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PTM OF BOISE, LLC DBA VALLEYRIDE RETIREMENT PLAN 401k Plan overview

Plan NamePTM OF BOISE, LLC DBA VALLEYRIDE RETIREMENT PLAN
Plan identification number 001

PTM OF BOISE, LLC DBA VALLEYRIDE RETIREMENT PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • 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.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

PTM OF BOISE, LLC DBA VALLEYRIDE has sponsored the creation of one or more 401k plans.

Company Name:PTM OF BOISE, LLC DBA VALLEYRIDE
Employer identification number (EIN):270962881
NAIC Classification:485110
NAIC Description: Urban Transit Systems

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PTM OF BOISE, LLC DBA VALLEYRIDE RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012016-01-01AMY RYAN
0012015-01-01DELLA DEGROOT
0012014-01-01TOSHIA HIRAI LAWLESS
0012013-01-01TOSHIA HIRAI LAWLESS
0012012-01-01TOSHIA HIRAI LAWLESS
0012011-01-01TOSHIA HIRAI LAWLESS
0012010-01-01TOSHIA HIRAI LAWLESS

Plan Statistics for PTM OF BOISE, LLC DBA VALLEYRIDE RETIREMENT PLAN

401k plan membership statisitcs for PTM OF BOISE, LLC DBA VALLEYRIDE RETIREMENT PLAN

Measure Date Value
2016: PTM OF BOISE, LLC DBA VALLEYRIDE RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0190
Total number of active participants reported on line 7a of the Form 55002016-01-0185
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0114
Total of all active and inactive participants2016-01-0199
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0199
Number of participants with account balances2016-01-0199
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: PTM OF BOISE, LLC DBA VALLEYRIDE RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0181
Total number of active participants reported on line 7a of the Form 55002015-01-0187
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-013
Total of all active and inactive participants2015-01-0190
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0190
Number of participants with account balances2015-01-0163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: PTM OF BOISE, LLC DBA VALLEYRIDE RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0193
Total number of active participants reported on line 7a of the Form 55002014-01-0179
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-012
Total of all active and inactive participants2014-01-0181
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0181
Number of participants with account balances2014-01-0170
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: PTM OF BOISE, LLC DBA VALLEYRIDE RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0189
Total number of active participants reported on line 7a of the Form 55002013-01-0188
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-015
Total of all active and inactive participants2013-01-0193
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0193
Number of participants with account balances2013-01-0189
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: PTM OF BOISE, LLC DBA VALLEYRIDE RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0186
Total number of active participants reported on line 7a of the Form 55002012-01-0181
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-017
Total of all active and inactive participants2012-01-0188
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0188
Number of participants with account balances2012-01-0188
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: PTM OF BOISE, LLC DBA VALLEYRIDE RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0183
Total number of active participants reported on line 7a of the Form 55002011-01-0182
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-013
Total of all active and inactive participants2011-01-0185
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0185
Number of participants with account balances2011-01-0185
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: PTM OF BOISE, LLC DBA VALLEYRIDE RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-0188
Total number of active participants reported on line 7a of the Form 55002010-01-0179
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-014
Total of all active and inactive participants2010-01-0183
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-0183
Number of participants with account balances2010-01-0183
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010

Financial Data on PTM OF BOISE, LLC DBA VALLEYRIDE RETIREMENT PLAN

Measure Date Value
2016 : PTM OF BOISE, LLC DBA VALLEYRIDE RETIREMENT PLAN 2016 401k financial data
Total plan liabilities at end of year2016-12-31$0
Total plan liabilities at beginning of year2016-12-31$0
Total income from all sources2016-12-31$383,644
Expenses. Total of all expenses incurred2016-12-31$63,522
Benefits paid (including direct rollovers)2016-12-31$62,042
Total plan assets at end of year2016-12-31$2,275,777
Total plan assets at beginning of year2016-12-31$1,955,655
Value of fidelity bond covering the plan2016-12-31$300,000
Total contributions received or receivable from participants2016-12-31$39,167
Other income received2016-12-31$115,644
Net income (gross income less expenses)2016-12-31$320,122
Net plan assets at end of year (total assets less liabilities)2016-12-31$2,275,777
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$1,955,655
Total contributions received or receivable from employer(s)2016-12-31$228,833
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$1,480
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : PTM OF BOISE, LLC DBA VALLEYRIDE RETIREMENT PLAN 2015 401k financial data
Total plan liabilities at end of year2015-12-31$0
Total plan liabilities at beginning of year2015-12-31$0
Total income from all sources2015-12-31$37,212
Expenses. Total of all expenses incurred2015-12-31$320,162
Benefits paid (including direct rollovers)2015-12-31$318,060
Total plan assets at end of year2015-12-31$1,955,655
Total plan assets at beginning of year2015-12-31$2,238,605
Value of fidelity bond covering the plan2015-12-31$300,000
Total contributions received or receivable from participants2015-12-31$11,223
Other income received2015-12-31$-10,361
Net income (gross income less expenses)2015-12-31$-282,950
Net plan assets at end of year (total assets less liabilities)2015-12-31$1,955,655
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$2,238,605
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-1022015-12-31$2,266
Total contributions received or receivable from employer(s)2015-12-31$36,350
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$2,102
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : PTM OF BOISE, LLC DBA VALLEYRIDE RETIREMENT PLAN 2014 401k financial data
Total plan liabilities at end of year2014-12-31$0
Total plan liabilities at beginning of year2014-12-31$0
Total income from all sources2014-12-31$178,204
Expenses. Total of all expenses incurred2014-12-31$568,047
Benefits paid (including direct rollovers)2014-12-31$564,730
Total plan assets at end of year2014-12-31$2,238,605
Total plan assets at beginning of year2014-12-31$2,628,448
Value of fidelity bond covering the plan2014-12-31$300,000
Total contributions received or receivable from participants2014-12-31$11,151
Expenses. Other expenses not covered elsewhere2014-12-31$3,317
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$133,924
Noncash contributions received2014-12-31$0
Net income (gross income less expenses)2014-12-31$-389,843
Net plan assets at end of year (total assets less liabilities)2014-12-31$2,238,605
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$2,628,448
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-1022014-12-31$2,266
Total contributions received or receivable from employer(s)2014-12-31$33,129
Value of certain deemed distributions of participant loans2014-12-31$0
Value of corrective distributions2014-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : PTM OF BOISE, LLC DBA VALLEYRIDE RETIREMENT PLAN 2013 401k financial data
Transfers to/from the plan2013-12-31$0
Total plan liabilities at end of year2013-12-31$0
Total plan liabilities at beginning of year2013-12-31$0
Total income from all sources2013-12-31$623,579
Expenses. Total of all expenses incurred2013-12-31$425,260
Benefits paid (including direct rollovers)2013-12-31$413,248
Total plan assets at end of year2013-12-31$2,628,448
Total plan assets at beginning of year2013-12-31$2,430,129
Value of fidelity bond covering the plan2013-12-31$300,000
Total contributions received or receivable from participants2013-12-31$100,462
Expenses. Other expenses not covered elsewhere2013-12-31$0
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$327,565
Noncash contributions received2013-12-31$0
Net income (gross income less expenses)2013-12-31$198,319
Net plan assets at end of year (total assets less liabilities)2013-12-31$2,628,448
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$2,430,129
Total contributions received or receivable from employer(s)2013-12-31$195,552
Value of certain deemed distributions of participant loans2013-12-31$0
Value of corrective distributions2013-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$12,012
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : PTM OF BOISE, LLC DBA VALLEYRIDE RETIREMENT PLAN 2012 401k financial data
Transfers to/from the plan2012-12-31$0
Total plan liabilities at end of year2012-12-31$0
Total plan liabilities at beginning of year2012-12-31$0
Total income from all sources2012-12-31$613,909
Expenses. Total of all expenses incurred2012-12-31$196,086
Benefits paid (including direct rollovers)2012-12-31$194,029
Total plan assets at end of year2012-12-31$2,430,129
Total plan assets at beginning of year2012-12-31$2,012,306
Value of fidelity bond covering the plan2012-12-31$300,000
Total contributions received or receivable from participants2012-12-31$119,352
Other income received2012-12-31$246,693
Net income (gross income less expenses)2012-12-31$417,823
Net plan assets at end of year (total assets less liabilities)2012-12-31$2,430,129
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$2,012,306
Total contributions received or receivable from employer(s)2012-12-31$247,864
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$2,057
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
2011 : PTM OF BOISE, LLC DBA VALLEYRIDE RETIREMENT PLAN 2011 401k financial data
Transfers to/from the plan2011-12-31$0
Total plan liabilities at end of year2011-12-31$0
Total plan liabilities at beginning of year2011-12-31$0
Total income from all sources2011-12-31$348,492
Expenses. Total of all expenses incurred2011-12-31$211,068
Benefits paid (including direct rollovers)2011-12-31$209,233
Total plan assets at end of year2011-12-31$2,012,306
Total plan assets at beginning of year2011-12-31$1,874,882
Value of fidelity bond covering the plan2011-12-31$300,000
Total contributions received or receivable from participants2011-12-31$117,632
Expenses. Other expenses not covered elsewhere2011-12-31$0
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-19,419
Noncash contributions received2011-12-31$0
Net income (gross income less expenses)2011-12-31$137,424
Net plan assets at end of year (total assets less liabilities)2011-12-31$2,012,306
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$1,874,882
Total contributions received or receivable from employer(s)2011-12-31$250,279
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$1,835
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
2010 : PTM OF BOISE, LLC DBA VALLEYRIDE RETIREMENT PLAN 2010 401k financial data
Transfers to/from the plan2010-12-31$0
Total plan liabilities at end of year2010-12-31$0
Total plan liabilities at beginning of year2010-12-31$0
Total income from all sources2010-12-31$1,947,636
Expenses. Total of all expenses incurred2010-12-31$72,754
Benefits paid (including direct rollovers)2010-12-31$72,079
Total plan assets at end of year2010-12-31$1,874,882
Total plan assets at beginning of year2010-12-31$0
Value of fidelity bond covering the plan2010-12-31$200,000
Total contributions received or receivable from participants2010-12-31$108,605
Expenses. Other expenses not covered elsewhere2010-12-31$0
Contributions received from other sources (not participants or employers)2010-12-31$1,476,276
Other income received2010-12-31$130,280
Noncash contributions received2010-12-31$0
Net income (gross income less expenses)2010-12-31$1,874,882
Net plan assets at end of year (total assets less liabilities)2010-12-31$1,874,882
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$0
Total contributions received or receivable from employer(s)2010-12-31$232,475
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$675
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0

Form 5500 Responses for PTM OF BOISE, LLC DBA VALLEYRIDE RETIREMENT PLAN

2016: PTM OF BOISE, LLC DBA VALLEYRIDE RETIREMENT 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: PTM OF BOISE, LLC DBA VALLEYRIDE RETIREMENT 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: PTM OF BOISE, LLC DBA VALLEYRIDE RETIREMENT 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: PTM OF BOISE, LLC DBA VALLEYRIDE RETIREMENT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: PTM OF BOISE, LLC DBA VALLEYRIDE RETIREMENT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: PTM OF BOISE, LLC DBA VALLEYRIDE RETIREMENT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: PTM OF BOISE, LLC DBA VALLEYRIDE RETIREMENT PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01First time form 5500 has been submittedYes
2010-01-01Submission has been amendedNo
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

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number331362-01
Policy instance 1
Insurance contract or identification number331362-01
Number of Individuals Covered63
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?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number331362-01
Policy instance 1
Insurance contract or identification number331362-01
Number of Individuals Covered70
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number331362-01
Policy instance 1
Insurance contract or identification number331362-01
Number of Individuals Covered89
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number331362-01
Policy instance 1
Insurance contract or identification number331362-01
Number of Individuals Covered88
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number331362-01
Policy instance 1
Insurance contract or identification number331362-01
Number of Individuals Covered85
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number331362-01
Policy instance 1
Insurance contract or identification number331362-01
Number of Individuals Covered83
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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