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HVAC SERVICES, INC. EMPLOYEE STOCK OWNERSHIP PLAN 401k Plan overview

Plan NameHVAC SERVICES, INC. EMPLOYEE STOCK OWNERSHIP PLAN
Plan identification number 002

HVAC SERVICES, INC. EMPLOYEE STOCK OWNERSHIP PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Stock bonus
  • 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.
  • Leveraged ESOP - An ESOP that acquires employer securities with borrowed money or other debt-financing techniques. A completed Schedule E must be attached to a Form 5500 filed for an ESOP.
  • The employer maintaining this ESOP is an S Corporation
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Plan requiring that all or part of employer contributions be invested and held, at least for a limited period, in employer securities.

401k Sponsoring company profile

HVAC SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name:HVAC SERVICES, INC.
Employer identification number (EIN):010451459
NAIC Classification:238220
NAIC Description:Plumbing, Heating, and Air-Conditioning Contractors

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HVAC SERVICES, INC. EMPLOYEE STOCK OWNERSHIP PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022023-01-01
0022022-01-01
0022021-01-01
0022020-01-01
0022019-01-01
0022018-01-01
0022018-01-01
0022017-01-01SUSAN BURGESS

Plan Statistics for HVAC SERVICES, INC. EMPLOYEE STOCK OWNERSHIP PLAN

401k plan membership statisitcs for HVAC SERVICES, INC. EMPLOYEE STOCK OWNERSHIP PLAN

Measure Date Value
2023: HVAC SERVICES, INC. EMPLOYEE STOCK OWNERSHIP PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-0150
Total number of active participants reported on line 7a of the Form 55002023-01-0141
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-0112
Total of all active and inactive participants2023-01-0153
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2023-01-010
Total participants2023-01-0153
Number of participants with account balances2023-01-0153
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2023-01-015
2022: HVAC SERVICES, INC. EMPLOYEE STOCK OWNERSHIP PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0147
Total number of active participants reported on line 7a of the Form 55002022-01-0138
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0111
Total of all active and inactive participants2022-01-0149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-0149
Number of participants with account balances2022-01-0149
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-013
2021: HVAC SERVICES, INC. EMPLOYEE STOCK OWNERSHIP PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0149
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 benefits2021-01-017
Total of all active and inactive participants2021-01-0147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-0147
Number of participants with account balances2021-01-0147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-013
2020: HVAC SERVICES, INC. EMPLOYEE STOCK OWNERSHIP PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0146
Total number of active participants reported on line 7a of the Form 55002020-01-0140
Number of retired or separated participants receiving benefits2020-01-011
Number of other retired or separated participants entitled to future benefits2020-01-019
Total of all active and inactive participants2020-01-0150
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-0150
Number of participants with account balances2020-01-0150
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-013
2019: HVAC SERVICES, INC. EMPLOYEE STOCK OWNERSHIP PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0148
Total number of active participants reported on line 7a of the Form 55002019-01-0141
Number of retired or separated participants receiving benefits2019-01-011
Number of other retired or separated participants entitled to future benefits2019-01-014
Total of all active and inactive participants2019-01-0146
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0146
Number of participants with account balances2019-01-0146
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-012
2018: HVAC SERVICES, INC. EMPLOYEE STOCK OWNERSHIP PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0141
Total number of active participants reported on line 7a of the Form 55002018-01-0140
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-0140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0140
Number of participants with account balances2018-01-0138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: HVAC SERVICES, INC. EMPLOYEE STOCK OWNERSHIP PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-010
Total number of active participants reported on line 7a of the Form 55002017-01-0141
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-0141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0141
Number of participants with account balances2017-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010

Financial Data on HVAC SERVICES, INC. EMPLOYEE STOCK OWNERSHIP PLAN

Measure Date Value
2023 : HVAC SERVICES, INC. EMPLOYEE STOCK OWNERSHIP PLAN 2023 401k financial data
Total plan liabilities at end of year2023-12-31$9,301
Total plan liabilities at beginning of year2023-12-31$9,429
Total income from all sources2023-12-31$3,210,933
Expenses. Total of all expenses incurred2023-12-31$289,220
Benefits paid (including direct rollovers)2023-12-31$259,135
Total plan assets at end of year2023-12-31$17,435,352
Total plan assets at beginning of year2023-12-31$14,513,767
Value of fidelity bond covering the plan2023-12-31$1,000,000
Total contributions received or receivable from participants2023-12-31$247,933
Expenses. Other expenses not covered elsewhere2023-12-31$377
Contributions received from other sources (not participants or employers)2023-12-31$5,236
Other income received2023-12-31$2,843,097
Net income (gross income less expenses)2023-12-31$2,921,713
Net plan assets at end of year (total assets less liabilities)2023-12-31$17,426,051
Net plan assets at beginning of year (total assets less liabilities)2023-12-31$14,504,338
Assets. Value of participant loans2023-12-31$2,286
Assets. Value of employer securities2023-12-31$6,066,639
Total contributions received or receivable from employer(s)2023-12-31$114,667
Expenses. Administrative service providers (salaries,fees and commissions)2023-12-31$29,708
2022 : HVAC SERVICES, INC. EMPLOYEE STOCK OWNERSHIP PLAN 2022 401k financial data
Total plan liabilities at end of year2022-12-31$9,429
Total plan liabilities at beginning of year2022-12-31$9,552
Total income from all sources2022-12-31$-1,361,372
Expenses. Total of all expenses incurred2022-12-31$222,163
Benefits paid (including direct rollovers)2022-12-31$192,773
Total plan assets at end of year2022-12-31$14,513,767
Total plan assets at beginning of year2022-12-31$16,097,425
Value of fidelity bond covering the plan2022-12-31$500,000
Total contributions received or receivable from participants2022-12-31$222,565
Expenses. Other expenses not covered elsewhere2022-12-31$382
Contributions received from other sources (not participants or employers)2022-12-31$23,592
Other income received2022-12-31$-1,702,560
Net income (gross income less expenses)2022-12-31$-1,583,535
Net plan assets at end of year (total assets less liabilities)2022-12-31$14,504,338
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$16,087,873
Assets. Value of participant loans2022-12-31$6,786
Assets. Value of employer securities2022-12-31$4,545,416
Total contributions received or receivable from employer(s)2022-12-31$95,031
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$29,008
2021 : HVAC SERVICES, INC. EMPLOYEE STOCK OWNERSHIP PLAN 2021 401k financial data
Total plan liabilities at end of year2021-12-31$9,552
Total plan liabilities at beginning of year2021-12-31$9,671
Total income from all sources2021-12-31$3,044,220
Expenses. Total of all expenses incurred2021-12-31$188,163
Benefits paid (including direct rollovers)2021-12-31$155,785
Total plan assets at end of year2021-12-31$16,097,425
Total plan assets at beginning of year2021-12-31$13,241,487
Value of fidelity bond covering the plan2021-12-31$500,000
Total contributions received or receivable from participants2021-12-31$235,435
Expenses. Other expenses not covered elsewhere2021-12-31$386
Other income received2021-12-31$2,695,894
Net income (gross income less expenses)2021-12-31$2,856,057
Net plan assets at end of year (total assets less liabilities)2021-12-31$16,087,873
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$13,231,816
Assets. Value of participant loans2021-12-31$22,088
Assets. Value of employer securities2021-12-31$4,623,502
Total contributions received or receivable from employer(s)2021-12-31$112,891
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$31,992
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$34,007
2020 : HVAC SERVICES, INC. EMPLOYEE STOCK OWNERSHIP PLAN 2020 401k financial data
Total plan liabilities at end of year2020-12-31$9,671
Total plan liabilities at beginning of year2020-12-31$9,784
Total income from all sources2020-12-31$2,623,840
Expenses. Total of all expenses incurred2020-12-31$536,574
Benefits paid (including direct rollovers)2020-12-31$506,121
Total plan assets at end of year2020-12-31$13,241,487
Total plan assets at beginning of year2020-12-31$11,154,334
Value of fidelity bond covering the plan2020-12-31$500,000
Total contributions received or receivable from participants2020-12-31$226,067
Expenses. Other expenses not covered elsewhere2020-12-31$392
Other income received2020-12-31$2,286,997
Net income (gross income less expenses)2020-12-31$2,087,266
Net plan assets at end of year (total assets less liabilities)2020-12-31$13,231,816
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$11,144,550
Assets. Value of participant loans2020-12-31$37,257
Assets. Value of employer securities2020-12-31$3,276,000
Total contributions received or receivable from employer(s)2020-12-31$110,776
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$30,061
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
2019 : HVAC SERVICES, INC. EMPLOYEE STOCK OWNERSHIP PLAN 2019 401k financial data
Transfers to/from the plan2019-12-31$8,818,334
Total plan liabilities at end of year2019-12-31$9,784
Total plan liabilities at beginning of year2019-12-31$10,407
Total income from all sources2019-12-31$856,506
Expenses. Total of all expenses incurred2019-12-31$396
Total plan assets at end of year2019-12-31$11,154,334
Total plan assets at beginning of year2019-12-31$1,480,513
Value of fidelity bond covering the plan2019-12-31$500,000
Expenses. Other expenses not covered elsewhere2019-12-31$396
Other income received2019-12-31$856,000
Net income (gross income less expenses)2019-12-31$856,110
Net plan assets at end of year (total assets less liabilities)2019-12-31$11,144,550
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$1,470,106
Assets. Value of employer securities2019-12-31$2,336,000
Total contributions received or receivable from employer(s)2019-12-31$506
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
2018 : HVAC SERVICES, INC. EMPLOYEE STOCK OWNERSHIP PLAN 2018 401k financial data
Total plan liabilities at end of year2018-12-31$10,407
Total plan liabilities at beginning of year2018-12-31$10,000
Total income from all sources2018-12-31$3,690,513
Expenses. Total of all expenses incurred2018-12-31$407
Total plan assets at end of year2018-12-31$3,700,513
Total plan assets at beginning of year2018-12-31$10,000
Value of fidelity bond covering the plan2018-12-31$500,000
Expenses. Other expenses not covered elsewhere2018-12-31$407
Other income received2018-12-31$3,690,000
Net income (gross income less expenses)2018-12-31$3,690,106
Net plan assets at end of year (total assets less liabilities)2018-12-31$3,690,106
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$0
Assets. Value of employer securities2018-12-31$3,700,000
Total contributions received or receivable from employer(s)2018-12-31$513
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
2017 : HVAC SERVICES, INC. EMPLOYEE STOCK OWNERSHIP PLAN 2017 401k financial data
Total plan liabilities at end of year2017-12-31$10,000
Total plan liabilities at beginning of year2017-12-31$0
Total income from all sources2017-12-31$0
Expenses. Total of all expenses incurred2017-12-31$0
Total plan assets at end of year2017-12-31$10,000
Total plan assets at beginning of year2017-12-31$0
Value of fidelity bond covering the plan2017-12-31$500,000
Net income (gross income less expenses)2017-12-31$0
Net plan assets at end of year (total assets less liabilities)2017-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$0
Assets. Value of employer securities2017-12-31$10,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0

Form 5500 Responses for HVAC SERVICES, INC. EMPLOYEE STOCK OWNERSHIP PLAN

2023: HVAC SERVICES, INC. EMPLOYEE STOCK OWNERSHIP PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan benefit arrangement - TrustYes
2022: HVAC SERVICES, INC. EMPLOYEE STOCK OWNERSHIP 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 – TrustYes
2022-01-01Plan benefit arrangement - TrustYes
2021: HVAC SERVICES, INC. EMPLOYEE STOCK OWNERSHIP 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 – TrustYes
2021-01-01Plan benefit arrangement - TrustYes
2020: HVAC SERVICES, INC. EMPLOYEE STOCK OWNERSHIP 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 – TrustYes
2020-01-01Plan benefit arrangement - TrustYes
2019: HVAC SERVICES, INC. EMPLOYEE STOCK OWNERSHIP 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 – TrustYes
2019-01-01Plan benefit arrangement - TrustYes
2018: HVAC SERVICES, INC. EMPLOYEE STOCK OWNERSHIP 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 – TrustYes
2018-01-01Plan benefit arrangement - TrustYes
2017: HVAC SERVICES, INC. EMPLOYEE STOCK OWNERSHIP PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01First time form 5500 has been submittedYes
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 – TrustYes
2017-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number334402-01
Policy instance 1
Insurance contract or identification number334402-01
Number of Individuals Covered17
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
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
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberN/A
Policy instance 2
Insurance contract or identification numberN/A
Number of Individuals Covered1
Insurance policy start date2022-12-25
Insurance policy end date2023-12-24
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
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number334402-01
Policy instance 1
Insurance contract or identification number334402-01
Number of Individuals Covered14
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
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number334402-01
Policy instance 1
Insurance contract or identification number334402-01
Number of Individuals Covered15
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
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number334402-01
Policy instance 1
Insurance contract or identification number334402-01
Number of Individuals Covered14
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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

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