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M & G JEWELERS, INC. 401(K) PLAN 401k Plan overview

Plan NameM & G JEWELERS, INC. 401(K) PLAN
Plan identification number 001

M & G JEWELERS, INC. 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • 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

M & G JEWELERS, INC. has sponsored the creation of one or more 401k plans.

Company Name:M & G JEWELERS, INC.
Employer identification number (EIN):330852382
NAIC Classification:423940
NAIC Description:Jewelry, Watch, Precious Stone, and Precious Metal Merchant Wholesalers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan M & G JEWELERS, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01BRIAN GROCE2023-05-31
0012021-01-01BRIAN GROCE2022-06-28
0012020-01-01
0012019-01-01
0012018-01-01
0012017-01-01BRIAN GROCE
0012016-01-01MICHAEL INSALAGO2017-10-04
0012015-01-01MICHAEL INSALAGO2016-05-19
0012014-01-01MICHAEL INSALAGO2015-03-16

Plan Statistics for M & G JEWELERS, INC. 401(K) PLAN

401k plan membership statisitcs for M & G JEWELERS, INC. 401(K) PLAN

Measure Date Value
2020: M & G JEWELERS, INC. 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01107
Total number of active participants reported on line 7a of the Form 55002020-01-0169
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0114
Total of all active and inactive participants2020-01-0183
Total participants2020-01-0183
Number of participants with account balances2020-01-0152
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: M & G JEWELERS, INC. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01103
Total number of active participants reported on line 7a of the Form 55002019-01-0173
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0116
Total of all active and inactive participants2019-01-0189
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0189
Number of participants with account balances2019-01-0163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: M & G JEWELERS, INC. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01125
Total number of active participants reported on line 7a of the Form 55002018-01-0183
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-018
Total of all active and inactive participants2018-01-0191
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0191
Number of participants with account balances2018-01-0161
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: M & G JEWELERS, INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01121
Total number of active participants reported on line 7a of the Form 55002017-01-0192
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0123
Total of all active and inactive participants2017-01-01115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01115
Number of participants with account balances2017-01-0180
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010

Financial Data on M & G JEWELERS, INC. 401(K) PLAN

Measure Date Value
2020 : M & G JEWELERS, INC. 401(K) PLAN 2020 401k financial data
Total income from all sources (including contributions)2020-12-31$407,876
Total of all expenses incurred2020-12-31$306,904
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$269,452
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$218,608
Value of total assets at end of year2020-12-31$1,972,141
Value of total assets at beginning of year2020-12-31$1,871,169
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$37,452
Total interest from all sources2020-12-31$3,812
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$88,208
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$88,208
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$190,000
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$157,275
Participant contributions at end of year2020-12-31$40,035
Participant contributions at beginning of year2020-12-31$61,124
Participant contributions at end of year2020-12-31$8,202
Participant contributions at beginning of year2020-12-31$164
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Income. Non cash contributions2020-12-31$0
Value of net income/loss2020-12-31$100,972
Value of net assets at end of year (total assets less liabilities)2020-12-31$1,972,141
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$1,871,169
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$1,872,196
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$1,779,755
Interest on participant loans2020-12-31$3,140
Interest earned on other investments2020-12-31$672
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$47,707
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$27,890
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$97,248
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 contributions2020-12-31Yes
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$61,333
Employer contributions (assets) at end of year2020-12-31$4,001
Employer contributions (assets) at beginning of year2020-12-31$2,236
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$269,452
Contract administrator fees2020-12-31$37,452
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 plan2020-12-31Unqualified
Accountancy firm name2020-12-31WRIGHT FORD YOUNG & CO
Accountancy firm EIN2020-12-31953288054
2019 : M & G JEWELERS, INC. 401(K) PLAN 2019 401k financial data
Total income from all sources (including contributions)2019-12-31$674,582
Total of all expenses incurred2019-12-31$160,834
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$115,908
Expenses. Certain deemed distributions of participant loans2019-12-31$15,696
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$350,161
Value of total assets at end of year2019-12-31$1,871,169
Value of total assets at beginning of year2019-12-31$1,357,421
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$29,230
Total interest from all sources2019-12-31$3,604
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$129,083
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$129,083
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$160,000
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$203,050
Participant contributions at end of year2019-12-31$61,124
Participant contributions at beginning of year2019-12-31$42,379
Participant contributions at end of year2019-12-31$164
Participant contributions at beginning of year2019-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$53,536
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Income. Non cash contributions2019-12-31$0
Value of net income/loss2019-12-31$513,748
Value of net assets at end of year (total assets less liabilities)2019-12-31$1,871,169
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$1,357,421
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$1,779,755
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$1,286,462
Interest on participant loans2019-12-31$3,293
Interest earned on other investments2019-12-31$311
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$27,890
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$24,453
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$191,734
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$93,575
Employer contributions (assets) at end of year2019-12-31$2,236
Employer contributions (assets) at beginning of year2019-12-31$4,127
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$115,908
Contract administrator fees2019-12-31$29,230
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 name2019-12-31WRIGHT FORD YOUNG & CO
Accountancy firm EIN2019-12-31953288054
2018 : M & G JEWELERS, INC. 401(K) PLAN 2018 401k financial data
Total income from all sources (including contributions)2018-12-31$181,031
Total of all expenses incurred2018-12-31$132,203
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$97,926
Expenses. Certain deemed distributions of participant loans2018-12-31$16,583
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$300,038
Value of total assets at end of year2018-12-31$1,357,421
Value of total assets at beginning of year2018-12-31$1,308,593
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$17,694
Total interest from all sources2018-12-31$2,930
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$122,059
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$122,059
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$131,000
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$203,177
Participant contributions at end of year2018-12-31$42,379
Participant contributions at beginning of year2018-12-31$46,703
Participant contributions at end of year2018-12-31$0
Participant contributions at beginning of year2018-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$0
Value of other receiveables (less allowance for doubtful accounts) 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$48,828
Value of net assets at end of year (total assets less liabilities)2018-12-31$1,357,421
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$1,308,593
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$1,286,462
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$1,225,189
Interest on participant loans2018-12-31$2,636
Interest earned on other investments2018-12-31$294
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$24,453
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$34,162
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-243,996
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$96,861
Employer contributions (assets) at end of year2018-12-31$4,127
Employer contributions (assets) at beginning of year2018-12-31$2,539
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$97,926
Contract administrator fees2018-12-31$17,694
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 name2018-12-31WRIGHT FORD YOUNG & CO
Accountancy firm EIN2018-12-31953288054
2017 : M & G JEWELERS, INC. 401(K) PLAN 2017 401k financial data
Total income from all sources (including contributions)2017-12-31$486,066
Total of all expenses incurred2017-12-31$63,660
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$51,368
Expenses. Certain deemed distributions of participant loans2017-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$318,864
Value of total assets at end of year2017-12-31$1,308,593
Value of total assets at beginning of year2017-12-31$886,187
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$12,292
Total interest from all sources2017-12-31$3,484
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$61,380
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$61,380
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$100,000
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$209,986
Participant contributions at end of year2017-12-31$46,703
Participant contributions at beginning of year2017-12-31$105,732
Participant contributions at end of year2017-12-31$0
Participant contributions at beginning of year2017-12-31$2,752
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$3,909
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$422,406
Value of net assets at end of year (total assets less liabilities)2017-12-31$1,308,593
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$886,187
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$1,225,189
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$745,971
Interest on participant loans2017-12-31$3,119
Interest earned on other investments2017-12-31$365
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$34,162
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$26,952
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$102,338
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$104,969
Employer contributions (assets) at end of year2017-12-31$2,539
Employer contributions (assets) at beginning of year2017-12-31$4,780
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$51,368
Contract administrator fees2017-12-31$12,292
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 name2017-12-31WRIGHT FORD YOUNG & CO.
Accountancy firm EIN2017-12-31953288054

Form 5500 Responses for M & G JEWELERS, INC. 401(K) PLAN

2020: M & G JEWELERS, INC. 401(K) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
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: M & G JEWELERS, INC. 401(K) PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
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: M & G JEWELERS, INC. 401(K) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement - TrustYes
2017: M & G JEWELERS, INC. 401(K) PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number336962-01
Policy instance 1
Insurance contract or identification number336962-01
Number of Individuals Covered6
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $215
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $108
Insurance broker organization code?3
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number336962-01
Policy instance 1
Insurance contract or identification number336962-01
Number of Individuals Covered6
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $120
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Commission paid to Insurance BrokerUSD $60
Insurance broker organization code?3
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number336962-01
Policy instance 1
Insurance contract or identification number336962-01
Number of Individuals Covered6
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $125
Total amount of fees paid to insurance companyUSD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $63
Amount paid for insurance broker fees0
Insurance broker organization code?3
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number336962-01
Policy instance 1
Insurance contract or identification number336962-01
Number of Individuals Covered11
Total amount of commissions paid to insurance brokerUSD $136
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $68
Insurance broker organization code?3
Insurance broker nameCURTIS CARLSON

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