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ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 401k Plan overview

Plan NameADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN
Plan identification number 001

ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • 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.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

ADELPHOI USA, INC. has sponsored the creation of one or more 401k plans.

Company Name:ADELPHOI USA, INC.
Employer identification number (EIN):237170997
NAIC Classification:624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01
0012017-01-01GARY GRUSKA
0012016-01-01GARY GRUSKA
0012015-01-01GARY GRUSKA
0012014-01-01GARY GRUSKA GARY GRUSKA2015-04-11
0012014-01-01GARY GRUSKA
0012013-01-01GARY GRUSKA GARY GRUSKA2014-07-22
0012012-01-01GARY GRUSKA GARY GRUSKA2013-07-29
0012011-01-01LISA DYSERT LISA DYSERT2012-07-26
0012010-01-01WALLACE PERKINS WALLACE PERKINS2011-07-13
0012009-01-01WALLACE R PERKINS WALLACE R PERKINS2010-07-06

Plan Statistics for ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN

401k plan membership statisitcs for ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN

Measure Date Value
2022: ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-011,099
Total number of active participants reported on line 7a of the Form 55002022-01-01628
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-01566
Total of all active and inactive participants2022-01-011,194
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-011,194
Number of participants with account balances2022-01-011,143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-01124
2021: ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-011,122
Total number of active participants reported on line 7a of the Form 55002021-01-01632
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-01467
Total of all active and inactive participants2021-01-011,099
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-011,099
Number of participants with account balances2021-01-011,050
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-01113
2020: ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-011,039
Total number of active participants reported on line 7a of the Form 55002020-01-01642
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-01480
Total of all active and inactive participants2020-01-011,122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-011,122
Number of participants with account balances2020-01-011,067
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-01117
2019: ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-011,110
Total number of active participants reported on line 7a of the Form 55002019-01-01676
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-01353
Total of all active and inactive participants2019-01-011,029
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-011
Total participants2019-01-011,030
Number of participants with account balances2019-01-01982
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-01168
2018: ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-011,083
Total number of active participants reported on line 7a of the Form 55002018-01-01680
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-01425
Total of all active and inactive participants2018-01-011,105
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-011
Total participants2018-01-011,106
Number of participants with account balances2018-01-011,051
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-01162
2017: ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01901
Total number of active participants reported on line 7a of the Form 55002017-01-01667
Number of retired or separated participants receiving benefits2017-01-012
Number of other retired or separated participants entitled to future benefits2017-01-01328
Total of all active and inactive participants2017-01-01997
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01997
Number of participants with account balances2017-01-01928
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-0182
2016: ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01841
Total number of active participants reported on line 7a of the Form 55002016-01-01709
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-01225
Total of all active and inactive participants2016-01-01934
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01934
Number of participants with account balances2016-01-01814
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-0188
2015: ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01736
Total number of active participants reported on line 7a of the Form 55002015-01-01684
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-01133
Total of all active and inactive participants2015-01-01817
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01817
Number of participants with account balances2015-01-01594
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-0135
2014: ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01274
Total number of active participants reported on line 7a of the Form 55002014-01-010
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-010
Number of participants with account balances2014-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01584
Total number of active participants reported on line 7a of the Form 55002013-01-01599
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0169
Total of all active and inactive participants2013-01-01668
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01668
Number of participants with account balances2013-01-01495
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-0183
2012: ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01630
Total number of active participants reported on line 7a of the Form 55002012-01-01575
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0159
Total of all active and inactive participants2012-01-01634
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01634
Number of participants with account balances2012-01-01475
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-0140
2011: ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01606
Total number of active participants reported on line 7a of the Form 55002011-01-01592
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-0151
Total of all active and inactive participants2011-01-01643
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01643
Number of participants with account balances2011-01-01492
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01736
Total number of active participants reported on line 7a of the Form 55002010-01-01565
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-0156
Total of all active and inactive participants2010-01-01621
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-01621
Number of participants with account balances2010-01-01463
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-01102
2009: ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01726
Total number of active participants reported on line 7a of the Form 55002009-01-01663
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-01146
Total of all active and inactive participants2009-01-01809
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01809
Number of participants with account balances2009-01-01522
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-0178

Financial Data on ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN

Measure Date Value
2022 : ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$-1,816,934
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$2,004,996
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$1,894,556
Expenses. Certain deemed distributions of participant loans2022-12-31$6,957
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$2,180,503
Value of total assets at end of year2022-12-31$22,364,042
Value of total assets at beginning of year2022-12-31$26,185,972
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$103,483
Total interest from all sources2022-12-31$15,152
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$835,467
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$835,467
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$1,636,215
Participant contributions at end of year2022-12-31$294,020
Participant contributions at beginning of year2022-12-31$257,291
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$74,458
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-3,821,930
Value of net assets at end of year (total assets less liabilities)2022-12-31$22,364,042
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$26,185,972
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$21,220,552
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$25,022,487
Interest on participant loans2022-12-31$15,152
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$849,470
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$906,194
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-4,848,056
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$469,830
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$1,894,556
Contract administrator fees2022-12-31$103,483
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31BAKER TILLY US, LLP
Accountancy firm EIN2022-12-31390859910
2021 : ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$191
Total income from all sources (including contributions)2021-12-31$5,044,376
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$1,588,284
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$1,490,941
Expenses. Certain deemed distributions of participant loans2021-12-31$417
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$2,111,227
Value of total assets at end of year2021-12-31$26,185,972
Value of total assets at beginning of year2021-12-31$22,730,071
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$96,926
Total interest from all sources2021-12-31$16,622
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$600,052
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$600,052
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$1,500,366
Participant contributions at end of year2021-12-31$257,291
Participant contributions at beginning of year2021-12-31$260,856
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$190,343
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$191
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$3,456,092
Value of net assets at end of year (total assets less liabilities)2021-12-31$26,185,972
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$22,729,880
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$25,022,487
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$21,461,317
Interest on participant loans2021-12-31$16,622
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$906,194
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$1,007,898
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$2,316,475
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$420,518
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$1,490,941
Contract administrator fees2021-12-31$96,926
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31BAKER TILLY US, LLP
Accountancy firm EIN2021-12-31390859910
2020 : ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$191
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$4,739,551
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$1,090,957
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$1,003,479
Expenses. Certain deemed distributions of participant loans2020-12-31$11,083
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$1,992,935
Value of total assets at end of year2020-12-31$22,730,071
Value of total assets at beginning of year2020-12-31$19,081,286
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$76,395
Total interest from all sources2020-12-31$18,038
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$570,427
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$570,427
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$1,000,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$1,470,701
Participant contributions at end of year2020-12-31$260,856
Participant contributions at beginning of year2020-12-31$341,876
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$132,061
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$191
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$0
Administrative expenses (other) incurred2020-12-31$16,483
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$3,648,594
Value of net assets at end of year (total assets less liabilities)2020-12-31$22,729,880
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$19,081,286
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$21,461,317
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$17,933,751
Interest on participant loans2020-12-31$18,038
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$1,007,898
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$805,659
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$2,158,151
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$390,173
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$1,003,479
Contract administrator fees2020-12-31$59,912
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31ARNETT CARBIS TOOTHMAN, LLP
Accountancy firm EIN2020-12-31550486667
2019 : ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$4,961,017
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$1,260,268
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$1,189,235
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$1,724,331
Value of total assets at end of year2019-12-31$19,081,286
Value of total assets at beginning of year2019-12-31$15,380,537
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$71,033
Total interest from all sources2019-12-31$29,291
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$427,812
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$427,812
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$1,000,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$1,315,847
Participant contributions at end of year2019-12-31$341,876
Participant contributions at beginning of year2019-12-31$237,863
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$45,832
Administrative expenses (other) incurred2019-12-31$18,800
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$3,700,749
Value of net assets at end of year (total assets less liabilities)2019-12-31$19,081,286
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$15,380,537
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$17,933,751
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$14,308,999
Interest on participant loans2019-12-31$17,305
Interest earned on other investments2019-12-31$11,986
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$805,659
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$833,675
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$2,779,583
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$362,652
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$1,189,235
Contract administrator fees2019-12-31$52,233
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31ARNETT CARBIS TOOTHMAN, LLP
Accountancy firm EIN2019-12-31550486667
2018 : ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$801,898
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$1,450,941
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$1,385,289
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$1,765,002
Value of total assets at end of year2018-12-31$15,380,537
Value of total assets at beginning of year2018-12-31$16,029,580
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$65,652
Total interest from all sources2018-12-31$21,697
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$435,252
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$435,252
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$1,000,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$1,179,912
Participant contributions at end of year2018-12-31$237,863
Participant contributions at beginning of year2018-12-31$143,303
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$168,030
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-649,043
Value of net assets at end of year (total assets less liabilities)2018-12-31$15,380,537
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$16,029,580
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$14,308,999
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$15,102,045
Interest on participant loans2018-12-31$10,945
Interest earned on other investments2018-12-31$10,752
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$833,675
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$784,232
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-1,420,053
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$417,060
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$1,385,289
Contract administrator fees2018-12-31$65,652
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31ARNETT CARBIS TOOTHMAN, LLP
Accountancy firm EIN2018-12-31550486667
2017 : ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$3,884,513
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$2,020,141
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$1,933,588
Expenses. Certain deemed distributions of participant loans2017-12-31$18,933
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$1,622,559
Value of total assets at end of year2017-12-31$16,029,580
Value of total assets at beginning of year2017-12-31$14,165,208
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$67,620
Total interest from all sources2017-12-31$20,475
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$1,000,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$1,094,626
Participant contributions at end of year2017-12-31$143,303
Participant contributions at beginning of year2017-12-31$189,769
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$189,345
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$0
Administrative expenses (other) incurred2017-12-31$13,128
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$1,864,372
Value of net assets at end of year (total assets less liabilities)2017-12-31$16,029,580
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$14,165,208
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$15,102,045
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$13,125,685
Interest on participant loans2017-12-31$8,940
Interest earned on other investments2017-12-31$11,535
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$784,232
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$849,754
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$2,241,479
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$338,588
Employer contributions (assets) at end of year2017-12-31$0
Employer contributions (assets) at beginning of year2017-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$1,933,588
Contract administrator fees2017-12-31$54,492
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31ARNETT CARBIS TOOTHMAN, LLP
Accountancy firm EIN2017-12-31550486667
2016 : ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$83
Total income from all sources (including contributions)2016-12-31$2,592,385
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$1,156,854
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$1,045,583
Expenses. Certain deemed distributions of participant loans2016-12-31$36,617
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$1,611,301
Value of total assets at end of year2016-12-31$14,165,208
Value of total assets at beginning of year2016-12-31$12,729,760
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$74,654
Total interest from all sources2016-12-31$22,141
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$1,099,635
Participant contributions at end of year2016-12-31$189,769
Participant contributions at beginning of year2016-12-31$214,414
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$122,668
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$83
Administrative expenses (other) incurred2016-12-31$12,416
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$1,435,531
Value of net assets at end of year (total assets less liabilities)2016-12-31$14,165,208
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$12,729,677
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$13,125,685
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$11,829,844
Interest on participant loans2016-12-31$9,503
Interest earned on other investments2016-12-31$12,638
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$849,754
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$685,190
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$958,943
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$388,998
Employer contributions (assets) at end of year2016-12-31$0
Employer contributions (assets) at beginning of year2016-12-31$312
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$1,045,583
Contract administrator fees2016-12-31$62,238
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31RICHARD B. GUSKIEWICZ & ASSOCIATES
Accountancy firm EIN2016-12-31251330186
2015 : ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$83
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$1,276,096
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$916,316
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$850,765
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$1,352,599
Value of total assets at end of year2015-12-31$12,729,760
Value of total assets at beginning of year2015-12-31$12,369,897
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$65,551
Total interest from all sources2015-12-31$10,983
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$910,919
Participant contributions at end of year2015-12-31$214,414
Participant contributions at beginning of year2015-12-31$271,579
Participant contributions at end of year2015-12-31$0
Participant contributions at beginning of year2015-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$171,522
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$83
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$359,780
Value of net assets at end of year (total assets less liabilities)2015-12-31$12,729,677
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$12,369,897
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$11,829,844
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$11,513,726
Interest on participant loans2015-12-31$10,983
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$685,190
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$584,592
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-87,486
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31Yes
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$270,158
Employer contributions (assets) at end of year2015-12-31$312
Employer contributions (assets) at beginning of year2015-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$850,765
Contract administrator fees2015-12-31$65,551
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31RICHARD B. GUSKIEWICZ & ASSOCIATES
Accountancy firm EIN2015-12-31251330186
2014 : ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$3,179,279
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$1,500,450
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$1,459,122
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$2,276,718
Value of total assets at end of year2014-12-31$12,369,897
Value of total assets at beginning of year2014-12-31$10,691,068
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$41,328
Total interest from all sources2014-12-31$11,361
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$2,966
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2014-12-31$2,966
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
If this is an individual account plan, was there a blackout period2014-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$886,723
Participant contributions at end of year2014-12-31$271,579
Participant contributions at beginning of year2014-12-31$255,848
Participant contributions at end of year2014-12-31$0
Participant contributions at beginning of year2014-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$1,117,423
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$1,678,829
Value of net assets at end of year (total assets less liabilities)2014-12-31$12,369,897
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$10,691,068
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$11,513,726
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$8,538,345
Interest on participant loans2014-12-31$11,361
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$584,592
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$1,896,875
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$888,234
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31Yes
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$272,572
Employer contributions (assets) at end of year2014-12-31$0
Employer contributions (assets) at beginning of year2014-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$1,459,122
Contract administrator fees2014-12-31$41,328
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31RICHARD B. GUSKIEWICZ & ASSOCIATES
Accountancy firm EIN2014-12-31251330186
Unrealized appreciation/depreciation of real estate assets2014-06-04$0
Unrealized appreciation/depreciation of other (non real estate) assets2014-06-04$0
Total unrealized appreciation/depreciation of assets2014-06-04$0
Total transfer of assets to this plan2014-06-04$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-06-04$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-06-04$0
Total income from all sources (including contributions)2014-06-04$35,153
Total loss/gain on sale of assets2014-06-04$0
Total of all expenses incurred2014-06-04$2,515,654
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-06-04$2,509,161
Expenses. Certain deemed distributions of participant loans2014-06-04$0
Value of total corrective distributions2014-06-04$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-06-04$0
Value of total assets at end of year2014-06-04$0
Value of total assets at beginning of year2014-06-04$2,480,501
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-06-04$6,493
Total income from rents2014-06-04$0
Total interest from all sources2014-06-04$9,261
Total dividends received (eg from common stock, registered investment company shares)2014-06-04$386
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-06-04No
Total dividends received from registered investment company shares (eg mutual funds)2014-06-04$386
Administrative expenses professional fees incurred2014-06-04$0
Was this plan covered by a fidelity bond2014-06-04Yes
Value of fidelity bond cover2014-06-04$500,000
If this is an individual account plan, was there a blackout period2014-06-04No
Were there any nonexempt tranactions with any party-in-interest2014-06-04No
Amount of non-exempt transactions with any party-in-interest2014-06-04$0
Contributions received from participants2014-06-04$0
Participant contributions at end of year2014-06-04$0
Participant contributions at beginning of year2014-06-04$45,980
Participant contributions at end of year2014-06-04$0
Participant contributions at beginning of year2014-06-04$-5,691
Income. Received or receivable in cash from other sources (including rollovers)2014-06-04$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2014-06-04$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-06-04$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-06-04$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-06-04$0
Other income not declared elsewhere2014-06-04$0
Administrative expenses (other) incurred2014-06-04$0
Liabilities. Value of operating payables at beginning of year2014-06-04$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-06-04No
Value of net income/loss2014-06-04$-2,480,501
Value of net assets at end of year (total assets less liabilities)2014-06-04$0
Value of net assets at beginning of year (total assets less liabilities)2014-06-04$2,480,501
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-06-04No
Were any loans by the plan or fixed income obligations due to the plan in default2014-06-04No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2014-06-04$0
Were any leases to which the plan was party in default or uncollectible2014-06-04No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2014-06-04$0
Investment advisory and management fees2014-06-04$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-06-04$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-06-04$1,252,829
Interest on participant loans2014-06-04$723
Income. Interest from loans (other than to participants)2014-06-04$0
Interest earned on other investments2014-06-04$8,538
Income. Interest from US Government securities2014-06-04$0
Income. Interest from corporate debt instruments2014-06-04$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-06-04$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-06-04$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-06-04$1,181,692
Expenses. Payments to insurance carriers foe the provision of benefits2014-06-04$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-06-04$25,506
Net investment gain/loss from pooled separate accounts2014-06-04$0
Net investment gain or loss from common/collective trusts2014-06-04$0
Net gain/loss from 103.12 investment entities2014-06-04$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-06-04No
Was there a failure to transmit to the plan any participant contributions2014-06-04No
Has the plan failed to provide any benefit when due under the plan2014-06-04No
Contributions received in cash from employer2014-06-04$0
Employer contributions (assets) at end of year2014-06-04$0
Employer contributions (assets) at beginning of year2014-06-04$5,691
Income. Dividends from preferred stock2014-06-04$0
Income. Dividends from common stock2014-06-04$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-06-04$2,509,161
Contract administrator fees2014-06-04$6,493
Liabilities. Value of benefit claims payable at beginning of year2014-06-04$0
Did the plan have assets held for investment2014-06-04No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-06-04No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-06-04Yes
Aggregate proceeds on sale of assets2014-06-04$0
Aggregate carrying amount (costs) on sale of assets2014-06-04$0
Liabilities. Value of acquisition indebtedness at beginning of year2014-06-04$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-06-04No
Opinion of an independent qualified public accountant for this plan2014-06-04Disclaimer
Accountancy firm name2014-06-04RICHARD B. GUSKIEWICZ & ASSOCIATES
Accountancy firm EIN2014-06-04251330186
2013 : ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2013 401k financial data
Unrealized appreciation/depreciation of real estate assets2013-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2013-12-31$0
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total transfer of assets to this plan2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total income from all sources (including contributions)2013-12-31$2,677,777
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$1,183,647
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$1,153,142
Expenses. Certain deemed distributions of participant loans2013-12-31$0
Value of total corrective distributions2013-12-31$2,346
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$1,095,121
Value of total assets at end of year2013-12-31$10,691,068
Value of total assets at beginning of year2013-12-31$9,196,938
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$28,159
Total income from rents2013-12-31$0
Total interest from all sources2013-12-31$65,352
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$147,663
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$147,663
Administrative expenses professional fees incurred2013-12-31$0
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$500,000
If this is an individual account plan, was there a blackout period2013-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Amount of non-exempt transactions with any party-in-interest2013-12-31$0
Contributions received from participants2013-12-31$811,921
Participant contributions at end of year2013-12-31$255,848
Participant contributions at beginning of year2013-12-31$196,528
Participant contributions at end of year2013-12-31$0
Participant contributions at beginning of year2013-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$54,221
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$0
Other income not declared elsewhere2013-12-31$0
Administrative expenses (other) incurred2013-12-31$0
Liabilities. Value of operating payables at beginning of year2013-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$1,494,130
Value of net assets at end of year (total assets less liabilities)2013-12-31$10,691,068
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$9,196,938
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2013-12-31$0
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2013-12-31$0
Investment advisory and management fees2013-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$8,538,345
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$7,121,893
Interest on participant loans2013-12-31$9,596
Income. Interest from loans (other than to participants)2013-12-31$0
Interest earned on other investments2013-12-31$55,756
Income. Interest from US Government securities2013-12-31$0
Income. Interest from corporate debt instruments2013-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$1,896,875
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$1,878,517
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$1,369,641
Net investment gain/loss from pooled separate accounts2013-12-31$0
Net investment gain or loss from common/collective trusts2013-12-31$0
Net gain/loss from 103.12 investment entities2013-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$228,979
Employer contributions (assets) at end of year2013-12-31$0
Employer contributions (assets) at beginning of year2013-12-31$0
Income. Dividends from preferred stock2013-12-31$0
Income. Dividends from common stock2013-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$1,153,142
Contract administrator fees2013-12-31$28,159
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$0
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Aggregate proceeds on sale of assets2013-12-31$0
Aggregate carrying amount (costs) on sale of assets2013-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2013-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31RICHARD B. GUSKIEWICZ & ASSOCIATES
Accountancy firm EIN2013-12-31251330186
2012 : ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2012 401k financial data
Unrealized appreciation/depreciation of real estate assets2012-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2012-12-31$0
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total transfer of assets to this plan2012-12-31$0
Total transfer of assets from this plan2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total income from all sources (including contributions)2012-12-31$2,245,365
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$1,269,321
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$1,244,338
Expenses. Certain deemed distributions of participant loans2012-12-31$0
Value of total corrective distributions2012-12-31$2,836
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$1,261,733
Value of total assets at end of year2012-12-31$9,196,938
Value of total assets at beginning of year2012-12-31$8,220,894
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$22,147
Total income from rents2012-12-31$0
Total interest from all sources2012-12-31$62,330
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$115,025
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2012-12-31$115,025
Administrative expenses professional fees incurred2012-12-31$0
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$500,000
If this is an individual account plan, was there a blackout period2012-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Amount of non-exempt transactions with any party-in-interest2012-12-31$0
Contributions received from participants2012-12-31$814,345
Participant contributions at end of year2012-12-31$196,528
Participant contributions at beginning of year2012-12-31$207,387
Participant contributions at end of year2012-12-31$0
Participant contributions at beginning of year2012-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$214,486
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2012-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$0
Other income not declared elsewhere2012-12-31$8
Administrative expenses (other) incurred2012-12-31$0
Liabilities. Value of operating payables at beginning of year2012-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$976,044
Value of net assets at end of year (total assets less liabilities)2012-12-31$9,196,938
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$8,220,894
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2012-12-31$0
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2012-12-31$0
Investment advisory and management fees2012-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$7,121,893
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$6,125,475
Interest on participant loans2012-12-31$7,913
Income. Interest from loans (other than to participants)2012-12-31$0
Interest earned on other investments2012-12-31$54,417
Income. Interest from US Government securities2012-12-31$0
Income. Interest from corporate debt instruments2012-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$1,878,517
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$1,888,032
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$806,269
Net investment gain/loss from pooled separate accounts2012-12-31$0
Net investment gain or loss from common/collective trusts2012-12-31$0
Net gain/loss from 103.12 investment entities2012-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$232,902
Employer contributions (assets) at end of year2012-12-31$0
Employer contributions (assets) at beginning of year2012-12-31$0
Income. Dividends from preferred stock2012-12-31$0
Income. Dividends from common stock2012-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$1,244,338
Contract administrator fees2012-12-31$22,147
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$0
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Aggregate proceeds on sale of assets2012-12-31$0
Aggregate carrying amount (costs) on sale of assets2012-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2012-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31RICHARD B. GUSKIEWICZ & ASSOCIATES
Accountancy firm EIN2012-12-31251330186
2011 : ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2011 401k financial data
Unrealized appreciation/depreciation of real estate assets2011-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2011-12-31$0
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total transfer of assets to this plan2011-12-31$0
Total transfer of assets from this plan2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total income from all sources (including contributions)2011-12-31$949,264
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$875,519
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$845,800
Expenses. Certain deemed distributions of participant loans2011-12-31$5,540
Value of total corrective distributions2011-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$913,681
Value of total assets at end of year2011-12-31$8,220,894
Value of total assets at beginning of year2011-12-31$8,147,149
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$24,179
Total income from rents2011-12-31$0
Total interest from all sources2011-12-31$61,904
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$87,291
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$87,291
Administrative expenses professional fees incurred2011-12-31$0
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$500,000
If this is an individual account plan, was there a blackout period2011-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Amount of non-exempt transactions with any party-in-interest2011-12-31$0
Contributions received from participants2011-12-31$792,541
Participant contributions at end of year2011-12-31$207,387
Participant contributions at beginning of year2011-12-31$213,290
Participant contributions at end of year2011-12-31$0
Participant contributions at beginning of year2011-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$26,866
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2011-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-12-31$0
Other income not declared elsewhere2011-12-31$0
Administrative expenses (other) incurred2011-12-31$0
Liabilities. Value of operating payables at beginning of year2011-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$73,745
Value of net assets at end of year (total assets less liabilities)2011-12-31$8,220,894
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$8,147,149
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2011-12-31$0
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2011-12-31$0
Investment advisory and management fees2011-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$6,125,475
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$6,319,284
Interest on participant loans2011-12-31$8,727
Income. Interest from loans (other than to participants)2011-12-31$0
Interest earned on other investments2011-12-31$53,177
Income. Interest from US Government securities2011-12-31$0
Income. Interest from corporate debt instruments2011-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$1,888,032
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$1,614,575
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$-113,612
Net investment gain/loss from pooled separate accounts2011-12-31$0
Net investment gain or loss from common/collective trusts2011-12-31$0
Net gain/loss from 103.12 investment entities2011-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$94,274
Employer contributions (assets) at end of year2011-12-31$0
Employer contributions (assets) at beginning of year2011-12-31$0
Income. Dividends from preferred stock2011-12-31$0
Income. Dividends from common stock2011-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$845,800
Contract administrator fees2011-12-31$24,179
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$0
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Aggregate proceeds on sale of assets2011-12-31$0
Aggregate carrying amount (costs) on sale of assets2011-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2011-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31RICHARD B. GUSKIEWICZ
Accountancy firm EIN2011-12-31251330186
2010 : ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2010 401k financial data
Unrealized appreciation/depreciation of real estate assets2010-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$0
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total transfer of assets to this plan2010-12-31$0
Total transfer of assets from this plan2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total income from all sources (including contributions)2010-12-31$1,797,984
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$1,331,179
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$1,305,185
Expenses. Certain deemed distributions of participant loans2010-12-31$0
Value of total corrective distributions2010-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$808,435
Value of total assets at end of year2010-12-31$8,147,149
Value of total assets at beginning of year2010-12-31$7,680,344
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$25,994
Total income from rents2010-12-31$0
Total interest from all sources2010-12-31$60,409
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$91,301
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2010-12-31$91,301
Administrative expenses professional fees incurred2010-12-31$0
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$500,000
If this is an individual account plan, was there a blackout period2010-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Amount of non-exempt transactions with any party-in-interest2010-12-31$0
Contributions received from participants2010-12-31$804,081
Participant contributions at end of year2010-12-31$213,290
Participant contributions at beginning of year2010-12-31$143,567
Participant contributions at end of year2010-12-31$0
Participant contributions at beginning of year2010-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$4,354
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2010-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$0
Other income not declared elsewhere2010-12-31$0
Administrative expenses (other) incurred2010-12-31$0
Liabilities. Value of operating payables at beginning of year2010-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$466,805
Value of net assets at end of year (total assets less liabilities)2010-12-31$8,147,149
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$7,680,344
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2010-12-31$0
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2010-12-31$0
Investment advisory and management fees2010-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$6,319,284
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$5,607,964
Interest on participant loans2010-12-31$8,319
Income. Interest from loans (other than to participants)2010-12-31$0
Interest earned on other investments2010-12-31$52,090
Income. Interest from US Government securities2010-12-31$0
Income. Interest from corporate debt instruments2010-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$1,614,575
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$1,928,813
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$837,839
Net investment gain/loss from pooled separate accounts2010-12-31$0
Net investment gain or loss from common/collective trusts2010-12-31$0
Net gain/loss from 103.12 investment entities2010-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$0
Employer contributions (assets) at end of year2010-12-31$0
Employer contributions (assets) at beginning of year2010-12-31$0
Income. Dividends from preferred stock2010-12-31$0
Income. Dividends from common stock2010-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$1,305,185
Contract administrator fees2010-12-31$25,994
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$0
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Aggregate proceeds on sale of assets2010-12-31$0
Aggregate carrying amount (costs) on sale of assets2010-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2010-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31RICHARD B GUSKIEWICZ
Accountancy firm EIN2010-12-31251330186
2009 : ADELPHOI USA, INC. TAX DEFERRED ANNUITY 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 ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN

2022: ADELPHOI USA, INC. TAX DEFERRED ANNUITY 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: ADELPHOI USA, INC. TAX DEFERRED ANNUITY 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: ADELPHOI USA, INC. TAX DEFERRED ANNUITY 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: ADELPHOI USA, INC. TAX DEFERRED ANNUITY 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: ADELPHOI USA, INC. TAX DEFERRED ANNUITY 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: ADELPHOI USA, INC. TAX DEFERRED ANNUITY 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: ADELPHOI USA, INC. TAX DEFERRED ANNUITY 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 – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
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: ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
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: ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
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
2010: ADELPHOI USA, INC. TAX DEFERRED ANNUITY PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: ADELPHOI USA, INC. TAX DEFERRED ANNUITY 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

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number370222-01
Policy instance 1
Insurance contract or identification number370222-01
Number of Individuals Covered81
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?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
Other information about contractGROUP ANNUITY CONTRACT
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number370222-01
Policy instance 1
Insurance contract or identification number370222-01
Number of Individuals Covered91
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?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
Other information about contractGROUP ANNUITY CONTRACT
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number370222-01
Policy instance 1
Insurance contract or identification number370222-01
Number of Individuals Covered107
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?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
Other information about contractGROUP ANNUITY CONTRACT
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number370222-01
Policy instance 1
Insurance contract or identification number370222-01
Number of Individuals Covered104
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?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
Other information about contractGROUP ANNUITY CONTRACT
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number370222-01
Policy instance 1
Insurance contract or identification number370222-01
Number of Individuals Covered114
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?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
Other information about contractGROUP ANNUITY CONTRACT
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number370222-01
Policy instance 1
Insurance contract or identification number370222-01
Number of Individuals Covered134
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?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
Other information about contractGROUP ANNUITY CONTRACT
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number370222-01
Policy instance 1
Insurance contract or identification number370222-01
Number of Individuals Covered90
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractGROUP ANNUITY CONTRACT
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number370222-01
Policy instance 2
Insurance contract or identification number370222-01
Number of Individuals Covered31
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractGROUP ANNUITY CONTRACT
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number441463
Policy instance 1
Insurance contract or identification number441463
Number of Individuals Covered0
Insurance policy start date2014-01-01
Insurance policy end date2014-12-05
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?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
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number441462
Policy instance 1
Insurance contract or identification number441462
Number of Individuals Covered0
Insurance policy start date2014-01-01
Insurance policy end date2014-06-04
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
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
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number441463
Policy instance 1
Insurance contract or identification number441463
Number of Individuals Covered668
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
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
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number441463
Policy instance 1
Insurance contract or identification number441463
Number of Individuals Covered634
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 $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
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
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number441463
Policy instance 1
Insurance contract or identification number441463
Number of Individuals Covered643
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
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
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number441463
Policy instance 1
Insurance contract or identification number441463
Number of Individuals Covered621
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
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
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

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