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INSIGNIA LIVING OF P. R. 1081. 01(D) PLAN 401k Plan overview

Plan NameINSIGNIA LIVING OF P. R. 1081. 01(D) PLAN
Plan identification number 001

INSIGNIA LIVING OF P. R. 1081. 01(D) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Plan not intended to be qualified - A plan not intended to be qualified under Code sections 401, 403, or 408.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

INSIGNIA LIVING OF P. R., INC. has sponsored the creation of one or more 401k plans.

Company Name:INSIGNIA LIVING OF P. R., INC.
Employer identification number (EIN):660753708
NAIC Classification:621498
NAIC Description:All Other Outpatient Care Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan INSIGNIA LIVING OF P. R. 1081. 01(D) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01MILTON CRUZ MILTON CRUZ2019-06-13
0012017-01-01MILTON CRUZ MILTON CRUZ2018-09-26

Plan Statistics for INSIGNIA LIVING OF P. R. 1081. 01(D) PLAN

401k plan membership statisitcs for INSIGNIA LIVING OF P. R. 1081. 01(D) PLAN

Measure Date Value
2022: INSIGNIA LIVING OF P. R. 1081. 01(D) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01124
Total number of active participants reported on line 7a of the Form 55002022-01-01172
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0125
Total of all active and inactive participants2022-01-01197
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01197
Number of participants with account balances2022-01-0146
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: INSIGNIA LIVING OF P. R. 1081. 01(D) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01115
Total number of active participants reported on line 7a of the Form 55002021-01-01107
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0117
Total of all active and inactive participants2021-01-01124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01124
Number of participants with account balances2021-01-0133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: INSIGNIA LIVING OF P. R. 1081. 01(D) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01130
Total number of active participants reported on line 7a of the Form 55002020-01-01100
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0115
Total of all active and inactive participants2020-01-01115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01115
Number of participants with account balances2020-01-0132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-011
2019: INSIGNIA LIVING OF P. R. 1081. 01(D) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01122
Total number of active participants reported on line 7a of the Form 55002019-01-01122
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-018
Total of all active and inactive participants2019-01-01130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01130
Number of participants with account balances2019-01-0135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-011
2018: INSIGNIA LIVING OF P. R. 1081. 01(D) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0136
Total number of active participants reported on line 7a of the Form 55002018-01-01117
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-015
Total of all active and inactive participants2018-01-01122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01122
Number of participants with account balances2018-01-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: INSIGNIA LIVING OF P. R. 1081. 01(D) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-010
Total number of active participants reported on line 7a of the Form 55002017-01-0136
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-0136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0136
Number of participants with account balances2017-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010

Financial Data on INSIGNIA LIVING OF P. R. 1081. 01(D) PLAN

Measure Date Value
2022 : INSIGNIA LIVING OF P. R. 1081. 01(D) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$15,630
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$111,059
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$106,330
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$71,364
Value of total assets at end of year2022-12-31$258,060
Value of total assets at beginning of year2022-12-31$353,489
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$4,729
Total interest from all sources2022-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31No
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$53,512
Participant contributions at beginning of year2022-12-31$1,685
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$2,385
Administrative expenses (other) incurred2022-12-31$4,729
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-95,429
Value of net assets at end of year (total assets less liabilities)2022-12-31$258,060
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$353,489
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$258,060
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$351,342
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-55,734
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31Yes
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$15,467
Employer contributions (assets) at beginning of year2022-12-31$462
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$106,330
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31SHARON & GONZALEZ LLC
Accountancy firm EIN2022-12-31660891476
2021 : INSIGNIA LIVING OF P. R. 1081. 01(D) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$99,158
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$5,020
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$800
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$61,173
Value of total assets at end of year2021-12-31$353,489
Value of total assets at beginning of year2021-12-31$259,351
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$4,220
Total interest from all sources2021-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31No
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$48,395
Participant contributions at end of year2021-12-31$1,685
Participant contributions at beginning of year2021-12-31$1,545
Administrative expenses (other) incurred2021-12-31$4,220
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$94,138
Value of net assets at end of year (total assets less liabilities)2021-12-31$353,489
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$259,351
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$351,342
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$257,134
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$37,985
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31Yes
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$12,778
Employer contributions (assets) at end of year2021-12-31$462
Employer contributions (assets) at beginning of year2021-12-31$672
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$800
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31SHARON & GONZALEZ LLC
Accountancy firm EIN2021-12-31660891476
2020 : INSIGNIA LIVING OF P. R. 1081. 01(D) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$86,793
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$24,311
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$21,159
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$57,271
Value of total assets at end of year2020-12-31$259,351
Value of total assets at beginning of year2020-12-31$196,869
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$3,152
Total interest from all sources2020-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31No
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$42,548
Participant contributions at end of year2020-12-31$1,545
Administrative expenses (other) incurred2020-12-31$3,152
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$62,482
Value of net assets at end of year (total assets less liabilities)2020-12-31$259,351
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$196,869
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$257,134
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$196,869
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$29,522
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$14,723
Employer contributions (assets) at end of year2020-12-31$672
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$21,159
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31SHARON & GONZALEZ, CPA'S LLC
Accountancy firm EIN2020-12-31660891476
2019 : INSIGNIA LIVING OF P. R. 1081. 01(D) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$95,908
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$93,666
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$91,004
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$61,099
Value of total assets at end of year2019-12-31$196,869
Value of total assets at beginning of year2019-12-31$194,627
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$2,662
Total interest from all sources2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$37,784
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$9,536
Administrative expenses (other) incurred2019-12-31$2,662
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$2,242
Value of net assets at end of year (total assets less liabilities)2019-12-31$196,869
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$194,627
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$196,869
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$194,627
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$34,809
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$13,779
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$91,004
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 name2019-12-31SHARON & GONZALEZCPA'S LLC
Accountancy firm EIN2019-12-31660891476
2018 : INSIGNIA LIVING OF P. R. 1081. 01(D) PLAN 2018 401k financial data
Total income from all sources2018-12-31$182,816
Expenses. Total of all expenses incurred2018-12-31$644
Total plan assets at end of year2018-12-31$194,627
Total plan assets at beginning of year2018-12-31$12,455
Total contributions received or receivable from participants2018-12-31$26,596
Expenses. Other expenses not covered elsewhere2018-12-31$644
Other income received2018-12-31$152,156
Net income (gross income less expenses)2018-12-31$182,172
Net plan assets at end of year (total assets less liabilities)2018-12-31$194,627
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$12,455
Total contributions received or receivable from employer(s)2018-12-31$4,064
2017 : INSIGNIA LIVING OF P. R. 1081. 01(D) PLAN 2017 401k financial data
Total income from all sources2017-12-31$12,455
Expenses. Total of all expenses incurred2017-12-31$0
Total plan assets at end of year2017-12-31$12,455
Total plan assets at beginning of year2017-12-31$0
Total contributions received or receivable from participants2017-12-31$11,950
Net income (gross income less expenses)2017-12-31$12,455
Net plan assets at end of year (total assets less liabilities)2017-12-31$12,455
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$0
Total contributions received or receivable from employer(s)2017-12-31$505

Form 5500 Responses for INSIGNIA LIVING OF P. R. 1081. 01(D) PLAN

2022: INSIGNIA LIVING OF P. R. 1081. 01(D) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement - TrustYes
2021: INSIGNIA LIVING OF P. R. 1081. 01(D) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement - TrustYes
2020: INSIGNIA LIVING OF P. R. 1081. 01(D) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: INSIGNIA LIVING OF P. R. 1081. 01(D) PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: INSIGNIA LIVING OF P. R. 1081. 01(D) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement - TrustYes
2017: INSIGNIA LIVING OF P. R. 1081. 01(D) PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01First time form 5500 has been submittedYes
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number501740-P1
Policy instance 1
Insurance contract or identification number501740-P1
Number of Individuals Covered0
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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 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
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?3
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number501740-P1
Policy instance 1
Insurance contract or identification number501740-P1
Number of Individuals Covered0
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1
Total amount of fees paid to insurance companyUSD $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 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
Commission paid to Insurance BrokerUSD $1
Insurance broker organization code?3

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