J & L PIZZA COMPANY, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan J & L PIZZA COMPANY RETIREMENT PLAN
| Measure | Date | Value |
|---|
| 2023: J & L PIZZA COMPANY RETIREMENT PLAN 2023 401k membership |
|---|
| Total participants, beginning-of-year | 2023-01-01 | 3 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-01-01 | 3 |
| Number of retired or separated participants receiving benefits | 2023-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2023-01-01 | 0 |
| Total of all active and inactive participants | 2023-01-01 | 3 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2023-01-01 | 0 |
| Total participants | 2023-01-01 | 3 |
| Number of participants with account balances | 2023-01-01 | 2 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2023-01-01 | 0 |
| 2022: J & L PIZZA COMPANY RETIREMENT PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 3 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 3 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 3 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2022-01-01 | 0 |
| Total participants | 2022-01-01 | 3 |
| Number of participants with account balances | 2022-01-01 | 2 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2022-01-01 | 0 |
| 2021: J & L PIZZA COMPANY RETIREMENT PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 2 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 3 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 3 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2021-01-01 | 0 |
| Total participants | 2021-01-01 | 3 |
| Number of participants with account balances | 2021-01-01 | 2 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2021-01-01 | 0 |
| 2020: J & L PIZZA COMPANY RETIREMENT PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 3 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 2 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 2 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2020-01-01 | 0 |
| Total participants | 2020-01-01 | 2 |
| Number of participants with account balances | 2020-01-01 | 2 |
| 2019: J & L PIZZA COMPANY RETIREMENT PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 3 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 3 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 3 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2019-01-01 | 0 |
| Total participants | 2019-01-01 | 3 |
| Number of participants with account balances | 2019-01-01 | 2 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2019-01-01 | 0 |
| 2018: J & L PIZZA COMPANY RETIREMENT PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 3 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 3 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 3 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2018-01-01 | 0 |
| Total participants | 2018-01-01 | 3 |
| Number of participants with account balances | 2018-01-01 | 2 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2018-01-01 | 0 |
| 2017: J & L PIZZA COMPANY RETIREMENT PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 2 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 2 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
| Total of all active and inactive participants | 2017-01-01 | 2 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2017-01-01 | 0 |
| Total participants | 2017-01-01 | 2 |
| Number of participants with account balances | 2017-01-01 | 2 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2017-01-01 | 0 |
| 2016: J & L PIZZA COMPANY RETIREMENT PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 2 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 2 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
| Total of all active and inactive participants | 2016-01-01 | 2 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2016-01-01 | 0 |
| Total participants | 2016-01-01 | 2 |
| Number of participants with account balances | 2016-01-01 | 2 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2016-01-01 | 0 |
| 2015: J & L PIZZA COMPANY RETIREMENT PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 2 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 2 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
| Total of all active and inactive participants | 2015-01-01 | 2 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2015-01-01 | 0 |
| Total participants | 2015-01-01 | 2 |
| Number of participants with account balances | 2015-01-01 | 2 |
| 2014: J & L PIZZA COMPANY RETIREMENT PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 3 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 2 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 0 |
| Total of all active and inactive participants | 2014-01-01 | 2 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-01-01 | 0 |
| Total participants | 2014-01-01 | 2 |
| Number of participants with account balances | 2014-01-01 | 2 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2014-01-01 | 0 |
| 2013: J & L PIZZA COMPANY RETIREMENT PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 3 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 3 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 0 |
| Total of all active and inactive participants | 2013-01-01 | 3 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-01-01 | 0 |
| Total participants | 2013-01-01 | 3 |
| Number of participants with account balances | 2013-01-01 | 3 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-01-01 | 0 |
| 2012: J & L PIZZA COMPANY RETIREMENT PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 2 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 2 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 0 |
| Total of all active and inactive participants | 2012-01-01 | 2 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-01-01 | 0 |
| Total participants | 2012-01-01 | 2 |
| Number of participants with account balances | 2012-01-01 | 2 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-01-01 | 0 |
| 2011: J & L PIZZA COMPANY RETIREMENT PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-03 | 2 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-03 | 2 |
| Number of retired or separated participants receiving benefits | 2011-01-03 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-01-03 | 0 |
| Total of all active and inactive participants | 2011-01-03 | 2 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-01-03 | 0 |
| Total participants | 2011-01-03 | 2 |
| Number of participants with account balances | 2011-01-03 | 2 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2011-01-03 | 0 |
| Measure | Date | Value |
|---|
| 2023 : J & L PIZZA COMPANY RETIREMENT PLAN 2023 401k financial data |
|---|
| Total income from all sources | 2023-12-31 | $-1,999 |
| Expenses. Total of all expenses incurred | 2023-12-31 | $0 |
| Total plan assets at end of year | 2023-12-31 | $32,522 |
| Total plan assets at beginning of year | 2023-12-31 | $34,521 |
| Value of fidelity bond covering the plan | 2023-12-31 | $20,000 |
| Total contributions received or receivable from participants | 2023-12-31 | $400 |
| Other income received | 2023-12-31 | $-2,599 |
| Net income (gross income less expenses) | 2023-12-31 | $-1,999 |
| Net plan assets at end of year (total assets less liabilities) | 2023-12-31 | $32,522 |
| Net plan assets at beginning of year (total assets less liabilities) | 2023-12-31 | $34,521 |
| Assets. Value of employer securities | 2023-12-31 | $1,448 |
| Total contributions received or receivable from employer(s) | 2023-12-31 | $200 |
| 2022 : J & L PIZZA COMPANY RETIREMENT PLAN 2022 401k financial data |
|---|
| Total income from all sources | 2022-12-31 | $-18,967 |
| Expenses. Total of all expenses incurred | 2022-12-31 | $0 |
| Total plan assets at end of year | 2022-12-31 | $34,521 |
| Total plan assets at beginning of year | 2022-12-31 | $53,488 |
| Value of fidelity bond covering the plan | 2022-12-31 | $20,000 |
| Total contributions received or receivable from participants | 2022-12-31 | $677 |
| Other income received | 2022-12-31 | $-19,968 |
| Net income (gross income less expenses) | 2022-12-31 | $-18,967 |
| Net plan assets at end of year (total assets less liabilities) | 2022-12-31 | $34,521 |
| Net plan assets at beginning of year (total assets less liabilities) | 2022-12-31 | $53,488 |
| Assets. Value of employer securities | 2022-12-31 | $7,013 |
| Total contributions received or receivable from employer(s) | 2022-12-31 | $324 |
| 2021 : J & L PIZZA COMPANY RETIREMENT PLAN 2021 401k financial data |
|---|
| Total plan liabilities at beginning of year | 2021-12-31 | $76 |
| Total income from all sources | 2021-12-31 | $-15,259 |
| Expenses. Total of all expenses incurred | 2021-12-31 | $145 |
| Total plan assets at end of year | 2021-12-31 | $53,488 |
| Total plan assets at beginning of year | 2021-12-31 | $68,968 |
| Value of fidelity bond covering the plan | 2021-12-31 | $20,000 |
| Total contributions received or receivable from participants | 2021-12-31 | $1,404 |
| Other income received | 2021-12-31 | $-17,311 |
| Net income (gross income less expenses) | 2021-12-31 | $-15,404 |
| Net plan assets at end of year (total assets less liabilities) | 2021-12-31 | $53,488 |
| Net plan assets at beginning of year (total assets less liabilities) | 2021-12-31 | $68,892 |
| Assets. Value of employer securities | 2021-12-31 | $22,175 |
| Total contributions received or receivable from employer(s) | 2021-12-31 | $648 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2021-12-31 | $145 |
| 2020 : J & L PIZZA COMPANY RETIREMENT PLAN 2020 401k financial data |
|---|
| Total plan liabilities at end of year | 2020-12-31 | $76 |
| Total income from all sources | 2020-12-31 | $9,219 |
| Expenses. Total of all expenses incurred | 2020-12-31 | $113 |
| Total plan assets at end of year | 2020-12-31 | $68,968 |
| Total plan assets at beginning of year | 2020-12-31 | $59,786 |
| Value of fidelity bond covering the plan | 2020-12-31 | $20,000 |
| Total contributions received or receivable from participants | 2020-12-31 | $1,384 |
| Other income received | 2020-12-31 | $7,197 |
| Net income (gross income less expenses) | 2020-12-31 | $9,106 |
| Net plan assets at end of year (total assets less liabilities) | 2020-12-31 | $68,892 |
| Net plan assets at beginning of year (total assets less liabilities) | 2020-12-31 | $59,786 |
| Assets. Value of employer securities | 2020-12-31 | $42,127 |
| Total contributions received or receivable from employer(s) | 2020-12-31 | $638 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2020-12-31 | $113 |
| 2019 : J & L PIZZA COMPANY RETIREMENT PLAN 2019 401k financial data |
|---|
| Total income from all sources | 2019-12-31 | $27,741 |
| Expenses. Total of all expenses incurred | 2019-12-31 | $0 |
| Total plan assets at end of year | 2019-12-31 | $59,786 |
| Total plan assets at beginning of year | 2019-12-31 | $32,045 |
| Value of fidelity bond covering the plan | 2019-12-31 | $20,000 |
| Total contributions received or receivable from participants | 2019-12-31 | $1,622 |
| Other income received | 2019-12-31 | $25,375 |
| Net income (gross income less expenses) | 2019-12-31 | $27,741 |
| Net plan assets at end of year (total assets less liabilities) | 2019-12-31 | $59,786 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-12-31 | $32,045 |
| Assets. Value of employer securities | 2019-12-31 | $37,700 |
| Total contributions received or receivable from employer(s) | 2019-12-31 | $744 |
| 2018 : J & L PIZZA COMPANY RETIREMENT PLAN 2018 401k financial data |
|---|
| Total income from all sources | 2018-12-31 | $12,651 |
| Expenses. Total of all expenses incurred | 2018-12-31 | $85 |
| Total plan assets at end of year | 2018-12-31 | $32,045 |
| Total plan assets at beginning of year | 2018-12-31 | $19,479 |
| Value of fidelity bond covering the plan | 2018-12-31 | $20,000 |
| Total contributions received or receivable from participants | 2018-12-31 | $1,226 |
| Other income received | 2018-12-31 | $10,857 |
| Net income (gross income less expenses) | 2018-12-31 | $12,566 |
| Net plan assets at end of year (total assets less liabilities) | 2018-12-31 | $32,045 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-12-31 | $19,479 |
| Assets. Value of employer securities | 2018-12-31 | $15,284 |
| Total contributions received or receivable from employer(s) | 2018-12-31 | $568 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2018-12-31 | $85 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2018-12-31 | $0 |
| 2017 : J & L PIZZA COMPANY RETIREMENT PLAN 2017 401k financial data |
|---|
| Total income from all sources | 2017-12-31 | $7,200 |
| Expenses. Total of all expenses incurred | 2017-12-31 | $70 |
| Total plan assets at end of year | 2017-12-31 | $19,479 |
| Total plan assets at beginning of year | 2017-12-31 | $12,349 |
| Value of fidelity bond covering the plan | 2017-12-31 | $25,000 |
| Total contributions received or receivable from participants | 2017-12-31 | $1,496 |
| Other income received | 2017-12-31 | $5,016 |
| Net income (gross income less expenses) | 2017-12-31 | $7,130 |
| Net plan assets at end of year (total assets less liabilities) | 2017-12-31 | $19,479 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-12-31 | $12,349 |
| Assets. Value of employer securities | 2017-12-31 | $3,221 |
| Total contributions received or receivable from employer(s) | 2017-12-31 | $688 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-12-31 | $70 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2017-12-31 | $0 |
| 2016 : J & L PIZZA COMPANY RETIREMENT PLAN 2016 401k financial data |
|---|
| Total income from all sources | 2016-12-31 | $-166 |
| Expenses. Total of all expenses incurred | 2016-12-31 | $49 |
| Total plan assets at end of year | 2016-12-31 | $12,349 |
| Total plan assets at beginning of year | 2016-12-31 | $12,564 |
| Value of fidelity bond covering the plan | 2016-12-31 | $25,000 |
| Total contributions received or receivable from participants | 2016-12-31 | $2,423 |
| Other income received | 2016-12-31 | $-3,689 |
| Net income (gross income less expenses) | 2016-12-31 | $-215 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-31 | $12,349 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-31 | $12,564 |
| Assets. Value of employer securities | 2016-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2016-12-31 | $1,100 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-12-31 | $49 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2016-12-31 | $0 |
| 2015 : J & L PIZZA COMPANY RETIREMENT PLAN 2015 401k financial data |
|---|
| Total income from all sources | 2015-12-31 | $1,593 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $0 |
| Total plan assets at end of year | 2015-12-31 | $12,564 |
| Total plan assets at beginning of year | 2015-12-31 | $10,971 |
| Value of fidelity bond covering the plan | 2015-12-31 | $25,000 |
| Total contributions received or receivable from participants | 2015-12-31 | $2,463 |
| Other income received | 2015-12-31 | $-1,988 |
| Net income (gross income less expenses) | 2015-12-31 | $1,593 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $12,564 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $10,971 |
| Assets. Value of employer securities | 2015-12-31 | $4,465 |
| Total contributions received or receivable from employer(s) | 2015-12-31 | $1,118 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2015-12-31 | $0 |
| 2014 : J & L PIZZA COMPANY RETIREMENT PLAN 2014 401k financial data |
|---|
| Total income from all sources | 2014-12-31 | $-18,008 |
| Expenses. Total of all expenses incurred | 2014-12-31 | $1,159 |
| Benefits paid (including direct rollovers) | 2014-12-31 | $1,159 |
| Total plan assets at end of year | 2014-12-31 | $10,971 |
| Total plan assets at beginning of year | 2014-12-31 | $30,138 |
| Value of fidelity bond covering the plan | 2014-12-31 | $25,000 |
| Total contributions received or receivable from participants | 2014-12-31 | $2,363 |
| Other income received | 2014-12-31 | $-21,464 |
| Net income (gross income less expenses) | 2014-12-31 | $-19,167 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $10,971 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $30,138 |
| Assets. Value of employer securities | 2014-12-31 | $6,215 |
| Total contributions received or receivable from employer(s) | 2014-12-31 | $1,093 |
| 2013 : J & L PIZZA COMPANY RETIREMENT PLAN 2013 401k financial data |
|---|
| Total income from all sources | 2013-12-31 | $-20,136 |
| Expenses. Total of all expenses incurred | 2013-12-31 | $0 |
| Total plan assets at end of year | 2013-12-31 | $30,138 |
| Total plan assets at beginning of year | 2013-12-31 | $50,274 |
| Value of fidelity bond covering the plan | 2013-12-31 | $25,000 |
| Total contributions received or receivable from participants | 2013-12-31 | $1,466 |
| Other income received | 2013-12-31 | $-22,320 |
| Net income (gross income less expenses) | 2013-12-31 | $-20,136 |
| Net plan assets at end of year (total assets less liabilities) | 2013-12-31 | $30,138 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-12-31 | $50,274 |
| Assets. Value of employer securities | 2013-12-31 | $27,863 |
| Total contributions received or receivable from employer(s) | 2013-12-31 | $718 |
| 2012 : J & L PIZZA COMPANY RETIREMENT PLAN 2012 401k financial data |
|---|
| Total income from all sources | 2012-12-31 | $-11,025 |
| Expenses. Total of all expenses incurred | 2012-12-31 | $0 |
| Total plan assets at end of year | 2012-12-31 | $50,274 |
| Total plan assets at beginning of year | 2012-12-31 | $61,299 |
| Value of fidelity bond covering the plan | 2012-12-31 | $20,000 |
| Other income received | 2012-12-31 | $-11,025 |
| Net income (gross income less expenses) | 2012-12-31 | $-11,025 |
| Net plan assets at end of year (total assets less liabilities) | 2012-12-31 | $50,274 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-12-31 | $61,299 |
| Assets. Value of employer securities | 2012-12-31 | $50,274 |
| 2011 : J & L PIZZA COMPANY RETIREMENT PLAN 2011 401k financial data |
|---|
| Total income from all sources | 2011-12-31 | $61,300 |
| Expenses. Total of all expenses incurred | 2011-12-31 | $1 |
| Benefits paid (including direct rollovers) | 2011-12-31 | $1 |
| Total plan assets at end of year | 2011-12-31 | $61,299 |
| Contributions received from other sources (not participants or employers) | 2011-12-31 | $65,812 |
| Other income received | 2011-12-31 | $-4,512 |
| Net income (gross income less expenses) | 2011-12-31 | $61,299 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-31 | $61,299 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-31 | $0 |
| Assets. Value of employer securities | 2011-12-31 | $61,299 |
| 2023: J & L PIZZA COMPANY RETIREMENT PLAN 2023 form 5500 responses |
|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Submission has been amended | No |
| 2023-01-01 | This submission is the final filing | No |
| 2023-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2023-01-01 | Plan is a collectively bargained plan | No |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan funding arrangement – Trust | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement - Trust | Yes |
| 2022: J & L PIZZA COMPANY RETIREMENT PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Submission has been amended | No |
| 2022-01-01 | This submission is the final filing | No |
| 2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-01-01 | Plan is a collectively bargained plan | No |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – Trust | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement - Trust | Yes |
| 2021: J & L PIZZA COMPANY RETIREMENT PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Submission has been amended | No |
| 2021-01-01 | This submission is the final filing | No |
| 2021-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-01-01 | Plan is a collectively bargained plan | No |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – Trust | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement - Trust | Yes |
| 2020: J & L PIZZA COMPANY RETIREMENT PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Submission has been amended | No |
| 2020-01-01 | This submission is the final filing | No |
| 2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-01-01 | Plan is a collectively bargained plan | No |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – Trust | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement - Trust | Yes |
| 2019: J & L PIZZA COMPANY RETIREMENT PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Submission has been amended | No |
| 2019-01-01 | This submission is the final filing | No |
| 2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-01-01 | Plan is a collectively bargained plan | No |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – Trust | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement - Trust | Yes |
| 2018: J & L PIZZA COMPANY RETIREMENT PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Submission has been amended | No |
| 2018-01-01 | This submission is the final filing | No |
| 2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-01-01 | Plan is a collectively bargained plan | No |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – Trust | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement - Trust | Yes |
| 2017: J & L PIZZA COMPANY RETIREMENT PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | No |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – Trust | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement - Trust | Yes |
| 2016: J & L PIZZA COMPANY RETIREMENT PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – Trust | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement - Trust | Yes |
| 2015: J & L PIZZA COMPANY RETIREMENT PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – Trust | Yes |
| 2015-01-01 | Plan benefit arrangement - Trust | Yes |
| 2014: J & L PIZZA COMPANY RETIREMENT PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Submission has been amended | No |
| 2014-01-01 | This submission is the final filing | No |
| 2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-01-01 | Plan is a collectively bargained plan | No |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – Trust | Yes |
| 2014-01-01 | Plan benefit arrangement - Trust | Yes |
| 2013: J & L PIZZA COMPANY RETIREMENT PLAN 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Submission has been amended | No |
| 2013-01-01 | This submission is the final filing | No |
| 2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-01-01 | Plan is a collectively bargained plan | No |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – Trust | Yes |
| 2013-01-01 | Plan benefit arrangement - Trust | Yes |
| 2012: J & L PIZZA COMPANY RETIREMENT PLAN 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Submission has been amended | No |
| 2012-01-01 | This submission is the final filing | No |
| 2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-01-01 | Plan is a collectively bargained plan | No |
| 2012-01-01 | Plan funding arrangement – Trust | Yes |
| 2012-01-01 | Plan benefit arrangement - Trust | Yes |
| 2011: J & L PIZZA COMPANY RETIREMENT PLAN 2011 form 5500 responses |
|---|
| 2011-01-03 | Type of plan entity | Single employer plan |
| 2011-01-03 | First time form 5500 has been submitted | Yes |
| 2011-01-03 | Submission has been amended | Yes |
| 2011-01-03 | This submission is the final filing | No |
| 2011-01-03 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2011-01-03 | Plan is a collectively bargained plan | No |
| 2011-01-03 | Plan funding arrangement – Trust | Yes |
| 2011-01-03 | Plan benefit arrangement - Trust | Yes |
| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | 915831-01 |
| Policy instance | 1 |
| Insurance contract or identification number | 915831-01 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $144 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 number | 915831-01 |
| Policy instance | 1 |
| Insurance contract or identification number | 915831-01 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $143 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $143 | | Insurance broker organization code? | 3 |
|
| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | 915831-01 |
| Policy instance | 1 |
| Insurance contract or identification number | 915831-01 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $145 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $145 | | Insurance broker organization code? | 3 |
|
| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | 915831-01 |
| Policy instance | 1 |
| Insurance contract or identification number | 915831-01 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $113 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $113 | | Insurance broker organization code? | 3 |
|
| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | 915831-01 |
| Policy instance | 1 |
| Insurance contract or identification number | 915831-01 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $96 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $96 | | Insurance broker organization code? | 3 |
|
| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | 915831-01 |
| Policy instance | 1 |
| Insurance contract or identification number | 915831-01 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $85 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $85 | | Insurance broker organization code? | 3 |
|
| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | 915831-01 |
| Policy instance | 1 |
| Insurance contract or identification number | 915831-01 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $70 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $70 | | Insurance broker organization code? | 3 | | Insurance broker name | MARK HEGSTROM |
|
| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | 915831-01 |
| Policy instance | 1 |
| Insurance contract or identification number | 915831-01 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2016-01-01 | | Insurance policy end date | 2016-12-31 | | Total amount of commissions paid to insurance broker | USD $49 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $49 | | Insurance broker organization code? | 3 | | Insurance broker name | MARK HEGSTROM |
|
| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | 915831-01 |
| Policy instance | 1 |
| Insurance contract or identification number | 915831-01 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $32 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $32 | | Insurance broker organization code? | 3 | | Insurance broker name | MARK HEGSTROM |
|
| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | 915831-01 |
| Policy instance | 1 |
| Insurance contract or identification number | 915831-01 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $20 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20 | | Insurance broker organization code? | 3 | | Insurance broker name | MARK HEGSTROM |
|
| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | 915831-01 |
| Policy instance | 1 |
| Insurance contract or identification number | 915831-01 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $2 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Commission paid to Insurance Broker | USD $2 | | Insurance broker organization code? | 3 | | Insurance broker name | MARK HEGSTROM |
|
