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DOCTORS MED PLUS MEDICAL CENTER 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan NameDOCTORS MED PLUS MEDICAL CENTER 401(K) PROFIT SHARING PLAN
Plan identification number 002

DOCTORS MED PLUS MEDICAL CENTER 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

LAWRENCE H. NEWMAN, M.D. A MEDICAL CORP. DBA DOCTORS MED PLUS MED CNTR has sponsored the creation of one or more 401k plans.

Company Name:LAWRENCE H. NEWMAN, M.D. A MEDICAL CORP. DBA DOCTORS MED PLUS MED CNTR
Employer identification number (EIN):953498305
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DOCTORS MED PLUS MEDICAL CENTER 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022018-01-01
0022017-01-01
0022016-01-01
0022015-01-01
0022014-01-01
0022013-01-01LAWRENCE H. NEWMAN, M.D.
0022012-01-01LAWRENCE H. NEWMAN, M.D.
0022011-01-01LAWRENCE H. NEWMAN, M.D.
0022009-01-01DOUGLAS S. HENDRY

Plan Statistics for DOCTORS MED PLUS MEDICAL CENTER 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for DOCTORS MED PLUS MEDICAL CENTER 401(K) PROFIT SHARING PLAN

Measure Date Value
2016: DOCTORS MED PLUS MEDICAL CENTER 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0122
Total number of active participants reported on line 7a of the Form 55002016-01-010
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0121
Total of all active and inactive participants2016-01-0121
Total participants2016-01-0121
Number of participants with account balances2016-01-0121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: DOCTORS MED PLUS MEDICAL CENTER 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0116
Total number of active participants reported on line 7a of the Form 55002015-01-0117
Number of retired or separated participants receiving benefits2015-01-011
Number of other retired or separated participants entitled to future benefits2015-01-014
Total of all active and inactive participants2015-01-0122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0122
Number of participants with account balances2015-01-0122
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: DOCTORS MED PLUS MEDICAL CENTER 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0119
Total number of active participants reported on line 7a of the Form 55002014-01-0113
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-013
Total of all active and inactive participants2014-01-0116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0116
Number of participants with account balances2014-01-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: DOCTORS MED PLUS MEDICAL CENTER 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0120
Total number of active participants reported on line 7a of the Form 55002013-01-0112
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-017
Total of all active and inactive participants2013-01-0119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0119
Number of participants with account balances2013-01-0119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: DOCTORS MED PLUS MEDICAL CENTER 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0122
Total number of active participants reported on line 7a of the Form 55002012-01-0116
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-014
Total of all active and inactive participants2012-01-0120
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0120
Number of participants with account balances2012-01-0120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: DOCTORS MED PLUS MEDICAL CENTER 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0115
Total number of active participants reported on line 7a of the Form 55002011-01-0115
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 participants2011-01-0119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0119
Number of participants with account balances2011-01-0119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: DOCTORS MED PLUS MEDICAL CENTER 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0117
Total number of active participants reported on line 7a of the Form 55002009-01-0110
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-012
Total of all active and inactive participants2009-01-0112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0112
Number of participants with account balances2009-01-0112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on DOCTORS MED PLUS MEDICAL CENTER 401(K) PROFIT SHARING PLAN

Measure Date Value
2016 : DOCTORS MED PLUS MEDICAL CENTER 401(K) PROFIT SHARING PLAN 2016 401k financial data
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$182,363
Expenses. Total of all expenses incurred2016-12-31$153,815
Benefits paid (including direct rollovers)2016-12-31$147,275
Total plan assets at end of year2016-12-31$1,361,723
Total plan assets at beginning of year2016-12-31$1,333,175
Value of fidelity bond covering the plan2016-12-31$125,000
Total contributions received or receivable from participants2016-12-31$67,286
Expenses. Other expenses not covered elsewhere2016-12-31$150
Other income received2016-12-31$92,265
Net income (gross income less expenses)2016-12-31$28,548
Net plan assets at end of year (total assets less liabilities)2016-12-31$1,361,723
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$1,333,175
Total contributions received or receivable from employer(s)2016-12-31$22,812
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$6,390
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : DOCTORS MED PLUS MEDICAL CENTER 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total plan liabilities at end of year2015-12-31$0
Total plan liabilities at beginning of year2015-12-31$0
Total income from all sources2015-12-31$101,962
Expenses. Total of all expenses incurred2015-12-31$9,854
Benefits paid (including direct rollovers)2015-12-31$3,248
Total plan assets at end of year2015-12-31$1,333,175
Total plan assets at beginning of year2015-12-31$1,241,067
Value of fidelity bond covering the plan2015-12-31$125,000
Total contributions received or receivable from participants2015-12-31$85,767
Expenses. Other expenses not covered elsewhere2015-12-31$158
Other income received2015-12-31$-22,711
Net income (gross income less expenses)2015-12-31$92,108
Net plan assets at end of year (total assets less liabilities)2015-12-31$1,333,175
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$1,241,067
Total contributions received or receivable from employer(s)2015-12-31$38,906
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$6,448
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : DOCTORS MED PLUS MEDICAL CENTER 401(K) PROFIT SHARING PLAN 2014 401k financial data
Total plan liabilities at end of year2014-12-31$0
Total plan liabilities at beginning of year2014-12-31$1,000
Total income from all sources2014-12-31$153,945
Expenses. Total of all expenses incurred2014-12-31$27,906
Benefits paid (including direct rollovers)2014-12-31$21,568
Total plan assets at end of year2014-12-31$1,241,067
Total plan assets at beginning of year2014-12-31$1,116,028
Value of fidelity bond covering the plan2014-12-31$125,000
Total contributions received or receivable from participants2014-12-31$75,700
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$48,157
Noncash contributions received2014-12-31$0
Net income (gross income less expenses)2014-12-31$126,039
Net plan assets at end of year (total assets less liabilities)2014-12-31$1,241,067
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$1,115,028
Total contributions received or receivable from employer(s)2014-12-31$30,088
Value of certain deemed distributions of participant loans2014-12-31$0
Value of corrective distributions2014-12-31$166
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$6,172
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : DOCTORS MED PLUS MEDICAL CENTER 401(K) PROFIT SHARING PLAN 2013 401k financial data
Transfers to/from the plan2013-12-31$0
Total plan liabilities at end of year2013-12-31$1,000
Total plan liabilities at beginning of year2013-12-31$0
Total income from all sources2013-12-31$283,819
Expenses. Total of all expenses incurred2013-12-31$11,767
Benefits paid (including direct rollovers)2013-12-31$5,056
Total plan assets at end of year2013-12-31$1,116,028
Total plan assets at beginning of year2013-12-31$842,976
Value of fidelity bond covering the plan2013-12-31$55,000
Total contributions received or receivable from participants2013-12-31$78,896
Expenses. Other expenses not covered elsewhere2013-12-31$5,711
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$170,501
Noncash contributions received2013-12-31$0
Net income (gross income less expenses)2013-12-31$272,052
Net plan assets at end of year (total assets less liabilities)2013-12-31$1,115,028
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$842,976
Assets. Value of participant loans2013-12-31$0
Total contributions received or receivable from employer(s)2013-12-31$34,422
Value of certain deemed distributions of participant loans2013-12-31$0
Value of corrective distributions2013-12-31$1,000
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : DOCTORS MED PLUS MEDICAL CENTER 401(K) 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$202,923
Expenses. Total of all expenses incurred2012-12-31$14,152
Benefits paid (including direct rollovers)2012-12-31$7,026
Total plan assets at end of year2012-12-31$842,976
Total plan assets at beginning of year2012-12-31$654,205
Value of fidelity bond covering the plan2012-12-31$55,000
Total contributions received or receivable from participants2012-12-31$76,948
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$92,117
Noncash contributions received2012-12-31$0
Net income (gross income less expenses)2012-12-31$188,771
Net plan assets at end of year (total assets less liabilities)2012-12-31$842,976
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$654,205
Assets. Value of participant loans2012-12-31$1,042
Total contributions received or receivable from employer(s)2012-12-31$33,858
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$7,126
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : DOCTORS MED PLUS MEDICAL CENTER 401(K) PROFIT SHARING PLAN 2011 401k financial data
Transfers to/from the plan2011-12-31$0
Total plan liabilities at end of year2011-12-31$0
Total plan liabilities at beginning of year2011-12-31$135
Total income from all sources2011-12-31$72,866
Expenses. Total of all expenses incurred2011-12-31$12,233
Benefits paid (including direct rollovers)2011-12-31$3,408
Total plan assets at end of year2011-12-31$654,205
Total plan assets at beginning of year2011-12-31$593,707
Value of fidelity bond covering the plan2011-12-31$55,000
Total contributions received or receivable from participants2011-12-31$66,175
Expenses. Other expenses not covered elsewhere2011-12-31$8,825
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-20,290
Noncash contributions received2011-12-31$0
Net income (gross income less expenses)2011-12-31$60,633
Net plan assets at end of year (total assets less liabilities)2011-12-31$654,205
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$593,572
Assets. Value of participant loans2011-12-31$12,924
Total contributions received or receivable from employer(s)2011-12-31$26,981
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$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : DOCTORS MED PLUS MEDICAL CENTER 401(K) PROFIT SHARING PLAN 2010 401k financial data
Transfers to/from the plan2010-12-31$0
Total plan liabilities at end of year2010-12-31$135
Total plan liabilities at beginning of year2010-12-31$1,214
Total income from all sources2010-12-31$143,434
Expenses. Total of all expenses incurred2010-12-31$11,774
Benefits paid (including direct rollovers)2010-12-31$5,033
Total plan assets at end of year2010-12-31$593,707
Total plan assets at beginning of year2010-12-31$463,126
Value of fidelity bond covering the plan2010-12-31$55,000
Total contributions received or receivable from participants2010-12-31$56,885
Expenses. Other expenses not covered elsewhere2010-12-31$6,741
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$58,391
Noncash contributions received2010-12-31$0
Net income (gross income less expenses)2010-12-31$131,660
Net plan assets at end of year (total assets less liabilities)2010-12-31$593,572
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$461,912
Assets. Value of participant loans2010-12-31$22,871
Total contributions received or receivable from employer(s)2010-12-31$28,158
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$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
2009 : DOCTORS MED PLUS MEDICAL CENTER 401(K) 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 DOCTORS MED PLUS MEDICAL CENTER 401(K) PROFIT SHARING PLAN

2016: DOCTORS MED PLUS MEDICAL CENTER 401(K) PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: DOCTORS MED PLUS MEDICAL CENTER 401(K) PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: DOCTORS MED PLUS MEDICAL CENTER 401(K) PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: DOCTORS MED PLUS MEDICAL CENTER 401(K) PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: DOCTORS MED PLUS MEDICAL CENTER 401(K) PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: DOCTORS MED PLUS MEDICAL CENTER 401(K) 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 – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: DOCTORS MED PLUS MEDICAL CENTER 401(K) PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number39885
Policy instance 1
Insurance contract or identification number39885
Number of Individuals Covered20
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
Total amount of commissions paid to insurance brokerUSD $7,378
Total amount of fees paid to insurance companyUSD $677
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,378
Insurance broker organization code?3
Amount paid for insurance broker fees677
Insurance broker namePENSYS, INC.
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number39885
Policy instance 1
Insurance contract or identification number39885
Number of Individuals Covered20
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $7,365
Total amount of fees paid to insurance companyUSD $249
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,365
Insurance broker organization code?3
Amount paid for insurance broker fees249
Insurance broker namePENSYS, INC.
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number39885
Policy instance 1
Insurance contract or identification number39885
Number of Individuals Covered14
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $6,563
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,563
Insurance broker organization code?3
Insurance broker nameLPL FINANCIAL CORPORATION
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number39885
Policy instance 1
Insurance contract or identification number39885
Number of Individuals Covered17
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $5,175
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?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 $5,175
Insurance broker organization code?3
Insurance broker nameLPL FINANCIAL CORPORATION
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number39885
Policy instance 1
Insurance contract or identification number39885
Number of Individuals Covered18
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $4,614
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?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 $4,614
Insurance broker organization code?3
Insurance broker nameLPL FINANCIAL CORPORATION
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number39885
Policy instance 1
Insurance contract or identification number39885
Number of Individuals Covered16
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $4,542
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?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
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number39885
Policy instance 1
Insurance contract or identification number39885
Number of Individuals Covered13
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $3,234
Total amount of fees paid to insurance companyUSD $276
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
Commission paid to Insurance BrokerUSD $3,234
Insurance broker organization code?3
Amount paid for insurance broker fees276
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker nameSAN LUIS PENSION CONSULTANTS, INC.

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