55002012-01-0132
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-013
Total of all active and inactive participants2012-01-0135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0135
Number of participants with account balances2012-01-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0131
Total number of active participants reported on line 7a of the Form 55002011-01-0127
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-014
Total of all active and inactive participants2011-01-0131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-012
Total participants2011-01-0133
Number of participants with account balances2011-01-0131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K 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 55002009-01-0129
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-016
Total of all active and inactive participants2009-01-0135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0135
Number of participants with account balances2009-01-0135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN

Measure Date Value
2022 : INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN 2022 401k financial data
Total income from all sources2022-12-31$-2,255,938
Expenses. Total of all expenses incurred2022-12-31$192,847
Benefits paid (including direct rollovers)2022-12-31$96,046
Total plan assets at end of year2022-12-31$17,968,062
Total plan assets at beginning of year2022-12-31$20,416,847
Value of fidelity bond covering the plan2022-12-31$500,000
Total contributions received or receivable from participants2022-12-31$594,384
Contributions received from other sources (not participants or employers)2022-12-31$86,000
Other income received2022-12-31$-3,607,512
Noncash contributions received2022-12-31$0
Net income (gross income less expenses)2022-12-31$-2,448,785
Net plan assets at end of year (total assets less liabilities)2022-12-31$17,968,062
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$20,416,847
Total contributions received or receivable from employer(s)2022-12-31$671,190
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$96,801
2021 : INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN 2021 401k financial data
Total plan liabilities at beginning of year2021-12-31$0
Total income from all sources2021-12-31$4,083,024
Expenses. Total of all expenses incurred2021-12-31$287,071
Benefits paid (including direct rollovers)2021-12-31$193,462
Total plan assets at end of year2021-12-31$20,308,895
Total plan assets at beginning of year2021-12-31$16,512,942
Value of fidelity bond covering the plan2021-12-31$500,000
Total contributions received or receivable from participants2021-12-31$447,760
Contributions received from other sources (not participants or employers)2021-12-31$9,045
Other income received2021-12-31$3,038,170
Net income (gross income less expenses)2021-12-31$3,795,953
Net plan assets at end of year (total assets less liabilities)2021-12-31$20,308,895
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$16,512,942
Total contributions received or receivable from employer(s)2021-12-31$588,049
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$93,609
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
2020 : INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN 2020 401k financial data
Total plan liabilities at end of year2020-12-31$0
Total plan liabilities at beginning of year2020-12-31$0
Total income from all sources2020-12-31$3,205,317
Expenses. Total of all expenses incurred2020-12-31$522,680
Benefits paid (including direct rollovers)2020-12-31$465,122
Total plan assets at end of year2020-12-31$16,512,942
Total plan assets at beginning of year2020-12-31$13,830,305
Value of fidelity bond covering the plan2020-12-31$500,000
Total contributions received or receivable from participants2020-12-31$379,744
Contributions received from other sources (not participants or employers)2020-12-31$173,194
Other income received2020-12-31$2,326,879
Net income (gross income less expenses)2020-12-31$2,682,637
Net plan assets at end of year (total assets less liabilities)2020-12-31$16,512,942
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$13,830,305
Assets. Value of participant loans2020-12-31$1,498
Assets. Value of assets in partnership/joint-venture interests2020-12-31$11,817
Total contributions received or receivable from employer(s)2020-12-31$325,500
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$57,558
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
2019 : INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN 2019 401k financial data
Total plan liabilities at end of year2019-12-31$0
Total plan liabilities at beginning of year2019-12-31$0
Total income from all sources2019-12-31$2,677,810
Expenses. Total of all expenses incurred2019-12-31$129,235
Benefits paid (including direct rollovers)2019-12-31$87,929
Total plan assets at end of year2019-12-31$13,830,305
Total plan assets at beginning of year2019-12-31$11,281,730
Value of fidelity bond covering the plan2019-12-31$500,000
Total contributions received or receivable from participants2019-12-31$355,623
Contributions received from other sources (not participants or employers)2019-12-31$0
Other income received2019-12-31$2,096,114
Net income (gross income less expenses)2019-12-31$2,548,575
Net plan assets at end of year (total assets less liabilities)2019-12-31$13,830,305
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$11,281,730
Assets. Value of assets in partnership/joint-venture interests2019-12-31$11,436
Total contributions received or receivable from employer(s)2019-12-31$226,073
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$41,306
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
2018 : INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN 2018 401k financial data
Transfers to/from the plan2018-12-31$0
Total plan liabilities at end of year2018-12-31$0
Total plan liabilities at beginning of year2018-12-31$0
Total income from all sources2018-12-31$-119,789
Expenses. Total of all expenses incurred2018-12-31$5,285,049
Benefits paid (including direct rollovers)2018-12-31$5,239,515
Total plan assets at end of year2018-12-31$11,281,730
Total plan assets at beginning of year2018-12-31$16,686,568
Value of fidelity bond covering the plan2018-12-31$500,000
Total contributions received or receivable from participants2018-12-31$215,380
Assets. Value of loans (other than to participants)2018-12-31$0
Expenses. Other expenses not covered elsewhere2018-12-31$0
Contributions received from other sources (not participants or employers)2018-12-31$0
Other income received2018-12-31$-694,201
Noncash contributions received2018-12-31$0
Net income (gross income less expenses)2018-12-31$-5,404,838
Net plan assets at end of year (total assets less liabilities)2018-12-31$11,281,730
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$16,686,568
Assets. Value of assets in partnership/joint-venture interests2018-12-31$11,439
Total contributions received or receivable from employer(s)2018-12-31$359,032
Value of certain deemed distributions of participant loans2018-12-31$0
Value of corrective distributions2018-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$45,534
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
2017 : INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN 2017 401k financial data
Total plan liabilities at end of year2017-12-31$0
Total plan liabilities at beginning of year2017-12-31$0
Total income from all sources2017-12-31$3,076,036
Expenses. Total of all expenses incurred2017-12-31$926,979
Benefits paid (including direct rollovers)2017-12-31$883,893
Total plan assets at end of year2017-12-31$16,686,568
Total plan assets at beginning of year2017-12-31$14,537,511
Value of fidelity bond covering the plan2017-12-31$500,000
Total contributions received or receivable from participants2017-12-31$229,159
Assets. Value of loans (other than to participants)2017-12-31$12,426
Expenses. Other expenses not covered elsewhere2017-12-31$0
Contributions received from other sources (not participants or employers)2017-12-31$0
Other income received2017-12-31$2,470,475
Noncash contributions received2017-12-31$0
Net income (gross income less expenses)2017-12-31$2,149,057
Net plan assets at end of year (total assets less liabilities)2017-12-31$16,686,568
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$14,537,511
Assets. Value of assets in partnership/joint-venture interests2017-12-31$11,190
Total contributions received or receivable from employer(s)2017-12-31$376,402
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$43,086
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN 2016 401k financial data
Transfers to/from the plan2016-12-31$0
Total plan liabilities at end of year2016-12-31$0
Total plan liabilities at beginning of year2016-12-31$0
Total income from all sources2016-12-31$1,605,884
Expenses. Total of all expenses incurred2016-12-31$61,046
Benefits paid (including direct rollovers)2016-12-31$18,991
Total plan assets at end of year2016-12-31$14,537,511
Total plan assets at beginning of year2016-12-31$12,992,673
Value of fidelity bond covering the plan2016-12-31$500,000
Total contributions received or receivable from participants2016-12-31$176,791
Assets. Value of loans (other than to participants)2016-12-31$21,000
Expenses. Other expenses not covered elsewhere2016-12-31$0
Contributions received from other sources (not participants or employers)2016-12-31$0
Other income received2016-12-31$1,016,084
Noncash contributions received2016-12-31$0
Net income (gross income less expenses)2016-12-31$1,544,838
Net plan assets at end of year (total assets less liabilities)2016-12-31$14,537,511
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$12,992,673
Assets. Value of assets in partnership/joint-venture interests2016-12-31$11,094
Total contributions received or receivable from employer(s)2016-12-31$413,009
Value of certain deemed distributions of participant loans2016-12-31$0
Value of corrective distributions2016-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$42,055
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2014 : INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN 2014 401k financial data
Transfers to/from the plan2014-12-31$0
Total plan liabilities at end of year2014-12-31$0
Total plan liabilities at beginning of year2014-12-31$0
Total income from all sources2014-12-31$1,147,044
Expenses. Total of all expenses incurred2014-12-31$655,280
Benefits paid (including direct rollovers)2014-12-31$600,461
Total plan assets at end of year2014-12-31$12,409,299
Total plan assets at beginning of year2014-12-31$11,917,535
Value of fidelity bond covering the plan2014-12-31$500,000
Total contributions received or receivable from participants2014-12-31$164,770
Assets. Value of loans (other than to participants)2014-12-31$3,000
Expenses. Other expenses not covered elsewhere2014-12-31$0
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$529,535
Net income (gross income less expenses)2014-12-31$491,764
Net plan assets at end of year (total assets less liabilities)2014-12-31$12,409,299
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$11,917,535
Assets. Value of assets in partnership/joint-venture interests2014-12-31$3
Total contributions received or receivable from employer(s)2014-12-31$452,739
Value of corrective distributions2014-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$54,819
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN 2013 401k financial data
Transfers to/from the plan2013-12-31$0
Total plan liabilities at end of year2013-12-31$0
Total plan liabilities at beginning of year2013-12-31$0
Total income from all sources2013-12-31$1,780,113
Expenses. Total of all expenses incurred2013-12-31$53,673
Benefits paid (including direct rollovers)2013-12-31$0
Total plan assets at end of year2013-12-31$11,917,535
Total plan assets at beginning of year2013-12-31$10,191,095
Value of fidelity bond covering the plan2013-12-31$500,000
Total contributions received or receivable from participants2013-12-31$121,726
Assets. Value of loans (other than to participants)2013-12-31$37,840
Expenses. Other expenses not covered elsewhere2013-12-31$15,927
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$1,238,185
Noncash contributions received2013-12-31$0
Net income (gross income less expenses)2013-12-31$1,726,440
Net plan assets at end of year (total assets less liabilities)2013-12-31$11,917,535
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$10,191,095
Assets. Value of assets in partnership/joint-venture interests2013-12-31$3
Total contributions received or receivable from employer(s)2013-12-31$420,202
Value of certain deemed distributions of participant loans2013-12-31$0
Value of corrective distributions2013-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$37,746
2012 : INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN 2012 401k financial data
Transfers to/from the plan2012-12-31$0
Total plan liabilities at end of year2012-12-31$0
Total plan liabilities at beginning of year2012-12-31$0
Total income from all sources2012-12-31$1,253,458
Expenses. Total of all expenses incurred2012-12-31$1,254,821
Benefits paid (including direct rollovers)2012-12-31$1,218,116
Total plan assets at end of year2012-12-31$10,191,095
Total plan assets at beginning of year2012-12-31$10,192,458
Value of fidelity bond covering the plan2012-12-31$500,000
Total contributions received or receivable from participants2012-12-31$139,036
Assets. Value of loans (other than to participants)2012-12-31$37,840
Expenses. Other expenses not covered elsewhere2012-12-31$0
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$736,169
Noncash contributions received2012-12-31$0
Net income (gross income less expenses)2012-12-31$-1,363
Net plan assets at end of year (total assets less liabilities)2012-12-31$10,191,095
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$10,192,458
Assets. Value of assets in partnership/joint-venture interests2012-12-31$42,102
Total contributions received or receivable from employer(s)2012-12-31$378,253
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$36,705
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN 2011 401k financial data
Total plan liabilities at end of year2011-12-31$0
Total plan liabilities at beginning of year2011-12-31$0
Total income from all sources2011-12-31$438,769
Expenses. Total of all expenses incurred2011-12-31$167,945
Benefits paid (including direct rollovers)2011-12-31$122,333
Total plan assets at end of year2011-12-31$10,192,458
Total plan assets at beginning of year2011-12-31$9,921,634
Value of fidelity bond covering the plan2011-12-31$500,000
Total contributions received or receivable from participants2011-12-31$109,661
Assets. Value of loans (other than to participants)2011-12-31$31,840
Expenses. Other expenses not covered elsewhere2011-12-31$16,383
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-120,108
Noncash contributions received2011-12-31$0
Net income (gross income less expenses)2011-12-31$270,824
Net plan assets at end of year (total assets less liabilities)2011-12-31$10,192,458
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$9,921,634
Assets. Value of assets in partnership/joint-venture interests2011-12-31$84,204
Total contributions received or receivable from employer(s)2011-12-31$449,216
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$29,229
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN 2010 401k financial data
Transfers to/from the plan2010-12-31$0
Total plan liabilities at end of year2010-12-31$0
Total plan liabilities at beginning of year2010-12-31$0
Total income from all sources2010-12-31$1,556,688
Expenses. Total of all expenses incurred2010-12-31$55,315
Benefits paid (including direct rollovers)2010-12-31$16,004
Total plan assets at end of year2010-12-31$9,921,634
Total plan assets at beginning of year2010-12-31$8,420,261
Value of fidelity bond covering the plan2010-12-31$500,000
Total contributions received or receivable from participants2010-12-31$117,237
Assets. Value of loans (other than to participants)2010-12-31$79,840
Expenses. Other expenses not covered elsewhere2010-12-31$16,383
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$960,381
Noncash contributions received2010-12-31$0
Net income (gross income less expenses)2010-12-31$1,501,373
Net plan assets at end of year (total assets less liabilities)2010-12-31$9,921,634
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$8,420,261
Assets. Value of participant loans2010-12-31$1,420
Assets. Value of assets in partnership/joint-venture interests2010-12-31$84,204
Total contributions received or receivable from employer(s)2010-12-31$479,070
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$22,928
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
2009 : INTERCOMMUNITY EMERGENCY MEDICAL GROUP 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 INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN

2022: INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K 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: INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K 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: INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K 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: INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K 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: INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K 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: INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K 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: INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K 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 – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2014: INTERCOMMUNITY EMERGENCY MEDICAL GROUP 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 – TrustYes
2014-01-01Plan benefit arrangement - TrustYes
2013: INTERCOMMUNITY EMERGENCY MEDICAL GROUP 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 – TrustYes
2013-01-01Plan benefit arrangement - TrustYes
2012: INTERCOMMUNITY EMERGENCY MEDICAL GROUP 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 – TrustYes
2012-01-01Plan benefit arrangement - TrustYes
2011: INTERCOMMUNITY EMERGENCY MEDICAL GROUP 401K PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
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 – TrustYes
2011-01-01Plan benefit arrangement - TrustYes
2009: INTERCOMMUNITY EMERGENCY MEDICAL GROUP 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

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number81D816
Policy instance 1
Insurance contract or identification number81D816
Number of Individuals Covered44
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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?Yes
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
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number81D816
Policy instance 1
Insurance contract or identification number81D816
Number of Individuals Covered50
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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?Yes
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
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number81D816
Policy instance 1
Insurance contract or identification number81D816
Number of Individuals Covered45
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 $20,429
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?Yes
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
Amount paid for insurance broker fees20429
Additional information about fees paid to insurance brokerEXPENSES
Insurance broker organization code?5
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number81D816
Policy instance 1
Insurance contract or identification number81D816
Number of Individuals Covered42
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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?Yes
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 (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number10975
Policy instance 1
Insurance contract or identification number10975
Number of Individuals Covered38
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $12,438
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 $10,660
Insurance broker organization code?3
Insurance broker nameGOLDBERG SWEDELSON & ASSOCIATES INC
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number43199
Policy instance 1
Insurance contract or identification number43199
Number of Individuals Covered1
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
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 (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number10975
Policy instance 2
Insurance contract or identification number10975
Number of Individuals Covered29
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $7,021
Total amount of fees paid to insurance companyUSD $1,346
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 $7,021
Insurance broker organization code?3
Amount paid for insurance broker fees1346
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker nameGOLDBERG SWEDELSON & ASSOCIATES INC
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number43199
Policy instance 1
Insurance contract or identification number43199
Number of Individuals Covered1
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
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 (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number10975
Policy instance 2
Insurance contract or identification number10975
Number of Individuals Covered27
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $5,580
Total amount of fees paid to insurance companyUSD $889
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 $5,580
Insurance broker organization code?3
Amount paid for insurance broker fees889
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker nameGOLDBERG SWEDELSON & ASSOCIATES INC
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number43199
Policy instance 1
Insurance contract or identification number43199
Number of Individuals Covered22
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 $707
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 $0
Amount paid for insurance broker fees707
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker organization code?5
Insurance broker nameGOLDBERG SWEDELSON & ASSOCIATES, IN
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number43199
Policy instance 2
Insurance contract or identification number43199
Number of Individuals Covered1
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
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 (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number10975
Policy instance 1
Insurance contract or identification number10975
Number of Individuals Covered21
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $4,004
Total amount of fees paid to insurance companyUSD $1,109
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?Yes
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
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number43199
Policy instance 2
Insurance contract or identification number43199
Number of Individuals Covered1
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
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 (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number10975
Policy instance 1
Insurance contract or identification number10975
Number of Individuals Covered21
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $3,228
Total amount of fees paid to insurance companyUSD $432
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?Yes
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 $3,228
Insurance broker organization code?3
Amount paid for insurance broker fees432
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker nameLIDEN, MORTON, NESTLE & SOLED, INC.

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